Bridging the perception-practice gap: a mixed-methods study on interprofessional collaboration for diabetes and periodontitis management

Diabetes and periodontitis have a bidirectional association, yet interprofessional collaboration (IPC) for their management remains inconsistent in clinical practice. Notably, national and international guidelines often omit oral health assessment from routine diabetes management. This study aims to assess primary care professionals’ perceptions of this association and their related management practices, and to explore the underlying barriers to low bidirectional screening and referral rates. A sequential explanatory mixed methods design was used. Community medical practitioners, community nurses, and dentists were recruited via stratified sampling from relevant healthcare institutions. First, an online quantitative questionnaire assessed their knowledge of the diabetes-periodontitis association, clinical behaviors, and referral practices. Subsequently, semi-structured qualitative interviews were conducted with a subset of participants to explore the reasons for the perception-practice gap, based on the quantitative findings. A total of 319 participants completed the questionnaire, with 118 of them also taking part in semi-structured interviews. Over 90% of participants recognized the bidirectional association between diabetes and periodontitis, yet obvious gaps existed in clinical practice. Professional groups also differed in perceptions, particularly of screening responsibilities. Thematic analysis of interviews identified three key issues undermining IPC. Although primary care and dental professionals widely acknowledge the bidirectional association between diabetes and periodontitis and show willingness to collaborate interprofessionally, a notable perception-practice gap remains in their collaborative management. To address this, targeted interprofessional training, clear referral protocols, and strengthened policy support are recommended to enhance the effectiveness of IPC in primary care.