IADR Abstract Archives
Dental Management of Hypertensive and Diabetic Patients by General Dentists
Objectives: Hypertensive patients are at risk for complications when receiving dental care while diabetic patients may face poorer oral health outcomes. They require more meticulous care and special precautions. Previous studies suggest that many dentists do not follow the American Dental Association (ADA) guidelines when providing comprehensive dental care for their hypertensive and diabetic patients. This prospective study analyzed the level of compliance with ADA dental management protocols by general dentists in Los Angeles for hypertensive and diabetic patients.
Methods: 202 general dentists in Los Angeles completed telephone or on paper surveys. The questionnaire included 9 Likert scale questions (5-point response scale with 1 being highly unlikely and 5 being highly likely) exploring the level of compliance with specific dental management protocols. Bivariate analysis and Logistic regression models were performed to evaluate the association between compliance and participant’s gender, year of graduation from dental school and participation in General Practice Residency (GPR) or Advanced Education in General Dentistry (AEGD).
Results: Data suggests an overall low level of compliance with ADA guidelines by general dentists in Los Angeles. For patients with hypertension, 44% indicated they establish baseline blood pressure, 55% monitor blood pressure periodically but 69% reported modifying the amount of Epinephrine used in local anesthesia. For patients diagnosed with diabetes, 51% indicated that they assess glycemic control, 57% prescribe antibiotics for surgeries, and 49% monitor for oral manifestations such as oral candidiasis. More recent graduates were more likely to comply with treatment guidelines for both hypertensive patients (p= 0.01) and diabetic patients (p<0.001). Dentists who participated in postdoctoral training are positively associated with higher levels of compliance.
Conclusions: Educational measures utilizing an evidence-based approach are needed to improve dental providers’ compliance with the nationally accepted standards for management of the medically complex patients.
Methods: 202 general dentists in Los Angeles completed telephone or on paper surveys. The questionnaire included 9 Likert scale questions (5-point response scale with 1 being highly unlikely and 5 being highly likely) exploring the level of compliance with specific dental management protocols. Bivariate analysis and Logistic regression models were performed to evaluate the association between compliance and participant’s gender, year of graduation from dental school and participation in General Practice Residency (GPR) or Advanced Education in General Dentistry (AEGD).
Results: Data suggests an overall low level of compliance with ADA guidelines by general dentists in Los Angeles. For patients with hypertension, 44% indicated they establish baseline blood pressure, 55% monitor blood pressure periodically but 69% reported modifying the amount of Epinephrine used in local anesthesia. For patients diagnosed with diabetes, 51% indicated that they assess glycemic control, 57% prescribe antibiotics for surgeries, and 49% monitor for oral manifestations such as oral candidiasis. More recent graduates were more likely to comply with treatment guidelines for both hypertensive patients (p= 0.01) and diabetic patients (p<0.001). Dentists who participated in postdoctoral training are positively associated with higher levels of compliance.
Conclusions: Educational measures utilizing an evidence-based approach are needed to improve dental providers’ compliance with the nationally accepted standards for management of the medically complex patients.