• Annals of family medicine · May 2021

    Implementation of an Oral Care Protocol for Primary Diabetes Care: A Pilot Cluster-Randomized Controlled Trial.

    • Martijn J L Verhulst, Wijnand J Teeuw, GerdesVictor E AVEADepartment of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands., and Bruno G Loos.
    • Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands paro@acta.nl.
    • Ann Fam Med. 2021 May 1; 19 (3): 197-206.

    PurposeAlthough diabetes care guidelines recommend paying attention to oral health, the effect on daily practice has been limited, and patients with diabetes have yet to benefit. We investigated whether implementation of an oral care protocol for general practitioners (GPs [family physicians]) can improve patient-centered outcomes for patients with type 2 diabetes.MethodsTwenty-four GP offices were randomly assigned to the experimental or control group (12 offices each). In the experimental group, GPs and nurse practitioners implemented an oral care protocol. No extra attention was given to oral health in the control group. The primary outcome parameter was oral health-related quality of life (QoL) assessed with the 14-item Oral Health Impact Profile at baseline and 1 year later. Other outcomes were self-reported oral health complaints and general health-related QoL (36-item Short Form Health Survey).ResultsOf 764 patients with type 2 diabetes, 543 (71.1%) completed the 1-year follow-up. More patients reported improved oral health-related QoL in the experimental group (35.2%) compared to the control group (25.9%) (P = .046; P adj = .049). In a secondary post hoc analysis including GP offices with ≥60% patient follow-up (n = 18), improvement was 38.3% and 24.9%, respectively (P and P adj = .011). Improvement of self-reported oral health complaints did not differ between groups. The intervention had no effect on general health-related QoL, with the exception of the concept scale score for changes in health over time (P adj = .033).ConclusionsImplementation of an oral care protocol in primary diabetes care improved oral health-related QoL in patients with type 2 diabetes.© 2021 Annals of Family Medicine, Inc.

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