A need exists for further promotion of oral self-care among adults with diabetes. Support by dental and other health care professionals involved in diabetes care should be encouraged.
We assessed changes in periodontal treatment needs among patients with diabetes and the risk factors involved in this phenomenon. The sample consisted of 120 dentate subjects, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic. They underwent periodontal examination in 1999 and were re-examined in 2001. The drop-out rate was 4%. Clinical periodontal examination included identification of visible plaque, the presence of calculus, and use of the Community Periodontal Index of Treatment Needs (CPITN) index. Diabetes-related factors consisted of information about duration of diabetes, complications, and HbA1c values. Oral health-related factors were collected by questionnaire. The CPITN index proved to be insensitive to change. Pathological pockets (CPITN 3 or 4) were found in 80% of subjects (n = 115) and 48% of sextants (n = 627); in 1999, the corresponding rates were 77% and 49%. The tooth-based individual CPITN index (code 3 or 4) revealed periodontal deterioration in 38 patients. Smoking and infrequent interdental cleaning were significant factors explaining periodontal deterioration in logistic regression. Risk factors should be taken into account when planning prevention, treatment, and supportive periodontal therapy strategies. In diabetes care, the common risk factor approach can be implemented to promote oral health among individuals with diabetes.
Excessive periodontal treatment needs found, indicate that current dental care may be insufficient in adults with diabetes. Oral health among high-risk groups, especially those with poor metabolic control, should be promoted by collaboration between dental and health care professionals involved in diabetes care.
We assessed the effects of oral self-care on periodontal health indicators among adults with diabetes. The sample consisted of 120 dentate individuals, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic in southwest Finland. Clinical periodontal examination included identification of visible plaque, the presence of calculus, and use of the Community Periodontal Index of Treatment Needs (CPITN). A questionnaire focused on self-treatment, self-prevention, and self-diagnosis of oral diseases, utilization of dental services, and patients' knowledge and attitudes towards oral health. The New Century model of oral health promotion was used as a theoretical framework for analysis of determinants of oral self-care. Although individuals aged 40 years or older were more frequent interdental cleaners, significantly better oral health indicators were found among younger patients. Women reported brushing their teeth more frequently, and differences in plaque and calculus indices were significantly lower than those of men. Self-reported good oral condition was strongly associated with frequent dental visits and less plaque and calculus. No missing teeth and age less than 40 years were predictors of lower plaque, calculus, and CPITN scores. A significant association was found only between frequent dental visits and reduced amount of calculus. Self-reported frequency of oral health habits among adults with diabetes seemed to have little effect on periodontal health indicators. Adults with diabetes should benefit from comprehensive oral self-care, and more attention is needed for improving the quality and outcome of these habits.
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