Factors associated with the practice of periodontal management by diabetes educator nurses for outpatients with diabetes: A nationwide survey in Japan

Feasibility of a nursing guide for the oral management of outpatients with diabetes mellitus

Support for nurses is necessary to enable them to practice the oral management of patients with diabetes; however, no support for nurses in this context has been reported. The objective of this study was to verify the feasibility of a nursing guide for the oral management of outpatients with type 2 diabetes, aimed at giving nurses the ability to independently practice oral management for patients with diabetes in an outpatient department. Questionnaires were administered to 25 certified diabetes educator nurses from 54 medical facilities. The evaluation and degree of understanding of the guide were assessed using items in the nursing guide. In addition, opinions and impressions about the guide in the form of free responses were requested. Descriptive statistics were calculated for all measured variables, and data gathered from the free responses were divided into categories based on their similarities and differences. The feasibility of the nursing guide was confirmed, and nurses confidently provided education regarding oral management to patients with diabetes using the guide. These results suggest that a guide may improve nurses' knowledge, skills, and confidence in providing patient education and improve the overall practice of oral management. Further improvements based on the opinions of nurses, such as the expression of terms, implementation of checklists for oral assessment, and identification of devices that can be utilized in a shorter time, are needed to facilitate the implementation of the guide into practice by nurses.

Oral symptoms and oral hygiene behaviors among patients with type 2 diabetes at a hospital in Japan: A Cross-Sectional Study

OBJECTIVES

Effective daily oral hygiene behavior will prevent periodontal disease. This study aimed to examine the oral symptoms, oral hygiene behaviors, and factors contributing to oral hygiene behaviors among patients with type 2 diabetes in a hospital in Japan.

METHODS

A cross-sectional survey was conducted with 198 patients with type 2 diabetes. Oral symptoms were assessed using a dichotomous scale based on clinical guidelines. Oral hygiene behaviors were assessed based on the frequency of daily tooth brushing and the use of interdental cleaning aids. Chi-square tests and logistic regression analyses were also performed.

RESULTS

Overall, 71.2% of the participants had oral symptoms. Of the participants, 80.3% performed twice daily tooth brushing and 61.1% did not perform interdental cleaning on a daily basis. Logistic regression analysis revealed that tooth brushing behavior was negatively associated with male patients (odds ratio [OR] = 0.45, 95% confidence interval [CI]: 0.25-0.80), difficulty with mastication (OR = 0.63, CI: 0.43-0.92), and tooth loss (OR = 0.68, CI: 0.46-1.00) and positively associated with periodontal disease (OR = 1.73, CI: 1.10-2.72). There were no significant variables related to the use of interdental cleaning aids.

CONCLUSIONS

Patients need to learn about the necessity for regular oral hygiene behaviors and the appropriate way. In particular, support for male patients, those who have difficulty with mastication, those who have experienced natural tooth loss, and those who have not been diagnosed with periodontal disease are needed.

Clinical Outcomes and Oral Health-Related Quality of Life after Periodontal Treatment with Community Health Worker Strategy in Patients with Type 2 Diabetes: A Randomized Controlled Study

Interventions engaging community health workers (CHW) for diabetes management aim to improve diabetes care and self-management behaviors among patients. We evaluated the effects of nonsurgical periodontal treatment (NSPT) with the CHW strategy on oral self-care behaviors, periodontal status and oral health-related quality of life (OHQoL) in patients with type 2 diabetes mellitus (T2DM). The participants were randomly assigned to experimental (EG; n = 35) and control (CG; n = 33) groups. All participants received NSPT, whereas the patients in the EG also received one-on-one 30 min lessons from a CHW over 4 weeks. The EG exhibited greater improvement in the probing pocket depth (β = −0.2, effect size [ES] = 0.61) and clinical attachment level (β = −0.2, ES = 0.59) at 1-month follow-up than the CG did. The ES increased over the 1-, 3- and 6-month follow-ups, indicating an increase in OHQoL (ES = 0.19, 0.60, and 0.62, respectively) in the EG. The patients in the EG were more likely to change their oral self-care behaviors than patients in the CG were. The NSPT with CHW strategy had a positive effect on 1-month periodontal treatment outcomes, long-term OHQoL and oral self-care behaviors in patients with T2DM.