Oral Health Status, Knowledge, and Behaviours of People with Diabetes in Sydney, Australia

Abstract

This study assessed self-reported oral health status, knowledge, and behaviours of people living with diabetes along with barriers and facilitators in accessing dental care. A cross sectional survey of 260 patients from four public diabetes clinics in Sydney, Australia was undertaken using a 35-item questionnaire. Data were analysed using SPSS software with descriptive and logistic regression analyses. More than half (53.1%) of respondents reported having dental problems which negatively impacted their related quality of life. Less than half (45%) had adequate oral health knowledge. Only 10.8% reported receiving any oral health information in diabetes care settings, which had higher odds of demonstrating adequate oral health knowledge (AOR, 2.60; 95% CI, 1.06–6.34). Similarly, 62.7% reported seeing a dentist in the last 12 months. Having private health insurance (AOR, 3.70; 95% CI, 1.85–7.40) had higher odds of seeing a dentist in the past 12 months. Dental costs were a major contributor to avoiding or delaying dental visit. Patients living with diabetes have unmet oral health needs particularly around the awareness of its importance and access to affordable dental services. Diabetes care providers can play a crucial role in this area by promoting oral health to their patients.

Developing and pilot testing an oral health screening tool for diabetes care providers

“…These are very positive findings that could be attributed to the way the items were developed. The first item explored the most common dental problems linked with poor oral health, and more than half of the respondents reported (53%) these concerns (dry mouth, gaps between teeth, pain in teeth and/or gums and loose teeth) in the related study surveying people with diabetes in Australia [ 38 ]. The second item related to the frequency of dental visits in the last 12 months as the evidence shows that infrequent dental attendance is associated with poor oral health [ 51 ].…”

“…A meta-analysis 23 studies of analysing diagnostic accuracy found that specificity significantly reduced with higher prevalence [ 56 ]. These findings are relevant to the current study as there is a high prevalence of dental problems among people with diabetes ranging from 53–86% depending on the demographic profile [ 38 , 57 , 58 ]. Low specificity and NPV is an issue for screening tools if there are cost implications or risk of harm and discomfort to the patient from treatment [ 53 ].…”

“…Previous research in Australia has shown that diabetes educators and GPs prefer short screening tools due to their time constraints [ 2 , 24 ]. Further a recent doctoral study surveyed the views of 260 patients with diabetes in Sydney and found that more than 88% were receptive to diabetes care providers asking questions about their oral health and initiating dental referrals [ 62 ]. These initial studies suggest that the tool could be acceptable for all stakeholders, but more research is needed to confirm that it can be implemented into practice and is easy to use in diabetes care settings without evoking any discomfort from patients.…”

“…Further, the study was undertaken across metropolitan Sydney, Australia and thus the findings may differ in other populations of people with diabetes from regional/rural areas as well as other countries. However, all attempts were made to recruit diverse participants from across the socio-economic spectrum in Sydney including those from culturally and linguistically diverse backgrounds and the resulting sample was fairly representative of the population data from the Australian National Diabetes Audit [ 38 ]. Another limitation is that only one aspect of the psychometric assessment of the tool was assessed and other aspects like construct validity was not undertaken.…”

“…The tool was tested as part of a cross-sectional survey that assessed the self-reported oral health status, knowledge and behaviours of people living with diabetes. Additional information about this survey has been published elsewhere by Poudel et al [ 38 ]. The data pertaining to the oral health screening tool was used for the analysis in this study.…”