title: Factors associated with regular dental visits among hemodialysis patients.
abstract: OBJECTIVE
  To investigate awareness and attitudes about preventive dental visits among dialysis patients; to clarify the barriers to visiting the dentist.
  
  
  METHODS
  Subjects included 141 dentate outpatients receiving hemodialysis treatment at two facilities, one with a dental department and the other without a dental department. We used a structured questionnaire to interview participants about their awareness of oral health management issues for dialysis patients, perceived oral symptoms and attitudes about dental visits. Bivariate analysis using the χ(2) test was conducted to determine associations between study variables and regular dental check-ups. Binominal logistic regression analysis was used to determine factors associated with regular dental check-ups.
  
  
  RESULTS
  There were no significant differences in patient demographics between the two participating facilities, including attitudes about dental visits. Therefore, we included all patients in the following analyses. Few patients (4.3%) had been referred to a dentist by a medical doctor or nurse. Although 80.9% of subjects had a primary dentist, only 34.0% of subjects received regular dental check-ups. The most common reasons cited for not seeking dental care were that visits are burdensome and a lack of perceived need. Patients with gum swelling or bleeding were much more likely to be in the group of those not receiving routine dental check-ups (χ(2) test, P < 0.01). Logistic regression analysis demonstrated that receiving dental check-ups was associated with awareness that oral health management is more important for dialysis patients than for others and with having a primary dentist (P < 0.05).
  
  
  CONCLUSIONS
  Dialysis patients should be educated about the importance of preventive dental care. Medical providers are expected to participate in promoting dental visits among dialysis patients.
authors.affiliation: Masami Yoshioka, Shizuko Yanagisawa, Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Yoshioka
authors.affiliation: Masami Yoshioka, Shizuko Yanagisawa, Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Shirayama
authors.affiliation: Masami Yoshioka, Shizuko Yanagisawa, Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan.
authors.forename: Issei
authors.initials: I
authors.lastname: Imoto
authors.affiliation: Masami Yoshioka, Shizuko Yanagisawa, Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hinode
authors.affiliation: Masami Yoshioka, Shizuko Yanagisawa, Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan.
authors.forename: Shizuko
authors.initials: S
authors.lastname: Yanagisawa
authors.affiliation: Masami Yoshioka, Shizuko Yanagisawa, Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Takeuchi
authors.affiliation: Masami Yoshioka, Shizuko Yanagisawa, Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Bando
authors.affiliation: Masami Yoshioka, Shizuko Yanagisawa, Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan.
authors.forename: Narushi
authors.initials: N
authors.lastname: Yokota
keywords: Dental visit; Health management; Hemodialysis; Oral health; Questionnaire