Diabetes in the dental office: using NHANES III to estimate the probability of undiagnosed disease.
OBJECTIVE
Recent data have suggested that in the past 15 years there has been a dramatic increase in the incidence of diabetes mellitus in the USA. However, evidence suggests that approximately one-third of diabetes cases remain undiagnosed. Because 60% of Americans see a dentist at least once per year for routine, nonemergent, care, it is reasonable to propose that the dental office can be a healthcare location actively involved in screening for unidentified diabetes.


METHODS
This study used NHANES III to develop a predictive equation that can form the basis of a tool to help dentists determine the probability of undiagnosed diabetes by using self-reported data and periodontal clinical parameters routinely assessed in the dental office.


RESULTS
Our analyses reveal that individuals with a self-reported family history of diabetes, hypertension, high cholesterol levels and clinical evidence of periodontal disease bear a probability of 27-53% of having undiagnosed diabetes, with Mexican-American men exhibiting the highest probability and white women the lowest.


CONCLUSIONS
These findings suggest that the dental office could provide an important opportunity to identify individuals unaware of their diabetic status.
Borrell
L N
LN
Department of Epidemiology, Columbia University College of Dental Medicine and Mailman School of Public Health, Columbia University, New York, NY 10032, USA. lnb2@columbia.edu
Kunzel
C
C
Lamster
I
I
Lalla
E
E
D000328:Adult; D000367:Age Factors; D003729:Dental Care; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis*; D005006:Ethnicity; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications; D012307:Risk Factors; D012737:Sex Factors; D014481:United States