Oral health behaviors in medical patients with diabetes mellitus.

Purpose: Periodontal disease is common among patients with noninsulin dependent diabetes mellitus (NIDDM) and insulin dependent diabetes mellitus (IDDM) and interferes with diabetic control. However, no study has examined predictors of oral health behavior among patients with diabetes in a medical setting. This study describes self-reported oral hygiene among primary care patients with IDDM and NIDDM, evaluating age, race, gender, psychosocial stress, family dysfunction, and other health predictors of preventive oral behaviors.

Methods: A written survey of oral health behaviors, psychological stress, and family function was conducted among 390 out of 473 possible primary care dentate patients with diabetes (IDDM=81; NIDDM=309). Fasting blood sugar and hemoglobin A1C also were obtained. Data were collected between January 1989 and June 1991, and analyzed using Mantel-Haenszel's chi-square and logistic regression.

Results: Patients with IDDM with severe family dysfunction were less likely to brush, floss, or visit a dentist regularly than those with better reported family function. Whites with NIDDM were more likely to practice these oral health behaviors than were blacks. Female gender correlated with flossing in the group of patients with IDDM, and with brushing in both groups. Patients with NIDDM who exercised were also more likely to visit the dentist annually. Age was positively associated with a history of periodontal disease in the group with IDDM.

Conclusions: These data document for the first time the relationship between family dysfunction and oral health practices of patients with IDDM, and corroborate the known associations among white race, female gender, and oral hygiene. This information could be used to coordinate diabetic oral health promotion between primary care physicians and oral health professionals.