Knowledge, attitudes, and practices of medical and dental professionals in Hong Kong regarding interprofessional management of diabetes and periodontal diseases

Abstract

Background: There is a well-established bidirectional relationship between diabetes mellitus and periodontal diseases. The interdisciplinary approach in managing diabetic patients is favoured. Objective: The aims of this project were to investigate the knowledge, attitudes, and practice of medical and dental practitioners in managing diabetes and periodontal diseases, and to explore the interdisciplinary approach in managing diabetic patients in Hong Kong. Materials and Methods: This project consisted of two main parts, i.e., (1) a qualitative and (2) a quantitative study. The qualitative study included several interviews with physicians and dentists in Hong Kong to understand their current clinical practice, and to investigate their perspectives on medical-dental collaboration in terms of managing diabetic patients. The quantitative study was designed as a survey using a self-completed questionnaire. Based on the findings of the interviews, two questionnaires were developed for physicians and dentists, respectively. Convenient sampling method was employed to collect responses from physicians and dentists, respectively. Results: One physician and 5 dentists accepted the interview. As for the survey, a total of 165 dentists joined the questionnaire survey. Most of them (150, 91%) were general dental practitioners, obtained basic dental degree in Hong Kong (153, 93%), and less than half (75, 46%) had additional postgraduate qualifications. Only 13% of the dentists reported to perform diabetic screening test in their clinical practice. Lack of necessity/urgency (71%) was cited as the top reason for not conducting diabetic screening. More than half of the dentists (58%) reported that they had made verbal recommendations for patients with periodontitis to seek diabetes consultations, while only 15% of the dentists had made written referrals. It was found that dentists with postgraduate qualifications (p=0.017) and under group practices with physicians (p=0.029) were more likely to make verbal recommendations. Besides, 58 physicians took part in the questionnaire survey. Around half of them were specialists and most of them (88%) held additional postgraduate qualifications. Majority of the physicians (72%) were aware of the bidirectional relationship between diabetes and periodontal diseases. However, they (81%) did not examine diabetic patients’ oral conditions or inquire about diabetic patients’ oral health problems. Majority of the physicians never or rarely made verbal recommendations (86%) or written referrals (54%) for diabetic patients to seek dental care. In addition, over 70% of physicians reported that they never received referrals from dentists for diabetic consultation. Conclusion: In Hong Kong, collaborations of medical and dental practitioners in managing diabetes and periodontal diseases are insufficient. Guidelines and structured referral systems, in addition to further training, are in need for both dentists and physicians to improve care for patients with diabetes and periodontal diseases.