The relationship between diabetes and periodontitis is established and described as a bidirectional influence, whereas that with dental caries is still controversial. The objective of this study was to analyze the relationship between blood glucose control and oral diseases in a population of diabetics followed at the "Centre Anti Diabétique d'Abidjan" (CADA). The dental condition of the diabetics included in this cross-sectional study was assessed by the DMF index, periodontal condition by the CPITN and oral hygiene by the OHIS index. Diabetes data were extracted from CADA patient medical records. Blood glucose control has been defined by an average of the blood glucose values of the last 3 months less than or equal to 1.26 g/l. Regression models were constructed to estimate the risk of diabetes imbalance adjusted for all characteristics collected. The sample of 356 diabetics consisted of 53.7% women with an average age of 55.6 years (range: 12-85 years). The average DMF index was 7.9 (Std: 6.6) with an estimated prevalence of caries of 77.0%, that of periodontitis of 53.1%. The proportion of subjects with good glycemic control was estimated at 41.3%. The characteristics associated with glycemic control were: dry mouth (p = 0.005), type of diabetes treatment (p < 0.00014) and duration of diabetes (p = 0.039) and periodontal status assessed with the CPITN (p = 0.014). The results of this study confirmed the link between periodontitis and glycemic control of diabetes described in the literature but didn't find significant association between dental caries
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In many developing countries, the establishment of insurance mechanisms is recommended to remove the financial barrier related to access to care. In Côte d'Ivoire, the General Mutual of State Employees and Agents (Mugefci) pursues this objective. However, concerns remain about the ability of this prepayment mechanism alone to ensure effective consumption of oral health care. The purpose of this paper, which is to contribute to the optimal use of insurance mechanisms, was to assess the accessibility of the oral health care of Mugefci beneficiaries. The cross-sectional study, which was conducted by the Medical Service for Civil Servants, concerned Mugefci beneficiaries who had come for medical consultation. The data collected included decayed tooth indices, absent due to caries or obturated, the DMF index, the time of the recourse and the reasons for giving up dental care as well as the willingness to pay for the care. The numbers and frequencies related to these variables have been calculated. 216 Mugefci beneficiaries participated in the study. The prevalence of caries was 50.9%, with a DMF index of 4.2. Self-medication was the first therapeutic remedy (47.7%) and 18.1% of beneficiaries reported that they had given up care due to lack of money. 47.2% of beneficiaries had a poor perception of dental care. The study showed that the existence of health insurance does not guarantee effective access to care. The availability of a quality care offer, the improvement of insurance coverage and the information of the beneficiaries about the services offered are factors to be taken into account to ensure effective consumption of oral health care.
The objective of this cross-sectional study was to determine the type of care that can be achieved and the epidemiological profile of patients attending the 3 public dental practices in the Haut-Sassandra region, in Côte d’Ivoire. The data collection concerned socio-demographic characteristics, reason for consultation, oral hygiene, dental condition, malocclusions and the availability of equipment for the performance of procedures. The 400 patients observed (51.5% male) were aged 16.0 to 86.0 years (mean=35.5 years; SD=13.1 years). The main reasons for consultation were pain (91.5%) and aesthetics (23.5%). Oral hygiene was insufficient for 36.8% of subjects. Oral conditions were malocclusions (12.8%), caries (98.7%) and edentulous (65.7%) with only 11.8% with prosthesis. The average DMFT index was 9.3. Only extractions and resin attached prostheses were possible in all 3 health facilities. Preventive dentistry (sealent, fluoridation), dentofacial orthopedics and implantology were not available in any dental practice. The most frequently performed acts were extractions (74.5%). The results of this study highlight the need for oral health planning with service equipment and awareness among populations who shouldn’t wait until they are in pain to consult.
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