Knowledge, attitudes, and practices regarding periodontal assessment and co-management during orthodontic care among Moroccan dentists: a nationwide cross-sectional survey

Periodontal diseases are common chronic inflammatory conditions that may compromise the planning, safety, and outcomes of orthodontic treatment, particularly in adults and in patients with reduced periodontal support. In such patients, orthodontic care requires accurate periodontal diagnosis, confirmation of disease stability before treatment initiation, careful biomechanical adaptation, and close coordination with periodontal maintenance. However, the extent to which dentists providing orthodontic care integrate these principles into routine practice remains insufficiently documented, particularly in North African settings. This study assessed the knowledge, attitudes, and practices of Moroccan dentists providing orthodontic care regarding the diagnosis and management of patients with periodontal diseases. A nationwide cross-sectional online survey was conducted in Morocco between September 2025 and February 2026. Eligible participants were dentists practicing orthodontics exclusively or within general practice. The questionnaire included demographic variables, 8 knowledge items, and 9 attitude/practice items covering diagnosis, screening, treatment timing, interdisciplinary collaboration, and periodontal maintenance. Item-level descriptives used available-case denominators. Knowledge (0–7), attitude (0–2), practice (0–6), and total KAP (0–15) scores were calculated. Associations with periodontitis-case management were explored using logistic regression; correlates of KAP scores were examined using linear regression, with candidate variables selected from univariable analyses ( p < 0.20). Of 418 platform entries, 118 blank entries were excluded; 300 practitioners from 11 regions provided at least 1 valid response, including 190 complete questionnaires. Only 18.3% correctly defined periodontitis and 46.3% identified the radiographic criterion for bone loss, whereas 81.1% recognized apical displacement of the center of resistance and 70.4% identified intrusion as the movement associated with bone gain. Pre-orthodontic periodontal screening was reported by 63.0%, but systematic full-mouth 6-site probing by only 16.5%. Among periodontitis cases, 44.4% reported formal periodontal stability confirmation before treatment initiation and 35.9% waited 3 months after active periodontal therapy. Median knowledge, attitude, and total scores were 2 (interquartile range (IQR) 0–3)/7, 1 (IQR 0–1)/2, and 6 (IQR 1–7)/15; mean practice score was 2.36 ± 1.25/6. A total of 84.0% expressed a need for continuing education. Moroccan dentists showed suboptimal ortho-periodontal performance, with limited comprehensive periodontal assessment and variable interdisciplinary coordination. Training should prioritize periodontal diagnosis, full-mouth assessment, and structured co-management pathways.