Association of Oral Health Assessment Tool Findings With Periodontal Screening Outcomes in Adults With Diabetes

Periodontal disease is common among adults with diabetes, yet periodontal screening is rarely incorporated into routine outpatient diabetes care. The Oral Health Assessment Tool (OHAT) is a structured observational tool designed for non-dental healthcare professionals; however, its relationship with periodontal screening findings remains unclear.

To examine the association between OHAT findings and periodontal screening outcomes in adults attending diabetes outpatient clinics.

This cross-sectional study included adults with type 1 or type 2 diabetes at a tertiary hospital in Sydney, Australia. Periodontal screening was performed using the Periodontal Screening and Recording (PSR) system, and oral health was assessed using OHAT. Periodontal status was dichotomized as no/mild (PSR 0-2) versus moderate-to-severe (PSR ≥ 3). Logistic regression examined associations of OHAT domains and total OHAT burden with periodontal status. Covariate-adjusted models assessed robustness. Screening performance was evaluated using sensitivity, specificity, and predictive values.

Among 120 participants (mean age 61.5 years, 64.2% with type 2 diabetes), 71.4% demonstrated moderate-to-severe periodontal findings. Mean OHAT score was 4.99 (SD 2.02). Change/unhealthy ratings for tongue (OR 3.23, 95% CI 1.30-8.02), gums and oral tissues (OR 4.59, 95% CI 1.78-11.85), and increasing categories of decayed teeth (OR 2.06, 95% CI 1.05-4.05) were associated with moderate-to-severe findings. Higher total OHAT score (> 5 vs. ≤ 5) was strongly associated with moderate-to-severe periodontal findings (OR 7.00, 95% CI 2.25-21.76), with consistent results. This threshold showed high specificity (87.5%) and positive predictive value (90.9%), but moderate sensitivity (50.0%).

OHAT findings were associated with moderate-to-severe periodontal screening findings among adults with diabetes, supporting further evaluation of OHAT as a pragmatic screening and referral aid in settings where formal periodontal assessment is not routinely available. Its performance when administered by non-dental clinicians requires further investigation.