Paquette David W, Bell Kathryn P, Phillips Ceib, Offenbacher Steven, Wilder Rebecca S
Dr. Paquette is Professor and Associate Dean for Education, Stony Brook University School of Dental Medicine; Prof. Bell is Assistant Professor, Pacific University School of Dental Health Science; Dr. Phillips is Professor, Department of Orthodontics and Assistant Dean for Advanced Education/Graduate Programs, University of North Carolina at Chapel Hill School of Dentistry; Dr. Offenbacher is W.R. Kenan Jr. Distinguished Professor, Chair of the Department of Periodontology, and Director of the Center for Oral and Systemic Diseases, North Carolina Oral Health Institute, University of North Carolina at Chapel Hill School of Dentistry; and Prof. Wilder is Professor in the Department of Dental Ecology, Director of Graduate Dental Hygiene Education, and Director of Faculty Development, University of North Carolina at Chapel Hill School of Dentistry.
J Dent Educ. 2015 Jun;79(6):626-35.
Population studies consistently support associations between poor oral (periodontal) health and systemic diseases such as cardiovascular disease (CVD) and diabetes. The aim of this study was to assess the knowledge of dentists and document their opinions regarding the evidence on oral-systemic disease relationships. A survey consisting of 39 items was developed and mailed to 1,350 licensed dentists in North Carolina. After three mailings, 667 dentists (49%) meeting inclusion criteria responded. The respondents were predominantly male (76.3%), in solo practice (59.5%), and in non-rural settings (74%). More than 75% of these dentists correctly identified risk factors like diet, genetics, smoking, obesity, and physical inactivity for CVD and diabetes. The majority rated the evidence linking periodontal disease with CVD and diabetes as strong (71% and 67%, respectively). These dentists were most comfortable inquiring about patients' tobacco habits (93%), treating patients with diabetes (89%) or CVD (84%) and concurrent periodontal disease, and discussing diabetes-periodontal disease risks with patients (88%). Fewer respondents were comfortable asking patients about alcohol consumption (54%) or providing alcohol counseling (49%). Most agreed that dentists should be trained to identify risk factors (96%) or actively manage systemically diseased patients (74%). Over 90% agreed that medical and dental professionals should be taught to practice more collaboratively. These data indicate that these dentists were knowledgeable about oral-systemic health associations, had mixed comfort levels translating the evidence into clinical practice, but expressed support for interprofessional education to improve their readiness to actively participate in their patients' overall health management.
人群研究一直支持不良口腔（牙周）健康与心血管疾病（CVD）和糖尿病等全身性疾病之间的关联。本研究的目的是评估牙医的知识水平，并记录他们对口腔 - 全身疾病关系证据的看法。一项包含39个条目的调查问卷被制定出来，并邮寄给北卡罗来纳州1350名持牌牙医。经过三次邮寄后，667名符合纳入标准的牙医（49%）做出了回应。受访者主要为男性（76.3%），从事单人执业（59.5%），且在非农村地区工作（74%）。超过75%的这些牙医正确识别出饮食、遗传、吸烟、肥胖和缺乏体育锻炼等CVD和糖尿病的风险因素。大多数人将牙周病与CVD和糖尿病之间的证据评为强有力的（分别为71%和67%）。这些牙医在询问患者的吸烟习惯（93%）、治疗患有糖尿病（89%）或CVD（84%）以及并发牙周病的患者，以及与患者讨论糖尿病 - 牙周病风险（88%）方面最为得心应手。较少的受访者在询问患者饮酒情况（54%）或提供酒精咨询（49%）时感到自在。大多数人同意牙医应该接受培训以识别风险因素（96%）或积极管理患有全身性疾病的患者（74%）。超过90%的人同意应该教导医学和牙科专业人员进行更多的协作。这些数据表明，这些牙医了解口腔 - 全身健康关联，在将证据转化为临床实践方面的自在程度不一，但表示支持跨专业教育，以提高他们积极参与患者整体健康管理的准备程度。
