IADR Abstract Archives
Implementation of oral care in the Dutch primary diabetes care system
Objectives: International guidelines promote the implementation of oral care in diabetes care, but in the Netherlands, this is far from optimal so far. A considerable number of diabetes patients probably do not visit the dentist frequently. We aimed to investigate if structured implementation of oral care in Dutch primary diabetes care can motivate the patients to regularly visit the dentist and subsequently improve their oral health related quality of life (OHRQoL).
Methods: In this cluster randomized controlled trial, 24 general practitioner (GP) offices are participating (12 experimental [Exp], 12 control [Ctrl]). Within the experimental GP offices, oral care was implemented by: 1) giving information about the importance of oral health, 2) motivating the patient to visit the dentist, 3) providing an oral hygiene introduction kit (SUNSTAR Suisse S.A.). The 12 control GP offices provided their usual diabetes care. At baseline and one year later, OHRQoL (OHIP-14) was measured for both groups. Difference scores for the OHIP-14 dimensions were calculated, and inter-group differences were analyzed using Mann-Whitney U tests.
Results: A total of 770 diabetes patients were included. To date, 54.5% have completed follow-up (190 Exp, 230 Ctrl; 40.4% still in process; 5.1% dropout). In the Exp-group, 99% of the patients visited the dentist, compared to 76% in the Ctrl-group (p<0.001). After one year follow-up, the Exp-group showed more improvement in total OHIP-14 score (Mean Difference Exp [MDExp]: -0.87±3.81), compared to the Ctrl-group (MDCtrl: -0.25±3.95; p=0.057). Sub-analysis showed that, in particular, the OHIP-14 dimension handicap significantly improved in the Exp-group, but not in the Ctrl-group (MDExp: -0.06±0.34; MDCtrl: 0.02±0.32; p=0.042).
Conclusions: Adding a strict oral care protocol to primary diabetes care increased dentist visit frequency and improved OHRQoL in diabetes patients. Therefore, implementation of oral care in diabetes care is recommended.
Methods: In this cluster randomized controlled trial, 24 general practitioner (GP) offices are participating (12 experimental [Exp], 12 control [Ctrl]). Within the experimental GP offices, oral care was implemented by: 1) giving information about the importance of oral health, 2) motivating the patient to visit the dentist, 3) providing an oral hygiene introduction kit (SUNSTAR Suisse S.A.). The 12 control GP offices provided their usual diabetes care. At baseline and one year later, OHRQoL (OHIP-14) was measured for both groups. Difference scores for the OHIP-14 dimensions were calculated, and inter-group differences were analyzed using Mann-Whitney U tests.
Results: A total of 770 diabetes patients were included. To date, 54.5% have completed follow-up (190 Exp, 230 Ctrl; 40.4% still in process; 5.1% dropout). In the Exp-group, 99% of the patients visited the dentist, compared to 76% in the Ctrl-group (p<0.001). After one year follow-up, the Exp-group showed more improvement in total OHIP-14 score (Mean Difference Exp [MDExp]: -0.87±3.81), compared to the Ctrl-group (MDCtrl: -0.25±3.95; p=0.057). Sub-analysis showed that, in particular, the OHIP-14 dimension handicap significantly improved in the Exp-group, but not in the Ctrl-group (MDExp: -0.06±0.34; MDCtrl: 0.02±0.32; p=0.042).
Conclusions: Adding a strict oral care protocol to primary diabetes care increased dentist visit frequency and improved OHRQoL in diabetes patients. Therefore, implementation of oral care in diabetes care is recommended.