0034 Dental utilisation, body mass index and oral and general health variables in those with clinically severe obesity: a survey-based cohort study Zanab Malik1,2, Woosung Sohn2, Shanika Nanayakkara2, Kathryn Williams3,4 1Department of Oral Medicine, Oral and Special Needs , Westmead Centre for Oral Health, Westmead , , NSW 2The School of Dentistry, Faculty of Medicine and Health 3Nepean Family Metabolic Health Service (NFMHS), Nepean Blue Mountains Local Health District, Kingswood, NSW, Australia 4Charles Perkins Centre-Nepean, The University of Sydney, NSW, Australia

INTRODUCTION RESULTS CONCLUSIONS Those attending a public hospital-based obesity service P value Of the 82 individuals who consented to participate, Entire cohort BMI tertile 1 BMI tertile 2 BMI tertile 3 Patients with clinically severe obesity reported poor dental with clinically severe obesity tend to have higher rates of Variable N = 81 N = 27 N = 27 N = 27 adverse diet and physical activity behaviours, and chronic 81 (98.8%) completed the study questionnaire and utilisation, high levels of dental anxiety and fair to high 0.02 diseases.1,2 Some studies report poor oral health in people 74 (91.3%) answered additional screening questions Age (median, IQR) 51 (39-63) 58 (45-68) 48 (35-64) 45 (37-58) levels of oral health related quality of life which had no 0.2 relating to their general wellbeing and mental health. Gender – male significant association with body mass index. Medical with obesity when compared to the background 24 (29.6) 11 (40.1) 5 (18.5) 8 (29.6) population.3-6 Data linking body mass index (BMI) and The median BMI of the cohort was 49.1kg/m2 (IQR (number, % group) complications, lack of wellbeing and poor mental health 43.2-57.3kg/m2) and median age 51 (IQR 39-63) BMI (kg/m2)* (median, 49.1 (43.2 to 42.3 (40.3- 49.1 (47.2- 60.6 (57.3- <0.05 may complicate dental management. These factors, and the dental utilisation with oral and general health variables IQR) 57.3) 43.2) 51.1) 66.1) including dental anxiety, oral health related quality of life years. Of participants, 50 (61.7%) reported that their Anxiety and/or 0.1 limitations of conventional dental chairs for a majority of Depression (number, % last dental visit was more than one year ago and 24 31 (38.3) 9 (33.3) 15 (55.6) 7 (25.9) these patients, support an increased number and promotion (OHRQoL), wellbeing and mental health are lacking. group) (29.6%) of participants reported high levels of dental of bariatric dental facilities, including Special Needs Dental This study aimed to explore the relationship between BMI anxiety. Across the cohort, there were fair to high Obstructive sleep 0.6 Units, in addition to education of dental practitioners in and these parameters in individuals attending a hospital- apnoea (number, % 39 (48.1) 12 (44.4) 12 (44.4) 15 (55.6) levels of OHRQoL. Screening questions suggested group) obesity management. based obesity service. low general wellbeing and poor mental health in this Type 2 diabetes 0.3 mellitus (number, % 42 (51.9) 17 (63.0) 14 (51.9) 11 (40.7) METHODS patient cohort. BMI was not significantly correlated group) REFERENCES This study was a single-site project. Ethics approval was with any of the variables of dental utilisation, dental Chronic pain (number, 0.1 1. NACOS. National Framework for Clinical Obesity Services First Edition. gained from the Nepean Blue Mountains Local Health % group) 16 (19.8) 4 (14.8) 3 (11.1) 9 (33.3) National Association of Clinical Obesity Services 2020 VIC 3926 anxiety or OHRQoL (p>0.05). District Human Research Ethics Committee (project Australia; 2. Atlantis E, Kormas N, Samaras K, et al. Clinical obesity Services in Public number: 2018/ETH00353). Between August 2019 and A. Wellbeing Screening Question: In general, I would Table 1: Demographics and medical comorbidities of interest in the study population n = 81 and by BMI tertiles in Australia: a position statement based on expert consensus. February 2020, all adult patients of the Nepean Family say my health is: Clinical obesity 2018;8:203-210. Metabolic Health Service (NFMHS), a hospital-based 100% 3. Östberg A-L, Bengtsson C, Lissner L, Hakeberg M. Oral health and 90% obesity indicators. BMC Oral Health 2012;12:50. 80% Entire multidisciplinary obesity service, were invited to participate BMI tertile 1 BMI tertile 2 BMI tertile 3 4. Forslund HB, Lindroos AK, Blomkvist K, et al. Number of teeth, body 70% cohort P value N =27 N =27 N =27 mass index, and dental anxiety in middle-aged Swedish women. Acta in the study at time of their usual consultations. Data on oral 60% Poor N =81 50% Fair Odontol Scand 2002;60:346-352. and general health were obtained through surveys and the Dental utilisation 40% Good 5. Kantovitz KR, Pascon FM, Rontani RMP, Gaviao MBD, Pascon FM. Obesity and dental caries--A systematic review. Oral health & preventive participants’ medical records. Age, gender, BMI and medical 30% Very good Last dental visit more complications of interest were recorded from the medical % of Tertile or cohort 20% Excellent than 1 year ago (Number, 50 (61.7) 13 (48.1) 16 (59.3) 21 (77.8) 0.4 dentistry 2006;4: 10% % group) 6. Marshall A, Loescher A, Marshman Z. A scoping review of the record. 0% implications of adult obesity in the delivery and acceptance of dental care. Tertile1 Tertile2 Tertile3 The study survey was designed by the research team and Visiting frequency ≥ once Br Dent J 2016;221:251. BMI Tertiles Cohort n=74 per year (number, % 22 (27.2) 9 (33.3) 6 (22.2) 7 (25.9) 0.6 contained questions on dental utilisation, oral health group) ACKNOWLEDGEMENTS variables including dental anxiety and oral health related B. Mental health Screening Question: Over the past week, the statement Visiting only when The authors would like to acknowledge the help of the quality of life. Study surveys were distributed in person, by "I felt that life was meaningless" applied to me: needed (number, % 43 (53.1) 13 (48.1) 18 (66.7) 12 (44.4) 0.6 group) electronic link or by mail for completion, depending on 100% multidisciplinary health and wellbeing team including 90% Mo st of the time Dental anxiety for treatment tomorrow dietitians Sally Badorrek and Gillian Rosic, physiotherapist participant preference. Participants were asked screening 80% 70% Good part of the Not or slightly anxious Gavin Cho and clinical psychologist Sophia Kwan, Dr Avanti questions for general health variables including indicators of 41 (50.6) 16 (59.3) 12 (44.4) 13 (48.1) 0.6 60% time (number, % group) Karve and Dr Babak Sarrafpour in the university oversight wellbeing and mental health. After performing graphical 50% Some of the 40% time Very to extremely anxious and academic support for this project. Lastly, we thank the inspection of BMI data in relation to the primary outcome of 30% Not at all 24 (29.6) 6 (22.2) 10 (37.0) 8 (29.6) 0.6 (number, % group) timing of last dental visit, the cohort was divided into BMI % of Tertile or cohort 20% participants of this study, without whom the research is not 10% possible. tertiles and all variables described for the whole cohort and 0% Oral health related quality of life Tertile1 Tertile2 Tertile3 by BMI tertiles. Univariate associations between BMI tertiles OHIP-14 scores / total 56 12.0 (4.5- 11.0 (4.0- 14.0 (7.0- BMI Tertiles Cohort n=74 10 (6.0-22.0) 0.8 CONTACT and other study variables were determined using chi (median, IQR) 20.5) 23.0) 19.0) squared for categorical variables and Kruskal Wallis test for Corresponding author: Dr Zanab Malik; who is completing a DClinDent Figure 1A and 1B: Participant responses to screening questions on wellbeing Table 2: Dental utilisation, dental anxiety and OHRQoL of the study population and by BMI (Special Needs Dentistry) with The University of Sydney continuous variables. The level of significance for all and mental health by BMI tertiles and across the cohort (n=74) tertiles statistical tests was set at p ≤ 0.05. Email: [email protected]

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