Awareness and clinical practices of pulmonologists regarding the periodontal–pulmonary link: a cross-sectional study

BACKGROUND: Periodontitis and chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma, are chronic inflammatory conditions that share common risk factors and pathophysiological mechanisms. Accumulating evidence indicates a bidirectional relationship between periodontal inflammation and respiratory disease outcomes; however, the extent to which pulmonologists recognize and incorporate this association into clinical practice remains unclear. Therefore, this study aimed to evaluate pulmonologists' awareness, perspectives, and clinical practice approaches regarding the relationship between periodontal disease and COPD/asthma. METHODS: A questionnaire-based, cross-sectional study was conducted among 111 pulmonologists. The survey assessed demographic characteristics, oral health awareness, knowledge of periodontal-pulmonary interactions, and clinical behaviors related to oral health inquiry and dental referral. Data was analyzed using descriptive statistics and chi-square tests to examine associations between responses and participant characteristics. RESULTS: Most participants (91.9%) lacked formal education on the periodontal-pulmonary link, yet a significant 'desire-knowledge gap' emerged, with 68.5% were willing to attend structured training. Although 61.3% reported that patients referring to dentists, 54.1% never inquired about oral symptoms. While clinical awareness was high for inhaler side effects, 66.7% remained uncertain about shared inflammatory mechanisms and the impact of periodontal treatment on COPD exacerbations. Notably, female pulmonologists and those in university settings demonstrated significantly higher knowledge and proactive inquiry patterns. CONCLUSION: Pulmonologists exhibit a significant 'desire-knowledge gap', characterized by a lack of formal education despite high receptivity to interdisciplinary training. Awareness remains fragmented and largely confined to local inhaler effects, leaving systemic inflammatory risks and clinical inquiry neglected. Integrating oral-systemic health into medical curricula and fostering collaborative referral cultures-particularly in non-academic settings-are essential to bridge this clinical gap and optimize the holistic management of patients with COPD and asthma.