title: Dental care visits among dentate adults with diabetes and periodontitis.
abstract: OBJECTIVE
  Two national surveys have shown that dentate adults with diabetes are less likely to visit a dentist than are those without diabetes; one survey showed this association only among women. We hypothesize that periodontal health among those with diabetes could explain this disparity. This report investigates the influence of periodontitis on the association between diabetes and dental care visits. It also tests whether disparities are limited to women.
  
  
  METHODS
  Data from the 1999-2004 National Health and Nutrition Examination Survey were used. Covariates included age, sex, race/ethnicity, poverty status, education level, dental insurance, and periodontitis status. Weighted analyses were limited to dentate adults aged > or =25 years.
  
  
  RESULTS
  Overall, 56.8 percent of dentate adults with diabetes reported having a dental care visit in the preceding year compared with 64.7 percent for those without diabetes. In a multivariable model, diabetes status was significantly associated with having a dental care visit, independent of periodontitis status and covariates. Neither periodontitis status nor sex served as effect modifiers for the association between diabetes status and dental care visits.
  
  
  CONCLUSIONS
  These data revealed that dental care visits for dentate adults with diabetes were unrelated to their periodontal health, suggesting that fear of periodontal therapy did not influence visit patterns. These data also showed that dental care visit disparities existed for all adults with diabetes, not just women. Future research should investigate whether factors that are indirectly related to diabetes status, such as competing costs, attitudes, and knowledge, are influencing dental care visit patterns among dentate adults with diabetes.
authors: Department of Health Promotion and Policy, University of Maryland Dental School, 650 West Baltimore Street, Room 2207, Baltimore, MD 21201, USA. mmacek@umaryland.edu
authors: Mark D
authors: MD
authors: Macek
authors: Scott L
authors: SL
authors: Tomar
mesh_terms: D000328:Adult; D000368:Aged; D003729:Dental Care / Q000706:statistics & numerical data*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000523:psychology; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications / Q000523:psychology; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States