Diabetes and Dental Visits

In our professional lives, we may take our knowledge for granted, expecting that others know what we know. We may assume that patients—particularly those who are medically compromised— understand the importance of good oral health and regular professional care. I’ve made these assumptions about patient awareness, too, which is why I was truly surprised when I read a recent study about the frequency of dental visits by individuals with diabetes.

A new study conducted by researchers at the New York University Rory Meyers College of Nursing in New York and East Carolina University Brody School of Medicine in Greenville, North Carolina, shows that adults with diabetes are less likely to visit the dentist than individuals with prediabetes or without diabetes.¹ These findings are alarming to say the least. The bidirectional relationship between diabetes and periodontal conditions is well documented, with diabetes impacting periodontal health and periodontal health affecting glycemic control. Therefore, it is reasonable to assume that regular visits to an oral health professional for assessment and preventive and treatment measures could improve diabetes conditions, most notably in individuals with a periodontal disease. So why does it appear that patients don’t know this important information, or if they do know it, why aren’t they proactive in seeking care?

The data analyzed in this study are from a national survey that examined healthrelated behavioral risk factors along with preventive health practices, care access, and chronic health conditions. It’s especially notable that this study was conducted by medical (not dental) colleagues, further emphasizing the importance of oral health to overall health. It was also the first to assess trends in dental visits by Americans with diabetes, prediabetes, or no diabetes. In the survey, respondents were asked if they had ever been told they have diabetes. It was then determined whether they had a dental visit in the past year. The study included 2,500,257 dentate respondents, with results showing that 61.4% of adults with diabetes had a dental visit in 2014 and that an average of three in 10 adults with diabetes did not have an annual dental visit.

Several reasons for not seeing an oral health professional were presented, including the cost of care, minimal knowledge about the relationship between diabetes and oral health, and lack of insurance. Racial and ethnic disparities were also apparent in the analysis. One of the concluding remarks stated: “Expanding dental insurance coverage and improving access to dental providers are needed, especially in the minority population and disadvantaged groups with diabetes and prediabetes.”¹

This study presents a strong call to action for medical and oral care providers alike. Individuals with diabetes need to be educated about the relationship between oral health and diabetes. In addition, health care providers need to advocate for insurance coverage and increased access to care. It’s time for our practice acts to adapt to the needs of the community, so those who require care can receive it. This is a perfect example of how dental hygienists and dental therapists can expand their scope of practice into the medical community by working with professionals who treat patients with diabetes.

Jill Rethman, RDH, BA
Editor in Chief
jrethman@belmontpublications.com

REFERENCE

1. Luo H, Bell RA, Wright W, Wu Q, Wu B. Trends in annual dental visits among US dentate adults with and without self-reported diabetes and prediabetes, 2004–2014. J Am Dent Assoc. March 31, 2018. Epub ahead of print.

From Dimensions of Dental Hygiene. May 2018;16(5):10.