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Table of Contents
ORIGINAL ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 3  |  Page : 14-16

Awareness and attitude of medical professionals toward periodontitis in diabetes mellitus patients: A questionnaire study


1 Postgraduate Student, Department of Periodontology, Mansarovar Dental College, Bhopal, Madhya Pradesh, India
2 Reader, Department of Periodontology, Mansarovar Dental College, Bhopal, Madhya Pradesh, India
3 Professor and HOD, Department of Periodontology, Mansarovar Dental College, Bhopal, Madhya Pradesh, India
4 Senior Lecturer, Department of Periodontology, Mansarovar Dental College, Bhopal, Madhya Pradesh, India

Date of Web Publication30-Jan-2019

Correspondence Address:
Dr. Richa Agrawal
Department of Periodontology, Mansarovar Dental College, Kolar Road, Bhopal - 462 042, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INPC.INPC_10_18

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  Abstract 


Introduction: There is developing evidence to support the two-way relationship between diabetes and periodontitis (PD), with diabetes increasing the threat for PD and periodontal inflammation negatively affecting glycemic control.
Aim: The objective of this survey was to investigate the dental knowledge of medical doctors regarding PD being a complication of diabetes mellitus and their attitude toward timely referral of such patients to a dental practitioner.
Materials and Methods: A questionnaire survey was carried out among medical physicians in all the medical colleges of Bhopal. The questionnaire included 16 questions, and the filled questionnaire was immediately collected and analyzed through SPSS software version 16 and Pearson's correlation test.
Results: The present study found that medical practitioners in Bhopal hold a certain awareness about oral health, and that there is an association between periodontal health and diabetes; nevertheless, majority do not sustain the awareness of the nexus between the two.
Conclusion: Educational programs can be included in medical and dental curricula to upsurge interprofessional education to enhance care for patients with diabetes and address their treatment needs.

Keywords: Attitude, awarness, diabetes mellitus, medical professionals, periodontitis


How to cite this article:
Peter S, Agrawal R, Khashu H, Yada S, Chouksey A, Tiwari M. Awareness and attitude of medical professionals toward periodontitis in diabetes mellitus patients: A questionnaire study. Int J Prev Clin Dent Res 2018;5:14-6

How to cite this URL:
Peter S, Agrawal R, Khashu H, Yada S, Chouksey A, Tiwari M. Awareness and attitude of medical professionals toward periodontitis in diabetes mellitus patients: A questionnaire study. Int J Prev Clin Dent Res [serial online] 2018 [cited 2019 Dec 6];5:14-6. Available from: http://www.ijpcdr.org/text.asp?2018/5/3/14/251047




  Introduction Top


The oral cavity is defined as the mirror of the body.[1] Periodontal disease is one of the most prevalent multifactorial diseases that occurs in tissue surrounding teeth in response to bacterial accumulation or dental plaque on teeth.[2] Bacterial accumulation indicates an inflammatory reaction from the body. Literature evidence have proved a link between periodontitis (PD) and systemic disease.[3] Diabetes mellitus (DM), a systemic disease, has been indisputably confirmed as a major risk factor for PD. Awareness along with knowledge regarding the management of both these facets of disease assumes dominant importance for effective treatment.[1]

Many medical doctors are less acquainted with the oral cavity and oral diseases bearing systemic origin.[4] Therefore, creating awareness of the importance of the interrelationship between systemic and oral diseases among medical doctors is the need of the hour.[5] The objective of this survey was to investigate the dental knowledge of medical doctors regarding PD, being a complication of DM, and their attitude toward oral health treatment aspects and timely referral to dentist.


  Materials and Methods Top


A questionnaire survey was carried out among 210 medical physicians in all the medical colleges of Bhopal. In total, 75 postgraduates and 121 undergraduates responded (n = 196) to the questionnaire given. The questionnaire included 16 specially designed questions, which was distributed by the investigator and was verbally communicated that responses would remain confidential. The filled questionnaire was immediately collected and analyzed through SPSS software version 16 (SPSS Inc., Chicago, IL, USA) for Pearson's correlation test.


  Results Top


The data thus collected were compiled, analyzed, and interpreted. Results were expressed in terms of graphs and proportions by using Pearson's correlation test with P < 0.05. In total, 210 medical physicians participated and among them 196 responses were received (93% response rate). The demographic data for the medical doctors are shown in [Table 1].
Table 1: Demographic data with percentage distribution of the 196 medical doctors who responded to the questionnaire

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Of the 196 study participants, 128 (65%) doctors reported that there is an interrelationship between DM and PD, whereas 68 (34%) of them reported that there is no interrelationship between DM and PD [Graph 1].



There was a statistically significant relationship between the qualification and the awareness of relationship between DM and periodontal disease (P < 0.05). Furthermore, there was a statistically significant relationship between the qualification, age of practitioners, and awareness of knowing PD being the 6th complication of DM (P < 0.05).


  Discussion Top


The mouth is the major way of entry to the body and is fitted with challenging mechanisms for detecting the environment and fighting back against invading pathogens.[2] Poor oral conditions may undesirably affect general health and certain medical conditions may have an adverse impact on oral health.[6] PD, an infection in the oral cavity, has been termed the “sixth complication of diabetes.”[7] Diabetes has been indisputably confirmed as a major risk factor for PD.[8],[9],[10] The risk of PD is increased about threefold in diabetic individuals compared with nondiabetic individuals.[11] The referral rate (81%) in the present study may be considered significantly higher when compared with the findings of Owens et al.,[12] with rates of 48%. Many studies have demonstrated that periodontal treatment may improve glycemic control.[13],[14],[15] In the present study, 84.6% (n = 166) of the respondents were unaware of the fact that treating PD may reduce the blood glucose level in DM patients and their awareness about the need to increase the dental visits of poorly controlled diabetic patients was very less, about 60% disapproving the relative need.

Hence, our results underscore the need for endorsing collaboration between dental and medical doctors while treating diabetic patients for better treatment outcome. For this purpose, a better learning program of education about the relationship between PD and DM and other systemic-related diseases during undergraduate and postgraduate education and training should be made mandatory. In the presence of systemic diseases/conditions such as DM which are related to inflammation, the relationship between PD and systemic health should not be overlooked by medical doctors. Patients could be treated better in a multidisciplinary fashion by consulting both medical and dental practitioners.


  Conclusion Top


With this study, one can conclude that physicians in Bhopal have some knowledge about oral health and they acknowledge that there is a link between periodontal disease and diabetes; however, most of them are unaware that treating PD reduces glucose level in diabetic patients. It may be the right time for executing symposiums in medical and dental curricula to increase interprofessional education and collaborating physicians and dental surgeons to give enhanced care to patients with DM for better treatment outcomes.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Chitta H, Chaitanya NC, Lavanya R, Reddy MP, Imran, Subramanyam. Awareness of medical doctors on oral health: A cross sectional study. Oral Health Dent Manage 2015;14:6.  Back to cited text no. 1
    
2.
NIDCR. Available from:http://www.nidcr.nih.gov/oralhealth. [Last accessed on 2018 Oct 30].  Back to cited text no. 2
    
3.
Watt RG. Strategies and approaches in oral disease prevention and health promotion. Bull World Health Organ 2005;83:711-8.  Back to cited text no. 3
    
4.
Kim J, Amar S. Periodontal disease and systemic conditions: A bidirectional relationship. Odontology 2006;94:10-21.  Back to cited text no. 4
    
5.
Paquette DW. The periodontal infection-systemic disease link: A review of the truth or myth. J Int Acad Periodontol 2002;4:101-9.  Back to cited text no. 5
    
6.
Radha G, Shaik Hyder Ali KH, Pushpanjali K. Knowledge and attitude and practice of oral health among nursing staff and nursing students of Bangalore city. J Indian Assoc Public Health Dent 2008;11:17-21.  Back to cited text no. 6
    
7.
Hendricson WD, Cohen PA. Oral health care in the 21st century: Implications for dental and medical education. Acad Med 2001;76:1181-206.  Back to cited text no. 7
    
8.
Salvi GE, Carollo-Bittel B, Lang NP. Effects of diabetes mellitus on periodontal and peri-implant conditions: Update on associations and risks. J Clin Periodontol 2008;35:398-409.  Back to cited text no. 8
    
9.
Chávarry NG, Vettore MV, Sansone C, Sheiham A. The relationship between diabetes mellitus and destructive periodontal disease: A meta-analysis. Oral Health Prev Dent 2009;7:107-27.  Back to cited text no. 9
    
10.
Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics: A meta-analysis. J Diabetes Complications 2006;20:59-68.  Back to cited text no. 10
    
11.
Mealey BL, Ocampo GL. Diabetes mellitus and periodontal disease. Periodontol 2000 2007;44:127-53.  Back to cited text no. 11
    
12.
Owens JB, Wilder RS, Southerland JH, Buse JB, Malone RM. North Carolina internists' and endocrinologists' knowledge, opinions, and behaviors regarding periodontal disease and diabetes: Need and opportunity for interprofessional education. J Dent Educ 2011;75:329-38.  Back to cited text no. 12
    
13.
Katagiri S, Nitta H, Nagasawa T, Uchimura I, Izumiyama H, Inagaki K, et al. Multi-center intervention study on glycohemoglobin (HbA1c) and serum, high-sensitivity CRP (hs-CRP) after local anti-infectious periodontal treatment in type 2 diabetic patients with periodontal disease. Diabetes Res Clin Pract 2009;83:308-15.  Back to cited text no. 13
    
14.
Kiran M, Arpak N, Unsal E, Erdoğan MF. The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol 2005;32:266-72.  Back to cited text no. 14
    
15.
Promsudthi A, Pimapansri S, Deerochanawong C, Kanchanavasita W. The effect of periodontal therapy on uncontrolled type 2 diabetes mellitus in older subjects. Oral Dis 2005;11:293-8.  Back to cited text no. 15
    



 
 
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