General Dentists and Periodontal Referrals

Objectives: to explore which factors affect dentists' referrals of patients with periodontal disease. Specifically, it will be explored which (a) diagnostic considerations, (b) practice characteristics / considerations, and (c) patient factors affect dentists' referrals to periodontists.

Methods: Survey data were collected from 160 members of the Michigan Dental Association. The respondents were predominantly male (77.2%), white (95.3%), and ranged in age from 26 to 86 years (Mean=49.87 years; SD=11.049).

Results: Twenty-one dentists (15.0%) did not refer a patient to a periodontist during the past month; 96 dentists (68.6%) made between 1 and 5 referrals, and 23 dentists (16.3%) referred more than 5 patients during the past month. Diagnostic characteristics such as the mm pocket depth and / or percentage of bone loss considered when making decisions concerning periodontal treatment recommendations differed widely, but did not correlate with the number of patients referred. However, the location of the practice affected referrals: Providers in urban settings were more likely to refer patients for periodontal treatment. Practice considerations such as a desire to treat more patients in their own practices, indicating that they cannot afford to refer patients, and agreement with the statement that they prefer not to refer patients correlated significantly with the number of patients referred to a periodontist during the past month (r=.214; p=.012 / r=.-.180; p=.036 / r=-.217; p=.011). Patient factors such as the patients' age, ability to pay, dental fear, general health, and oral hygiene status also affected referral patterns.

Conclusion: Given the findings in recent studies that show that general dentists might refer patients with periodontal disease not at all or too late to periodontists, it seems crucial to explore which factors affect dentists' referral patterns. These data showed that financial considerations as well as patient-related factors are of significance in the referral process.