title: Dentists' knowledge and opinions of oral-systemic disease relationships: relevance to patient care and education.
abstract: Population studies consistently support associations between poor oral (periodontal) health and systemic diseases such as cardiovascular disease (CVD) and diabetes. The aim of this study was to assess the knowledge of dentists and document their opinions regarding the evidence on oral-systemic disease relationships. A survey consisting of 39 items was developed and mailed to 1,350 licensed dentists in North Carolina. After three mailings, 667 dentists (49%) meeting inclusion criteria responded. The respondents were predominantly male (76.3%), in solo practice (59.5%), and in non-rural settings (74%). More than 75% of these dentists correctly identified risk factors like diet, genetics, smoking, obesity, and physical inactivity for CVD and diabetes. The majority rated the evidence linking periodontal disease with CVD and diabetes as strong (71% and 67%, respectively). These dentists were most comfortable inquiring about patients' tobacco habits (93%), treating patients with diabetes (89%) or CVD (84%) and concurrent periodontal disease, and discussing diabetes-periodontal disease risks with patients (88%). Fewer respondents were comfortable asking patients about alcohol consumption (54%) or providing alcohol counseling (49%). Most agreed that dentists should be trained to identify risk factors (96%) or actively manage systemically diseased patients (74%). Over 90% agreed that medical and dental professionals should be taught to practice more collaboratively. These data indicate that these dentists were knowledgeable about oral-systemic health associations, had mixed comfort levels translating the evidence into clinical practice, but expressed support for interprofessional education to improve their readiness to actively participate in their patients' overall health management.
authors.affiliation: Dr. Paquette is Professor and Associate Dean for Education, Stony Brook University School of Dental Medicine; Prof. Bell is Assistant Professor, Pacific University School of Dental Health Science; Dr. Phillips is Professor, Department of Orthodontics and Assistant Dean for Advanced Education/Graduate Programs, University of North Carolina at Chapel Hill School of Dentistry; Dr. Offenbacher is W.R. Kenan Jr. Distinguished Professor, Chair of the Department of Periodontology, and Director of the Center for Oral and Systemic Diseases, North Carolina Oral Health Institute, University of North Carolina at Chapel Hill School of Dentistry; and Prof. Wilder is Professor in the Department of Dental Ecology, Director of Graduate Dental Hygiene Education, and Director of Faculty Development, University of North Carolina at Chapel Hill School of Dentistry. david.paquette@stonybrook.edu.
authors.forename: David W
authors.initials: DW
authors.lastname: Paquette
authors.affiliation: Dr. Paquette is Professor and Associate Dean for Education, Stony Brook University School of Dental Medicine; Prof. Bell is Assistant Professor, Pacific University School of Dental Health Science; Dr. Phillips is Professor, Department of Orthodontics and Assistant Dean for Advanced Education/Graduate Programs, University of North Carolina at Chapel Hill School of Dentistry; Dr. Offenbacher is W.R. Kenan Jr. Distinguished Professor, Chair of the Department of Periodontology, and Director of the Center for Oral and Systemic Diseases, North Carolina Oral Health Institute, University of North Carolina at Chapel Hill School of Dentistry; and Prof. Wilder is Professor in the Department of Dental Ecology, Director of Graduate Dental Hygiene Education, and Director of Faculty Development, University of North Carolina at Chapel Hill School of Dentistry.
authors.forename: Kathryn P
authors.initials: KP
authors.lastname: Bell
authors.affiliation: Dr. Paquette is Professor and Associate Dean for Education, Stony Brook University School of Dental Medicine; Prof. Bell is Assistant Professor, Pacific University School of Dental Health Science; Dr. Phillips is Professor, Department of Orthodontics and Assistant Dean for Advanced Education/Graduate Programs, University of North Carolina at Chapel Hill School of Dentistry; Dr. Offenbacher is W.R. Kenan Jr. Distinguished Professor, Chair of the Department of Periodontology, and Director of the Center for Oral and Systemic Diseases, North Carolina Oral Health Institute, University of North Carolina at Chapel Hill School of Dentistry; and Prof. Wilder is Professor in the Department of Dental Ecology, Director of Graduate Dental Hygiene Education, and Director of Faculty Development, University of North Carolina at Chapel Hill School of Dentistry.
authors.forename: Ceib
authors.initials: C
authors.lastname: Phillips
authors.affiliation: Dr. Paquette is Professor and Associate Dean for Education, Stony Brook University School of Dental Medicine; Prof. Bell is Assistant Professor, Pacific University School of Dental Health Science; Dr. Phillips is Professor, Department of Orthodontics and Assistant Dean for Advanced Education/Graduate Programs, University of North Carolina at Chapel Hill School of Dentistry; Dr. Offenbacher is W.R. Kenan Jr. Distinguished Professor, Chair of the Department of Periodontology, and Director of the Center for Oral and Systemic Diseases, North Carolina Oral Health Institute, University of North Carolina at Chapel Hill School of Dentistry; and Prof. Wilder is Professor in the Department of Dental Ecology, Director of Graduate Dental Hygiene Education, and Director of Faculty Development, University of North Carolina at Chapel Hill School of Dentistry.
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.affiliation: Dr. Paquette is Professor and Associate Dean for Education, Stony Brook University School of Dental Medicine; Prof. Bell is Assistant Professor, Pacific University School of Dental Health Science; Dr. Phillips is Professor, Department of Orthodontics and Assistant Dean for Advanced Education/Graduate Programs, University of North Carolina at Chapel Hill School of Dentistry; Dr. Offenbacher is W.R. Kenan Jr. Distinguished Professor, Chair of the Department of Periodontology, and Director of the Center for Oral and Systemic Diseases, North Carolina Oral Health Institute, University of North Carolina at Chapel Hill School of Dentistry; and Prof. Wilder is Professor in the Department of Dental Ecology, Director of Graduate Dental Hygiene Education, and Director of Faculty Development, University of North Carolina at Chapel Hill School of Dentistry.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Wilder
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000150:complications* / Q000235:genetics; D003430:Cross-Sectional Studies; D003729:Dental Care; D017742:Dental Care for Chronically Ill; D048909:Diabetes Complications / Q000235:genetics; D004032:Diet; D004497:Education, Dental; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010348:Patient Care Team; D010353:Patient Education as Topic; D010510:Periodontal Diseases / Q000150:complications* / Q000235:genetics; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011331:Private Practice; D011365:Professional Practice Location; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking
keywords: dental education; dental practice; dentists; interprofessional education; oral-systemic links; periodontal disease; periodontitis; risk assessment