Attitudes and Practices of Dental Hygienists Regarding Diabetes Screening and Medical-Dental Collaboration: A Nationwide Cross-Sectional Study in Japan.

: Despite the bidirectional relationship between diabetes and periodontal disease, dental hygienists' role in diabetes screening remains underexplored in Japan. Previous studies have not examined the relationship between attitudes and actual screening practices. This study aimed to assess dental hygienists' attitudes regarding diabetes screening and medical-dental collaboration, examine current practices, and investigate the association between attitudes and practices. : A nationwide cross-sectional survey was conducted among dental hygienists from 1340 dental clinics using stratified random sampling. Participants completed an anonymous questionnaire assessing attitudes (4-point Likert scale) and screening practices (4-point frequency scale). Exploratory factor analysis and multiple regression analysis examined attitude-practice associations. Of 1340 surveys distributed, 95 valid responses were obtained (response rate: 7.2%). Participants showed low implementation rates for lifestyle and physical sign assessment in diabetes (below 35%, except thirst: 68.4%) but moderate-to-high rates for medical history evaluation (44.2-75.8%). Multiple regression analysis revealed that lack of confidence and knowledge in diabetes management was negatively associated with both lifestyle assessment (β = -0.38; 95% CI -0.72 to -0.23) and medical history evaluation (β = -0.55; 95% CI -0.63 to -0.32). Desire to participate in diabetes education was positively associated with medical history evaluation (β = 0.21; 95% CI 0.24 to 4.38). : Despite low response rate limiting generalizability, this first nationwide Japanese survey indicates that confidence and knowledge deficits significantly hinder diabetes screening practices. Targeted educational interventions could enhance screening implementation and strengthen medical-dental collaboration, improving early diabetes detection.