Leveraging Dental Visits for Systemic Health: Diabetes Screening and Referral Compliance in Periodontitis Patients in Malaysia

Abstract

Background/Objectives: Opportunistic diabetes screening in dental clinics is an innovative strategy with significant public health implications. Methods: This prospective observational study assessed diabetes risk and referral compliance among periodontitis patients using the Finnish Diabetes Risk Score (FINDRISC) and capillary fasting blood glucose (cFBG). Patients with FINDRISC ≥ 11 and/or cFBG ≥ 5.6 mmol/L were classified as high-risk and referred for further medical evaluation, with compliance tracked through medical practitioner feedback. Results: A total of 142 participants were recruited by 20 general dental practitioners (GDPs). Of these, 36.4% (n = 47) had a FINDRISC ≥ 11, with a mean score of 7.7 ± 4.5, and 26.3% (n = 34/129) had cFBG levels ≥ 5.6 mmol/L. There was no significant difference between periodontal status and FINDRISC (p = 0.291) or between periodontal status and cFBG (p = 0.129). Overall, 54 patients (41.8%) were referred for follow-up, with 33 (61.1%) completing the process. Among those who completed referrals, 10 (30.3%) were diagnosed with prediabetes and seven (21.2%) with diabetes. Non-compliance was more common among patients from lower socioeconomic backgrounds. Conclusions: This study shows the feasibility of integrating diabetes risk screening into private dental practice and its potential to identify high-risk individuals. Shared care models and policy adaptations are essential to improve interdisciplinary collaboration and overcome referral compliance barriers.