Factors Affecting Patient Referral to Periodontists from General Dental Practitioners in the City of Manila: A Descriptive Cross-sectional Study.

Background and objective: The primary determinant for patient referral by general dental practitioners (GDPs) to periodontists differs based on the country of practice. Moreover, previous research has revealed that GDP preferences for managing periodontal patients, actual number of referrals, and the overall decision-making process have evolved over time. Understanding the periodontal referral pattern of Filipino GDPs could help identify factors that promote or inhibit referral to periodontists. These factors may in turn be used as basis for the formulation of periodontal referral guidelines for use by GDPs in the Philippines. Therefore, this study aimed to determine the factors that affect the referral patterns of Filipino GDPs to periodontists, with GDPs practicing in the City of Manila as the representative population.

Methods: A descriptive cross-sectional study design with the use of a self-administered survey was utilized for this study. Participants were 75 licensed dentists practicing in the City of Manila who were members of the Philippine Dental Association-Manila Dental Chapter. The questionnaire collected information on sociodemographic characteristics of the participants, periodontal referral pattern, and the factors considered by the participants when referring patients to a periodontist. Descriptive statistics (frequency and percentage) were used to report the study's findings.

Results: Majority (92%) indicated that they regularly referred patients with periodontal disease to periodontists, with a personal estimate of up to 20 periodontal case referrals monthly by 81.3% of the participants and >20 referrals for 10.7%. The clinical factors considered as most important when referring to a periodontist were the type of periodontal disease (81.3%), periodontitis severity (74.7%), and the presence of a complex medical history (61.3%). Among the non-clinical factors, the most influential were the following: uncooperative patient (32%), perceived personal skill (24%), postgraduate training of the periodontist (21.3%), and the patient's financial capacity (13.3%).

Conclusion: Multiple factors affect the decision of general dental practitioners in the City of Manila when referring patients to a periodontist. Majority are influenced by clinical factors such as the type and severity of periodontal disease and the systemic condition of the patient. Although considered to a much lesser degree compared to clinical factors, the top non-clinical factors that Manila GDPs base their referral decisions include the assessment that a patient is uncooperative and the perceived adequacy of personal skills in managing periodontal patients.