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Periodontal disease risk factors in elderly and older adults with diabetes mellitus comorbidity using the PRECEDE–PROCEED framework: a cross-sectional study


 
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1. Title Title of document Periodontal disease risk factors in elderly and older adults with diabetes mellitus comorbidity using the PRECEDE–PROCEED framework: a cross-sectional study
 
2. Creator Author's name, affiliation, country Gilang Rasuna Sabdho Wening; Universitas Airlangga; Indonesia
 
2. Creator Author's name, affiliation, country Yufitri Mayasari; Universitas Prof. Dr. Moestopo (Beragama); Indonesia
 
2. Creator Author's name, affiliation, country Ainol Haniza Kherul Anuwar; Universiti Malaya; Malaysia
 
2. Creator Author's name, affiliation, country M. Daffa Refasyah Putra; Universitas Airlangga; Indonesia
 
2. Creator Author's name, affiliation, country Rinta Giska Putri; Universitas Airlangga; Indonesia
 
3. Subject Discipline(s) Dentistry; Dental Public Health; Periodontology
 
3. Subject Keyword(s) Diabetes mellitus, periodontal disease, elderly, risk factors, oral hygiene
 
3. Subject Subject classification Periodontal disease; Diabetes mellitus; Elderly health
 
4. Description Abstract Introduction: Diabetes mellitus (DM) increases the risk and severity of periodontal disease, particularly among elderly populations. Behavioral and contextual determinants may further exacerbate periodontal vulnerability in individuals with DM. This study aimed to describe periodontal disease risk factors among elderly and older adults with diabetes mellitus using the PRECEDE framework, focusing on predisposing, reinforcing, and enabling factors. Methods: A descriptive cross-sectional study was conducted among 33 elderly and older adults with confirmed diabetes mellitus at the Dukuh Kupang Primary Health Center, Surabaya, Indonesia. Data were collected using structured questionnaires assessing predisposing (knowledge, dietary adherence, physical activity, medication use), reinforcing (family and healthcare support), and enabling factors (health service utilization), alongside clinical periodontal examination using the Harald Löe Plaque Index. Data were analyzed descriptively and presented as frequencies and percentages. Results:  Periodontal risk was categorized as moderate in 51.5% and high in 48.5% of respondents. Predisposing factors showed that 72.7% did not regulate food portions, 54.5% did not adhere to physician-recommended diets, 42.4% did not exercise regularly, and 21.2% did not consistently take antidiabetic medication. Reinforcing factors indicated that 39.4% reported limited family support for medication adherence and 18.2% reported insufficient health education support. Enabling factors revealed that 15.2% did not undergo regular blood glucose examinations and 18.2% did not routinely record glucose levels. Clinically, 57.6% had plaque index scores above the mean, indicating substantial plaque accumulation. Conclusion: Periodontal vulnerability among elderly individuals with diabetes mellitus is characterized by a convergence of unfavorable predisposing (21.2–72.7%), reinforcing (18.2–39.4%), and enabling (15.2–18.2%) factors. Strengthening behavioral modification strategies, social support systems, and structured diabetes monitoring within primary healthcare settings may be important to reduce the burden of periodontal disease.
 
5. Publisher Organizing agency, location Universitas Padjadjaran
 
6. Contributor Sponsor(s)
 
7. Date (YYYY-MM-DD) 2026-04-02
 
8. Type Status & genre Peer-reviewed Article
 
8. Type Type Original article; descriptive study; cross-sectional design
 
9. Format File format PDF
 
10. Identifier Uniform Resource Identifier https://jurnal.unpad.ac.id/pjd/article/view/66984
 
10. Identifier Digital Object Identifier (DOI) https://doi.org/10.24198/pjd.vol38no1.66984
 
11. Source Title; vol., no. (year) Padjadjaran Journal of Dentistry; Vol 38, No 1 (2026): March 2026
 
12. Language English=en en
 
13. Relation Supp. Files Article Turnitin (2MB)
 
14. Coverage Geo-spatial location, chronological period, research sample (gender, age, etc.)
 
15. Rights Copyright and permissions Copyright (c) 2026 Padjadjaran Journal of Dentistry
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