Knowledge, Attitude and Practices of Diabetics regarding Oral Health

ABSTRACT

Background: Diabetics are at an increased risk of certain oral diseases like tooth loss, caries, gingivitis and infections which influence the quality of their life and negatively affect diabetic control. The occurrence and severity of these diseases can be decreased by good oral hygiene practices. Many diabetic patients do not know that they are more prone to oral diseases and that they should be extra careful about their oral hygiene.

Objective: This study was done to assess the baseline knowledge, attitude and practices of diabetic patients regarding their oral health.

Methods: A cross-sectional descriptive survey was conducted on 240 walk-in diabetics fulfilling the criteria, using questionnaire as a research tool, at the Diabetic Clinic of Shaikh Zayed Medical Complex, Lahore. Patients suffering from both type-1 and type-2 diabetes of all age groups were included, who were willing to participate, had at least one tooth of their own and had been diagnosed with diabetes for at least six months. Diabetic medical personnel and patients with apparent physical or mental handicap were excluded from the study.

Results: Among 240 diabetics, aged 17-80 years; majority were females (58%) and housewives (52%).  Maximum cases (82%) had an urban residence; and were non smokers (70%). Majority of subjects (64%) lack the knowledge regarding oral health’s relationship to diabetes. Majority (57 %) did not know that diabetes predisposed them to oral diseases and 7.6 % denied any existence of a link between diabetes and oral health.  Only 6% of the patients knew about this issue through their treating physicians.

Diabetic population claimed a positive attitude towards their oral health, and significant correlation was found between their knowledge (imparted by physician) and behaviors. For an oral problem 47 % were of opinion that a dentist should be consulted, 20 % said that a physician should be consulted while to 28 % self remedy was the solution to dental problems. About 45% said that if told of their predisposition to oral disease, they would increase their brushing frequency. Majority (63%) said that good oral hygiene would help them overcome dental problems, if any. Only 2% patients brushed their teeth three times a day and 22% brushed twice daily. Brushing frequency was significantly affected by increased education, physician’s counseling, urban residence and age; young patients showing better habits especially in terms of brushing twice daily.

Conclusions: Diabetics lack the knowledge regarding oral health’s relationship to diabetes mostly due to lack of oral health counseling on part of physicians. The diabetics require a continuous motivation by health care providers so that they maintain a more than adequate level of oral hygiene.