[Dental health and dental care according diabetic status; results from 2008 ESPS study]

Abstract

Background: Poorly controlled diabetes leads to serious complications including periodontal disease, oral disease leading to tooth loss. Diabetics benefit from care facilitated follow-up. Social inequalities are observed in oral health and diabetes. The objective of this study was to estimate the effect of the social factors on oral health and use of dental care for people with diabetes from the Health and Social Protection Survey 2008 (ESPS) and to compare it with that observed among non-diabetic people.

Methods: The ESPS is a representative survey of the French population. In 2008, data were derived from a self-administered health questionnaire given to all household members aged 16 or older. The scope of this study was restricted to persons aged 35 and over (12.082) having filled out their health survey (8961). Diabetes was defined from self-reports of disease or use of anti-diabetic medication. Oral health was estimated from perceived oral health and the number of missing teeth not replaced. Use of dental care was measured by self-report of a visit within the last two years. Socio-demographic and social coverage indicators were collected.

Results: The participation rate was 74.1% and prevalence of diabetes was 7.2% (648). People with diabetes had a poorer dental status (42.7% vs 26.5% - OR=1.22, 95% CI [1.01-1.47]), related to social characteristics. The effect of level of precariousness on dental health was equivalent in diabetic and non-diabetic populations. The use of dental care (73.4% of participants) was associated with social factors. Diabetics were less likely to consult dentists than non-diabetics (61.5% vs 74.4%), but this difference was not statistically significant (OR=0.86, 95%CI [0.72-1.04]). The effect of the level of precariousness on use of dental care was the same in both populations.

Conclusion: This study raises the question of the impact of recommendations on monitoring dental health among diabetics especially for vulnerable populations despite better management and coverage.

Keywords: Dental care; Diabetes mellitus; Diabète; Déterminants sociaux; Oral health; Recours aux soins; Santé orale; Socio-economic factors.