Abstract

BackgroundPeople with uncontrolled diabetes are at greater risk for several oral health problems, particularly periodontal (gum) disease. Periodontal disease also impacts diabetes control. Good oral hygiene and regular dental visits are recommended to prevent and manage oral health problems. Several studies have been conducted to assess the oral health knowledge, attitudes, and practices of people with diabetes yet a review of these findings has not yet been undertaken. The aim of this systematic review was to synthesize current evidence on the knowledge, attitudes and practices of people with diabetes in relation to their oral health care.MethodsA systematic search of all literature was carried out in five databases using key search terms. The inclusion criteria were: 1) published in the English language; 2) from 2000 to November, 2017; 3) conducted on persons with any type of diabetes and of all ages; 4) explored at least one study outcome (knowledge or attitude or practices toward oral health care); and 5) used quantitative methods of data collection. No restrictions were placed on the quality and setting of the study.ResultsA total of 28 studies met the inclusion criteria. The studies included a total of 27,894 people with diabetes and were conducted in 14 countries. The review found that people with diabetes have inadequate oral health knowledge, poor oral health attitudes, and fewer dental visits. They rarely receive oral health education and dental referrals from their care providers. Provision of oral health education by diabetes care providers and referral to dentists when required, was associated with improved oral health behaviours among patients.ConclusionsOverall, people with diabetes have limited oral health knowledge and poor oral health behaviours. It is therefore essential to educate patients about their increased risk for oral health problems, motivate them for good oral health behaviours and facilitate access to dental care.

Highlights

  • People with uncontrolled diabetes are at greater risk for several oral health problems, periodontal disease

  • The studies originated from 14 countries namely, United States of America (USA; n = 8), India (n = 5), Saudi Arabia (n = 2), Malaysia (n = 2), Pakistan (n = 2), United Kingdom (UK; n = 1), Sweden (n = 1), Ireland (n = 1), Finland (n = 1), Brazil (n = 1), United Arab Emirates (UAE; n = 1), Jordon (1) South Korea (n = 1) and Iran (n = 1)

  • The results of this review show that a majority of people with diabetes are unaware of the bidirectional link between diabetes and periodontal disease and they have limited knowledge of their risks for oral health problems [18, 29,30,31,32, 34, 36,37,38,39,40,41,42,43,44,45]

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Summary

Introduction

People with uncontrolled diabetes are at greater risk for several oral health problems, periodontal (gum) disease. Several studies have been conducted to assess the oral health knowledge, attitudes, and practices of people with diabetes yet a review of these findings has not yet been undertaken. The aim of this systematic review was to synthesize current evidence on the knowledge, attitudes and practices of people with diabetes in relation to their oral health care. Not commonly discussed in diabetes care, people with uncontrolled diabetes are at increased risk of developing oral health problems, periodontal (gum) disease [3]. Periodontal disease, which includes both gingivitis and periodontitis, is a common inflammatory disorder caused by pathogenic microflora in the Poudel et al BMC Public Health (2018) 18:577 biofilm that forms adjacent to the teeth on a daily basis [4]. Moderate periodontitis affects approximately 40–60% of the adults worldwide [8]

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