Three hundred thirteen patients (123 men and 190 women) participated in the study (mean age: 53 ± 17 years; range: 18–87 years). In group 1 (dental setting: private practice), questionnaires were completed by 109 patients (mean age: 51 ± 15 years; range: 18–82 years; 24 men and 85 women). In group 2 (dental setting: healthcare system within the hospital), questionnaires were completed by 104 patients (mean age: 53 ± 18 years; range: 21–80 years; 50 men and 54 women). Group 3 (dental setting: intramoenia private hospital practice) included 100 questionnaires (mean age: 54 ± 19 years; range: 19–87 years; 51 women and 49 men).
Table 1 summarizes the sociodemographic data of the main patients at baseline, divided into three different settings.
Most patients showed a BMI within the normal range (P= 0.02; Figure 1). Group 1 had the highest number of underweight patients (N = 8), while Groups 2 and 3 showed the highest number of overweight or obese patients (N= 50 and N = 43, respectively).
Group 1 private practice (N = 105, as four patients did not record their height and/or weight); Group 2 intra-hospital healthcare system (N = 104); Group 3 intra-moenia private practice within the hospital (N = 100).
Most patients in Group 1 (private practice) reported not taking medications daily (mean = 0.7 ± 1.2 medications/day; range: 0–7 medications) (Fig. 2). In Group 2 (hospital care system) and Group 3 (private practice within the hospital, intra-moenia ), most patients used one or more medications daily (mean = 1.8 ± 2.1 medications/day with a range of 0–10 medications and mean = 1.5 ± 2.4 medications/day with a range of 0 –10 drugs, respectively) (Fig. 2). Group 2 showed a higher number of patients taking 3 or more drugs per day (P <0.01; Fig. 2).
Group 1 private practice (N = 109); Group 2 intra-hospital healthcare system (N = 103, one patient reported no response); Group 3 intra-moeniaprivate practice within the hospital (N= 100).
Answers to the questionnaire
“Have you ever been on a diet?”
This question provides an indication of the previous patient’s propensity and sensitivity to receive nutritional advice. In all groups, approximately half of the patients reported having followed a diet: 63 patients in group 1, 57 patients in group 2 and 47 patients in group 3, without significant differences (P= 0.28). In most cases the diet was prescribed by a dietitian, nutritionist or doctor, while in only a few cases the diet was composed by oneself (Group 1, N= 10; Group 2, N= 22; Group 3, N= 23). In group 1, the patients who were already on a diet were predominantly women (8 men and 38 women), while in the other groups the genders were balanced.
In Group 1, 15 of the 63 patients (23.8%) who had already dieted had a BMI outside the range: 3 of them were obese (class I N= 1; class II N= 1; class III N= 1) and 11 were overweight, while 1 patient was slightly underweight. Among patients who reported never dieting (N= 46), a significantly higher number of patients (N= 21; 45.6%; P= 0.02) recorded a BMI out of range compared to patients already on a diet: 10 patients were overweight, 4 were obese(class I N= 2; class IIN= 2) and 7 were slightly underweight.
In Group 2, 30 of 47 patients (63.8%) who had already dieted showed a BMI outside the range (three were in class I obesity; 27 patients were overweight). This was significantly more patients than non-diet patients with BMI out of range ( N= 22 out of 57, 38.5%;P= 0.02 ;15 were overweight, five were in class I obesity and two were slightly underweight).
In Group 3, 29 of the 53 patients (54.7%) who were already dieting had a BMI outside the range (twenty were overweight, six were class I obese, two were class II obese, one had slightly underweight), and among 47 patients without prior dieting, 17 (36.1%; P= 0.17) had a BMI outside the range (twelve were overweight, two were in class I obesity, one was in class II obesity, one was slightly underweight, one was visibly underweight).
“Do you want advice about nutrition, both in general and specifically to prevent oral diseases, such as periodontal disease, tooth decay and oral cancer?”
Most patients (>80%) in all three groups reported willingness to receive nutritional information ( Fig. 3 ;P= 0.01). Of the patients who were not interested in nutritional advice, two in Group 1 were underweight, while in Group 3 one was overweight and one was class I obese. Group 2 showed a greater number of patients who were “indifferent” to receiving the nutritional advice.
“Do you think a dentist, a nutritionist or both should give you such advice?”
Group 1 private practice (N= 109); Group 2 intra-hospital healthcare system ( N= 104); Group 3intra-moeniaprivate practice within the hospital ( N= 100).
In group 1, 5 patients did not answer this question; thus, only 94 responses were collected.
The majority of patients in all groups identified that both the dentist and the nutritionist had the role of providing advice (Fig. 4; P<0.01). In some cases the role of only the dentist or only the nutritionist was recognized, with no difference between the two figures for Group 1, while Group 2 recognized the role of the nutritionist more than Group 3, who reported a predominant importance. from the dentist (Fig. 4;P= 0.0002).
“Do you think the figure of the nutritionist can be useful in the dental clinics?”
Group 1 private practice (N= 104, five patients reported no answer); Group 2 intra-hospital healthcare system ( N= 104); Group 3intra-moeniaprivate practice within the hospital ( N= 100).
In all groups, the nutritionist was perceived as useful by most patients in the dental setting, especially in Group 2, which included healthcare patients (Fig. 5;P= 0.05).
“Would you be interested in having at the dental clinic you refer to a nutritionist who can advise on nutrition in general, and also provide a diet useful for controlling and preventing diseases other than those of the mouth (systemic diseases, such as diabetes or cardiovascular disease)?”
Group 1 private practice (N= 105; five patients did not answer this question); Group 2 intra-hospital healthcare system ( N= 104); Group 3intra-moeniaprivate practice within the hospital ( N= 100).
Most patients expressed interest in an expert nutritionist at the dental clinic they referred to (Fig. 6; P<0.01). This was significantly more evident in Group 2, where more than 80% of patients responded positively to this item (Fig. 6;P= 0.003). Among patients who were not interested in having a nutritionist in the dental setting, 8 patients had a BMI outside the range in group 1 (four were overweight; two were in class I obesity; one was in class II obesity obese; one was slightly underweight); 4 patients were overweight in group 2; Eight patients in group 3 were out of range (six were overweight; two were in class I obesity).
“Do you think it would be useful, in addition to diet planning, to regularly contact the nutritionist to monitor the achievement of nutritional goals?”
Group 1 private practice (N= 108; one patient did not answer this question); Group 2 intra-hospital healthcare system ( N= 100; four patients did not answer); Group 3intra-moeniaprivate practice within the hospital ( N= 100).
Scheduling regular nutritional follow-up was recognized as valuable by most patients, especially in Group 2, where patients responded positively in more than 80% of cases. (Fig. 7;P<0.01).
Group 1 private practice (N= 106; three patients did not answer this question); Group 2 intra-hospital healthcare system ( N= 104); Group 3intramoeniaprivate practice within the hospital (N= 99; one patient did not answer this question).