Postpartum U.S. Women's Oral Health Knowledge, Attitudes, and Practices During Pregnancy.

OBJECTIVE: The purpose of this study was to assess oral health knowledge, attitudes, and practices of women who had given birth in the United States within the past 2 years, and to evaluate factors affecting women's dental service utilization during pregnancy. METHODS: This study used a descriptive, cross-sectional design and employed non-probability sampling methods. The 47-item questionnaire included: oral health behaviors (8), knowledge (5), attitudes (12), and practices during pregnancy (10), and demographic (12) questions. Participants were recruited through multiple postpartum support group forums on Facebook. Logistic regression was used to identify potential predictors of dental utilization during pregnancy. RESULTS: Ninety-one percent of the participants had at least an associate's degree, and 85.6% had dental insurance coverage during pregnancy. Approximately 56% knew the connection between poor oral health and pregnancy complications; however, only 11% obtained this information from their OBGYNs and 10% from their dental offices. Although women aware of the association were more likely to visit the dental office during pregnancy (64%, p < .001), the majority (74%) who experienced tooth or gum related issues during pregnancy reported not receiving any dental or gum treatment. Women, who had positive dental attitudes and awareness of an increased risk of pregnancy complications due to poor oral health, were more likely to receive dental care during pregnancy regardless of dental coverage. CONCLUSION: Medical and dental providers could play an active role in educating women on the importance of having good oral health, potential oral/systemic relationships, and the benefits of receiving dental care during pregnancy.

Oral Health Considerations of Children: Grandparent Caregiver Perceptions, Behaviors, and Knowledge.

INTRODUCTION: In the United States, approximately 2.7 million grandparents have permanent custody of their grandchildren. Prevalence of primary dental caries has remained steady for those living in poverty, and among children of color. Children in the care of their grandparents frequently live in socioeconomically disadvantaged households, where dental disparities continue to exist. Research regarding the grandfamily dynamic as it relates to oral health, is limited. The purpose of this study was to investigate oral health perceptions, behaviors, and knowledge of grandparents raising/caring for their grandchildren; and explore how a grandparent caregiver's oral health knowledge influences their perceptions/behaviors regarding their grandchild's oral health. METHODS: This descriptive, cross-sectional survey research used non-probability sampling strategies to recruit grandparents who were the primary caregiver of their grandchildren, aged birth to eighteen years. A validated questionnaire was employed, both in-person and electronically. RESULTS: A total of 75 grandparents participated and answered 52% (SD = 27%) of oral health knowledge questions correctly. The study showed a correlation between low-income grandparents (M = 3.94, SD = 1.02) having higher pediatric oral health knowledge. Additionally, results indicated the greater the knowledge, the more positive intent to assist grandchildren with routine brushing and in checking their teeth for cavities. CONCLUSIONS: This study demonstrated that regardless of socioeconomic status, grandparent caregiver's oral health knowledge can positively affect their oral health-related behaviors and values, which could influence their grandchildren's' oral health. Further research regarding grandparent caregiver utilization of public health pediatric services and dental education programs, and the potential influence of these programs on pediatric oral health, should be explored.

Oral Health Professionals Knowledge, Attitudes and Practices Toward Patients with Depression.

Purpose: Depression is a rising global health concern manifesting bidirectional relationships between chronic disease conditions such as type 2 diabetes and oral health. The purpose of this study was to explore the knowledge, attitudes, and practices of oral health care professionals towards individuals with depression.Methods: A 24-item, validated Knowledge Attitudes and Practices (KAP) survey was used for this descriptive, cross-sectional study. Non-probability, convenience and snowball sampling was used to recruit oral health care professionals (dentists, dental hygienists and dental assistants) to participate in an electronic survey. Descriptive statistics were used to analyze the data.Results: A total of 288 oral health care professionals (n=288) met the inclusion criteria. Age of the provider was positively correlated with reviewing or assisting in reviewing patient's depression history during routine dental visits (r=.16, p=.007), and referring or assisting in referring a patient to a mental health specialist (r=.30, p<.001). Number of years of practice was positively associated with referring or assisting in the referral of a patient to a mental health specialist (r=.29, p=.001). Oral health care professionals who indicated having had mental health during their education were more likely to indicate reviewing a history of depression with the patient (rho=.17, p=.004).Conclusion: Age, lack of practice experience and education may influence oral health care professionals' attitudes and practices when providing care for patients with depression. Mental health and its relationship to oral and systemic health may be an appropriate addition to dental program curricula. Oral health care providers should consider modifying routine practices to include the special needs of patients with depression.

Oral Health-Related Quality of Life of Children: An Assessment of the Relationship between Child and Caregiver Reporting.

Purpose: Oral and craniofacial conditions or diseases can impact an individual's health and quality of life. The purpose of this study was to assess the perceived oral health related quality of life (OHRQoL) of children, and evaluate the reported level of agreement between caregivers and their children.Methods: Purposive sampling was used to recruit children ages 8-15, and their caregivers from a dental clinic in a pediatric hospital for this descriptive, cross-sectional study. A modified version of a validated measure, Child Oral Health Impact Profile-Short Form (COHIP-SF), was used for a 22-item questionnaire encompassing three subscales: oral health, functional well-being, and social emotional well-being. Two additional items were included to assess child/caregiver's level of agreement. A dental chart review was also conducted to assess the child's overbite, overjet, and decayed surfaces. Data were analyzed through descriptive statistics and examined for assumptions of normality and linearity.Results: Sixty child/caregiver pairs (n=120) participated in this study. Overbite, overjet and decayed surfaces were not found to be related to any OHRQoL variable, including child/caregiver ratings and overall agreement (p>.05). Average OHRQoL scores for caregivers found to be more positive those of their children (p=.02). Agreement between caregivers and the child's gender was shown to be significant (p=.01). Female child scores differed significantly from males with respect to their caregiver responses (p=.02). Caregivers rated a higher OHRQoL for female children, thus overestimating their female child's reported OHRQoL.Conclusions: The moderate level of agreement found between children and caregivers reinforces the importance of including the child, as well as the caregiver, when assessing OHRQoL.

An Oral Health Education Training Intervention: A pilot study with Haitian schoolteachers.

Purpose: Risk factors for oral disease are elevated among disadvantaged populations living in developing countries; rural Haitian school children have limited or no access to health care services. The purpose of this pilot study was to assess Haitian schoolteachers' attitudes and knowledge on oral health prior to and after attending an oral health educational intervention as well as their perceptions and experiences of receiving and implementing oral health education in a Haitian classroom setting.Methods: This mixed methods study used a quantitative, quasi-experimental, one-group pre/post-test design, before and after a 3-day oral health educational training in Borel, Haiti. A validated pre-and post-test questionnaire measured changes in oral health knowledge and attitudes. A qualitative, phenomenological approach was used to analyze information gathered during focus groups, using a semi-structured interview guide, to explore schoolteachers' perceptions and experiences regarding the training intervention and the six-week implementation of the oral health curriculum.Results: A purposeful sample of nine Haitian primary schoolteachers (n=9) consented to participate in the study. Oral health knowledge and attitude mean scores of the participants demonstrated improvement from pre-test (70%) to post-test (78%) scores. Qualitative findings revealed two major themes; confidence and empowerment, and improved oral health knowledge and hygiene behavior.Conclusion: Quantitative results from this study confirmed that training Haitian schoolteachers to integrate oral health education in the classroom can be an effective method for improving schoolteachers' personal oral health knowledge and attitudes. Findings also revealed a positive outlook on the training intervention and the application of an oral health education curriculum in the classroom. Results from this study provide a foundational knowledge for future oral health education trainings in underdeveloped countries with limited resources.

Interest in Dental Hygiene Therapy: a study of dental hygienists in Maine.

Purpose: The purpose of this study was to assess the awareness of registered dental hygienists (RDHs), licensed in the state of Maine, regarding the midlevel dental hygiene therapist (DHT) provider model and to gather data regarding the degree of interest in enrolling in a DHT program.Methods: A quantitative cross-sectional study design with a non-probability purposive sampling of actively practicing RDHs in the state of Maine (n=1,284) was utilized for the web-based survey. Survey questions included awareness in the passage of DHT legislation, level of interest pursuing education and licensure in this midlevel provider model. Data was collected over a three-week period. Descriptive statistics and thematic analysis were used for data analysis.Results: Response rate was 21% (n=268). Sixty-five percent of respondents expressed interest in enrolling in a DHT program and 40% of those respondents stated a willingness to enroll in a DHT program within the coming year. Although willing to travel 25-50 miles, a majority of respondents preferred programs incorporating online components combined with clinical training completed in nearby communities. Themes emerging from the open-ended question regarding DHT program feasibility and appeal included: convenience, flexibility, cost/affordability, and independent or collaborative practice.Conclusion: Study outcomes indicated interest exists among Maine RDHs regarding the DHT provider role and enrollment in a DHT program. Although there are no DHT programs currently being offered in the New England states, results suggest further investigation is warranted regarding the development of a DHT program in the Northeastern United States.

Development and Testing of a Smartphone Application Prototype for Oral Health Promotion.

Purpose: The purpose of this study was to develop and test a smartphone application (app) prototype, ToothSense, as an oral health promotion tool for the prevention of Early Childhood Caries (ECC) based on the Theory of Planned Behavior (TPB).Methods: A quantitative and qualitative design process based on the TPB was used for the app development in the first phase of the study. A behavioral intervention technologic model was used to document the app features design, accounting for Doshi's intervention strategies for the TPB. Beta-testing of the app was hosted via an online software program. Testers were presented with a series of tasks and prompts followed by a 5-point Likert-scale questionnaire that quantitatively measured perceptions of the app's interactive design based on Jakob Nielsen's principles and behavioral strategies. A Net Promotor Score was calculated to determine the tester's likelihood to recommend the app prototype. Audio and video aspects of the app were qualitatively measured using a template approach.Results: Beta testers agreed the app met the majority of the five usability statements. The Net Promotor Score indicated a likelihood to recommend the app prototype. Thematic analyses revealed the following themes: interface design, navigation, terminology, information, and oral health promotion.Conclusion: Beta testing results from this study provided health promotion project design information for the prevention of ECC using the TPB and highlighted the importance and usability of smartphone app for oral health promotion.

Treatment of a Culturally Diverse Refugee Population: Dental hygiene students' perceptions and experiences.

Purpose: Dental hygiene professionals need to be prepared as part of their entry level education process, to treat the wide range of culturally diverse patients they may encounter in the United States. The purpose of this qualitative study was to explore the perceptions and experiences of a cohort of senior dental hygiene students in regards to their preparedness to treat a culturally diverse patient.Methods: A purposeful sample of second year dental hygiene students (n=18) participated in semi-structured group interviews before and after the treatment of a culturally diverse patient. Data was gathered and analyzed using a thematic analysis. Demographics were enumerated using frequency percentiles, means, and summary statistics.Results: Prior to the dental hygiene care appointment, the participants reported feeling confident and prepared to treat culturally diverse patients. Following the dental hygiene care appointment, participants reported feeling that more education and an increased number of clinical experiences were needed with culturally diverse patients.Conclusion: Exposing dental hygiene students to diverse patients in a clinical setting as part of the curriculum was an effective method towards building cultural preparedness.

Public Health Dental Hygienists in Massachusetts: A Qualitative Study.

Purpose: The aim of this qualitative, phenomenological study was to explore the attitudes and perceptions of public health dental hygienists on providing preventive care to underserved populations in Massachusetts.Methods: Non-probability purposive sampling was used for initial participant recruitment, and snowball sampling occurred thereafter. Data collection occurred through semi-structured interviews. Qualitative analysis was conducted using Pitney and Parker's eight-step CREATIVE process.Results: Data saturation occurred with 10 participants (n=10), one-third of the public health dental hygienists who are practicing in Massachusetts. The majority of practice settings included school-based programs (70%), while programs for children with special needs (10%) were the least common. Two major themes emerged from the data; (a) the opportunity to be an oral health change agent and (b) barriers to practice. Six subcategories emerged from the data and are reviewed within the context of their associated themes. Additionally, career satisfaction emerged as an unintended theme, and was reported as the driving force for the majority of participants.Conclusion: This study revealed a better understanding of the public health dental hygiene workforce model in Massachusetts. Public health dental hygienists in Massachusetts perceive themselves as change agents within the health care profession, and although barriers to practice are plentiful, these oral health care professionals are committed to improving access to dental care.

Child Care Providers' Knowledge About Dental Injury First Aid in Preschool-age Children.

Purpose: The aim of this study was to assess child care providers' level of knowledge of first aid management and attitudes towards dental injuries among preschool-age children within Fairfield County, Connecticut and Boston, Massachusetts.Methods: This descriptive cross-sectional study used a web-based, validated questionnaire adapted from several studies with permission from authors. A panel of 5 dental experts determined the relevance of the questions and overall content (I-CVI range 0.8-1; S-CVI = 0.95). The 28 question survey included demographics, level of knowledge, attitudes about traumatic dental injuries, emergency management, and 2 case study questions on management of luxation and tooth fracture. Survey data was coded and analyzed for associations and trends using STATA® statistics/data analysis software v. 11.2.Results: A total of 100 child care providers completed the online questionnaire. Eighty-four percent self-reported little to no knowledge about dental injury management. Sixty percent of child care providers agreed that they are responsible for managing dental injuries. Approximately two-thirds of child care providers reported not feeling adequately informed about dental injuries, with 77% expressing interest in receiving more information.Conclusions: The majority of child care providers' do not have the knowledge to perform adequate first aid following a dental injury. Professional development on first aid for dental injuries is recommended among this workforce population.

Vietnamese Oral Health Beliefs and Practices: Impact on the Utilization of Western Preventive Oral Health Care.

Purpose: Infrequent use of the Western health care by the Vietnamese may be explained by deeply-rooted traditional oral health beliefs and practices unique to the Asian culture. This study investigated Vietnamese oral health beliefs and practices and their relationship to the utilization of Western preventive oral health care services among Vietnamese-Americans.Methods: An exploratory, cross-sectional survey design with a convenience sample of 140 par-ticipants (n = 140) was used for this study. Participants were recruited on site of a Vietnamese-owned business, with questionnaires consisting of 28 questions that were distributed in hard copy by the principal investigator (PI) on multiple occasions and at various times of the day.Results: Spearman Rank Correlations tests showed participants who agreed with the statement, "Regular dental visits will help prevent dental problems," were more likely to utilize medical health services (p< 0.05) and visit a dentist if their "gums were bleeding" (p< 0.05). However, only 22.86% of the participants would visit a dentist if experiencing a toothache. Despite results showing a strong association between the use of medical health care services and the belief that dental visits can prevent future dental health problems, participants did not believe in seeking Western oral health care for all dental health issues. No statistical significance was found between age, gender, pri-mary language, years spent in the United States, education level, religion and the Vietnamese survey participants' individual oral beliefs and practices.Conclusion: The results suggest that Vietnamese Americans holding the belief that dental visits help prevent oral health problems, were more likely to utilize Western health care services. The study also supports existing literature that Vietnamese oral health beliefs and practices impact the use of Western health care services.

Oral Health Beliefs, Attitudes, and Practices of Albanian Immigrants in the United States.

Research indicates a high prevalence of oral disease among Albanians. There is a lack of evidence regarding oral health beliefs and practices among Albanian immigrants in the United States and abroad. This research seeks to better understand the oral health beliefs, attitudes, and practices among Albanian immigrants living in the United States. A descriptive study was employed with a purposive sample (n = 211) of Albanian adult immigrants. A cross-sectional validated questionnaire was provided in both English and Albanian, with a response rate of 66 %. Results revealed a high use of dental services among respondents, with 68 % reported as having a dental visit and cleaning within the past year. Although 25 % of participants stated their parents and grandparents have used folk remedies, 88 % of them stated that use of folk remedies did not influence their decision to seek professional dental care. Increasing age was inversely associated with the belief in the importance of retaining natural teeth, as older respondents were less likely to agree with the prior statement; older respondents were more likely to agree with the statement "bleeding gums are normal." Low oral health care access and utilization was not a factor among the majority of the Albanian immigrants studied. Focusing on providing age appropriate oral health education and behavioral strategies could increase oral health knowledge and potentially improve poor oral health status among this population.

An Assessment Model for Evaluating Outcomes in Federally Qualified Health Centers' Dental Departments: Results of a 5 Year Study.

PURPOSE: The purpose of this report was to establish baseline data on 10 oral health performance indicators over 5 fiscal years (2007 to 2008 through 2011 to 2012) for an Iowa health center. The baseline data provides an assessment model and reports outcomes based on the use of the model. Performance indicators show evidence of provider performance, accountability to stakeholders and provide the benchmarks required for dental management to develop future goals to improve oral health outcomes for atrisk populations. METHODS: Using descriptive statistic, this report extrapolated data from the Iowa Health Center's computer management systems software, HealthPro, and Centricity electronic medical records, and analyzed using IBM® SPSS® 19. This report describes the change in utilization for number and type of visits for uninsured and Medicaid patients over 5 fiscal years (a fiscal year is measured from November 1 through October 31). RESULTS: The number of patients receiving at least 1 dental visit in a measurement year showed n=81,673 procedures with 21% (17,167) being unduplicated patients. Preventive averaged 46%, restorative 18%, urgent care 22% and other procedures 14%. CONCLUSION: Federally qualified health centers (FQHCs) with a dental component serve populations with the greatest health disparities. This population includes ethnic and racial minorities, uninsured, underinsured, rural residents, Medicaid and Medicare. Establishing baseline data for FQHCs provides a foundational tool that will allow dental management to analyze successes as well as deficiencies in the goal to provide increased utilization to oral health care for at-risk populations.

Utilizing a Diabetes Risk Test and A1c Point-of-Care Instrument to Identify Increased Risk for Diabetes In an Educational Dental Hygiene Setting.

PURPOSE: The objective of this pilot study was to demonstrate the number of patients at increased risk for type 2 diabetes development using a validated survey; and to assess the rate of compliance for A1c screening in an educational dental hygiene setting. METHODS: This was a descriptive study using a purposive sample of patients in an academic dental hygiene clinic, who were 18 years or older, not diagnosed with prediabetes or type 2 diabetes. Utilizing the American Diabetes Association adopted diabetes risk survey, patients determined to be at increased risk for type 2 diabetes were offered the opportunity for further assessment by having their A1c tested using a point of care instrument. Patients demonstrating an increased risk for prediabetes or type 2 diabetes, with either the survey or the point of care instrument, were referred to their primary physician for further evaluation. RESULTS: A total 179 of the 422 solicited patients agreed to participate in the American Diabetes Association adopted diabetes risk survey. According to the survey guidelines, 77 participants were considered increased risk for type 2 diabetes for an at-risk prevalence of 48% (95% Confidence Interval (CI): 40 to 56%). The at-risk participants were then asked to have an A1c test of which 45 agreed (compliance rate 58%, 95% CI: 47 to 70%). Using American Diabetes Association A1c parameters, 60.98% (n=25) indicated a prediabetes (5.7 to 6.4%) range, and 4.88% (n=2) indicated a diabetes (≥6.5%) range. CONCLUSION: Utilizing the American Diabetes Association adopted diabetes risk survey in any dental setting could provide patients with invaluable health information, and potentially improve overall health outcomes.

Association between Early Childhood Caries, Feeding Practices and an Established Dental Home.

PURPOSE: Early Childhood Caries (ECC) is a significant public health concern disproportionately affecting low-income children. The purpose of this study was to assess the association between the establishment of a dental home and ECC prevalence in a group of Medicaid-enrolled preschool children, and to explore feeding practices associated with an increased prevalence of ECC in Medicaid-enrolled preschool children with an established dental home was evaluated. METHODS: A cross-sectional survey was conducted among Medicaid-enrolled children (n=132) between 2 and 5 years of age with an established dental home and no dental home to compare feeding practices, parental knowledge of caries risk factors and oral health status. RESULTS: Children with an established dental home had lower rates of biofilm (p<0.05), gingivitis (p<0.05) and mean decayed, missing and filled teeth (DMFT) scores (p<0.05). Children with no dental home consumed more soda and juice (p<0.05) daily, and ate more sticky fruit snacks (p<0.05) than children with an established dental home. Establishment of a dental home had a strong protective effect on caries and DMFT index (odds ratio=0.22) in both univariate and confounding adjusted analyses. CONCLUSION: The results suggest establishment of a dental home, especially among high-risk, low-income populations, decreases the prevalence of ECC and reduces the practice of cariogenic feeding behaviors.

Attitudes and Practices Among Medical Providers Regarding Oral Health Assessments in Young Children.

Research indicates that while most nondental medical providers believe pediatric oral assessments are important, most lack education and training. This study investigated a metropolitan area in Southern California medical providers' knowledge, attitudes and practices on oral health assessments. Results indicate a high incidence of incorrect dental knowledge. Common barriers were lack of knowledge and time. Early intervention and timely dental referrals among nondental medical providers can play a significant role in promoting oral health.

Oral Health Care Providers' Knowledge and Attitudes About Intimate Partner Violence.

Introduction: Given its high prevalence, intimate partner violence (IPV) is an important public health issue. Oral health care providers (OHCPs) often encounter victims of intimate partner abuse in dental settings, but there is a lack of existing literature regarding OHCPs' attitudes toward and knowledge of IPV.Purpose: This study assessed OHCPs' knowledge and perception of preparedness in assessment and management for IPV.Methods: Using a validated survey tool called PREMIS, this study assessed a convenience sample of OHCPs' knowledge and attitudes about the identification, assessment, and management of IPV.Results: The survey results obtained from 117 OHCPs indicated 92% had had some form of IPV education, but 45% felt they did not have sufficient training to assist individuals who were victims of IPV. Other areas in which the respondents felt ill-prepared included identifying victims of IPV (61.5%) and appropriate referrals to social services (64%). Only 7 to 9% screen new patients or those with abuse indicators on the history or exam.Conclusion: This study explored OHCPs' attitudes and knowledge of IPV and provided insight into IPV screening practices and management in dental care settings. Because injuries to the head, neck, and face are very common in IPV, OHCPs have the opportunity to play a key role in managing "the silent epidemic" of domestic violence by routinely including screening of new and returning patients and having a referral resources available.

Immigrant Caregivers of Young Children: Oral Health Beliefs, Attitudes, and Early Childhood Caries Knowledge.

The incidence of early childhood caries (ECC) is a global public health concern. The oral health knowledge of a caregiver can affect a child's risk for developing ECC. An exploratory study of the oral health knowledge and behaviors among caregivers of children 6 years of age and younger was conducted with a convenience sample of adults (n = 114) enrolled in English language or high school equivalency examination courses. The majority of study participants were born in Asia (47 %). Other birth regions included South America (16 %), Caribbean (16 %), Africa (10 %), and Central America (6 %). Study findings showed caregivers with low oral health knowledge were more likely to engage in behaviors that increase a child's risk for developing ECC. A statistically significant relationship was found between participants' rating of their child's dental health as poor and the belief that children should not be weaned from the nursing bottle by 12 months of age (P = 0.002), brushing should not begin upon tooth eruption (P = 0.01), and fluoride does not strengthen teeth and prevent dental caries (P = 0.005). Subjects who pre-chewed their child's food also exhibited behaviors including sharing eating utensils or a toothbrush with their child (P < 0.001). Additional caregiver behaviors included providing their child with a bottle containing cariogenic liquids in a crib (P < 0.001). As a result of this research, it is pertinent that culturally sensitive oral health promotion programs are developed and implemented to raise awareness and reduce the risk of dental disease among immigrant populations.

An Assessment Model for Evaluating Outcomes in Federally Qualified Health Centers' Dental Departments: Results of a 5 Year Study.

PURPOSE: The purpose of this report was to establish baseline data on 10 oral health performance indicators over 5 fiscal years (2007 to 2008 through 2011 to 2012) for an Iowa health center. The baseline data provides an assessment model and reports outcomes based on the use of the model. Performance indicators show evidence of provider performance, accountability to stakeholders and provide the benchmarks required for dental management to develop future goals to improve oral health outcomes for at-risk populations. METHODS: Using descriptive statistic, this report extrapolated data from the Iowa Health Center's computer management systems software, HealthPro, and Centricity electronic medical records, and analyzed using IBM® SPSS® 19. This report describes the change in utilization for number and type of visits for uninsured and Medicaid patients over 5 fiscal years (a fiscal year is measured from November 1 through October 31). RESULTS: The number of patients receiving at least 1 dental visit in a measurement year showed n=81,673 procedures with 21% (17,167) being unduplicated patients. Preventive averaged 46%, restorative 18%, urgent care 22% and other procedures 14%. CONCLUSION: Federally qualified health centers (FQHCs) with a dental component serve populations with the greatest health disparities. This population includes ethnic and racial minorities, uninsured, underinsured, rural residents, Medicaid and Medicare. Establishing baseline data for FQHCs provides a foundational tool that will allow dental management to analyze successes as well as deficiencies in the goal to provide increased utilization to oral health care for at-risk populations.

Short-term effects of non-surgical periodontal therapy on clinical measures of impaired glucose tolerance in people with prediabetes and chronic periodontitis.

PURPOSE: Diabetes and periodontal disease are conditions considered to be biologically linked. Prediabetes is a condition in which individuals have blood glucose levels, impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) or glycated hemoglobin (A1C) levels higher than normal but not high enough to be classified as diabetes. Few human studies address the relationship between periodontitis and prediabetes or clarify an association between periodontitis and prediabetes. The purpose of this pilot study was to examine the impact of non-surgical periodontal therapy (NSPT) on clinical measures of glycemic control in prediabetes. METHODS: Prediabetes measures of IFG, IGT, A1C and periodontal measures of pocket depth (PD), clinical attachment level (CAL), plaque index (PI) and gingival index (GI) were taken at baseline and 3 months in 12 subjects with prediabetes and chronic slight to moderate periodontitis. Blood samples were taken from each subject following an 8 hour fast. This study controlled for changes in medications, body-mass index, physical activity and diet. RESULTS: Comparison of mean prediabetes and periodontal measures from baseline and post-treatment at 3 months demonstrated clinical improvement for both periodontal and prediabetes measures. A mean reduction in PD of 0.27 (p=0.003), CAL of 0.32 (p=0.050) and A1C of 0.19 (p=0.015) reached statistical significance. CONCLUSION: This pilot study suggests NSPT improves A1C and periodontal measures at 3 months. The robustness of measures is limited due to the small sample size and lack of a control group. Further larger scale studies using a randomized control design would be informative.