Gingival Crevicular Blood as a Potential Screening Tool: A Cross Sectional Comparative Study

Abstract

Background: Diabetes is known to be one of the major global epidemic diseases, significantly associated with mortality and morbidity worldwide, conferring a substantial burden to the health care system. The epidemiological transition of this chronic disease tends to worsen unless preventive health strategies are implemented. Appropriate screening devices and standardized methods are crucial to prevent this potentially inauspicious life condition. Currently, the glucometer is the conventional device employed for blood glucose level determination that outputs the blood glucose reading. Glucometer performed in the dental office may be an important device in screening diabetes, so it can be addressed during a periodontal examination. Because gingival blood is a useful source to detect the glucose level, the focus is placed on the opportunity that might provide valuable diagnostic information. This study aimed to compare gingival crevicular blood with finger-stick blood glucose measurements using a self-monitoring glucometer, to evaluate whether gingival crevicular blood could be an alternative to allow accurate chairside glucose testing. Methods: A cross-sectional comparative study was performed among a 31–67-year-old population. Seventy participants with diagnosed type 2 diabetes and seventy healthy subjects, all with positive bleeding on probing, were enrolled. The gingival crevicular blood was collected using a glucometer to estimate the blood glucose level and compared with finger-stick blood glucose level. Results: The mean capillary blood glucose and gingival crevicular blood levels from all samples were, respectively, 160.42 ± 31.31 mg/dL and 161.64 ± 31.56 mg/dL for diabetic participants and 93.51 ± 10.35 mg/dL and 94.47 ± 9.91 mg/dL for healthy patients. In both groups, the difference between gingival crevicular blood and capillary blood glucose levels was non-significant (P < 0.05). The highly significant correlation between capillary blood glucose and gingival crevicular blood (r = 0.9834 for diabetic patients and r = 0.8153 for healthy participants) in both the groups was found. Conclusions: Gingival crevicular blood test was demonstrated as a feasible and useful primary screening tool test for detecting diabetes and for glucose estimation in non-diabetic patients. Use of gingival crevicular blood for screening is an attractive way of identifying a reasonable option of finger-stick blood glucose measurement under the appropriate circumstances. Rapid assessment may precede diagnostic evaluation in diabetic as well as healthy patients with acute severe bleeding. In addition, gingival crevicular blood levels may be needed to monitor the diabetic output.

Inflammatory Status and Glycemic Control Level of Patients with Type 2 Diabetes and Periodontitis: A Randomized Clinical Trial

“…The treatment of a patient with diabetes requires consideration of key pathogenic characteristics, the duration of disease, the age of patient and the presence of secondary diagnoses for specific complications or comorbidities [ 38 ]. Priority in management diabetes is the regression of pathology, by reaching the euglycemia and controlling the metabolic alterations [ 5 , 39 , 40 , 41 , 42 ]. The role of inflammation is under intensive scrutiny with several clinical trials to have been completed while more are in development [ 43 ].…”

Salivary tumor necrosis factor-alpha levels in periodontitis associated with diabetes mellitus after low level laser therapy as an adjunct to scaling and root planning

“…In the present study glucometer was used as a chairside diagnostic device, for RBS evaluation,[ 37 ] in order to improve the patient's comfort. As the literature also mentions that in some cases, HbA1c cannot be trusted due to defect in glycation or severe anemia.…”

“…Random blood sugar (RBS) level was evaluated at baseline and 8 weeks after treatment, using glucometer, by capillary finger-prick method. [ 36 37 ]…”

Antioxidant Effects of Curcumin Gel in Experimental Induced Diabetes and Periodontitis in Rats

“…The present finding revealed that the serum level of MDA was significantly increased in the experimental induced diabetes and periodontitis untreated group (EDP) as compared to the control group for all duration periods of 0, 7, 14, and 21 days. This increase may have been due to the fact that periodontitis was in active state and the peripheral blood neutrophils exhibited a hyperactive phenotype in terms of the production of ROS, which may have diffused into the blood stream [ 7 , 25 ]. This result was supported by a study on experimentally induced periodontitis in hyperglycemic Wistar rats [ 14 ] and demonstrated a significant elevation of MDA serum level in the untreated EDP group as compared to the control group.…”