Dental hygiene therapy periodontal screening integration into diabetes clinics and glycaemic control referral yield in Tanzanian primary care: an interrupted time-series analysis

Periodontal disease and diabetes interact bidirectionally, yet in Tanzanian primary care the two conditions are managed in separate clinical silos. The framework specifies the intervention components, the referral pathway, the outcome definitions and the statistical model required to estimate level and slope changes attributable to the integration. Because no primary data were collected for this methodological proposal, the paper draws on published evidence concerning periodontal-diabetes bidirectional relationships, task-shifting in human resources for health, and interrupted time-series methodology in health services research. The framework proposes that dental hygienists operating within diabetes clinics can identify previously undetected periodontal disease, generate referrals for glycaemic reassessment, and produce a measurable referral yield that can be tracked across pre- and post-intervention periods. The paper also addresses implementation constraints specific to Tanzanian primary care, including workforce density, supply chains and documentation systems. The contribution is a transferable evaluation architecture that permits causal inference from routine service data without requiring randomised allocation, and that can be adapted to comparable low-resource settings where dental hygiene therapy capacity is emerging.