Oral health problems among patients with type 2 diabetes attending UNRWA health centres in Gaza governorates: a cross-sectional study. (June 2022)

• Record Type: Journal Article
• Authors: Alqedra, Emad; Aljeesh, Yousef
• Is Part Of: Lancet. Volume 399(2022)Supplement 1
• Page Start: S20
• Publication Date: 2022-06
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(22)01155-2
• Languages: English
• ISSNs: 0140-6736

Abstract

Abstract: Background: Oral health is an essential component of general health. Oral diseases have a negative social impact and adverse consequences on quality of life, while their treatment places considerable economic burden on individuals, communities, and countries. As diabetes can have oral implications, this study aimed to assess oral health problems among patients with type 2 diabetes attending UNRWA health centres in Gaza governorates. Methods: This was an analytical cross-sectional study. 406 patients aged 35–65 years with type 2 diabetes (243 female, 163 male) were selected by systematic random sampling from five UNRWA health centres. WHO's basic methods tools (the standard oral health assessment form and WHO oral health questionnaire for adults) were used to collect data and assess oral health. Ethical and administrative approvals were obtained from the Helsinki Committee and Chief of the Department of Health, UNRWA Gaza, respectively. Findings: 136 (36%) of 374 participants with natural teeth never brushed their teeth and only 62 (17%) brushed their teeth twice or more per day. 219 (54%) of 406 participants had not experienced pain or discomfort associated with the teeth or mouth during the past 12 months. The mean decayed missing filled teeth (DMFT) score was 18·6. Only 61 (16·4%) of 374 participants had no gingival bleeding. The mean number of teeth showing gingival bleeding was 9·91 and showing no gingival bleeding was 9·79, and the mean number of teeth not present for the bleeding test was 9·14. Although nine (2%) of 374 participants had no periodontal pockets, the mean number of teeth with no pocket was 7·15, with a pocket of 4–5 mm was 7·84, with a pocket of 6 mm or more was 4·96, and that were not present for pocket measurement was 9·13. No treatment was needed for 34 (8%) of 406 participants, whereas prompt treatment (including scaling) was needed for 285 (70%) participants. The DMFT index was significantly associated with age, educational level, employment status, frequency of teeth brushing, duration of diabetes, and glycated haemoglobin (HbA 1c ) level. It was higher in male participants than in female participants, and in participants under the deep poverty line (as defined by the Palestinian Central Bureau of Statistics 2014). Gingival bleeding was significantly associated with sex (women were more likely to not have bleeding than were men) and frequency of tooth brushing, but there was no statistically significant association between gingival bleeding and periodontal pocket, sociodemographic factors, the HbA 1c level, or the duration of diabetes . Interpretation: Patients with type 2 diabetes have many oral health problems, and most are unaware of the oral implications of diabetes. A new UNRWA strategy for oral health should be devised to increase the awareness of patients and health providers about the oral implications of diabetes. In view of the low levels of awareness and personal dental care, similar studies should be conducted in the general population, in school students, and in high-risk groups, including pregnant women. Funding: None.