Embracing change in the dental practice to deliver better health outcomes

Dr Michael Smith1,2, A. Prof. Margaret Rogers1,3, Dr Jacqueline Pawlak1, Prof. Trisha Dunning3,4

1Barwon Health – Oral Health Services, Newcomb, Australia, 2Colac Area Health – Oral Health Services, Colac, Australia, 3Deakin University, Geelong, Australia, 4Barwon Health – Nursing and Education, Geelong, Australia

Aim:- The Colac-Otway Shire includes some disadvantaged sectors of the community and residents may have to travel 100km to attend a dental clinic.  Those from disadvantaged communities carry the highest burden of disease with respect to oral and general health.  The aim of this pilot study was to determine the feasibility of screening for diabetes at the community dental clinic in Colac, Victoria.

Method:- Adults attending the Colac Area Health Oral Health Service who consented to diabetes screening completed the Australian Type 2 Diabetes Risk Assessment (AUSDRISK) questionnaire with those at an intermediate to high risk (>6) offered an Alere Afinion ™ HbA1c (%) blood test (AS100 analyser) to determine the likelihood of diabetes.  Dental health assistants trained in oral health promotion working directly with clients is a feature of this model.    Participants in the high risk range using HbA1c were referred onto a GP or Diabetes Educator.

Results:- To date, 227 people have completed the AUSDRISK questionnaire with 118 (52%) in the high risk category for diabetes, 76 (33%) in the intermediate risk and 33 (14%) in the low risk category.  Currently, 184 participants have been screened using HbA1c testing.  Five participants had HbA1c scores between 6.0-7.0% (high range for non-diabetes) and 179 participants HbA1c was within the normal range.

Significance of findings to allied health:- The significance of this novel study is the initiation of a new model of care that links oral health with diabetes testing.  Phase 2 of the study involves a link being established between the Community Dental Clinic and Diabetes Educator.