In developing their diagnostic protocol it became evident that lab tests to assess risk factors for heart disease and diabetes, before and after treatment. All patients are tested for periodontal disease with the Florida Computer Probe which measures probing depth, bleeding and exudate. Those testing positive, with probe scores of 4mm or greater are advised as follows:

“You have developed periodontal disease”. Research has shown that periodontal disease can increase risk for heart disease, stroke and diabetes which can be measured with blood tests. Therefore we need to see if the periodontal disease has “gone systemic” yet just to make sure you are OK.

While the results have been of tremendous value to the practice and the patient there have been limitations

There have been many benefits of incorporating blood testing into the periodontal protocol

• It has always been difficult to get the patient to grasp the concept that perio is a systemic disease and does not just involve teeth. Blood testing takes the conversation into “real medicine” and really brings home the perio/systemic connection and the serious nature of their problem.
• As described above it provides an opening to the relationship with the MD.
• It documents the effects of your treatment, which could vary significantly with methodology.
•  The dentist may become the leading edge of preventative medicine and  save lives.
• The medical profession does not use Hs-CRP as a screening since it is non specific and they don’t have a pill for it.  However a high value which does not decrease to normal with perio treatment should be investigated and may turn up serious disease that would otherwise go undetected.  It should be noted that one of our offices helped discover cancer in a patient from these tests, and she credits her dentist with saving her life.
• Offices report finding undiagnosed diabetics weekly. If untreated, diabetes can reduce life expectancy by 15 years, especially when combined with periodontal disease.

• Compliance (send a patient to an outside laboratory) varies from practice to practice but often is no better than 50%.This is especially a problem for after treatment monitoring.
• It cost money. Each test will cost from $35-$100 and the question is who will, pay for it. Health insurance maybe, dental not likely.
• Sending out for testing can create a delay in the treatment process.

What if you could do blood testing in the dental office

• As part of the periodontal exam
• In five minutes
• With a simple finger stick
• With no prior preparation or fasting
• At a cost of around $10 per test

This would clearly provide all the benefits and remove the limitations. Thanks to a company called Cholestech working with the Centers for Dental Medicine, this process has begun and is rapidly progressing.

They have developed the LDX analyzer for in office Cholesterol and CRP testing

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And the GDX analyzer for diabetes testing

Adding in office blood testing to the dental office involved in periodontal treatment promises to provide a revolution in diagnosis, patient communication, physician relationships and treatment evaluation.

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