Oral Hygiene; knowledge, attitude, and practices among diabetic patients in Hebron- Palestine
Areej Hassan Mohammed Harahsheh
اريج حسن محمد حراحشه
Background: Diabetic patients are at greater risk for several oral health complications, particularly periodontal disease. Periodontal disease has an impact on diabetes control. Good oral hygiene knowledge and practices are recommended to prevent and manage oral health problems. Purpose: To assess the oral hygiene; knowledge, attitude, and practices levels among diabetic patients attending primary healthcare centers to synthesize current evidence base data in order to help in the effective planning of oral health services for diabetic patients in Palestine. Methods: A descriptive, cross-sectional study was conducted using face to face questionnaire. The Study participants consist of diabetic patients attending diabetes clinics in primary healthcare centers in Hebron Health Directorate. The study included 309 participants; 309 responded to the questionnaire, with a response rate of 100%. The questionnaire is divided into four parts: Part one: consist of two parts, section A: Has questions about information on the socio-demographic of participants, section B: Information on the clinical characteristics of participants, Part two: Has questions related to knowledge of oral hygiene, Part three: Has questions related to attitude towards oral hygiene, the questions collect information on oral hygiene practices. The questionnaire has to be designed in a way that it can precisely measure the dependent and independent variables in this research. To assess the level of diabetic patients' attitude about oral hygiene, the Likert scale is used it allows the respondent to choose the degree of agreement or disagreement with each item in the questionnaire when it comes to the stimulus purpose, the different items were measured on 5- point Likert scale to check the participant’s degree of convenience with the statement or not, as below: Strongly disagree (SD), disagree (D), neither agree nor disagree (NAD), agree (A), strongly agree (SA). To assess the level of diabetic patients' knowledge about Oral Hygiene a 3- point scale is used as below: Yes, no, don’t know. To assess the level of diabetic patients' practice about oral hygiene, the Likert scale is used, the different items were measured on 5- point Likert scale to check the participant’s degree of convenience with the statement or not, as below: Always, often, sometimes, rarely, never. Results: The study included a total of 309 patients with diabetes mellitus both types; type 1, and type 2. It was conducted in 5 diabetes clinics in primary healthcare centers in the Hebron Health Directorate. The review found that people with diabetes have a medium level of oral health knowledge (60%), High oral health attitudes (Mean score=4.09), and medium oral hygiene practices (Mean score=3.14). They rarely receive oral health education or information about the relation between diabetes and oral health. They also rarely receive dental referrals from their care providers. A majority of people with diabetes are unaware of the bidirectional link between diabetes and periodontal disease and they have limited knowledge of their risks for oral health problems. The study also found that (66.99%) attending primary healthcare centers in Hebron directorate are type2 diabetic patients, (57.28%) are more than 5 years diabetic patients, (61.81%) are not smoking, (56.63%) are poor HbA1c levels. The study showed a low awareness level that smoking with diabetes increases the incidence of oral problems. There is a significant relationship between control and uncontrol diabetic patients with knowledge and practice, results showed that knowledge and practice are better among patients with control diabetes. Provision of oral health education by diabetes care providers and referral to dentists can improve oral hygiene practices among patients. Conclusion: Diabetic patients have limited knowledge about the risk of diabetes on their oral health, lack compliance with recommended oral hygiene behavior. Knowledge and oral hygiene practices levels are better among patients with controlled diabetes. It is therefore essential to educate patients about their increased risk for oral complications and motivate them for good oral hygiene practice, facilitate access to dental care, and advise them to have regular dental checkups. Keywords: Oral hygiene, Diabetes Mellitus, Oral hygiene Knowledge, Attitude, Practices.