Association Between Severity of Sickle Cell Disease and Patient Nonadherence to Preventive Dental Care
Naglaa Shehab, A Basir Barmak, Adela PlanerovaAbstract
Objective
Patients with sickle cell disease (SCD) are at increased risk of oral health complications. Although preventive dental care is essential, many patients rely on emergency services, suggesting poor adherence. This study assessed the association between SCD severity, preventive dental attendance, and emergency dental utilization.
Methods
A retrospective cohort study was conducted among 120 patients with SCD. Disease severity was classified as mild or severe based on the annual number of sickle cell crises (SCC). Descriptive statistics and the Mann–Whitney U test were used to compare preventive and emergency dental visits between groups. Fisher exact tests were used to examine the association between employment status and SCD severity.
Results
Of the participants, 34.2% had mild SCD (n = 41) and 65.8% had severe SCD (n = 79). Preventive dental visits did not differ significantly between groups (P = .16), and 41.7% of patients had no preventive visit during the 6-year study period. Emergency dental visits were significantly higher among patients with severe SCD compared with those with mild disease (P = .01). Severe SCD was also associated with a higher rate of unemployment compared with mild SCD (P = .009).
Conclusion
Preventive dental visits were low in both groups, suggesting barriers to routine care. Patients with severe SCD had more emergency dental visits, while preventive care use was similar between groups. Higher unemployment among patients with severe disease also reflects socioeconomic challenges. Improving access to preventive care may help reduce emergency visits in patients with severe SCD.