title: Current status of collaborative relationships between dialysis facilities and dental facilities in Japan: results of a nationwide survey.
abstract: BACKGROUND
  Recent studies have reported an association between periodontal disease and mortality among dialysis patients. Therefore, preventive dental care should be considered very important for this population. In Japan, no systematic education has been undertaken regarding the importance of preventive dental care for hemodialysis patients--even though these individuals tend to have oral and dental problems. The aim of this study was to investigate the current state of collaborative relationships between hemodialysis facilities and dental services in Japan and also to identify strategies to encourage preventive dental visits among hemodialysis outpatients.
  
  
  METHODS
  A nationwide questionnaire on the collaborative relationship between dialysis facilities and dental facilities was sent by mail to all medical facilities in Japan offering outpatient hemodialysis treatment.
  
  
  RESULTS
  Responses were obtained from 1414 of 4014 facilities (35.2%). Among the 1414 facilities, 272 (19.2%) had a dental service department. Approximately 100,000 dialysis outpatients were receiving treatment at these participating facilities, which amounts to one-third of all dialysis patients in Japan. Of those patients, 82.9% received hemodialysis at medical facilities without dental departments. Only 87 of 454 small clinics without in-house dental departments (19.2%) had collaborative registered dental clinics. Medical facilities with registered dental clinics demonstrated a significantly more proactive attitude to routine collaboration on dental matters than facilities lacking such clinics.
  
  
  CONCLUSIONS
  Our nationwide survey revealed that most dialysis facilities in Japan have neither an in-house dental department nor a collaborative relationship with a registered dental clinic. Registration of dental clinics appears to promote collaboration with dental facilities on a routine basis, which would be beneficial for oral health management in hemodialysis patients.
authors.affiliation: Department of Oral Health Science and Social Welfare, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan. yoshioka.masami@tokushima-u.ac.jp.
authors.forename: Masami
authors.initials: M
authors.lastname: Yoshioka
authors.affiliation: Department of Community Medicine and Welfare, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan. shirayama@tokushima-u.ac.jp.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Shirayama
authors.affiliation: Department of Human Genetics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan. issehgen@tokushima-u.ac.jp.
authors.forename: Issei
authors.initials: I
authors.lastname: Imoto
authors.affiliation: Department of Hygiene and Oral Health Science, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan. hinode@tokushima-u.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hinode
authors.affiliation: Department of Oral Health Science and Social Welfare, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan. yanagisawa@tokushima-u.ac.jp.
authors.forename: Shizuko
authors.initials: S
authors.lastname: Yanagisawa
authors.affiliation: Department of Community Medicine and Welfare, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan. yukotakeuchi@tokushima-u.ac.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Takeuchi
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003749:Dental Facilities / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006436:Hemodialysis Units, Hospital / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D007564:Japan; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009909:Oral Health; D010518:Periodontitis / Q000175:diagnosis / Q000453:epidemiology*; D016730:Program Development; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D011795:Surveys and Questionnaires