Kaiser Permanente, Division of Research, 2000 Broadway, Oakland, CA 94612, USA.
Prev Chronic Dis. 2010 May;7(3):A57. Epub 2010 Apr 15.
People with diabetes are at increased risk of periodontal disease and tooth loss. Healthy People 2010 set a goal that 71% or more of people with diabetes should have an annual dental exam.
We assessed dental insurance and annual dental visits among dentate respondents from the Diabetes Study of Northern California (DISTANCE) Survey cohort (N = 20,188), an ethnically stratified, random sample of patients with diabetes aged 30 to 75 years receiving medical care from Kaiser Permanente Northern California. We calculated predicted probabilities for an annual dental visit (PPADV) by using regression models that incorporated age, sex, education level, annual household income, and self-reported race/ethnicity, stratified by whether the respondent had dental insurance.
Among 12,405 dentate patients, 9,257 (75%) had dental insurance. Annual dental visits were reported by 7,557 (82%) patients with dental insurance and 1,935 (61%) patients without dental insurance. The age-sex adjusted odds ratio for an annual dental visit was 2.66 (95% confidence interval, 2.33-3.03) for patients with dental insurance compared to those without dental insurance. For patients with dental insurance, the PPADV was 71% or more for all except those with the lowest household income. In contrast, for those without dental insurance, the PPADV was less than 71% for all except those with the most education or the highest income. We found some racial/ethnic subgroups were more likely than others to take advantage of dental insurance to have an annual dental visit.
Patients with diabetes in this managed care population who lacked dental insurance failed to meet the Healthy People 2010 goal for an annual dental visit. An increased effort should be made to promote oral health among people with diabetes.
糖尿病患者罹患牙周病和牙齿脱落的风险增加。“健康人民 2010”计划设定的目标是，71%或以上的糖尿病患者应每年进行一次牙科检查。
我们评估了北加利福尼亚糖尿病研究（DISTANCE）调查队列（N=20188）中已拔牙患者的牙科保险和每年牙科就诊情况。该队列是一个从 Kaiser Permanente 北加利福尼亚接受医疗服务的年龄在 30 岁至 75 岁的糖尿病患者中抽取的、种族分层的随机样本。我们通过回归模型计算了每年进行一次牙科就诊的预测概率（PPADV），模型中包含年龄、性别、教育水平、家庭年收入和自我报告的种族/民族信息，并根据患者是否有牙科保险进行分层。
在 12405 名已拔牙患者中，9257 名（75%）有牙科保险。有牙科保险的患者中，7557 名（82%）进行了每年一次的牙科就诊，而无牙科保险的患者中，1935 名（61%）进行了每年一次的牙科就诊。与无牙科保险的患者相比，有牙科保险的患者每年进行一次牙科就诊的年龄-性别校正比值比为 2.66（95%可信区间，2.33-3.03）。对于有牙科保险的患者，除了收入最低的患者外，所有患者的 PPADV 都在 71%或以上。相比之下，对于没有牙科保险的患者，除了受教育程度最高或收入最高的患者外，所有患者的 PPADV 都低于 71%。我们发现，一些种族/民族亚组比其他亚组更有可能利用牙科保险进行每年一次的牙科就诊。
在这个管理式医疗人群中，没有牙科保险的糖尿病患者未能达到“健康人民 2010”计划中每年进行一次牙科检查的目标。应加大力度促进糖尿病患者的口腔健康。
