Dental attendance patterns of patients with non-communicable diseases by six-year follow-up study

ARTICLES

Dental attendance patterns of patients with non-communicablediseases by six-year follow-up study

Yoriko Matsuoka, Kyoko Arai, Eriko Kawatsura, Kakuhiro Fukai

Abstract： Objectives: The objectives of this study were to examine the medical histories of new dental
patients and their attendance patterns after the initial contact.
Methods: Medical histories of 949 new adult dental patients were examined regarding four noncommunicable diseases (NCDs): heart disease, diabetes mellitus, hypertension, and cerebrovasculardisease. Additionally, their attendance patterns for regular dental check-ups were examined.
Logistic regression analysis was used to determine the influence of four factors - NCDs, gender,
age group, and number of present teeth - on dental attendance patterns.
Results: Of 949 new dental patients, 488 (51.4%) were males ranging from 20 years to 80 years ormore. As for the number of present teeth at the initial visit, 69.4% of males and 67.1% of females
had more than 25 teeth. History of NCDs in males was 17% for hypertension, 10.8% for diabetes
mellitus, 6.6% for heart disease, and 1.2% for cerebrovascular disease. In females, 13.4% had a history of hypertension while the prevalence of diabetes mellitus was 3.7%, heart disease was 2.6%,
and cerebrovascular disease was 0.4%. As for attendance patterns, females (64.2%) were more
likely to receive regular dental check-ups than males (58.2%). There was no significant correlation
between NCDs and regular dental check-ups.
Conclusion: These findings indicate that dental professionals should take a common risk factor
approach, making a greater effort to provide health information about the bi-directional relationship between oral health and NCDs.
Key words : regular dental check-ups, attendance patterns, non-communicable diseases, common risk factors

Introduction

health behavior, is an essential factor in the pre-Regular dental attendance, along with other oral

vention of oral disease progression and the maintenance of good oral condition with functional toothretention. Moreover, there is a bi-directional rela-【著者連絡先】〒341-0003 埼玉県三郷市彦成 3-86
深井歯科医院・深井保健科学研究所
松岡順子
TEL&FAX：048-957-3315
E-mail：yorikom@wg8.so-net.ne.jp

tionship between systemic and oral diseases. The
literature

hasshowna

positiveassociation

between periodontal diseases and non-communicable diseases (NCDs) such as diabetes mellitus, respiratory diseases, cardiovascular diseases, and̶4̶ヘルスサイエンス・ヘルスケア

Volume 11，No.1（2011）

adverse pregnancy outcomes1-10）．One report con-present teeth. SPSS 13.0 J was used for statisticalcerning diabetic adults showed that they were lessanalysis.

likely to have seen a dentist (65.8%) than to have
Resultsused health care services for diabetic treatments． A high incidence of systemic disease

Among 949 new dental patients, 488 (51.4%)

throughout a patient’s lifetime is likely to act as awere males and 461 (48.6%) were females, ranging

barrier to regular dental visitation. It has beenfrom 20 years to 80 years or more (Table 1).

shown that poor physical condition was one of theAbout a half (42.7%) of the patients occupied two

main reasons for failure to keep an appointment

age groups: 50-59 years (19.4%) and 60-69 years

and failure to maintain a routine attendance pat-(23.3%). As for the number of present teeth at the11）(86.3%)．

12-15）

tern

initial visit, among 484 males, 30.6% had less thanOn the other hand, the risk factors for NCDs

24 teeth and 69.4% had greater or equal 25 teeth.

include food intake behavior and cigarette smok-

Among 459 females, the percentage who had lessing, which are also risk factors for oral diseases, asthan 24 teeth vs. greater or equal 25 teeth was

highlighted by Sheiham and Watts in their “com-32.9% and 67.1%, respectively.

mon risk factor approach” ． From the stand-Males with histories of NCDs included 17% withpoint of a population approach, providing healthhypertension, 10.8% with diabetes mellitus, 6.6%

instruction to patients in a dental setting would bewith heart disease, and 1.2% with cerebrovascularan effective preventive measure.

disease. Females with histories of NCDs included16）

The purpose of this study was to examine the13.4% with hypertension, 3.7% with diabetes melli-

medical histories of new dental patients as well as

tus, 2.6% with heart disease, and 0.4% with cere-

their attendance patterns, namely whether or not

brovascular disease (Table 2).
As for attendance patterns, among 488 males,

they received regular dental check-ups after the

58.2% received regular dental check-ups (moreinitial visit.

than once) and 41.8% did not receive regularMethods

check-ups. Among 461 females, 64.2% had routine

The subjects were 949 new adult patients who

dental check-ups, and 35.8% did not. Females werevisited a dental clinic located in Saitama Prefec-

more likely to receive regular dental check-ups

ture during the six-year period from 2005 to 2010.

than males.

We examined the patients’medical histories

As seen in the results of the logistic regression

regarding four NCDs: heart disease, diabetes melli-analysis (Table 3), this study did not show NCDs

tus, hypertension, and cerebrovascular disease.
Additionally, their attendance patterns wereTable 1 New dental patients, 2005-2010

examined and subjects were divided into twogroups: those who had seen a dentist for regulardental check-ups more than once and those whohad not. Logistic regression analysis was used todetermine which factors influenced dental attendance patterns. The following four factors wereanalyzed: NCDs, gender, age group, and number of̶5̶Dental attendance patterns of patients with non-communicable diseases by six-year follow-up study

Table 2 History of non-communicable diseases of new dental patients, based on patient-provided medical histories

Table3-1 Comparison of regular dental atendants and non-regular dental atendants with NCDs' (Diabetes mellitus)
patients under adjusting for confounding factors (gender, age, and tooth number) by the multiple logistic
regression analysis

Table3-2 Comparison of regular dental atendants and non-regular dental atendants with NCDs' (Heart disease)patients under adjusting for confounding factors (gender, age, and tooth number) by the multiple logistic
regression analysis

Discussion

to have an influence on regular dental attendance
after adjusting for confounding factors (gender,Regular dental check-ups have a positive effectage, and tooth number).

on oral health and on maintaining a functional dentition. It was demonstrated in one study that
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Volume 11，No.1（2011）

Table3-3 Comparison of regular dental atendants and non-regular dental atendants with NCDs' (Hypertension)
patients under adjusting for confounding factors (gender, age, and tooth number) by the multiple logistic
regression Analysis

Table 3-4 Comparison of regular dental attendants and non-regular dental attendants with history of cerebrovascular disease, adjusting for confounding factors (gender, age, and tooth number) by the multiple logistic
regression analysis

among people who visited a dentist only when inwith systemic diseases such as diabetes mellitus

trouble, 40.3% had lost their natural functional

have a higher risk of oral diseases, compared withteeth. On the other hand, of those who visited athose without systemic diseases. If the incidence ofdentist for routine dental check-ups, only 20.3% (atoral problems and systemic diseases were a deter-

least annual attendance) and 19.9% (attendance atminant of routine dental visits, individuals who had

least once every two years) had lost theirhigher risks of tooth loss such as severe periodon-teeth17）．Tooth loss in people with type 2 diabetes

titis or diabetes mellitus would have visited den-was reported to be 15 times higher than in thosetists more often, compared with those who have a

without diabetes ． Adults with diabetes werelower risk of dental problems. The results of thisless likely to have visited a dental clinic (65.8%)

study, however, show that this is not the case. One

than those without diabetes (73.1%) within the pre-of the reasons for this may be that individualsceding 12 months (p=0.0000) ．

with NCDs do not get enough information about11）

18）

People who receive regular dental check-ups at

the complications of and bi-directional relationships

least once a year were significantly more likely to

between oral health and systemic diseases frombe younger, female, richer, more educated, non-their health care providers.

smokers, and to eat fruits and vegetables at least

On the other hand, the percentage of new den-once a day ．They were also more likely to havetal patients in this clinic who have histories ofno cost barriers, be dentate, have no perceived

NCDs was found to range from 0.4% to 17%.

17）． People

19）

symptoms, and have no fear of pain

These findings indicate that dental professionals
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Dental attendance patterns of patients with non-communicable diseases by six-year follow-up study9） Yeo B.K, Lim L.P, Paquette D.W, et al.: Periodontal
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should provide more health information about therelationship between oral health and NCDs in thedental setting. That is to say, a common risk factor approach towards NCDs should be encouraged
in the dental field.
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