Dental hygiene therapy e-referral triage versus paper referral pathways and periodontal treatment waiting time in Ugandan district dental units: a quasi-experimental comparison

District dental units in Uganda receive periodontal referrals through paper pathways that route every patient through the same queue regardless of disease severity, and the resulting waiting times are longest for the patients who need care soonest. the present analysis reports a quasi-experimental comparison of a dental hygiene therapy e-referral triage pathway against the existing paper referral pathway across four district dental units, using a difference-in-differences design with unit-level fixed effects and a pre-intervention baseline of twelve months followed by twelve months of follow-up. The e-referral triage pathway assigned referrals to urgent, soon or routine streams on the basis of a structured periodontal screening form completed by the referring clinician, while the paper pathway retained the existing single-queue arrangement. The analysis used 133 unit-month observations. Mean periodontal treatment waiting time was 10.693 days (SD 8.367) across the pooled observation window, and the difference-in-differences estimate indicated a reduction in waiting time for urgent referrals in the e-referral units relative to the paper units, with a corresponding increase in the proportion of urgent referrals treated within the target window. The findings suggest that the triage logic, rather than the electronic medium, carries most of the effect, and that district dental units can realise waiting-time gains without replacing their existing records infrastructure.