Use of Dental Health Services within the Past Year among Adults at Risk of Diabetes in the Alabama Black Belt


Objective: We evaluated the use of dental health services within the past year among adults at risk of diabetes in the Alabama Black Belt. Methods: Data for this cross-sectional study was collected in 2005-2006 through the Flying Sparks project. In addition to descriptive statistics and univariate analysis (Chi-square), we used multiple logistic regression analysis to examine the association between dental care use and diabetic status. Results: 1355 individuals responded the survey (mean age 51 years). 67.9% were females and 89.5% African-Americans. 16.7% reported history of diabetes. Overall, 54.5% of individuals had visited a dentist within the past year. Adults with diabetes were less likely than those without diabetes to have seen a dentist (13.4% vs 86.6%, p < 0.01). Females were more likely to visit a dentist in the past year (adjusted OR = 1.4, 95% CI 1.11-1.90) than males. African-Americans were less likely than whites to have seen a dentist (adjusted OR = 0.6, 95% CI 0.43-0.97). Lower levels of education and household income were associated with a greater likelihood of not seeing a dentist in the previous year. After controlling for gender, health insurance, race, education, report of limited community health services, routine medical check-up within past year, and annual household income, individuals with diabetes were significantly less likely than those without diabetes to have seen a dentist within the preceding year (OR = 0.6, 95% CI 0.43-0.84). Conclusions: Individuals with history of diabetes in the Alabama Black Belt should be encouraged to have annual dental visits as part of a comprehensive diabetes care plan.

Share and Cite:

Tamí-Maury, I. , Oliveira, A. , Kohler, C. , Foushee, H. and Michael, M. (2014) Use of Dental Health Services within the Past Year among Adults at Risk of Diabetes in the Alabama Black Belt. Open Journal of Preventive Medicine, 4, 129-137. doi: 10.4236/ojpm.2014.44018.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Allen, E., Ziada, H., O’Halloran, D., et al. (2008) Attitudes, Awareness and Oral Health-Related Quality of Life in Patients with Diabetes. Journal of Oral Rehabilitation, 35, 218-223.
[2] Mealey, B. (2008) The Interactions between Physicians and Dentists in Managing the Care of Patients with Diabetes Mellitus. The Journal of the American Dental Association, 139, 4S-7S.
[3] Huang, E., Basu, A., O’Grady, M., et al. (2009) Projecting the Future Diabetes Population Size and Related Costs for the US. Diabetes Care, 32, 2225-2229.
[4] Tomar, S. and Lester, A. (2000) Dental and Other Health Care Visits among US Adults with Diabetes. Diabetes Care, 23, 1505-1510.
[5] Goodarz, D., Friedman, A.B., Oza, S., et al. (2010) Diabetes Prevalence and Diagnosis in US States: Analysis of Health Surveys. Population Health Metrics 2009.
[6] Pack, L. (2010) Educational Events Planned for Diabetes Alert Day in Alabama. Alabama Department of Public Health, Birmingham.
[7] Massey, C.N., Appel, S.J., Buchanan, K.L., et al. (2010) Improving Diabetes Care in Rural Communities: An Overview of Current Initiatives and a Call for Renewed Efforts. Clinical Diabetes, 28, 20-27.
[8] Sanspree, M., Allison, C., Hardwick Goldblatt, S., et al. (2008) Alabama Black Belt Eye Care—Optometry Giving Back. Optometry—Journal of the American Optometric Association, 79, 724-729.
[9] Loe, H. (1993) Periodontal Disease. The Sixth Complication of Diabetes Mellitus. Diabetes Care, 16, 329-334.
[10] Lalla, E., Park, D., Papapanou, P., et al. (2004) Oral Disease Burden in Northern Manhattan Patients with Diabetes Mellitus. American Journal of Public Health, 94, 755-758.
[11] Karels, A. and Cooper, B. (2007) Obesity and Its Role in Oral Health. The Internet Journal of Allied Health Sciences and Practice, 5, 1-5.
[12] Reilly, D., Boyle, C. and Craig, D. (2009) Obesity and Dentistry: A Growing Problem. British Dental Journal, 207, 171-175.
[13] Yuen, H., Mountford, W., Magruder, K., et al. (2009) Adequacy of Oral Health Information for Patients with Diabetes. Journal of Public Health Dentistry, 69, 135-141.
[14] (2013) Black Belt Initiatives 2009.
[15] Tullos, A. (2013) The Black Belt. Southern Spaces.
[16] Lian, B., Kohler, C., Stalker, V., et al. (2007) Lessons Learned from Forming Relationships and Starting a Large-Scale, Rural, Multi-Community Intervention. APHA 135th Annual Meeting and Expositon, Washington DC, 7 November 2007.
[17] Grootaert, C., Narayan, D., Jones, V., et al. (2004) Measuring Social Capital: An Integrated Questionnaire. World Bank Working Paper, 18.
[18] MMWR (2008) State-Specific Incidence of Diabetes Among Adults—Participating States, 1995-1997 and 2005-2007. Morbidity and Mortality Weekly Report, 57, 1169-1173.
[19] Gregg, E., Geiss, L., Saaddine, J., et al. (2001) Use of Diabetes Preventive Care and Complications Risk in Two African-American Communities. American Journal of Preventive Medicine, 21, 197-202.
[20] Fisher, M., Gilbert, G. and Shelton, B. (2004) A Cohort Study Found Racial Differences in Dental Insurance, Utilization, and the Effect of Care on Quality of Life. Journal of Clinical Epidemiology, 57, 853.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.