Effectiveness of Lifestyle Change Plus Dental Care Program in Improving Glycemic and Periodontal Status in Aging Patients with Diabetes: A Cluster, Randomized, Controlled Trial

Abstract

The combination of lifestyle change and dental care in one program improved both glycemic and periodontal status in older patients with diabetes.

Evaluation of medical and dental visits in New York City: Opportunities to identify persons with and at risk for diabetes mellitus in dental settings

“…Such a referral program has been documented to result in patient visits to their primary medical providers, which led to improved metabolic management for patients with dysglycaemia . Patients and oral health providers see dental visits as an entry to the larger healthcare system . These findings highlight the potential impact that dental providers could have in contributing to the identification of at‐risk individuals and with referrals to medical providers may serve to improve patient health outcomes and reduce the enormous public health burden of DM …”

“…7 It is plausible that in NYC, a significant percentage of individuals living with or at risk of DM see an oral health provider for dysglycaemia-related oral diseases such as periodontal diseases, root caries, xerostomia and burning mouth syndrome. 10,12,27 Using patient self-reported risk factors and periodontal examination findings, the oral healthcare provider may consider a point of care glycosylated haemoglobin (HbA1c) screening test and referral to a primary care provider for the establishment of the definitive diagnosis, and treatment if needed. 5,28 The finding that a larger percentage of uninsured adults saw a dental provider than a medical provider requires further investigation.…”

Assessing the oral health of in-patients with diabetes using a clinical version of the Diabetes Oral Health Assessment Tool© and its association with dental examinations

“…Although the DiOHAT© comprises 4 factors and 21 items, it was revised for clinical use in a limited time frame by both nurses and patients as an assessment sheet formed as a questionnaire (answering "yes" or "no"). The following changes were made to items of the DiOHAT© : [1] "tooth brushing around the border between the teeth and marginal gingiva" and "brushing each tooth very carefully" were modified to "brushing each tooth carefully" ; [2] the item "perceptions of one's oral health condition" was deleted because patients with painful (6), stressful, or fearful memories of dental treatment require an intervention program, which was not part of this study ; and [3] the items "presence of dentures (partial or full)", "checking the inside of the patient's mouth", and "counting the patient's total number of teeth (exclusive of dentures, bridges, and implants)" were excluded from the questionnaire. These three items were evaluated by nurses as objective items.…”

Efficacy of Brief Lifestyle Change in conjunction with Dental Care (Brief-LCDC) Programs on glycemic and periodontal status among DM patients

“…The sample size was calculated from a previous study [20] and included 87 participants in each group by achieving 80 power at a 5 percent significant level. The Clinical Attachment loss (CAL) of intervention and control groups were 2.97 and 3.44 (effect size: 0.47), respectively, and the pooled variance was 1.23 [20]. The entire sample size was increased to 192 participants (96 per group) due to the 10 percent increase for attrition and refusal.…”

“…For example, the lifestyle change plus a dental care (LCDC) program, which combined lifestyle modification and oral health care intervention by using the common risk factor approach and MI was applied to aging DM patients. After the LCDC program, the elderly patients had better knowledge, attitude, and decreased blood sugar levels, and an improved periodontal status [20,21]. However, the LCDC program was only applied to aging DM patients and was time-consuming (20 min of MI per visit) and required increased health personnel to deal with the rise in DM patients.…”