Medical Screening by Dentists Has Benefits, Study Suggests

Laird Harrison

December 15, 2011

December 15, 2011 — Many patients see their dentists more often than other healthcare providers and might benefit from screening for medical conditions in dental offices, according to the results of a study published online December 15 in the American Journal of Public Health.

"The goal is not to have the dentist be the person who diagnoses diabetes, because that's outside their scope of practice," lead author Shiela M. Strauss, PhD, told Medscape Medical News.

Rather, the dentists could refer patients to medical physicians for follow-up if they detect high glucose, said Dr. Strauss, an associate professor in the New York University College of Nursing, New York City.

The researchers analyzed data from the Medical Expenditure Panel Survey, a nationally representative sample of US households taken by the US Agency for Healthcare Research and Quality.

They found that 26.0% of children and 24.1% of adults did not visit a general healthcare provider in 2008, including physicians, nurses, nurse practitioners, physician assistants, physical therapists, optometrists, and chiropractors, on an outpatient basis.

Of these individuals, 34.7% of children and 23.1% of adults visited a dentist, a total of 19.5 million people in the United States.

Looking closer at the children who visited a dentist but not a physician, Dr. Strauss and colleagues found that 38.7% were from low-income, near-poor, or poor families, and 26.4% were from families with high income.

The fact that 92.8% had at least some health insurance suggests that they were capable of following up on referrals to other healthcare providers, the researchers said.

Likewise, 26.4% of the adults who saw dentists but not other healthcare practitioners were from families with high income, but 21.1% were from low-income, near-poor, or poor families. Although 19.2% were unemployed, 85.4% had at least some health insurance.

How Can Dental Clinicians Help?

How can dental practitioners help these patients? First, they can look into their mouths for signs of disease elsewhere in the body, Dr. Strauss said.

Second, they can take detailed medical histories, including information that could indicate medical conditions for follow-up.

Finally, they could use tools such as blood pressure cuffs or finger-stick glucose monitors to check for biomarkers for such conditions as diabetes and hypertension. Diabetic screening by dentists has already become routine in Sweden, according to Dr. Strauss.

"I don't think it has to take much time," she said. "These can be done quite simply."

Practices who have tried this have seen benefits, she said. "Patients indicated to people close to them, 'This is a great dentist because they cared not only about my oral health but my overall health.' "

Some dental schools are already moving in this direction, said Thomas W. Radmer, DDS, undergraduate program director in oral and maxillofacial surgery at Marquette University, Milwaukee, Wisconsin. "Dentistry is really a crossroads," he said.

Already Marquette students learn to routinely check their patients' blood pressure and do random blood glucose screening, he said. In addition, they monitor warfarin levels.

He pointed out that blood glucose monitors are inexpensive to purchase, and that the screening can be done in less than 60 seconds.

"We do it as a service to our patients," he said. "I look at public health issues and I think this is a concern to dentists. People have multiple system conditions. Our students are being taught at Marquette that they are an integral part of the healthcare stream."

Dr. Radmer and Dr. Strauss have disclosed no relevant financial relationships.

Am J Pub Health. Published online December 15, 2011. Abstract

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