The Use of the Slipping Slipper Sign to Explore the Connection between the Feet and the Mouth in Patients with Diabetes Mellitus.

OBJECTIVE: Both periodontal disease and peripheral neuropathy are complications associated with poorly controlled diabetes. This study aimed to determine whether periodontal disease was more prevalent and more severe among patients with severe diabetic peripheral neuropathy. METHODS: A case-control study was performed; 46 patients with and 48 without the slipping slipper sign (SSS)-a surrogate clinical marker for severe peripheral neuropathy-were recruited from a diabetic outpatient clinic. Demography and data from the Basic Periodontal Examination (BPE) were assessed, in addition to the patients' periodontal health by 2 examiners blinded to patients' SSS status. Multivariate logistic regression was used to evaluate the associations between the risk factors for and the presence of the SSS, adjusting for age, gender, and ethnicity. RESULTS: The mean age of the sample was 55.8 years (±10.69 years). Most of the participants (77.7%) had either never been to a dentist or had last attended a dental clinic more than a year before this examination, and 83% did not have a dentist. Periodontal disease was advanced in 61.7%, and there was no association between the SSS and periodontal disease. Dental-service utilization variables were significantly associated with the SSS. Patients who did not have a regular dentist were more than 7 times more likely to have the SSS than were those who did (OR = 7.70; 95% CI: 1.12 53.21). CONCLUSION: In diabetic patients, oral health-related risk factors, such as not having a dentist, wearing a denture or dentures, and visiting a dentist once a year or more, may be associated with systemic complications, including peripheral neuropathy. Early collaboration between dentists and doctors on the care of patients with diabetes is recommended.

Knowledge, attitudes and behaviour towards preventive oral care in early childhood among paediatricians in Trinidad and Tobago: findings of a national survey.

OBJECTIVE: To determine paediatrician's knowledge and attitudes about oral health in Trinidad and Tobago. DESIGN AND METHOD: A pre-tested questionnaire was sent out via survey monkey to 70 out of 75 paediatricians registered with the Medical Board of Trinidad and for whom email addresses were available. Hard copies of the questionnaires were delivered to the paediatric departments of the Eric Williams Medical Sciences complex. Paediatricians that were unable to complete the questionnaire online were asked to complete hard copies. RESULTS: Forty-nine paediatricians responded, yielding a response rate of 70%. Most (95.9%) of the participants had positive views about routine dental visits, but yet only 28.6% advised a first dental visit between the ages 6 months and 1 year. Although the majority (91.8%) had positive views on fluoride supplementation, knowledge of appropriate fluoride dosages was not in keeping with current guidelines. Mixed views on the role of breastfeeding as a risk factor for developing decay were seen among respondents; 63.3% of the paediatricians indicated that they did not receive any education on the oral health of young children during their specialty training, and most felt they required additional training in this area. CONCLUSIONS: Paediatricians in Trinidad and Tobago demonstrated positive attitudes toward oral health. However, their knowledge with respect to oral disease prevention including the use of fluoride, and timing of the first dental visit appear to be lacking. Paediatricians may benefit from continuing education with regards to the oral health of children.