Oral Health Education in Patients with Diabetes: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Search Strategy
2.3. Selection Criteria
2.4. Selection of Studies
2.5. Quality Assessment and Risk of Bias
3. Results
3.1. Two-Way Relationship between Type 2 Diabetes and Periodontitis
3.2. Saliva, a Promising Biomarker Linking Oral Health to General Health
3.3. Dental Mortality—The Role of Telemedicine
3.4. Recent Methods for Controlling Periodontitis and DM2
3.5. Importance of Oral Health Education in Patients with Diabetes
Authors/Year/References | Country | Type of Study | Sample Size | Health Results/p-Value |
---|---|---|---|---|
Karki A et al., 2023 [1] | Australia | Meta-analysis | N = 45 studies (8336 patients) | Behavior interventions in patients with DM2 for better quality of life in LMIC; p1 = 0.001, p2 = 0.060, and p3 = 0.249. |
Valentim FB et al., 2021 [2] | Germany | Cross-sectional clinical study | N = 288 DM2 patients | DM2 patients’ low-level oral health and knowledge about periodontitis/diabetes relationship. Importance of integrated healthcare in this association; p1 < 0.005 and p2 < 0.05. |
Wu CZ et al., 2020 [3] | West China | Meta-analysis | N = 53 studies | Bidirectional relationship between periodontitis and DM2. Severe perio-, p = 0.000; mild perio-, p = 0.007. |
Ahmadinia R et al., 2022 [5] | Iran | Meta-analysis | N = 22 studies | Association between DM2 and tooth loss, p < 0.001. |
Botelho J et al., 2019 [4] | Portugal | Cross-sectional clinical study | N = 1.064 adults | Prevalence of periodontitis/DM2 as a risk factor for periodontitis; p < 0.001. |
Mattos MCO et al., 2019 [7] | Brazil | Meta-analysis | N = 15 studies (3894 patients) | Common inflammation biomarkers in saliva and plasma in patients with DM2 and periodontitis; p1 = 0.003 (IL-10) and p2 < 0.001 (IL-4). |
Rapone B et al., 2021 [9] | Italy | Randomized controlled trial | N = 187 DM2 patients | Short-term glycemic control level and systemic inflammatory status, after non-surgical periodontal therapy in patients with diabetes and periodontitis; p1 = 0.012 and p2 = 0 (6 months). |
Rapone B et al., 2020 [10] | Italy | Meta-analysis | N = 10 RCTs, each with 32 to 182 diabetic patients | Common denominator is periodontal inflammation in patients with DM2 and children and adolescents with DM1. But no results have yet emerged of a causal effect of periodontal inflammation on DM1; p < 0.001 and SMD = 0.36. |
Yu YH et al., 2022 [36] | USA | Meta-analysis | N1 = 506,594 (periodontitis) N2 = 426,824 (DM2) | Association of periodontal disease and systemic comorbidities and bone mineral density; p = 0.007–0.005. |
Derruau S et al., 2020 [11] | France | Meta-analysis | N = 2082, 3 oral and 7 general diseases were examined | Use of saliva for the diagnosis of oral and systemic diseases; p < 0.05. |
Ansari Moghadam S, et al., 2024 [12] | Finland | Cross-sectional clinical study | N = 175 > 65 years | Salivary defensins HNP-1 and hBDs are less effective in the elderly against Gram-negative anaerobic pathogenic microorganisms, which are mainly responsible for periodontal infection, but also against positive bacteria; p = 0.019. |
Poudel P et al., 2024 [13] | Australia | Meta-analysis | N = 62 studies | There is a gap in information and research around effective oral health care treatments and programs in geriatric dental care and a lack of policies and guidelines to assist both dental and medical health care professionals in integrating good oral health as part of healthy aging; p < 0.05. |
Joseph P et al., 2023 [14] | Germany | Meta-analysis | N = 44 studies (3382 patients) | Non-surgical periodontal therapy is an effective procedure for managing periodontitis in patients with systemic diseases; p < 0.05. |
Josy G et al., 2019 [16] | Australia | Prospective population-based study | N = 172,630 >45 years | Tooth loss and, to a lesser extent, self-rated health of teeth and gums are markers for increased risk of ischemic stroke, peripheral vascular disease, and all-cause mortality. Tooth loss is also a marker for increased risk of heart failure; ptrend < 0.05. |
Rauda Al et al., 2024 [37] | UAE | Meta-analysis | N = 9 studies | Reduction of obesity through individualized health and wellness programs. Association with chronic diseases. |
Wernicke K et al., 2021 [17] | Germany | Randomized controlled trial | N = 108 DM2 patients | Physical activity is an oral health-promoting measure in patients with DM2 and physical activity significantly reduces HbA1c concentrations; p1 = 0.005 (BOP) and p2 = 0.010 (HbA1c). |
Brinar S et al., 2023 [18] | Slovenia | Randomized controlled trial | N = 24 patients with DM2 and periodontitis | Antimicrobial photodynamic therapy (aPDT) by diode laser is an effective adjunct to standard non-surgical periodontal therapy, contributing to the control of periodontal inflammation; p < 0.05. |
Yap KCH et al., 2019 [19] | Malaysia | Meta-analysis | N = 6 studies | Systemic doxycycline as an adjunct to scaling and root planing does not significantly improve CAL for periodontal status or reduction of HbA1c levels in the treatment of diabetic patients with periodontitis; p < 0.05. |
Cao R. et al., 2019 [20] | China | Meta-analysis | N = 14 RCTs, 629 patients | NSPT treatment with aPDT + Doxy has the best efficacy in periodontal treatment and lowering HbA1c% of non-smoking CP without severe DM2 complications. Further studies are needed to confirm the results. |
Rapone B.et al., 2023 [22] | Italy | Randomized controlled trial | N = 100 patients with DM2 and periodontitis | Gaseous ozone therapy as supporting treatment for periodontitis in patients with DM2 has beneficial effect on HbA1c. Larger studies are needed to confirm the results; p1 = 0.007 and p2 = 0.001. |
Patterson-Norrie T, et al., 2024 [23] | Australia | National Survey clinical research | N = 149 dieticians | Dietary needs in specific groups and vulnerable populations, such as patients with chronic diseases, in relation to screening and referral for treatment to promote oral and general health; p = 0.001–0.028. |
Altun E et al., 2021 [24] | Germany | Cross-sectional clinical study | N = 6209 patients with severe and none/mild periodontitis | Association between diet habits and initiation/progression of periodontitis; p < 0.001. |
Amuasi AA et al., 2024 [25] | Ghana | Cross-sectional clinical study | N = 121 participants from two Special Schools | Poor oral health in children with special needs, decays and gums bleeding/DMFT value of 2.82. |
Mohseni Homagarani Y, et al., 2023 [27] | Iran | Meta-analysis | N = 11 studies, each with 88 to 350 diabetic patients | Oral health has an essential role in diabetic patients’ quality of life; SMD = 0.148. |
Hsu YJ et al., 2021 [28] | Taiwan | Randomized controlled trial | N = 76 (n1 = 39, n2 = 37) | NSPT periodontal therapy with the Community Health Workers (CHW) strategy improved short-term clinical treatment outcomes (PPD and CAL), reduced HbA1c high levels, and exerted a positive effect on long-term OHQoL in DM2 patients; p < 0.05. |
Hartono V et al., 2024 [29] | Indonesia | Randomized controlled trial | N = 40 patients with periodontitis | Implementation of interventions based on telemedicine can improve the cognitive and clinical data of patients with periodontal disease; p < 0.05. |
Hargraves VM, et al., 2024 [31] | USA | Qualitative clinical research | N = 44 patients (n1 = 21, n2 = 23) | Access to oral health care is limited for patients residing in assisted living facilities. There is a need to inform policymakers and advocates about access to oral health care as they develop new approaches. |
Hernández-Vásquez A, et al., 2020 [32] | Peru | Cross-sectional clinical study | N = 41,330 children age (1–11 years) | Need to increase use of oral health services in rural settings in order to reduce existing rural–urban inequalities and access to information on adequate oral hygiene practices; p < 0.001. |
Yanagita T et al., 2023 [34] | Japan | Survey research clinical study | N = 28 universities | Results from universities that conducted ‘‘pharmacology role-play’’. Pharmacology role-play is effective in (1) understanding medical treatment; (2) understanding patients’ feelings; (3) improvement of mental attitude and motivation as health professionals; (4) positive influence on study attitude. |
Hayashi T et al., 2022 [35] | Japan | Survey research clinical study | N1 = 176 hospitals with dental care, N2 = 321 hospitals cooperating with dentists | Society requires the involvement of dental hygienists in the field of palliative care to provide good oral care to patients with terminal illnesses and contribute to improving their quality of life. |
Chou Κ. et al., 2019 [19] | Malaysia | Meta-analysis | N = 6 RCTs, each with 15 to 35 diabetic patients | Systemic doxycycline as an adjunct to scaling and root planing does not significantly improve CAL for periodontal status or reduction of HbA1c levels in patients with diabetes; SMD = 0.13. |
Cai Y et al., 2024 [38] | South China | Cross-sectional clinical study | N = 678 college students | College students neglect oral hygiene and have limited understanding of their own oral issues. Considering the current poor oral health status observed in other age groups, such as children and older adults, it is strongly recommended to promote oral health education and provide guidance to all populations; p < 0.001 (to 8 factors). |
Qureshi A et al., 2021 [21] | Ojha University Campus, Karachi, Pakistan | Randomized controlled trial | N = 150 DM2 patients with moderate and severe periodontitis | NSPT with and without metronidazole is significantly efficacious, not only for reducing periodontitis but also for glycemic control in DM2 patients with periodontitis suffering from higher levels of HbA1c at baseline; p1 < 0.020 (3 months) and p2 < 0.06 (6 months). |
Toda K et al., 2019 [39] | Tokyo, Japan | Preliminary clinical study | N = 21 DM2 patients | Interventions and behaviors of the diabetic patients, which with education and follow-up can prevent, slow down, and control DM2 and its unpleasant consequences; p < 0.0167. |
Shungin D et al., 2019 [40] | UK | Meta-analysis | N = 33 studies ~500,000 people | This investigation used detailed clinical measures in combination with genetically validated proxy phenotypes to investigate the two major dental diseases, caries and periodontitis; p < 0.05. |
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Share and Cite
Petropoulou, P.; Kalemikerakis, I.; Dokoutsidou, E.; Evangelou, E.; Konstantinidis, T.; Govina, O. Oral Health Education in Patients with Diabetes: A Systematic Review. Healthcare 2024, 12, 898. https://doi.org/10.3390/healthcare12090898
Petropoulou P, Kalemikerakis I, Dokoutsidou E, Evangelou E, Konstantinidis T, Govina O. Oral Health Education in Patients with Diabetes: A Systematic Review. Healthcare. 2024; 12(9):898. https://doi.org/10.3390/healthcare12090898
Chicago/Turabian StylePetropoulou, Pinelopi, Ioannis Kalemikerakis, Eleni Dokoutsidou, Eleni Evangelou, Theocharis Konstantinidis, and Ourania Govina. 2024. "Oral Health Education in Patients with Diabetes: A Systematic Review" Healthcare 12, no. 9: 898. https://doi.org/10.3390/healthcare12090898