Type 2 diabetes is epidemic in the American Indian population. One problem health care providers face when working with the American Indian population is communicating about secondary complications, such as periodontal disease. From a public health standpoint, periodontal disease prevention is important not only to prevent unnecessary oral pain and tooth loss, but also to prevent other more serious systemic problems from occurring such as cardiovascular disease, strokes, and bacterial pneumonia. The purpose of this qualitative study was to examine the communication efforts of health care providers and understand if and how they discuss periodontal disease with their American Indian patients with type 2 diabetes. Structured interviews were conducted with health care providers at an American Indian community clinic using questions based on the model of communication competence. Data analysis consisted of an analysis of the interview transcripts looking for concepts, themes, and events to see if discussion of periodontal disease is occurring at diabetic visits. Results of the study showed that although all the providers knew about the link between diabetes and periodontal disease risk, not all the providers were discussing the risk with their patients, and time, perceived health literacy, and other priorities all played a role in the lack of communication. This finding has the potential to influence positive social change by being an impetus for change in current diabetic patient care policies in the areas of communication and education regarding American Indian patients with diabetes about periodontal disease risk.