Simon Lisa E, Karhade Deepti Shroff, Tobey Matthew L
Harvard School of Dental Medicine, Boston, MA.
Harvard Medical School, Boston, MA.
Diabetes Spectr. 2020 Feb;33(1):58-65. doi: 10.2337/ds18-0089.
Diabetes is associated with poor oral health, as well as reduced access to dental care. A large percentage of patients hospitalized in the United States carry a diagnosis of diabetes; however, the oral health status of patients with diabetes who are hospitalized is unknown.
All patients meeting inclusion criteria on the general medicine service of a tertiary care hospital were invited to participate. Subjects were asked about their access to dental care and perceptions of their oral health. A dental hygienist conducted examinations, including decayed, missing, and filled teeth (DMFT) and periodontal screening and recording (PSR) indices on a subset of subjects.
The 105 subjects had a mean age of 69 ± 12 years and a median A1C of 7.5 ± 2.1%. Rates of comorbidity and polypharmacy were high. The mean number of DMFT was 23.0 ± 7.2, with 10.1 ± 7.2 missing teeth. Forty- four percent of subjects had a removable prosthesis. Sixty-eight percent had a PSR index ≥4 in at least one sextant, indicating moderate periodontal disease.
Rates of missing teeth, removable prostheses, and periodonal inflammation were high among hospitalized patients with diabetes, but patients did not perceive their oral health to be poor. Health care providers should be aware of the oral health risks of patients with diabetes during hospitalization, and dentists should consider screening patients with diabetes for recent hospitalization.
糖尿病与口腔健康状况不佳以及获得牙科护理的机会减少有关。在美国,很大一部分住院患者被诊断患有糖尿病;然而,住院糖尿病患者的口腔健康状况尚不清楚。
邀请一家三级护理医院普通内科服务中所有符合纳入标准的患者参与。询问受试者获得牙科护理的情况以及他们对自身口腔健康的看法。一名牙科保健员对一部分受试者进行了检查,包括龋失补牙数(DMFT)和牙周筛查与记录(PSR)指数。
105名受试者的平均年龄为69±12岁,糖化血红蛋白(A1C)中位数为7.5±2.1%。合并症和多种药物治疗的发生率很高。DMFT的平均数为23.0±7.2,其中缺失牙数为10.1±7.2。44%的受试者佩戴可摘义齿。68%的受试者至少有一个牙象限的PSR指数≥4,表明患有中度牙周疾病。
住院糖尿病患者的缺牙率、可摘义齿佩戴率和牙周炎症发生率很高,但患者并不认为自己的口腔健康状况差。医疗保健提供者在患者住院期间应意识到糖尿病患者的口腔健康风险,牙医应考虑对近期住院的糖尿病患者进行筛查。