Expediting dental treatment for patients with diabetes mellitus in a university-based dental clinic.

Abstract

This pilot project was implemented to minimize barriers in access to care, reduce the risk for oral health and systemic diabetes complications, and optimize the health outcomes for patients with diabetes seeking comprehensive dental treatment. The intervention group included patients with diabetes who participated in hemoglobin A1c (HbA1c) testing during their initial dental screening appointment. The participants whose HbA1c value was ≤ 9.0% were expedited into the scheduling queue for the next comprehensive examination appointment. Health literacy was assessed regarding patients' understanding of the connection between oral health and diabetes. The mean number of days between screening and treatment plan development was decreased by 38.4%. Of the participants in the intervention group with an HbA1c value ≤ 9.0%, 44% rated their understanding of the connection between diabetes and gum disease as "poor", whereas 86% of the patients who were ineligible due to an HbA1c value ≥ 9.1% rated their understanding as "very good" or "excellent". Patients with diabetes will continue to benefit from this quality improvement project to minimize barriers to dental care and improve overall health outcomes as this intervention is adopted as a permanent practice change. The need has been highlighted for comprehensive education in practice settings concerning medical and dental collaboration, and patient awareness of the interrelationship between diabetes mellitus and oral disease. An increase in oral examinations, assessment of routine oral health behaviors, and referral to dental providers from the primary care setting is warranted.