Partnering with periodontal patients and care providers to establish research priorities for patient engagement in specialized periodontal care: A study protocol

INTRODUCTION

Periodontitis is highly prevalent and disproportionately affects vulnerable populations, including older adults, racial and ethnic minorities, and low-income individuals. While periodontal therapies are largely effective, patient engagement in periodontal care is problematic. The study describes in this protocol aims to identify the top ten research priorities or uncertainties for specialized periodontal care (SPC) that are most important to periodontal patients and care providers.

METHODS

The James Lind Alliance approach will guide the priority-setting partnership (PSP), which involves several steps: forming a PSP steering committee, gathering potential research uncertainties, summarizing the research uncertainties, verifying unanswered uncertainties, completing an interim priority setting survey, and facilitating a priority setting workshop. Study participants will be periodontal patients (n ~ 150) and care providers (n ~ 120), including general dentists, periodontists, and dental hygienists in Alberta, Canada. A steering committee representing the four stakeholder groups will oversee the study. Data on uncertainties from these groups will be gathered through two online surveys and focus groups. Demographic data (e.g., age, sex) will be collected to describe participants and ensure representation of all stakeholder groups. Uncertainties submitted by participants will be evaluated against the existing evidence gathered through a scoping review to determine if they have already been addressed. Unanswered uncertainties will be taken to a workshop where participants (n ~ 20) representing all the stakeholder groups will set the top ten research priorities. Data analysis will include descriptive statistics and content analysis. The study is expected to conclude in August 2026.

CONCLUSION

Study findings will be disseminated to raise awareness among researchers and funders on research priorities that matter most to patients and dental care providers regarding patient engagement in SPC.

Supportive periodontal care in dental practice: Part 2 - perceptions of locally referring UK general dental practitioners

Background Supportive periodontal care (SPC) is important in maintaining periodontal treatment outcomes. Hospital services provide specialist periodontal care at high costs. On completion of treatment, patients are discharged back to the general dental practitioner (GDP) to provide SPC. This project aimed to evaluate the change in GDPs' understanding of SPC over more than 20 years.Method A validated questionnaire about SPC was sent to GDPs during 1996 (397) and 2020 (300), with a response rate of 74% and 52%, respectively. The anonymous data were entered on a Microsoft Excel spreadsheet for analysis.Results In total, 98.5% of the GDPs in 1996 and 97% in 2020 perceived SPC to be highly important. Additionally, 49% in 2020 had a better understanding of SPC when compared to 1996 (42%). Finally, 70-74% (1996, 2020) of the GDPs indicated that they were responsible for SPC; however, 13-16% said that they were not.Conclusion and clinical relevance Notwithstanding the lower response rate in 2020, there has been an improvement in understanding and awareness of responsibility of SPC among GDPs. Reported challenges of provision were related to education and funding. If GDPs are to effectively deliver SPC, education and current funding should be addressed to prevent compromised treatment outcomes for patients.

Assessment of dental student education and preparedness in periodontics in two different models: Discipline-based and general practice-based learning

PURPOSE

To compare dental students' preparedness in clinical periodontal education following their participation in a discipline-based predoctoral periodontics clinic with dental students that received a general practice-based periodontal education.

METHODS

114 third-year dental students and 112 fourth-year dental students at the University of Texas Health Science Center in San Antonio, were emailed an online survey consisting of questions on their proficiency and confidence levels in diagnosing periodontal diseases and conditions, treatment planning, performing non-surgical periodontal treatment, identifying the need for referral, and their perceived impediments on their clinical periodontics education.

RESULTS

Approximately 97% of third-year dental students that participated in discipline-based predoctoral periodontics agree that they are overall confident in providing excellent periodontal care to their patients, and 91% of these students feel that their participation in the predoctoral periodontics clinic has enhanced their knowledge in periodontics as well as their confidence level when providing periodontal patient care. While 95% of fourth-year dental students agree that they feel confident in providing excellent periodontal care to their patients, only 83% felt that level of confidence during their third-year in dental school, and 77% believe that given the option to participate in the pre-doctoral periodontics clinic, their periodontal education would have been strengthened.

CONCLUSIONS

Our results show that the integration of a discipline based predoctoral periodontics clinic has benefited the dental students and boosted their knowledge and confidence in diagnosing and treating periodontal patients. This model can be improved by addressing space and time limitations.

Characteristics of dentists in the National Dental Practice-Based Research Network

OBJECTIVES

Our aims are to describe the characteristics of dentists, members of the US National Dental practice-based research network (PBRN) in the United States, and determine how often these dentists provide specific dental procedures.

METHODS

Dentists completed a questionnaire when they enrolled in the Network about their demographic and training characteristics and characteristics of their practices and patients. Dentists also reported the frequency of providing specific dental procedures. Data were analyzed using descriptive statistics.

RESULTS

Of 4,483 dentists in active clinical practice, 34% identified as females, 70% as white, and 73% as general dentists. Most dentists practiced in large metropolitan areas (87%) and in solo or small practices (72%). On average, they reported about one-half of their patients were children or older adults, a third were from historically underrepresented racial and ethnic groups, and one-quarter were covered by public insurance. Most dentists routinely performed restorations and fixed prosthetics (78%), extractions (59%), removable (44%) and implant (40%) prosthetics, and endodontics on incisor and premolar teeth (44%).

CONCLUSIONS

Dentists participating in the National Dental PBRN have much in common with dentists at large. The network has a broad representation of dentists, practice types, patient populations, and treatments offered, including diversity regarding race/ethnicity, gender, insurance, and geography of its practitioners and patients.

CLINICAL SIGNIFICANCE

Characteristics of National Dental PBRN dentists suggest that a broad range of dentists is interested in participating in national-level research studies, thereby enabling an array of clinical study settings and topics that can optimize the generalizability of study findings.

Dental Students’ Knowledge, Confidence, Ability, and Self-Reported Difficulties in Periodontal Education: A Mixed Method Pilot Study

Evidence on periodontal education areas in which students have difficulties and their factors are limited. In this study, third- and fourth-year dental students’ knowledge was assessed as well as their confidence and ability in five periodontal educational areas using a mixed-method approach. A survey was used to collect data related to history-taking, medical examination, diagnosis, treatment planning, and follow-up. Student answers were compared to the consensual answers of an expert panel using the cosine-similarity index (CSI). Descriptive statistics assessed confidence and ability for diagnosis. Semi-structured individual interviews were used to collect data on reported reasons for difficulties in periodontal education. A content analysis was employed to analyze the interview data. Eighteen third- and fourth-year dental students completed the survey and eleven were interviewed. Students’ knowledge was adequate regarding diagnosis and treatment planning. Third-year students’ median CSI were 0.93 and 0.89, respectively. Fourth-year students’ median CSI were 0.9 and 0.93, respectively. Students felt confident in history-taking and examination but lacked confidence and ability in diagnosis and treatment planning. Reported reasons for difficulties in periodontal education were linked to both preclinical and clinical pedagogical issues. Further improvements in preclinical and clinical periodontal education are needed to address students’ lack of knowledge, confidence, and skills in key periodontal areas.

Perspectives of the public dental workforce on the dental management of people with special needs

BACKGROUND

People with special health care needs continue to have difficulties accessing regular dental care partly due to oral health professionals feeling they lack the knowledge and experience to provide treatment to these individuals.

METHODS

Qualitative interviews and focus groups provided an insight into the types and nature of supports that oral health professionals working in the Australian public dental system desired and felt may improve their willingness and/or ability to treat patients with special needs.

RESULTS

Although participants did not identify one group of patients with special needs that were more difficult to treat, they did report a feeling of being unsupported. Clinicians felt that improved training and access to ongoing education in Special Needs Dentistry, opportunities for greater support from specialists or other health professionals, either through networking or other media such as telehealth, and fostering a more supportive clinical environment, particularly in relation to appointment lengths and productivity pressures, may improve their willingness and ability to treat patients with special needs.

CONCLUSIONS

Additional support, in the form of greater interaction with specialists and reduced time and productivity pressures, may improve the willingness of oral health professionals in the public dental system to treat patients with special needs.

Knowledge, dentist confidence and management of periodontal patients among general dentists from Belarus, Lithuania, Macedonia, Moldova and Romania

BACKGROUND

Evidence concerning periodontal practice in Eastern European countries is scarce. The aim of the present study was to investigate periodontal risk knowledge, patient management and self-perceived confidence among General Dentists (GDs) from five Eastern European regarding their provision of periodontal care.

METHODS

GDs from Belarus, Lithuania, Macedonia, Moldova and Romania participated in a questionnaire survey. Power calculations were used to identify the sample size for each country. The structured questionnaire included several domains of inquiry. The socio-demographic domain inquired about dentist's age, gender and years of clinical experience. The dental practice domain inquired about practice location, practising or not practising in a group practice and having or not having a periodontist or a dental hygienist in the practice. The distributions of answers across-countries were compared employing one way ANOVA (comparison of means) or Chi square test (comparison of proportions). For each country, the predictors of the study outcomes: a summative knowledge score for periodontal risks and dentist's confidence level were identified employing either linear or logistic multiple regression models.

RESULTS

The sample comprised 390 Belarussian, 488 Lithuanian, 349 Macedonian, 316 Moldovan, and 401 Romanian GDs. The majority of GDs (~ 80%) practiced in urban areas. Age and gender distributions differed significantly among countries. Significant across-country differences were found regarding working/not working in a group practice, having/not having access to a periodontist/dental hygienist and in proportions of patients receiving periodontal treatments or being referred to specialists. None of Macedonian patients nor the majority of Moldovan patients (78%) were referred to periodontists. There were also significant across-country differences in diagnosis, patient management and periodontal knowledge. Only in the Lithuanian cohort were dentists' confidence levels associated significantly with their knowledge. In all countries, taking a medical history was a consistent and significant predictor of having higher periodontal knowledge score. Except in Belarus, periodontal risk assessment was a significantly consistent predictor of certainty levels associated with the provision of periodontal treatments.

CONCLUSIONS

There were substantial differences among GDs in the five countries regarding diagnosis, dentist's confidence and management of periodontal patients.

Oral health and healthcare utilization in Belgian dentate adults

OBJECTIVES

In 2012-2014, the Belgian National Oral Health Data Registration and Evaluation Survey, integrated in the Health Interview Survey (HIS), was carried out. The present study investigated, in a sample of 1340 dentate adults (≥25 years), the association between oral healthcare utilization, oral health status and sociodemographic status.

METHODS

A multistage, stratified cluster sampling procedure was used. Oral examination for caries experience (World Health Organization, D₃ MFT-Index), periodontal status (Dutch Periodontal Screening Index, DPS-Index), number of teeth present and occlusal contacts without wearing removable dentures was performed by calibrated examiners. Oral healthcare utilization data were retrieved from the records of the Belgian Intermutualistic Agency. Participants' oral health and sociodemographic data were linked to registered oral care utilization in the previous 5-year period. Regular attenders (annual attenders and those with at least one registered contact in three different years) were compared with irregular attenders (those having had dental visits but not according to the definition of regular attenders) and nonattenders. Data were weighted to compensate for sampling and participation bias.

RESULTS

Six hundred and seventy-nine participants attended regularly, of whom 276 annually; 256 did not attend in the reference period. The overall D₃ MFT-Index was not noticeably different between attendance patterns (varying between 11 and 13), although regular attenders had more restored teeth than nonattenders (P < 0.01). No difference was seen for DPS-Index and number of teeth/occluding pairs (χ² test, P > 0.05). Females, participants with higher education, older participants and those in employment had higher rates of regular attendance.

CONCLUSIONS

Regular attenders had fewer untreated caries lesions, but neither lower caries experience nor lower DPS-Index than irregular attenders. Regular attendance was associated with sociodemographic variables.

Periodontal diagnosis, treatment, and referral patterns of general dental practitioners

AIM

The aim of the present study was to investigate the diagnosis, treatment, and referral patterns of periodontal patients by general dental practitioners (GDP).

METHODS

A questionnaire was mailed to registered GDP with publicly-listed postal addresses in Tasmania, Australia. Information was collected on demographics, training and professional development, examination, diagnosis and referral patterns, and periodontal treatment patterns.

RESULTS

Seventy-seven (44.5%) questionnaires were completed. Over 85% always or usually screened for periodontal disease. On average, 0 to ≤7 patients were diagnosed with periodontal disease. GDP were always or usually confident in treating gingivitis (100%), mild (98.7%) and moderate periodontitis (73.7%), and rarely or never confident in treating severe (81.6%) and aggressive periodontitis (86.8%). Over 38% frequently referred to periodontists, 35.5% sometimes, 21.1% rarely, and 5.3% never. Clinical factors associated with referral were periodontal pocketing of ≥6 mm, tooth mobility, no improvement following treatment, and a complex medical history.

CONCLUSIONS

Most GDP performed periodontal screening and diagnosis. They were confident in treating gingivitis and mild-to-moderate periodontitis. Referral to a periodontist was associated with disease severity, tooth mobility, a complex medical history, or unsuccessful treatment.

Non-clinical factors associated with referral to periodontal specialists

BACKGROUND

There is a limited body of literature exploring referral relationships between general dental practitioners and periodontists. Clinical and non-clinical factors associated with the referral process are rarely considered however a better understanding of these will improve the general dentist practitioner and periodontal specialist relationship and benefit patient management. This study investigated which non-clinical factors have an association with the referral of patients by general dental practitioners to periodontists in Tasmania, Australia.

METHODS

A questionnaire was emailed to registered general dental practitioners in Tasmania, Australia and information collected on demographics, referral patterns, and potential factors which may influence referral.

RESULTS

Response rate was 44.5%. Non-clinical factors that influenced referral were previous treatment by a periodontist (70.8%), a complex medical history (56.8%), the patient's reluctance to undergo periodontal treatment, medico-legal reasons, patient awareness of periodontal disease (47.3%), and lack of training (43.2%). Patients frequently declined periodontal referral due to cost (66.2%), oral health not being a priority (55.4%), or inconvenience (46.6%). The most important periodontist qualities were their reputation (84.0%), patient feedback (81.3%), ease of communication (72.0%), report quality (68.0%), and location (62.7%).

CONCLUSION

Non-clinical factors, such as practice type-, general dental practitioner-, patient-, periodontist-related factors are associated with referral by general dental practitioners to periodontists for periodontal management.

Factors affecting periodontal disease referral and the adherence to guidelines among general dentists

BACKGROUND

Current research highlights a need to investigate the factors affecting periodontal disease referral. Limited literature exists on periodontal disease referral in Australia and no comparison to the periodontal disease referral guidelines exists.

OBJECTIVE

This study analyses the factors affecting periodontal disease referral and the adherence to guidelines in general dentists in Queensland, Australia.

METHODS

Fifty-seven general dentists who are members of the Australian Dental Association (Queensland) undertook an online survey.

RESULTS

The disease factor regarded as most important (90% of respondents) was unresolved inflammation upon re-evaluation. The non-disease factor regarded as most important (79% of respondents) was the operator's level of training. There is low awareness of the guidelines (36.7%) yet a reasonable adherence to them (78.3%). Of those aware of the guidelines, there was a statistically significant poorer adherence to the guidelines compared to those unaware (P = 0.036), while there is no significant difference in the adherence to guidelines between those who have and those who have not attended continuing professional development (CPD) courses (P = 0.66).

CONCLUSIONS

Adherence to current guidelines is not significantly impacted by the level of awareness of the guidelines or CPD attendance. The results from this study suggest a need to refine the current guidelines to better inform decisions about periodontal disease referrals.

Scaling and root planing vs. conservative surgery in the treatment of chronic periodontitis

A renewed interest in conservative surgical techniques has been fueled by new technology, changes in referral patterns to periodontists and a desire to achieve periodontal health in the least invasive, most cost-efficient manner possible. Trends suggest that an increasing amount of periodontal care is being provided in the offices of general dentists. If true, it is likely that patients receiving care in these offices will be offered simpler surgical treatment modalities that do not require an extensive armamentarium. The purpose of this article was to review the effectiveness of six relatively simple surgical techniques - gingivectomy, flap debridement, modified Widman flap, excisional new attachment procedure, modified excisional new attachment procedure and laser-assisted new attachment procedure - and to compare the results obtained using these procedures with the well-known clinical benefits of scaling and root planing. The intent was to determine whether the benefits of surgical procedures in the hands of most general dentists extend beyond those of conventional nonsurgical therapy.

Comparative Analysis of User-Generated Online Yelp Reviews for Periodontal Practices in Multiple Metropolitan Markets

BACKGROUND

Previously published research for a single metropolitan market (Austin, Texas) found that periodontists fare poorly on the Yelp website for nearly all measured metrics, including average star ratings, number of reviews, review removal rate, and evaluations by "elite" Yelp users. The purpose of the current study is to confirm or refute these findings by expanding datasets to additional metropolitan markets of various sizes and geographic locations.

METHODS

A total of 6,559 Yelp reviews were examined for general dentists, endodontists, pediatric dentists, oral surgeons, orthodontists, and periodontists in small (Austin, Texas), medium (Seattle, Washington), and large (New York City, New York) metropolitan markets. Numerous review characteristics were evaluated, including: 1) total number of reviews; 2) average star rating; 3) review filtering rate; and 4) number of reviews by Yelp members with elite status. Results were compared in multiple ways to determine whether statistically significant differences existed.

RESULTS

In all metropolitan markets, periodontists were outperformed by all other dental specialties for all measured Yelp metrics in this study. Intermetropolitan comparisons of periodontal practices showed no statistically significant differences.

CONCLUSIONS

Periodontists were outperformed consistently by all other dental specialties in every measured metric on the Yelp website. These results were consistent and repeated in all three metropolitan markets evaluated in this study. Poor performance of periodontists on Yelp may be related to the age profile of patients in the typical periodontal practice. This may result in inadvertently biased filtering of periodontal reviews and subsequently poor performance in multiple other categories.

Non-Clinical Factors Associated With Referrals to Periodontal Specialists: A Systematic Review

BACKGROUND

Comprehensive understanding of the referral process and factors associated with it will assist general dentist (GD)-periodontist relationships and benefit patient care and services. Non-clinical factors (NCFs) influence clinical decision making but are rarely considered. The objective of this review is to identify NCFs found to be associated with referrals to periodontal specialists.

METHODS

A systematic review of English-language literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search was carried out using the Cumulative Index to Nursing and Allied Health Literature, Dentistry and Oral Sciences Sources, and PubMed. Search terms used included: 1) refer; 2) referral; 3) periodontal; and 4) periodontist. Potentially relevant publications were analyzed in detail using predetermined inclusion and exclusion criteria. Selected papers were assessed using the Mixed Methods Appraisal Tool, and data extracted were thematically synthesized.

RESULTS

Ten studies that examined NCFs fulfilled inclusion criteria. Four NCF themes identified were practice-, GD-, patient-, and periodontist-related factors.

CONCLUSIONS

Limited literature is available on NCFs associated with referrals to periodontal specialists. Within the limits of this systematic review, NCFs affecting the referral process are practice-, GD-, patient-, and periodontist-related factors. These vary among different GD populations studied. Factors that could be targeted to improve referral processes include geographic location, undergraduate training, and continuing professional development.

Treatment procedures and referral patterns of general dentists in Lithuania

BACKGROUND AND OBJECTIVE

The requirement for dental specialties and the number of specialists in each country depends on the content and execution of undergraduate dental education, the complex oral health care needs of the society and other factors. The aim of our study was to assess specific treatment procedures of Lithuanian general dentists and their need to refer patients to specialists.

MATERIALS AND METHODS

Census sampling was employed and the data collected by means of a structured questionnaire asking dentists about the frequency of specific treatment procedures they perform and the frequency of referrals they make to different dental specialists. The results are of a self-reported nature.

RESULTS

From general dental practice, 76.3% of cases needing orthodontic treatment were referred to orthodontists. About half of patients needing specialized care were referred to periodontists (50.2%), orthopedists (46.9%) and oral surgeons (45.0). More than one-third (39%) of the cases needing specialist care were referred to endodontists. Only one-third of patients were referred to pediatric dentists. In about 60% of cases needing respective care general dentists extracted teeth and roots, made incisions in acute jaw infections and treated young children; in about half of cases general dentists performed complex endodontic manipulations and treatment with fixed and removable prostheses.

CONCLUSIONS

There is a clear need for Lithuanian dental practitioners to refer patients to all types of dental specialists. Undergraduate dental education program and postgraduate training should be more directed toward the extraction of teeth and roots, treatment of young children and provision of dental prostheses to patients.

Provision of specific dental procedures by general dentists in the National Dental Practice-Based Research Network: questionnaire findings

Background

Objectives were to: (1) determine whether and how often general dentists (GDs) provide specific dental procedures; and (2) test the hypothesis that provision is associated with key dentist, practice, and patient characteristics.

Methods

GDs (n = 2,367) in the United States National Dental Practice-Based Research Network completed an Enrollment Questionnaire that included: (1) dentist; (2) practice; and (3) patient characteristics, and how commonly they provide each of 10 dental procedures. We determined how commonly procedures were provided and tested the hypothesis that provision was substantively related to the three sets of characteristics.

Results

Two procedure categories were classified as “uncommon” (orthodontics, periodontal surgery), three were “common” (molar endodontics; implants; non-surgical periodontics), and five were “very common” (restorative; esthetic procedures; extractions; removable prosthetics; non-molar endodontics). Dentist, practice, and patient characteristics were substantively related to procedure provision; several characteristics seemed to have pervasive effects, such as dentist gender, training after dental school, full-time/part-time status, private practice vs. institutional practice, presence of a specialist in the same practice, and insurance status of patients.

Conclusions

As a group, GDs provide a comprehensive range of procedures. However, provision by individual dentists is substantively related to certain dentist, practice, and patient characteristics. A large number and broad range of factors seem to influence which procedures GDs provide. This may have implications for how GDs respond to the ever-changing landscape of dental care utilization, patient population demography, scope of practice, delivery models and GDs’ evolving role in primary care.

Electronic supplementary material

The online version of this article (doi:10.1186/1472-6831-15-11) contains supplementary material, which is available to authorized users.

Economics of periodontal care: market trends, competitive forces and incentives

The adoption of new technologies for the treatment of periodontitis and the replacement of teeth has changed the delivery of periodontal care. The objective of this review was to conduct an economic analysis of a mature periodontal service market with a well-developed workforce, including general dentists, dental hygienists and periodontists. Publicly available information about the delivery of periodontal care in the USA was used. A strong trend toward increased utilization of nonsurgical therapy and decreased utilization of surgical periodontal therapy was observed. Although periodontal surgery remained the domain of periodontists, general dentists had taken over most of the nonsurgical periodontal care. The decline in surgical periodontal therapy was associated with an increased utilization of implant-supported prosthesis. Approximately equal numbers of implants were surgically placed by periodontists, oral and maxillofacial surgeons, and general dentists. Porter's framework of the forces driving industry competition was used to analyze the role of patients, dental insurances, general dentists, competitors, entrants, substitutes and suppliers in the periodontal service market. Estimates of out-of-pocket payments of self-pay and insured patients, reimbursement by dental insurances and providers' earnings for various periodontal procedures and alternative treatments were calculated. Economic incentives for providers may explain some of the observed shifts in the periodontal service market. Given the inherent uncertainty about treatment outcomes in dentistry, which makes clinical judgment critical, providers may yield to economic incentives without jeopardizing their ethical standards and professional norms. Although the economic analysis pertains to the USA, some considerations may also apply to other periodontal service markets.

Diabetes mellitus and periodontal health: dentists' knowledge

OBJECTIVES

There is a strong body of evidence to support the relationship between periodontal diseases and diabetes mellitus. Unless dental practitioners are aware of this link, they cannot apply the information to their daily practice. The aim of the study was, therefore, to evaluate the knowledge of dental practitioners concerning the effect of diabetes on periodontal health.

SUBJECTS AND METHODS

This was a cross-sectional survey of randomly selected dental practitioners in Kuwait. Participants were asked about specific periodontal complications which they believed that patients diagnosed with diabetes were more susceptible to.

RESULTS

A total of 220 dental practitioners (133 general dental practitioners and 87 dental specialists) participated in the study. Less than 60% of all study participants reported that tooth loss due to periodontal reasons and periodontal abscess were frequent among diabetic patients. Dental specialists, especially periodontists, were significantly more aware of periodontal complications associated with diabetes. Factors significantly associated with having knowledge about the effect of diabetes on periodontal health in logistic regression analysis were dentists who were older and those who were specialists.

CONCLUSIONS

The results of this study indicate that knowledge about the effects of diabetes on periodontal health among this sample of dental practitioners is generally low, and dentists may underestimate the outcomes of periodontal diseases in diabetic patients.

Knowledge about the association between periodontal diseases and diabetes mellitus: contrasting dentists and physicians

BACKGROUND

There is a strong body of evidence that supports the relationship between periodontal diseases and diabetes mellitus (DM). Many patients are unaware of the effects of diabetes on oral health. Whether health care providers are applying the information about the link between DM and periodontal diseases in their practices depends on the levels of their knowledge of such valuable information. Therefore, the aims of this study are to evaluate the knowledge of dental and medical practitioners concerning the effects of diabetes on periodontal health and to find out if the practitioners are aware of the bidirectional relationship between periodontal diseases and DM.

METHODS

This was a cross-sectional survey of randomly selected general practitioners practicing in Kuwait. Participants were asked about specific periodontal complications that they believed patients diagnosed with diabetes were more susceptible to, and their awareness of the bidirectional relationship between diabetes and periodontal diseases was evaluated.

RESULTS

A total of 510 general practitioners (232 physicians and 278 dentists) participated in the study. There were no significant differences between the two groups regarding mean ages, sex distributions, and years in practice. Only 50% of all study participants believed that patients with diabetes were more susceptible to tooth loss because of periodontal diseases than were individuals without diabetes. Dentists were significantly more aware of gingival bleeding, tooth mobility, and alveolar bone resorption than were physicians. Factors significantly associated with having knowledge about the effects of diabetes on periodontal health in logistic regression analyses were older age, female sex, and the dental profession.

CONCLUSION

The knowledge about the association between periodontal diseases and DM should be increased among dental and medical practitioners to effectively prevent, manage, and control diabetes and periodontal diseases.