Identifying Health Conditions at Dental Visits; Interview with Dr. Shiela Strauss
AAOSH editor Dr. Lee Ostler recently interviewed Dr. Shiela Strauss, associate professor at New York University’s Colleges of Dentistry and Nursing, to discuss the recently published article in the American Journal of Public health which demonstrated the fact that dental practices can serve as valuable sites to identify systemic health concerns among a significant segment of our population – people who are not see on a regular basis by their primary care physicians.
Dr. Strauss was the lead author in a June 2009 article in the Journal of Periodontology titled “The Potential Use of Gingival Blood for Measuring Glucose for Diabetes” (1), and a December 2011 article in the American Journal of Public Health titled “Identifying Unaddressesd Systemic Health Conditions at Dental Visits” (2).
This basic question which has found new life these days is - “Should dentists offer health screenings?”
The question is of particular significance because roughly one-quarter of adults today do not see a primary care health provider, but surprisingly, of this group approximately one fourth did see a dentist. This pattern was true for both children as well as adults.
Dr. Strauss’ research found that each year 20 million people in the United States do not see a primary health professional, but they do see their dentist. This means that for this group of people dentists are in a unique position to screen for a variety of general medical problems, including diabetes.
The so called “oral-systemic connection” has been in the news a lot over the past several years, and is the primary focus of the American Academy for Oral Systemic Health. But the “connections” go beyond the gums and the heart, which is the most common thought of “connection”. They are really more of a mouth-body connection, owing to the many medical disorders linked to the mouth. These include but are not limited to vascular disease, diabetes, sleep apnea, migraines, structural-postural problems, biocompatibility related health problems and so forth. Additionally, many general health disorders can be manifest in the mouth, such as HIV, eating disorders, substance abuse, sexually transmitted diseases, etc.
Strauss et al found that 93% of patients with periodontal disease met the same criteria that meet the American Diabetes Association guidelines which call for diabetes screening. Dr. Strauss indicates that dentists can and probably should be more proactive in utilizing the tools we have available (lab tests and screening questionnaires) to screen for basic medical problems. These include medical health questionnaires, and blood pressure measurements, as well as HbA1c and CRP when indicated.
1)- The Potential Use of Gingival Blood for Measuring Glucose for Diabetes: http://www.ncbi.nlm.nih.gov/pubmed/19485820
2)- Identifying Unaddressesd Systemic Health Conditions at Dental Visits: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2011.300420