Dental Care Visits among Dentate Adults with Diabetes, United States, 2003

Journal of Public Health Dentistry (Impact Factor: 1.65). 02/2008; 68(2):102 - 110. DOI: 10.1111/j.1752-7325.2007.00064.x


Objectives: Regular dental assessments are beneficial to adults with diabetes. This analysis evaluates nationally representative data to test the relation between diabetes status and dental care visits, and to compare diabetes care, foot care, eye care, and dental care visits among dentate adults with diabetes. Methods: Data from the 2003 National Health Interview Survey were used to test whether diabetes status was associated with dental care visits among dentate adults aged ≥25 years, controlling for available covariates. Results: There was a significant interaction between diabetes status and sex for the odds of having a dental care visit. Among dentate men, there was no significant association between diabetes status and dental care visits. Dentate women with diabetes were significantly less likely to have had a dental care visit than were dentate women without diabetes. Of the four types of health care visits compared, dentate adults with diabetes were least likely to have had a dental care visit in the preceding year. Disparities in health care visit rates across race/ethnicity, poverty status, and education categories were most pronounced for dental care. Conclusions: Having diabetes is associated with a variety of adverse health outcomes, including periodontitis. Adults with diabetes would benefit from regular health care visits to address these concerns, but this report shows that women with diabetes are underutilizing dental care services. The underutilization may be a result of the barriers to dental care that disproportionately affect women. Additional research should test the plausibility of these explanations and the influence of sex.

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    ABSTRACT: Two national surveys have shown that dentate adults with diabetes are less likely to visit a dentist than are those without diabetes; one survey showed this association only among women. We hypothesize that periodontal health among those with diabetes could explain this disparity. This report investigates the influence of periodontitis on the association between diabetes and dental care visits. It also tests whether disparities are limited to women. Data from the 1999-2004 National Health and Nutrition Examination Survey were used. Covariates included age, sex, race/ethnicity, poverty status, education level, dental insurance, and periodontitis status. Weighted analyses were limited to dentate adults aged > or =25 years. Overall, 56.8 percent of dentate adults with diabetes reported having a dental care visit in the preceding year compared with 64.7 percent for those without diabetes. In a multivariable model, diabetes status was significantly associated with having a dental care visit, independent of periodontitis status and covariates. Neither periodontitis status nor sex served as effect modifiers for the association between diabetes status and dental care visits. These data revealed that dental care visits for dentate adults with diabetes were unrelated to their periodontal health, suggesting that fear of periodontal therapy did not influence visit patterns. These data also showed that dental care visit disparities existed for all adults with diabetes, not just women. Future research should investigate whether factors that are indirectly related to diabetes status, such as competing costs, attitudes, and knowledge, are influencing dental care visit patterns among dentate adults with diabetes.
    Journal of Public Health Dentistry 06/2009; 69(4):284-9. DOI:10.1111/j.1752-7325.2009.00136.x · 1.65 Impact Factor
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    ABSTRACT: The purpose of this study was to determine levels of oral health knowledge and factors associated with adequate oral health knowledge in adults with diabetes. A convenience sample of 253 adult US residents with diabetes completed an oral health survey to assess their knowledge. Results showed that only 47% of the participants answered five or more (out of a maximum of seven) oral health knowledge items related to diabetes correctly. Participants who received oral health information related to diabetes have 2.9 times the odds of possessing adequate oral health knowledge (i.e., answered five or more items correctly) compared to participants who did not received that information controlling for education and race (OR=2.86, 95% CI 1.31-6.24, P=0.008). Given that oral health information provided by health professionals (dental and/or medical) contributes to improve oral health knowledge among adults with diabetes, health professionals should take the opportunity to educate patients with diabetes about the oral manifestations (e.g., dry mouth) and complications (e.g., periodontitis and oral candidiasis) of diabetes and to promote proper oral health behaviors.
    Diabetes research and clinical practice 09/2009; 86(3):239-46. DOI:10.1016/j.diabres.2009.09.010 · 2.54 Impact Factor
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    ABSTRACT: The University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco established a comprehensive dental care program at Laguna Honda Hospital, a public, skilled nursing facility. The program had three goals: (1) to provide dental students and residents an opportunity to provide oral health care for adults who were frail and medically compromised who could not come into the clinics, (2) to increase students' access to patients who needed removable prosthodontics, and (3) to fulfill Pacific's commitment to public service. Laguna Honda and Pacific pooled their resources to bring comprehensive dental care to patients who were not able to access the dental school clinics. The long-term goals are to restore and maintain the oral health of those who reside in the facility, and to educate future dentists to provide oral health care for similar populations.
    Special Care in Dentistry 05/2010; 30(3):95-8. DOI:10.1111/j.1754-4505.2010.00135.x
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