Attitudes and opinions of Oral healthcare professionals on screening for Type-2 diabetes

Abstract

Background As part of a larger study on the identification of undiagnosed Type 2 diabetes (T2D), and prediabetes patients in dental settings, this study explored oral healthcare professionals’ (OHP) attitudes with respect to the relevance and appropriateness of screening for prediabetes/T2D in general oral healthcare settings. It also aims to gain a deeper understanding of OHPs’ concerns and perceived barriers to screening for T2D. Methods Semi-structured interviews were conducted with 11 OHPs: eight dentists, two dental hygienists and one oral health therapist. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis. Results Themes that emerged from the interviews were organised under three major categories: 1) Implementation: OHPs willingness to screen for prediabetes/T2D; 2) Barriers to implementation of screenings; subdivided into: a) lack of knowledge and formal training about T2D screening methodology; b) concerns about patients’ awareness and acceptance of T2D screening in oral healthcare settings; c) costs and reimbursement for the time and resources required to screen patients; and d) legal and scope of practice; and 3) Collaboration and communication between OHPs and General practitioners (GP). Conclusions The oral healthcare setting was considered as appropriate for medical screening, and OHPs were willing to participate in screening for prediabetes/T2D. Nonetheless, for the successful implementation of a screening programme, several barriers need to be addressed, and effective medical screening would require collaboration between oral health and medical and other health professionals, as well as clarification of legal and reimbursement issues.

Oral health professionals screening for undiagnosed type-2 diabetes and prediabetes: the iDENTify study

“…This limits considerably the effectiveness of diabetes screenings. In other studies the percentage of patients attending GPs following a diabetes risk assessment in the oral healthcare setting (private, public and University clinic) has varied from 20 to 84% [ 4 , 19 , 27 , 33 ]. In each of these studies patients had consented to undertake screening and had been advised of the possibility of being referred to a GP for follow-up and yet subsequent follow-up was low.…”

“…Barriers to patients attending follow-up appointments with GPs included misplacing the referral letter, being too busy, being away, the perception the condition was not ‘serious enough’ GP’s [ 27 ] lack of knowledge about diabetes, not understanding the importance of follow-up, cost, fear and denial [ 37 ]. Patients not seeking a medical diagnosis was a barrier to the completion of our screening protocol, and further research is needed to understand the reasons for this and develop strategies to overcome it.…”

“…Registration of interest could also be made via the study website ( https://identifydiabetes.org/ ). OHPs also had the opportunity to register their interest in participating at the end of their completion of an Attitudes and Opinions to T2D screening in dental settings survey [ 27 ].…”

Diabetes and Oral Health (DiabOH): The Perspectives of Primary Healthcare Providers in the Management of Diabetes and Periodontitis in China and Comparison with Those in Australia

“…However, a current lack of collaboration remains between medical and oral health practitioners to manage these diseases, including screening [ 12 , 13 ]. One study indicated that rural general medical practitioners (GPs) in Australia had concerns about their competence to deal with oral health issues when consulting patients with emergency dental problems.…”

“…Standard practice involved providing short-term pain relief, prescriptions for antibiotics, and recommending patients to see an oral health professional [ 14 ]. Another paper looked at barriers within screening in a general practice environment, included legal and reimbursement issues [ 13 ]. This is consistent with general medical practice activity data that show that while GP consultations regularly involve patients raising dental concerns, the GPs’ oral health training and awareness are inadequate to deal with complex oral health issues [ 15 ].…”