Developing and pilot testing an oral health screening tool for diabetes care providers

Abstract Background People with poorly managed diabetes are at greater risk of periodontal disease. Periodontal disease that is not effectively managed can affect glycaemic levels. Diabetes care providers, including general practitioners and diabetes educators, are encouraged to promote oral health...

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Main Authors: Ajesh George, Prakash Poudel, Ariana Kong, Amy Villarosa, Hanny Calache, Amit Arora, Rhonda Griffiths, Vincent W. Wong, Mark Gussy, Rachel E. Martin, Phyllis Lau
Format: Article
Language:English
Published: BMC 2022-08-01
Series:BMC Primary Care
Subjects:
Online Access:https://doi.org/10.1186/s12875-022-01798-5
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author Ajesh George
Prakash Poudel
Ariana Kong
Amy Villarosa
Hanny Calache
Amit Arora
Rhonda Griffiths
Vincent W. Wong
Mark Gussy
Rachel E. Martin
Phyllis Lau
author_facet Ajesh George
Prakash Poudel
Ariana Kong
Amy Villarosa
Hanny Calache
Amit Arora
Rhonda Griffiths
Vincent W. Wong
Mark Gussy
Rachel E. Martin
Phyllis Lau
author_sort Ajesh George
collection DOAJ
description Abstract Background People with poorly managed diabetes are at greater risk of periodontal disease. Periodontal disease that is not effectively managed can affect glycaemic levels. Diabetes care providers, including general practitioners and diabetes educators, are encouraged to promote oral health of their clients. However, valid and reliable oral health screening tools that assess the risk of poor oral health, that are easy to administer among non-dental professionals, currently do not exist. Existing screening tools are difficult to incorporate into routine diabetes consultations due to their length. Thus, this study aimed to develop and pilot a short oral health screening tool that would identify risk of existing oral diseases and encourage appropriate referrals to the dental service. Methods A three-item screening tool was developed after a comprehensive review of the literature and consensus from an expert panel. The tool was then piloted as part of a larger cross-sectional survey of 260 adults with diabetes who were accessing public diabetes clinics at two locations in Sydney, Australia. As part of the survey, participants completed the three-item screening tool and a 14-item validated tool, the Oral Health Impact Profile (OHIP-14), which has been used previously in the preliminary validation of screening tools. Sensitivity and specificity analyses were then undertaken comparing the results of the two tools. Results A statistically significant correlation was found between the shorter screening tool and the OHIP-14 (rho = 0.453, p < 0.001), indicating adequate validity. The three-item tool had high sensitivity (90.5%, 95% CI 84.9%, 94.7%), with a specificity of 46.3% (95% CI 37.7%, 55.2%). The negative predictive value was 81.4% (95% CI 71.3, 89.3). No single item performed as well regarding sensitivity and negative predictive value when compared to the three items collectively. Conclusions The three-item screening tool developed was found to be valid and sensitive in identifying risk of poor oral health, requiring oral health referrals, among people with diabetes in this pilot. This is a simple, accessible tool that diabetes care providers could incorporate into their routine consultations. Further validation against comprehensive dental assessments is needed to reassess the tool’s specificity and sensitivity in diverse settings.
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spelling doaj.art-c639370837de45568d2f78a63df7c7de2022-12-22T03:59:06ZengBMCBMC Primary Care2731-45532022-08-012311810.1186/s12875-022-01798-5Developing and pilot testing an oral health screening tool for diabetes care providersAjesh George0Prakash Poudel1Ariana Kong2Amy Villarosa3Hanny Calache4Amit Arora5Rhonda Griffiths6Vincent W. Wong7Mark Gussy8Rachel E. Martin9Phyllis Lau10Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney UniversityAustralian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney UniversityAustralian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney UniversityAustralian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney UniversityAustralian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney UniversityTranslational Health Research Institute, Western Sydney UniversitySchool of Nursing & Midwifery, Western Sydney UniversitySouth-Western Sydney Clinical School, University of New South WalesLa Trobe Rural Health School, La Trobe UniversityAustralian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney UniversityMelbourne Dental School, The University of MelbourneAbstract Background People with poorly managed diabetes are at greater risk of periodontal disease. Periodontal disease that is not effectively managed can affect glycaemic levels. Diabetes care providers, including general practitioners and diabetes educators, are encouraged to promote oral health of their clients. However, valid and reliable oral health screening tools that assess the risk of poor oral health, that are easy to administer among non-dental professionals, currently do not exist. Existing screening tools are difficult to incorporate into routine diabetes consultations due to their length. Thus, this study aimed to develop and pilot a short oral health screening tool that would identify risk of existing oral diseases and encourage appropriate referrals to the dental service. Methods A three-item screening tool was developed after a comprehensive review of the literature and consensus from an expert panel. The tool was then piloted as part of a larger cross-sectional survey of 260 adults with diabetes who were accessing public diabetes clinics at two locations in Sydney, Australia. As part of the survey, participants completed the three-item screening tool and a 14-item validated tool, the Oral Health Impact Profile (OHIP-14), which has been used previously in the preliminary validation of screening tools. Sensitivity and specificity analyses were then undertaken comparing the results of the two tools. Results A statistically significant correlation was found between the shorter screening tool and the OHIP-14 (rho = 0.453, p < 0.001), indicating adequate validity. The three-item tool had high sensitivity (90.5%, 95% CI 84.9%, 94.7%), with a specificity of 46.3% (95% CI 37.7%, 55.2%). The negative predictive value was 81.4% (95% CI 71.3, 89.3). No single item performed as well regarding sensitivity and negative predictive value when compared to the three items collectively. Conclusions The three-item screening tool developed was found to be valid and sensitive in identifying risk of poor oral health, requiring oral health referrals, among people with diabetes in this pilot. This is a simple, accessible tool that diabetes care providers could incorporate into their routine consultations. Further validation against comprehensive dental assessments is needed to reassess the tool’s specificity and sensitivity in diverse settings.https://doi.org/10.1186/s12875-022-01798-5DiabetesOral healthScreeningHealth personnelPeriodontal disease
spellingShingle Ajesh George
Prakash Poudel
Ariana Kong
Amy Villarosa
Hanny Calache
Amit Arora
Rhonda Griffiths
Vincent W. Wong
Mark Gussy
Rachel E. Martin
Phyllis Lau
Developing and pilot testing an oral health screening tool for diabetes care providers
BMC Primary Care
Diabetes
Oral health
Screening
Health personnel
Periodontal disease
title Developing and pilot testing an oral health screening tool for diabetes care providers
title_full Developing and pilot testing an oral health screening tool for diabetes care providers
title_fullStr Developing and pilot testing an oral health screening tool for diabetes care providers
title_full_unstemmed Developing and pilot testing an oral health screening tool for diabetes care providers
title_short Developing and pilot testing an oral health screening tool for diabetes care providers
title_sort developing and pilot testing an oral health screening tool for diabetes care providers
topic Diabetes
Oral health
Screening
Health personnel
Periodontal disease
url https://doi.org/10.1186/s12875-022-01798-5
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