Strategies to improve the oral and dental health of people with diabetes
Strategies to improve the oral and dental health of people with diabetes
Iman Amanizadeh,1Mahdi Mozaffari,2Samira Pasandideh,3Khadijeh Momeni,4,*
1. Student Research Committee, Tehran University of Medical Sciences, Tehran, Iran 2. Student Research Committee, Dentistry School, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Shahid Kalantari Dental Clinic,Karimkhan Street,Tehran,Iran 4. Department of Operating Room, School of Allied Medical Sciences
Introduction: Diabetes is the main and growing health problem internationally. It caused an estimated 1.5 million deaths and was the ninth leading cause of death in 2019. Poorly managed diabetes can lead to multiple difficulties, one of them being dental and oral problems, which the most prevalent one of them is periodontal (gum) disease that is often presented as the sixth complication of diabetes.
In the past couple of years, substantial attention has been given toward these associations and their implication for people living with diabetes. But People with diabetes often are not informed about the relations between diabetic control and oral or periodontal diseases nor do they receive dental referrals from their diabetes care providers. Also, the study revealed 66. 38% of diabetic patients were never questioned about their oral hygiene by their diabetic educators. Another study focusing on the effectiveness of furnishing oral health information for diabetic patients indicated that participants who received the information, had 2.9 times the odds of maintaining adequate oral health knowledge compared to participants who did not receive the information.
Besides certified diabetes educators’ (CDEs) time constraints, no related oral health training programs and examination tools exist for them. But with proper training, not only CDEs, but non-dental professionals like nurses have successfully integrated oral healthcare in other settings. Also results of another survey conducted in Iran indicated the moderate level of knowledge and the practice of dental students in Tehran regarding the oral health of diabetic patients.
Methods: In this systematic review, we extracted the required articles using keywords and also citing databases such as PubMed, Scopus, Google Scholar and ProQuest. The statistical population of this study is all articles published until 2022. We checked the quality of the data and then reviewed 17 articles.
Results: Three main themes emerged from reviewed articles regarding CDE’s and dental hygienist’s perspective on oral health in diabetic patients. Education (educating the people, resources for patients, and professional practice guidelines), Inter-professional collaborative care (role of medical staff to raise awareness for oral health in diabetes) and Dental insurance.
Also, General Practitioners (GPs) reported 20–30% of their patients having oral health inconveniences. Several barriers were identified by GPs including absence of referral pathways, time constraints, and limited knowledge and training in promoting oral health care. GPs suggested that resources such as standardized assessment tool and education/training could assist them in promoting oral health care.
In addition, 62% of questioned CDEs in a survey agreed that CDEs need to join forces with dental specialists in disease management and 84% indicated interest in an oral health constituent being added to their ongoing education curriculum. Although, 51% discussed oral health with their patients and 64% said they have referred a patient to a dentist within the past year, but only 20 lt self-confident enough to provide an oral health screening to their patients.
Conclusion: The three emerging themes are interrelated, indicating that strategies to improve oral health for people with diabetes are multifaceted.
Important strategic arrangements across patient, general public, and care provider levels, comprising inter-professional collaborative care, dental and diabetes professional organizations is necessary to achieve the objective of improving oral health for people with diabetes,. Local, regional and national initiatives could promote or harmonize the assessment and management of the oral health of patients with diabetes to bridge the gap between medicine and dentistry in this field.