Çankaya Hülyaa, Güneri Pelinb, Epstein Joel B.c, Boyacıoğlu Hayaldcb
a Ege University School of Dentistry, Department of Oral and Maxillofacial Radiology, Izmir, Turkey
b Ege University, School of Dentistry, Department of Oral and Maxillofacial Radiology, Izmir, Turkey
c Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, CA, USA + Division of Otolaryngology and Head and Neck Surgery, City of Hope National Medical Center, CA, USA
d Ege University, Faculty of Science, Department of Statistics, İzmir, Turkey
Summary
Background/Aim: The aim was to evaluate Diabetes Mellitus (DM) patients’ awareness of their risk for oral and dental complications, to evaluate their oral health behaviors, assess their sources of related information, and to detect the influence of their awareness on oral health and dental management. Material and Methods: Total of 240 DM patients presenting to a university outpatient dental facility for routine care completed a self-administered questionnaire about demographic socioeconomic characteristics, oral health care and awareness on oral complications of DM. Dental status of each patient was recorded. Data were analyzed with Chi- square test; p was set as 0.05. Results: The patients’ mean age was 52.85 years; the majority had Type 2 DM (72.1%) and 61.7% were females. Two thirds of the patients had tooth loss; 65% brushed daily and used toothpick for interproximal cleaning (35%). Only 12.9% had regular dental visits and 37.5% reported their oral health as ‘poor’. DM patients rarely received guidance from their health care professionals regarding their oral health (28.3%). Even though 62.5% were aware of oral complications of DM, only 46.3% knew that oral health may affect DM. The patients with Type 1 and Type 2 DM had similar perceptions about their oral health status (p=0.15>0.05). However, insulin users were more aware of the interaction between oral health and DM (p>0.05), and were more likely to consider their oral health as ‘poor’ (p>0.05). Conclusions: DM patients’ awareness of the effect of DM on oral health was higher than that of the effect of oral health on DM management. Medical health care providers were failing to provide the necessary information regarding these issues when compared to dentists.
Keywords: community care; dental care; developing countries; health care; health education
Reference
Akyüz, S., Yarat, A., Bayer, H., Ipbuker, A. (2004) Diabetic patient’s knowledge level on oral health and habits (questionnaire). OHDMBSC, III, 11-14
al Habashneh, R., Khader, Y., Hammad, M.M., Almuradi, M. (2010) Knowledge and awareness about diabetes and periodontal health among Jordanians. Journal of Diabetes and its Complications, 24(6): 409-414
Albert, D.A., Ward, A., Allweiss, P., Graves, D.T., Knowler, W.C., Kunzel, C., Leibel, R.L., Novak, K.F., Oates, T.W., Papapanou, P.N., Schmidt, A.M., Taylor, G.W., Lamster, I.B., Lalla, E. (2012) Diabetes and oral disease: implications for health professionals. Annals of the New York Academy of Sciences, 1255(1): 1-15
Al-Habashneh, R., Barghout, N., Humbert, L., Khader, Y., Alwaeli, H. (2010) Diabetes and oral health: doctors’ knowledge, perception and practices. Journal of Evaluation in Clinical Practice, 16(5): 976-980
Al-Khabbaz, A.K., Al-Shammari, K.F. (2011) Diabetes Mellitus and Periodontal Health: Dentists’ Knowledge. Medical Principles and Practice, 20(6): 538-544
Al-Khabbaz, A.K., Al-Shammari, K.F., Al-Saleh, N.A. (2011) Knowledge About the Association Between Periodontal Diseases and Diabetes Mellitus: Contrasting Dentists and Physicians. Journal of Periodontology, 82(3): 360-366
Allen, E. M., Ziada, H. M., o`halloran D., Clerehugh, V., Allen, P. F. (2008) Attitudes, awareness and oral health-related quality of life in patients with diabetes. Journal of Oral Rehabilitation, 35(3): 218-223
American, D.A. (2015) Classification and diagnosis of diabetes. Diabetes Care, 38: 8-16
Amos, A.F., Mccarty, D.J., Zimmet, P. (1997) The Rising Global Burden of Diabetes and its Complications: Estimates and Projections to the Year 2010. Diabet Med, 14: S7-S85
Apoorva, S., Sridhar, N., Suchetha, A. (2013) Prevalence and severity of periodontal disease in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus) patients in Bangalore city: An epidemiological study. Journal of Indian Society of Periodontology, 17(1): 25
Bahammam, M. (2015) Periodontal health and diabetes awareness among Saudi diabetes patients. Patient Preference and Adherence, str. 225
Bakhshandeh, S., Murtomaa, H., Vehkalahti, M.M., Mofid, R., Suomalainen, K. (2008) Oral self-care and use of dental services among adults with diabetes mellitus. Oral Health Prev Dent, 6: 279-286
Bin, A.K.A. (2006) Diabetes mellitus and its oral complications: A brief review. Pakistan Oral & Dent Jr, 26: 97-100
Bowyer, V., Sutcliffe, P., Ireland, R., Lindenmeyer, A., Gadsby, R., Graveney, M., Sturt, J., Dale, J. (2011) Oral health awareness in adult patients with diabetes: a questionnaire study. British Dental Journal, 211(6): E12-E12
Boyle, E., Saunders, R., Drury, V. (2016) A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners. Journal of Clinical Nursing, 25(13-14): 1977-1986
Cheng, L., Leung, D.Y. P., Wu, Y., Sit, J.W. H., Yang, M., Li, X. (2018) Psychometric Properties of the Modified Personal Diabetes Questionnaire Among Chinese Patients With Type 2 Diabetes. Evaluation & the Health Professions, 41(1): 3-24
Commisso, L., Monami, M., Mannucci, E. (2011) Periodontal disease and oral hygiene habits in a type 2 diabetic population. Int J Dent Hyg, 9: 68-73
Daly, B., Arroll, B., Kenealy, T., Sheridan, N., Scragg, R. (2015) Management of diabetes by primary health care nurses in Auckland, New Zealand. Journal of Primary Health Care, 7(1): 42
Delong, L., Burkhart, N. (2008) Endocrine disorders: In general and oral pathology for the dental hygienist. Philadelphia: Lippincott Williams & Wilkins, 147-178
Eldarrat, A. (2011) Diabetics’ Awareness of Oral Disorders Associated with Diabetes Mellitus. Review. https:/www.iconceptpress.com/1209000627.pdf
Eldarrat, A.H. (2011) Awareness and attitude of diabetic patients about their increased risk for oral diseases. Oral Health Prev Dent, 9: 235-241
Eldarrat, A.H. (2011) Diabetic patients: their knowledge and perception of oral health. Libyan Journal of Medicine, 6(1): 5691
Emrich, L.J., Shlossman, M., Genco, R.J. (1991) Periodontal disease in non-insulin-dependent diabetes mellitus. J Periodontol, 62(2): 123-31
Faria-Almeida, R., Navarro, A., Bascones, A. (2006) Clinical and Metabolic Changes After Conventional Treatment of Type 2 Diabetic Patients With Chronic Periodontitis. Journal of Periodontology, 77(4): 591-598
Faten, M.R.I., Neima, A. (2013) Diabetic Patients Knowledge, Attitude and Practice toward Oral Health. J Educ Pract, 4: 19-25
Forouhi, N.G., Wareham, N.J. (2014) Epidemiology of diabetes. Medicine, 42(12): 698-702
Friesen, L.R., Walker, M.P., Kisling, R.E., Liu, Y., Williams, K.B. (2014) Knowledge of risk factors and the periodontal diseasesystemic link in dental students’ clinical decisions. J Dent Educ, 78: 1244-1251
Grossi, S.G., Skrepcinski, F.B., DeCaro, T., Robertson, D.C., Ho, A.W., Dunford, R.G., Genco, R.J. (1997) Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol, 68(8): 713-9
Grossi, S.G., Genco, R.J. (1998) Periodontal disease and diabetes mellitus: A two-way relationship. Ann Periodontol, 3(1): 51-61
Ishani, A., Greer, N., Taylor, B.C., Kubes, L., Cole, P., Atwood, M., Clothier, B., Ercan-Fang, N. (2011) Effect of Nurse Case Management Compared With Usual Care on Controlling Cardiovascular Risk Factors in Patients With Diabetes. Diabetes Care, 34(8): 1689-1694
Iwamoto, Y., Nishimura, F., Nakagawa, M., Sugimoto, H., Shikata, K., Makino, H., Fukuda, T., Tsuji, T., Iwamoto, M., Murayama, Y. (2001) The effect of antimicrobial periodontal treatment on circulating tumor necrosis factor-alpha and glycated hemoglobin level in patients with type 2 diabetes. J Periodontol, 72(6): 774-8
Jansson, H., Lindholm, E., Lindh, C., Groop, L., Bratthall, G. (2006) Type 2 diabetes and risk for periodontal disease: a role for dental health awareness. Journal of clinical periodontology, 33(6): 408-14
Kamath, D.G., Nayak, S.U., Pai, K. K., Shenoy, R. (2015) Knowledge and awareness of oral health among diabetic patients-a cross-sectional study from Mangalore City. International Journal of Diabetes in Developing Countries, 35(2): 71-75
Kamel, N.M., Badawy, Y.A., El-Zeiny, N.A., Merdan, I.A. (1999) Sociodemographic determinants of management behaviour of diabetic patients. II. Diabetics’ knowledge of the disease and their management behaviour. East Mediterr Health J, 5: 974-983
Kanli, A., Kanbur, N.O., Dural, S., Derman, O. (2008) Effects of oral health behaviors and socioeconomic factors on a group of Turkish adolescents. Quintessence Int, 39: e26-32
Karikoski, A., Ilanne-Parikka, P., Murtomaa, H. (2002) Oral self-care among adults with diabetes in Finland. Community Dentistry and Oral Epidemiology, 30(3): 216-223
Kawamura, M., Fukuda, S., Kawabata, K., Iwamoto, Y. (2008) Comparison of health behaviour and oral/medical conditions in non-insulin-dependent (type II) diabetics and non-diabetics. Australian Dental Journal, 43(5): 315-320
Lopes, M.H., Southerland, J.H., Buse, J.B., Malone, R.M., Wilder, R.S. (2012) Diabetes educators’ knowledge, opinions and behaviors regarding periodontal disease and diabetes. J Dent Hyg, 86: 82-90
Manfredi, M., McCullough, M., Vescovi, P., Al-Kaarawi, Z., Porter, S. (2004) Update on diabetes mellitus and related oral diseases. Oral Diseases, 10(4): 187-200
Martin, D., Elie, C., Dossier, C., Godot, C., Gagnayre, R., Choleau, C., Cahané, M., Robert, J. (2016) Diabetes knowledge in adolescents with type 1 diabetes and their parents and glycemic control. Pediatric Diabetes, 18(7): 559-565
Masood, M.K., Khan, A. A., Ali, M. M., Chaudhry, S. (2007) Oral Health Knowledge, Attitude, and Practices and Sources of Information for Diabetic Patients in Lahore, Pakistan. Diabetes Care, 30(12): 3046-3047
Moore, P.A., Orchard, T., Guggenheimer, J., Weyant, R.J. (2000) Diabetes and oral health promotion: a survey of disease prevention behaviors. Journal of the American Dental Association, 131(9): 1333-1341
Owens, J.B., Wilder, R.S., Southerland, J.H., Buse, J.B., Malone, R.M. (2011) North Carolina internists’ and endocrinologists’ knowledge, opinions, and behaviors regarding periodontal disease and diabetes: need and opportunity for interprofessional education. J Dent Educ, 75: 329-338
Paquette, D.W., Bell, K.P., Phillips, C., Offenbacher, S., Wilder, R.S. (2015) Dentists’ knowledge and opinions of oral-systemic disease relationships: relevance to patient care and education. J Dent Educ, 79: 626-635
Peker, I., Alkurt, M.T. (2014) Oral Impacts on Daily Performance in Turkish Adults Attending a Dental School. Journal of Contemporary Dental Practice, 15: 92-98
Rodrigues, D.C., Taba, M.J., Novaes, A.B., Souza, S.L., Grisi, M.F. (2003) Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol, 74(9): 1361-7
Sandberg, G.E., Sundberg, H.E., Wikblad, K.F. (2001) A controlled study of oral self-care and self-perceived oral health in type 2 diabetic patients. Acta Odontologica Scandinavica, 59(1): 28-33
Ship, J.A., Chavez, E.M. (2001) Special Senses: Disorders of Taste and Smell. u: Silverman Jr S., Eversole L.R., Truelove E.L. [ur.] Essentials of Oral Medicine, Hamilton-London: BC Decker Inc, 279-280
Ship, J.A. (2003) Diabetes and oral health. Journal of the American Dental Association, 134: 4S-10S
Siminerio, L.M., Funnell, M.M., Peyrot, M., Rubin, R.R. (2007) US Nurses’ Perceptions of Their Role in Diabetes Care. Diabetes Educator, 33(1): 152-162
Simpson, T.C., Weldon, J.C., Worthington, H.V., Needleman, I., Wild, S.H., Moles, D.R., i dr. (2015) Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Sys Rev, ;11:CD004714
Stanko, P., Izakovicova, H.L. (2014) Bidirectional association between diabetes mellitus and inflammatory periodontal disease. A review. Biomedical Papers, 158(1): 035-038
Stewart, J.E., Wager, K.A., Friedlander, A.H., Zadeh, H.H. (2001) The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. J Clin Periodontol, 28(4): 306-10
Taiwo, J.O. (2000) Oral health education needs of diabetic patients in Ibadan. Afr J Med Med Sci, 29: 269-274
Taylor, G.W. (2001) Bidirectional interrelationships between diabetes and periodontal diseases: An epidemiologic perspective. Ann Periodontol, 6(1): 99-112
Tomar, S. L., Lester, A. (2000) Dental and other health care visits among U.S. adults with diabetes. Diabetes Care, 23(10): 1505-1510
Valerio, M.A., Kanjirath, P.P., Klausner, C.P., Peters, M.C. (2011) A qualitative examination of patient awareness and understanding of type 2 diabetes and oral health care needs. Diabetes Research and Clinical Practice, 93(2): 159-165
van Dijk, C.E., Verheij, R.A., Hansen, J., van der Velden, L., Nijpels, G., Groenewegen, P.P., de Bakker, D.H. (2010) Primary care nurses: effects on secondary care referrals for diabetes. BMC Health Services Research, 10(1):
Walsh, J.L., Harris, B.H.L., Roberts, A.W. (2015) Evaluation of a community diabetes initiative: Integrating diabetes care. Primary Care Diabetes, 9(3): 203-210
Yuen, H.K., Mountford, W.K., Magruder, K.M., Bandyopadhyay, D., Hudson, P.L., Summerlin, L.M., Salinas, C.F. (2009) Adequacy of Oral Health Information for Patients with Diabetes. Journal of Public Health Dentistry, 69(2): 135-141
Yuen, H.K., Wolf, B.J., Bandyopadhyay, D., Magruder, K.M., Salinas, C.F., London, S.D. (2009) Oral health knowledge and behavior among adults with diabetes. Diabetes Research and Clinical Practice, 86(3): 239-246
Balkan Journal of Dental Medicine, 2018, vol. 22, br. 3, str. 138-145