662-P: Oral Health: Neglected Diabetes Intervention

Abstract

Oral health and diabetes can be mutually detrimental, Diabetes Education guidelines encourage good oral health practices: brushing, flossing and visiting dentist. We assessed the quality of patient outcomes and behaviors and provider support for oral health in a public hospital specialty diabetes (DM) clinic. Patients (n=99) completed waiting room surveys on oral health history, practices, barriers and knowledge. For quality assessment, providers completed self-administered surveys on their visit discussions for oral health. Population was 54% male, had mean age 59 yr and mean DM duration 13 yr, 24% had completed < 12th grade, 23% were current smokers, and 36% had some dental coverage. While most patients knew good oral health practices, only a minority followed them. This was reflected in tooth loss and oral problems. Most patients knew DM causes dental problems (75%) and dental problems could worsen DM (60%). Most (93%) reported they should brush 2 or more times per day, only 51% did that; (74%) believed in at least once daily flossing but only 31% did so; 82% said they should visit a dentist 2 or more times a year, only 17% did so. Access to dental care was a major issue: 66% reported cost and 11% time as barriers to dental visits. Brushing barriers included: time – 23%, forget – 11%, “don’t know”/”lazy” – 11% and tired – 7%. Good oral health practices decreased with age and tooth loss but increased with higher education. Only 17% utilized charity or sliding scale clinics. They had lost median of 7 teeth and 13% were completely edentulous. In past year 40%, had tooth ache, 30% bleeding gums, 20% loose teeth, and 28% decayed teeth. Provider support was low. Per the provider survey a minority (<30%) discussed the 3 oral health practices with half or more of patients. Patient oral health outcomes and practices are poor. Knowledge is not a major barrier. Oral health is associated with better DM control and quality of life, but intervention and support may be neglected by providers. DM Clinics must assess and improve oral health practices and education. Disclosure D.C. Ziemer: None. C.S. Barnes: None. R.S.M. Rupasinghe: None. S. Khare: None.