Background: Dentists in the US see an increasing number of patients with systemic conditions. These patients are\r\nchallenging to care for when the relationship between oral and systemic disease is not well understood. The\r\nprevalence of professional isolation exacerbates the problem due to the difficulty in finding expert advice or peer\r\nsupport. This study aims to identify whether dentists discuss the oral-systemic connection and what aspects they\r\ndiscuss; to understand their perceptions of and attitudes toward the connection; and to determine what information\r\nthey need to treat patients with systemic conditions.\r\nMethods: We retrieved 14,576 messages posted to the Internet Dental Forum from April 2008 to May 2009. Using\r\nnatural language processing and human classification, we identified substantive phrases and keywords and used them\r\nto retrieve 141messages on the oral-systemic connection. We then conducted coding and thematic analysis to identify\r\nrecurring themes on the topic.\r\nResults: Dentists discuss a variety of topics on oral diseases and systemic health, with the association between\r\nperiodontal and systemic diseases, the effect of dental materials or procedures on general health, and the impact\r\nof oral-systemic connection on practice behaviors as the leading topics. They also disseminate and share research\r\nfindings on oral and systemic health with colleagues online. However, dentists are very cautious about the nature of\r\nthe oral-systemic linkage that may not be causal. Nonetheless, they embrace the positive association as a motivating\r\npoint for patients in practice. When treating patients with systemic conditions, dentists enquire about the cause of less\r\ncommon dental diseases potentially in relation to medical conditions in one-third of the cases and in half of the cases\r\nseek clinical guidelines and evidence-based interventions on treating dental diseases with\r\nestablished association with systemic conditions.\r\nConclusions: Dentists� unmet information needs call for more research into the association between less studied\r\ndental conditions and systemic diseases, and more actionable clinical guidelines for well-researched disease\r\nconnections. To improve dissemination and foster behavioral change, it is imperative to understand what information\r\nclinicians need and in which situations. Leveraging peer influence via social media could be a useful strategy to achieve\r\nthe goal.
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