TY - JOUR
T1 - Chronic kidney disease and use of dental services in a united states public healthcare system
T2 - A retrospective cohort study
AU - Grubbs, Vanessa
AU - Plantinga, Laura C.
AU - Tuot, Delphine S.
AU - Powe, Neil R.
N1 - Funding Information:
We thank the patients and providers of the San Francisco Department of Community Health Network. VG was supported by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) through a Diversity Supplement to grant R01 DK70939. NRP was partially supported by grant K24DK02643 from the NIDDK. DST was supported by Award Number KL2RR024130 from the National Center for Research Resources.
PY - 2012
Y1 - 2012
N2 - Background: As several studies have shown an association between periodontal disease and chronic kidney disease (CKD), regular dental care may be an important strategy for reducing the burden of CKD. Access to dental care may be limited in the US public health system. Methods. In this retrospective cohort study of 6,498 adult patients with (n = 2,235) and without (n = 4,263) CKD and at least 12 months of follow-up within the San Francisco Department of Public Health Community Health Network clinical databases, we examined the likelihood of having a dental visit within the observation period (2005-2010) using Cox proportional hazards models. To determine whether dental visits reflected a uniform approach to preventive service use in this setting, we similarly examined the likelihood of having an eye visit among those with diabetes, for whom regular retinopathy screening is recommended. We defined CKD status by average estimated glomerular filtration rate based on two or more creatinine measurements 3 months apart (no CKD, 60 ml/min/1.73 m 2; CKD, < 60 ml/min/1.73 m 2). Results: Only 11.0% and 17.4% of patients with and without CKD, respectively, had at least one dental visit. Those with CKD had a 25% lower likelihood of having a dental visit [HR = 0.75, 95% CI (0.64-0.88)] than those without CKD after adjustment for confounders. Among the subgroup of patients with diabetes, 11.8% vs. 17.2% of those with and without CKD had a dental visit, while 58.8% vs. 57.8% had an eye visit. Conclusions: Dental visits, but not eye visits, in a US public healthcare setting are extremely low, particularly among patients with CKD. Given the emerging association between oral health and CKD, addressing factors that impede dental access may be important for reducing the disparate burden of CKD in this population.
AB - Background: As several studies have shown an association between periodontal disease and chronic kidney disease (CKD), regular dental care may be an important strategy for reducing the burden of CKD. Access to dental care may be limited in the US public health system. Methods. In this retrospective cohort study of 6,498 adult patients with (n = 2,235) and without (n = 4,263) CKD and at least 12 months of follow-up within the San Francisco Department of Public Health Community Health Network clinical databases, we examined the likelihood of having a dental visit within the observation period (2005-2010) using Cox proportional hazards models. To determine whether dental visits reflected a uniform approach to preventive service use in this setting, we similarly examined the likelihood of having an eye visit among those with diabetes, for whom regular retinopathy screening is recommended. We defined CKD status by average estimated glomerular filtration rate based on two or more creatinine measurements 3 months apart (no CKD, 60 ml/min/1.73 m 2; CKD, < 60 ml/min/1.73 m 2). Results: Only 11.0% and 17.4% of patients with and without CKD, respectively, had at least one dental visit. Those with CKD had a 25% lower likelihood of having a dental visit [HR = 0.75, 95% CI (0.64-0.88)] than those without CKD after adjustment for confounders. Among the subgroup of patients with diabetes, 11.8% vs. 17.2% of those with and without CKD had a dental visit, while 58.8% vs. 57.8% had an eye visit. Conclusions: Dental visits, but not eye visits, in a US public healthcare setting are extremely low, particularly among patients with CKD. Given the emerging association between oral health and CKD, addressing factors that impede dental access may be important for reducing the disparate burden of CKD in this population.
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U2 - 10.1186/1471-2369-13-16
DO - 10.1186/1471-2369-13-16
M3 - Article
C2 - 22471751
AN - SCOPUS:84859131449
SN - 1471-2369
VL - 13
JO - BMC nephrology
JF - BMC nephrology
IS - 1
M1 - 16
ER -