Scottish medical professionals lack awareness of diabetes-periodontal disease link
Scottish study reveals medical practitioners rarely discuss periodontal disease risk with diabetes patients; updated NICE and SDCEP guidance now available.
Most medical professionals do not discuss periodontal disease with diabetes patients
A survey of 128 medical healthcare professionals in Scotland found that most do not discuss the link between diabetes and periodontal disease with their patients, nor do they refer patients to dentists or inform dentists of a diabetes diagnosis. The study, conducted in 2021, included endocrinology consultants and registrars, general practitioners, diabetes specialist nurses, practice nurses and healthcare assistants across all 14 Scottish health boards. Researchers found that 92 percent of participants never or rarely advised patients with diabetes that their condition increases the risk of periodontal disease, and 93 percent never or rarely referred newly diagnosed patients to a dentist for oral assessment.
Knowledge gaps and barriers to communication
The primary obstacles to discussing the relationship are lack of knowledge and awareness. Seventy-three percent of participants indicated they were unaware of the link between diabetes and periodontal disease, and 92 percent were unfamiliar with guidance on managing this relationship. Time constraints and unclear referral pathways between medical and dental services also emerged as major barriers. Eighty-two percent reported insufficient time to discuss the topic, and 97 percent never or rarely contacted dentists to inform them of a patient's diabetes diagnosis. When asked about referring patients to dentists, 62 percent said they did not refer patients at all, while 34 percent would only indirectly signpost patients.
Potential solutions and future developments
Participants indicated support for interventions to improve communication. Forty-two percent said online learning resources for medical practitioners would be extremely helpful, while 67 percent identified an automated referral system alerting dentists to new diabetes diagnoses as the most useful tool. Since this study was completed in 2021, NICE updated its Type 2 diabetes guidance in 2022 with four new recommendations related to periodontitis, and in 2024 the Scottish Dental Clinical Effectiveness Programme published updated guidance on periodontal disease prevention and treatment that includes advice for medical practitioners. The researchers recommend future studies to assess whether these recent publications have changed medical professionals' behaviour and knowledge.
Frequently asked questions
Do medical professionals in Scotland discuss periodontal disease risk with diabetes patients?
No. Ninety-two percent of the 128 surveyed medical professionals never or rarely advised patients with diabetes about the increased risk of periodontal disease, and 90 percent never or rarely discussed how periodontal disease can worsen blood sugar control.
What percentage of medical professionals refer diabetes patients to dentists?
Sixty-two percent do not refer patients with diabetes to dentists at all. Thirty-four percent only indirectly signpost patients, and just 4 percent make direct referrals via letter, phone, email or fax.
Why don't Scottish medical professionals discuss the diabetes-periodontal disease link?
The main barriers are lack of knowledge and awareness (73 percent unaware of the link), insufficient appointment time (82 percent), unclear referral pathways, and no clear guidance on how to initiate the conversation.
What support would help medical professionals communicate about diabetes and periodontal disease?
Sixty-seven percent said an automated referral system alerting dentists to new diabetes diagnoses would be extremely useful, and 42 percent wanted online learning resources for medical practitioners.
Have guidelines changed since this study was conducted in 2021?
Yes. NICE updated its Type 2 diabetes guidance in 2022 with four new recommendations on periodontitis, and in 2024 the Scottish Dental Clinical Effectiveness Programme published updated guidance that includes advice for medical practitioners.
