Integrating knowledge into action: a mixed-methods study of interprofessional diabetes-periodontitis care
1
Preventive dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
2
Medical college, Anhui University of Science and Technology, Huainan, China
3
Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Diabetes and periodontitis have a well-established bidirectional relationship, with each exacerbating the other: diabetes impairs periodontal health via inflammatory dysregulation and oral microbiota imbalance, while periodontitis worsens glycemic control through systemic inflammation and insulin resistance. However, interprofessional collaboration between general practitioners and dentists for coordinated bidirectional screening and referrals remains fragmented globally, leaving a significant gap in interprofessional diabetes-periodontitis care despite broad recognition of the need for integration.
METHODS:
An explanatory sequential mixed-methods design was employed. First, a cross-sectional online survey was administered to 319 community-based general practitioners, nurses, and dentists in Shanghai, assessing their knowledge, attitudes, and clinical behaviors regarding diabetes-periodontitis management. Subsequently, semi-structured interviews were conducted with 118 participants to explore underlying reasons for identified gaps. Data were analyzed using descriptive statistics, chi-square tests, and thematic analysis.
RESULTS:
Over 90% of respondents acknowledged the bidirectional diabetesperiodontitis link, yet clinical practice showed marked gaps. Most community medical practitioners and nurses rarely performed oral health screening for diabetic patients, and referral rates were low. Perceptions of screening responsibility differed across professions, with dentists more supportive of medicalled oral screening than general practitioners. Qualitative analysis identified three core barriers: deficits in interdisciplinary awareness, limitations in clinical skills and tools, and systemic constraints such as high workload, unclear referral pathways, and insufficient resources.
CONCLUSIONS:
A significant gap persists in interprofessional diabetes-periodontitis care, driven by role ambiguity, knowledge deficits, and systemic inefficiencies. Measures should be taken to address these key issues to improve comprehensive primary care for patients with diabetes and periodontitis.
Diabetes and periodontitis have a well-established bidirectional relationship, with each exacerbating the other: diabetes impairs periodontal health via inflammatory dysregulation and oral microbiota imbalance, while periodontitis worsens glycemic control through systemic inflammation and insulin resistance. However, interprofessional collaboration between general practitioners and dentists for coordinated bidirectional screening and referrals remains fragmented globally, leaving a significant gap in interprofessional diabetes-periodontitis care despite broad recognition of the need for integration.
METHODS:
An explanatory sequential mixed-methods design was employed. First, a cross-sectional online survey was administered to 319 community-based general practitioners, nurses, and dentists in Shanghai, assessing their knowledge, attitudes, and clinical behaviors regarding diabetes-periodontitis management. Subsequently, semi-structured interviews were conducted with 118 participants to explore underlying reasons for identified gaps. Data were analyzed using descriptive statistics, chi-square tests, and thematic analysis.
RESULTS:
Over 90% of respondents acknowledged the bidirectional diabetesperiodontitis link, yet clinical practice showed marked gaps. Most community medical practitioners and nurses rarely performed oral health screening for diabetic patients, and referral rates were low. Perceptions of screening responsibility differed across professions, with dentists more supportive of medicalled oral screening than general practitioners. Qualitative analysis identified three core barriers: deficits in interdisciplinary awareness, limitations in clinical skills and tools, and systemic constraints such as high workload, unclear referral pathways, and insufficient resources.
CONCLUSIONS:
A significant gap persists in interprofessional diabetes-periodontitis care, driven by role ambiguity, knowledge deficits, and systemic inefficiencies. Measures should be taken to address these key issues to improve comprehensive primary care for patients with diabetes and periodontitis.
| eISSN: | 2654-1459 |
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