Determinants of Oral Health Outcomes and Quality of Life in Diabetic Patients from Western Romania: A Behavioral Model Approach.

Background/

Objectives

Oral health and diabetes are closely linked through shared inflammatory, behavioral, and socioeconomic factors. This study examined the determinants of oral health outcomes and oral-health-related quality of life (OHRQoL) in Romanian diabetic patients using Andersen's Behavioral Model.

Methods

A cross-sectional study was conducted in early 2025 among 79 diabetic patients at a public clinic in Western Romania. Data were collected through questionnaires, clinical oral exams, and the OHIP-14 instrument. Variables were analyzed using Andersen's Behavioral Model and standard statistical tests, including regression and correlation analyses.

Results

Participants had a mean age of 61.2 years; 86.1% had type 2 diabetes and 13.9% type 1. Over 49% reported gingival bleeding, and 38% experienced dental sensitivity. Regression analysis identified limited awareness (OR = 2.21, p = 0.033) and low income (OR = 1.89, p = 0.041) as significant predictors of periodontal symptoms. OHIP-14 scores were weakly correlated with glycemic control (r = 0.17) and dental sensitivity (r = 0.16) but not with objective periodontal parameters. Rural residence, lower education levels, and poor awareness were associated with reduced service utilization and poorer perceived oral health.

Conclusions

This study highlights the impact of behavioral, clinical, and socioeconomic factors on oral condition and OHRQoL. Oral health should be integrated into chronic disease care, with prevention-focused strategies aimed at improving access and reducing disparities, especially in older and rural populations.