{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:20:33Z","timestamp":1789741233353,"version":"4.0.1"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["5U54GM115458"],"award-info":[{"award-number":["5U54GM115458"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Diabetic patients are advised to have at least one dental examination per year. It is unclear to what extent different subgroups of US diabetic adults closely follow this recommendation. Thus, we assessed dental care utilization and related factors in a representative sample of US diabetic adults from rural and urban counties.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Cross-sectional data were from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). Survey logistic regression was used to account for the complex sampling design.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among 40,585 eligible participants, 24,887 (60% of the population) had at least one dental visit for any reason within the past year. The lowest compliance was observed among edentulous participants (27%, adjusted OR = 0.26, 95% CI = 0.22\u20130.31 vs. fully dentate). Dental compliance was also negatively associated with having a lower income or education, ever being a smoker, or having barriers to access to care. Rural residents had lower dental compliance compared to urban residents, particularly those without healthcare coverage.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Dental compliance among US adult diabetic individuals was low, particularly among rural residents, and as compared to other recommended diabetic care practices. Future public health interventions may target rural individuals without healthcare coverage, smokers and edentulous individuals. There is a need to integrate dental and medical care to facilitate cross-talks among different health professionals, so that educational preventive messages are reinforced at every healthcare visit.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0251120","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T19:38:58Z","timestamp":1620243538000},"page":"e0251120","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["US adults with diabetes mellitus: Variability in oral healthcare utilization"],"prefix":"10.1371","volume":"16","author":[{"given":"Lorena","family":"Baccaglini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7225-9925","authenticated-orcid":true,"given":"Adams","family":"Kusi Appiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahua","family":"Ray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2243-5788","authenticated-orcid":true,"given":"Fang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,5,5]]},"reference":[{"issue":"5","key":"pone.0251120.ref001","first-page":"1047","article-title":"Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030","volume":"27","author":"S Wild","journal-title":"Diabetes Care 2004"},{"issue":"8","key":"pone.0251120.ref002","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.3889\/oamjms.2018.294","article-title":"The burden of diabetes, its oral complications and their prevention and management","volume":"6","author":"MA Nazir","year":"2018","journal-title":"Open Access Macedonian Journal of Medical Sciences"},{"issue":"5","key":"pone.0251120.ref003","doi-asserted-by":"crossref","first-page":"478","DOI":"10.14219\/jada.archive.2013.0149","article-title":"Diabetes and tooth loss: An analysis of data from the national health and nutrition examination survey, 2003\u20132004","volume":"144","author":"MH Patel","year":"2013","journal-title":"J Am Dent Assoc"},{"key":"pone.0251120.ref004","volume-title":"National diabetes fact sheet: National estimates and general information on diabetes and prediabetes in the united states.","author":"Centers for Disease Control and Prevention","year":"2011"},{"issue":"12","key":"pone.0251120.ref005","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1902\/jop.1970.41.12.709","article-title":"Diabetes mellitus and periodontal disease: Two\u2010year longitudinal observations part I","volume":"41","author":"DW Cohen","year":"1970","journal-title":"J Periodontol"},{"issue":"9","key":"pone.0251120.ref006","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1902\/jop.1998.69.9.962","article-title":"Periodontal findings in elderly patients with non\u2010insulin dependent diabetes mellitus","volume":"69","author":"H Collin","year":"1998","journal-title":"J Periodontol"},{"issue":"3","key":"pone.0251120.ref007","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/j.1600-051X.1993.tb00338.x","article-title":"A longitudinal study on insulin\u2010dependent diabetes mellitus and periodontal disease","volume":"20","author":"B Sepp\u00e4l\u00e4","year":"1993","journal-title":"J Clin Periodontol"},{"issue":"1","key":"pone.0251120.ref008","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1902\/annals.1998.3.1.30","article-title":"Glycemic control and alveolar bone loss progression in type 2 diabetes","volume":"3","author":"GW Taylor","year":"1998","journal-title":"Annals of Periodontology"},{"key":"pone.0251120.ref009","article-title":"Periodontal disease as a predictor of undiagnosed diabetes or prediabetes in dental patients","author":"ES Heji","year":"2020","journal-title":"European Journal of Dentistry"},{"issue":"11","key":"pone.0251120.ref010","article-title":"Treatment of periodontal disease for glycaemic control in people with diabetes mellitus","author":"TC Simpson","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"pone.0251120.ref011","unstructured":"Centers for Disease Control and Prevention (CDC). 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