Background and Objective: The primary determinant for patient referral by general dental practitioners (GDPs) to periodontists differs based on the country of practice. Moreover, previous research has revealed that GDP preferences for managing periodontal patients, actual number of referrals, and the overall decision-making process have evolved over time. Understanding the periodontal referral pattern of Filipino GDPs could help identify factors that promote or inhibit referral to periodontists. These factors may in turn be used as basis for the formulation of periodontal referral guidelines for use by GDPs in the Philippines. Therefore, this study aimed to determine the factors that affect the referral patterns of Filipino GDPs to periodontists, with GDPs practicing in the City of Manila as the representative population. Methods: A descriptive cross-sectional study design with the use of a self-administered survey was utilized for this study. Participants were 75 licensed dentists practicing in the City of Manila who were members of the Philippine Dental Association-Manila Dental Chapter. The questionnaire collected information on sociodemographic characteristics of the participants, periodontal referral pattern, and the factors considered by the participants when referring patients to a periodontist. Descriptive statistics (frequency and percentage) were used to report the study’s findings. Results: Majority (92%) indicated that they regularly referred patients with periodontal disease to periodontists, with a personal estimate of up to 20 periodontal case referrals monthly by 81.3% of the participants and >20 referrals for 10.7%. The clinical factors considered as most important when referring to a periodontist were the type of periodontal disease (81.3% of the participants), periodontitis severity (74.7%), and the presence of a complex medical history 61.3%). Among the nonclinical factors, the most influential were the following: uncooperative patient (32% of the participants), perceived personal skill (24%), postgraduate training of the periodontist (21.3%), and the patient’s financial capacity (13.3%). Conclusion Multiple factors affect the decision of general dental practitioners in the City of Manila when referring patients to a periodontist. Majority are influenced by clinical factors such as the type and severity of periodontal disease and the systemic condition of the patient. Although considered to a much lesser degree compared to clinical factors, the top nonclinical factors that Manila GDPs base their referral decisions include the assessment that a patient is uncooperative and the perceived adequacy of personal skills in managing periodontal patients.
Human ; periodontal diseases ; referral and consultation ; dentists ; periodontists

Background and Objectives: Periodontitis and Diabetes Mellitus are both inflammatory conditions that trigger the host response in a similar manner. The effect of uncontrolled diabetes on the progression of periodontitis, as well as the effect of periodontal health on the glycemic control of a patient, have been well documented. The need to include oral health in the management of a diabetic patient is deemed necessary. The objective of this study is to determine the awareness of the interrelationship between diabetes and periodontal disease among Endocrinologists in the Philippines and to determine whether management of a diabetic patient includes measures on maintaining periodontal health. Methodology: A 20-item self-administered survey questionnaire was distributed to endocrinologists registered in the Philippine Society of Endocrinology, Diabetes and Metabolism (PSEDM) Seminar and General Assembly held on September 5-6, 2015 at Sofitel Manila, Pasay City. The questionnaire was comprised of eight multiple choice and 12 yes-no questions, which combined queries on demographics, associations between diabetes and periodontitis as well as patient management. Results: Most of the endocrinologists answered that tooth brushing and flossing should be performed at a minimum of twice a day (96.6%) and that frequency of dental visits should be at least every six months (71.3%). Although most endocrinologists claimed to be aware of the manifestations of gingivitis and periodontitis, only 3.6% accurately identified the symptoms of gingivitis and 3% accurately identified the symptoms of periodontitis. Majority (79.2%) were aware that periodontal disease affects Diabetes Mellitus (DM) and that DM is a risk factor for Periodontitis (95.9%). However, only 38.6% noted periodontitis as one of the complications of diabetes. More than half of the respondents refer their patients to dentists but less than half educate their patients on oral health. Conclusion More than 90% of the Endocrinologists are aware of the bidirectional relationship of Periodontal disease and diabetes mellitus but do not clearly know the difference between gingivitis and periodontitis. In addition, the awareness is not translated to the management of diabetic patients.
Endocrinologists ; Periodontal Diseases