Identifying patients in dental settings at risk of cardiovascular disease and diabetes

Abstract

Background: The purpose of our study was to identify patients in a dental setting at risk of already having or developing high blood pressure or high plasma glucose, investigate possible associations between these conditions and periodontal status and explore the correlation between screening results and follow-up assessments concerning the need for medical treatment and/or lifestyle changes performed by medical staff. Methods: A total of 170 dental patients were consecutively included at their regular yearly check-up visit. Data on age, weight, height, amount and use of tobacco and medication for cardiovascular disease and diabetes mellitus were collected, as well as data about systolic and diastolic blood pressure, in addition to pulse and plasma glucose. Clinical and radiographic examinations revealed data about periodontal status by probing periodontal pockets and measuring marginal alveolar bone loss by means of x-rays. Patients who exceeded normal diastolic blood pressure and plasma glucose values were referred for diagnosis and care. Results: Thirty-nine patients exhibiting high values were provided referrals and 24 or 14.1% of the 170 participants required additional care. The correlation between oral and medical health care concerning blood pressure recorded was 64.5% (p<0.001), while the correlation was 40.0% (p<0.001) concerning plasma glucose. Among middle aged men and elderly subjects, the data revealed/showed a significant correlation between marginal alveolar bone loss and high systolic blood pressure (p=0.001). Conclusions:The correlation between oral health care and medical health care registrations based on blood pressure and plasma glucose indicates that it may be appropriate for dental professionals to perform opportunistic medical screening and refer risk patients to the medical care system before complications occur. In order to identify medical risk patients in dental settings on the basis of high blood pressure, a suggestion may be to examine middle-aged men and elderly patients of both sexes who exhibit radiographic markers for marginal alveolar bone loss.

Association of Dental Care with Adherence to HEDIS Measures

“…However, the results are consistent with previous research that found that measurement of blood pressure in a dental setting could identify HTN. For example, Friman and colleagues 41 found that about 14% of patients receiving care in a dental setting had diastolic blood pressure values high enough to warrant further follow-up in a medical setting. Furthermore, Greenberg and colleagues 22 found that nearly 20% of patients receiving care in the University of Medicine and Dentistry of New Jersey Dental School were identified as having previously unidentified cardiovascular disease risk factors when their blood pressure and cholesterol were tested and a screening questionnaire was administered in the dental setting.…”

Medical screening in dental settings: a qualitative study of the views of authorities and organizations

“…The same authors also presented that dental settings could be a health promotion entry point into medical care for individuals not previously engaged with a primary care provider [ 30 ]. The cooperation between dental and medical care has proven to be an effective way to discover unknown hypertension [ 11 , 31 ].…”

“…The interest in medical screening in dental settings during the early 2000s has been extensive [ 8 – 11 ], and the activities to identify individuals with undiagnosed diabetes mellitus type II or undiagnosed hypertension have been positively received by patients and dentistry, and have shown to be cost-effective by achieving savings and health benefits.…”

“…Several studies were conducted to evaluate medical screening in dental settings [ 8 – 11 ] as associations have been pointed out between periodontal and cardiovascular diseases as well as diabetes [ 12 – 14 ]. These results indicate that medical screening in dental settings could be an effective component of disease prevention and enhance cross-border cooperation between dental and medical care [ 15 ].…”

Patient Experiences of Medical Screening Performed by the Dental Services: A Qualitative Study

“…In a small town in central Sweden, medical screening for blood pressure and plasma glucose was offered consecutively to 207 regular adult dental patients at their annual check-up, of whom 170 agreed to participate. Thirty-nine patients were referred to health care as possibly at risk of hypertension or diabetes, and 24 of these received further medical treatment or lifestyle recommendations [17].…”