Assessment of Knowledge and Attitude of Diabetes Mellitus Type 2 Patients about Their Oral Health in Mangalore, India

Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review

“… a Oh et al 2012, USA [ 28 ] N = 1209 (DM) 9140 (NDM); ≥45 y P ▪ Dental visit: 72.7% PWD vs 83.5% NDM (95% CI: 82.6%–84.4%, p < .0001) ▪ Diabetes status adversely affected the rate of preventive dental care ▪ Adults from racial/ethnic minority background (OR = 0.51, 95% CI: 0.33–0.79) or lower educational attainment (OR = 0.64, 95% CI: 0.47–0.88) had lower odds of having received preventive dental care a Orlando, et al, 2010, USA [ 29 ] N = 89 (T1DM); 12–19 y/ 40-Q K ▪ Perio~DM; 44% ▪ Health care providers advised PWD for dental check up (77%) b A ▪ Care of their OH was as important as taking care of medical health: 49% ▪ Plaque or tartar build up was a problem: 33% P ▪ Dental visit: 95.4%; majority (86.5%) paid through insurance Moore et al 2000, USA [ 30 ] N = 390 (T1DM), 203 age matched (NDM) K ▪ OH would be better if not have diabetes: 18.2% ▪ Health care providers advised for oral hygiene and dental visit: 27.1% b A ▪ PWD rated their overall oral health lower than control subjects ▪ The cost of dental care was main reason for avoiding routine visit P ▪ Brushing: 72.2% PWD vs 80.2% NDM ▪ Flossing: 33% vs 30% ▪ Dental visit: 68.9% vs 75.7% Alves et al, 2009, Brazil [ 31 ] N = 55 (T1DM), 55 age matched (NDM) K ▪ None enrolled in an oral health educational program ▪ Informed to visit dentist by health professional: 65.5% b A ▪ Reasons for avoiding dental visit: difficulty in scheduling an appointment (36.1%) and high treatment costs (27.8%) P ▪ Brushing: 92.7% PWD vs 76.4% NDM ▪ Flossing: 30.9% vs 18.2% ▪ Dental visit: 63.8% vs. 48.7% Arunkumar et al 2015. India [ 32 ] N = 185 (T2DM) K ▪ Perio~DM: 33% ▪ Informed about OH from physicians; none b Kejriwal et al2014, India [ 33 ] N = 300 (T2DM);18-65y/ 20-Q; V K <...>…”

“…Similarly, adequate oral health knowledge was also significantly associated with other factors such as, higher level of education ( p = 0.05) [ 41 ] and having received oral health information ( p = 0.008) [ 18 , 46 ]. Studies reported that the majority of the patients did not receive any oral health information from general physicians or diabetes care providers [ 29 – 33 , 42 , 46 , 49 ]. However, few studies such as, those conducted in USA [ 29 ] and Brazil [ 31 ] indicated that majority (77 and 65.5% respectively) of patients were advised by health professionals for dental checkups [ 29 ].…”

“…However, less than one third of participants (31%) from another study also stated that any oral health information provided would not affect their oral hygiene behaviours and dental checkups routines [ 44 ]. Similarly, some participants (41%) in a study conducted in India also preferred to consult physicians for oral problems [ 33 ].…”

“…Oral health care practices were reported in most of the studies ( n = 25) and addressed the patients’ frequency of brushing, flossing, and dental visits. In the studies ( n = 18) that reported frequency of brushing, just less than half of the participants who have diabetes (mean 49.3%, 95% CI 35.70–62.90) brushed twice a day [ 24 , 27 – 29 , 31 , 33 – 37 , 39 – 42 , 44 , 45 , 48 ]. Four studies presented data on regular flossing (≥1/day) by patients and only a quarter of them (mean 25.1%, 95% CI 10.36–39.88) undertook flossing at least once a day.…”

“…Across 20 studies just over half of the people with diabetes (mean 54%, 95% CI 42.80–65.25) had dental visits in the last 12 months [ 24 – 29 , 31 , 33 – 37 , 39 – 45 , 48 ]. In addition, the uptake of dental services was very low (mean 34.6%, range 10%–75.60%) in low or middle income countries [ 51 ], such as, India [ 33 , 37 , 43 ], Malaysia [ 36 , 40 ] and, Jordan [ 38 ] compared with high income countries [ 51 ] (mean 60.6%, range 12.6%–95.4%), which included USA [ 18 , 25 – 27 , 29 , 52 ], UK [ 42 ], Finland [ 50 ], Sweden [ 34 ], Ireland [ 39 ], UAE [ 49 ], Saudi Arabia [ 41 , 46 ] and Korea Republic [ 35 ]. Within the high income countries lower rate of dental visits was observed in Asian countries (range 12.6%–45.3%) [ 49 ] [ 41 , 46 ] [ 35 ] which was similar to other low income countries (10%–45%), except the one study from India which reported a dental visit rate of 75.6% [ 37 ].…”