Purpose: To assess the knowledge and attitudes of dentists at the largest municipal healthcare system in the United States with regard to point-of-care chairside diabetes testing in the dental clinic.
Keywords: diabetes, glucose monitoring, health promotion, interprofessional relations, primary health care
Materials and Methods: A 29-item survey was designed in a web-based platform (Survey Monkey) and distributed in November 2020 to 264 dental providers (attending dentists and residents) within eleven dental departments of the New York City Health + Hospitals municipal healthcare system. The questionnaire included sections on demographics, current practices, level of diabetes training, scope of practice, and attitudes regarding chairside diabetes testing. Descriptive statistics, bivariate analyses, and logistic regression analyses were performed, with statistical significance set at 0.05.
Results: Dentists’ willingness to provide chairside HbA1c screening was positively associated with their agreement that this was part of their role (OR = 7.2, p = 0.001) and that screening has an impact on diabetes control (OR = 4.3, p = 0.04). The two most commonly reported barriers to willingness to provide chairside HbA1c screening were amount of time required to obtain and discuss a patient’s test results (82.3%) and lack of reimbursement (70.6%).
Conclusion: Among the largest municipal healthcare systems in the US, there is very limited integration of diabetes screening and management in the dental setting. Given the epidemic of diabetes among the vulnerable population that these hospitals serve, the dental setting is a critical but underutilized site for diabetes screening and medical referral. Increased efforts should be directed towards implementing workflows that incorporate auxiliary dental staff in order to address barriers to chairside screening.