Diabetes and oral health (DiabOH) : pilot of two screening tools at a community health centre

Context: People with diabetes have increased prevalence of periodontitis and people with gum issues have higher risks of poor glycaemic control. Yet, patients with diabetes and/or periodontitis are not routinely screened. Unlike the widely used Australian Diabetes Risk Assessment (AUSDRISK) tool, currently there is no non-invasive screening instrument for periodontal risks. Objective: To pilot: 1. a periodontal risk assessment (PRISK) tool developed for non-dental health professionals with general practitioners (GPs), practice nurses (PNs) and diabetes educators (DEs); 2. the AUSDRISK tool with oral health professionals (OHPs). Design: Mixed methods exploratory study. PRISK is a non-invasive tool developed by the DiabOH research team in consultation with the project advisory group. This and the AUSDRISK tool were piloted with medical and dental staff at a community health centre (CHC). Practitioners then participated in focus groups and interviews to explore the tools’ acceptability and feasibility. Quantitative data was analysed descriptively; qualitative data was analysed thematically. Setting: A CHC in Melbourne. Participants: GPs, PNs, DEs and OHPs at the CHC. Findings: Seven GP/PNs/DEs conducted 59 PRISK assessments resulting in 23 dental referrals; 7 OHPs conducted 28 AUSDRISK assessments resulting in 7 medical referrals. Eleven practitioners provided feedback after the pilot. Most found the screening tools acceptable and feasible although there were concerns about patients’ receptiveness, time constraint and long public dental appointment waiting list. Implication(s) for practice: Further research to address the beliefs and barriers that impact on early detection and management would provide best-evidence care for patients with comorbid diabetes and periodontitis.