Less than optimal dental care among Rhode Island adults with diabetes: the need to assure oral health care for all adults with diabetes.

recent decades have seen an Increase In the prevalence of diabetes in both Rhode Island and the United States. In 2010, it was estimated that approximately 8% of Rhode Island adults age 18 years and older were living with a diagnosis of diabetes, a percentage amounting to more than 64,000 individuals. This trend of increasing diabetes prevalence is projected to continue in coming years due to the increasing rate of obesity, decreased physical activity, and growing elderly and minority populations. Periodontal disease is a major complication of diabetes. The association between periodontal disease and diabetes, particularly type II, is bi-directional. Chronic hyperglycemic conditions increase the risk of oral health complications such as periodontal disease via altered immune responses and compromised wound healing. In addition, periodontal disease provides a chronic bacterial inflammation and infection source that may adversely affect insulin sensitivity, which in turn deteriorates glycemic control. The oral health status of patients with diabetes should be closely monitored to reduce and eliminate periodontal infection and avoid further worsening diabetic condition. Given the current evidence, treating periodontal infection is considered an important component of overall diabetes management and care. The Centers for Disease Control and Prevention (CDC) and the American Diabetes Association (ADA) recommend that people with diabetes have a dental exam at least once every six months. Patients who have advanced periodontal disease or whose diabetic condition is not well controlled, should be seen by a dentist more frequently. The objectives of this report are to document the recent estimates of Rhode Island diabetic adults who received preventive dental care in the past year, and to assess determinants of disparity that may exist in the receipt of dental care among adults with diabetes.