Oral Health in Diabetes (OHDM): A Validated Tool to Measure Risk Beliefs and Awareness of Potential Complications

Abstract Background People with diabetes are at an increased risk of developing oral health complications, including periodontal disease and dental caries. Despite this heightened risk, perceptions and beliefs about risk and awareness of potential complications remain suboptimal amongst this group. Existing measures used to evaluate these drivers of oral health in adults with diabetes are limited in their scope and of unknown validity. Therefore, the aim of the present study was to develop and validate a new Diabetes Specific Oral Health scale (OHDM) to measure oral health factors in people living with diabetes. Methods A questionnaire was created based on existing measures and insights from relevant published literature, and refined in collaboration with dental professionals, scale development experts and with input from people with lived experience of diabetes. Three sets of data were collected from UK dwelling adults (18y+), living with diabetes (Type 1 or 2) via an online panel and subject to Parallel and Exploratory Factor Analysis (EFA) (n = 328), Confirmatory Factor Analysis (CFA) (n = 352) and test-retest reliability (n = 37). Results A 23-item scale was initially developed. Following parallel analysis and EFA a two-factor model (Oral Beliefs, Oral Complications) was deemed best fit. Five factor loadings were not significant and subsequently removed, resulting in an 18-item scale. All other loadings were significant and positive (0.5–0.72). CFA was conducted, confirming the two-factor model as a good fit (Tucker-Lewis Index = 0.995, Root Mean Square Error of Approximation = 0.017, Standardized Root Mean Square Residual = 0.073). Reliability of the two subscales was good: oral beliefs (ω T = 0.91), oral complications (ω T = 0.84). Conclusions The OHDM provides a valid research tool for measuring oral health complications and related beliefs in those living with diabetes. Future studies should seek to test the performance of this scale in different groups such as adolescents and those with gestational diabetes and explore its utility for informing targeted oral health education and intervention development. Clinical trial number: not applicable