OBJECTIVE The objective of this study was to determine general dentists' attitudes and practices related to patients with diabetes, a major public health issue with oral complications. METHODS This study was a cross-sectional survey of 265 randomly selected general dentists who were Delta Dental providers in California, West Virginia, and Pennsylvania. RESULTS Sixty-one percent of respondents believed that addressing diabetes was important to their role as a dentist, 86 percent advised patients with diabetes about periodontal risks, 18 percent provided diabetic-related services, 47 percent reported they knew how to assess for diabetes, and 42 percent felt well prepared to intervene with patients with diabetes. Adjusting for number of patients with diabetes and adult patients seen in the past month, dentists' formal training in diabetes assessment and management [odds ratio (OR) = 4.0, P = 0.000, confidence interval (CI) = 1.9, 8.5], and belief in the importance of their role as a dentist to intervene with patients with diabetes (OR = 1.6, P = 0.011, CI = 1.1,2.3) were both significant factors in providing services for patients with diabetes. Similarly, dentists' formal training (OR = 3.0, P = 0.02, CI = 1.2, 7.3) and belief in the importance of their role (OR = 1.9, P = 0.00, CI = 1.3, 2.6) were both significant factors in advising patients with diabetes about periodontal risk associated with diabetes. CONCLUSIONS Formal training and personal beliefs are important factors related to dentists' behavior toward patients with diabetes in the dental setting.