One of the most profound additions to the diagnostic weapons in the war on heart disease prevention is the Endo-Pat 2000. The Endo- Pat 2000 by Itamar Medical www.itamar-medical.com is the only scientifically proven, non-invasive method for assessing endothelial function that is FDA approved. The device is in use in leading medical centers and has been part of a number of cardiovascular clinical trials. Inflammation from oral infection can have an adverse effect on the endothelium and can result in a state of endothelial dysfunction. There is a direct and profound link between damaged endothelium and acute coronary incidents (heart attacks).

Recent research has shown that aggressively treating periodontal disease can significantly improve endothelial function www.medpagetoday.com, implying that a Wellness oriented practice with an EndoPAT could demonstrate impaired endothelial function as part of the diagnostic protocol prior to treatment and then demonstrate improvement post treatment.

Both cholesterol and CRP are predictive causal factors in heart function and useful to predict future acute cardiac events. Cardiologists now believe, however, that the best predictor of cardiac disease is the measurement of endothelial function. The endothelium is a thin single layer of specialized cells covering the inner surface of all the blood vessels in the body. This protective layer of cells separate the circulating blood from the venous tissues and provide vital functions. Healthy endothelium acts to control or modulate vascular contraction and relaxation (vasodilatation and vasoconstriction). Dysfunction of the endothelium is usually manifest by the presence of plaque build up, oxidative stress, and leukocyte adhesion, which impairs the endothelium from regulating prothrombotic and antithrombotic components. The constant expansion and contraction of our blood vessels is crucial to healthy heart function and circulation. If your vascular function is impaired your risk of a future cardiac event is not only probable—it is certain.

Previously, measuring vascular/endothelial function required an invasive and risky procedure known as an angiogram, where dye was injected into the veins and then tracked on a radiograph. A company called Itamar Medical has adapted their “PAT” or Peripherial Arterial Tone technology and a devise called the Endo-Pat 2000. This technology will be familiar to dentists involved in sleep apnea therapy for the measurement of endothelial function.

See - EndoPat on Fox News

The End-Pat 2000 gives the wellness-centered dental practice a simple-to-use medical devise that tells their patients that they are concerned about their total health—not just their dental health. Because most patients visit with their dentists and hygienists more frequently than they visit their physician, the dental practice is in a much better position to screen and help detect problems before they become symptomatic. As with most disease processes waiting until they have symptoms may lead to irreversible damage and impaired health. Using the Endo-Pat 2000 to screen for early symptoms of endothelial dysfunction years before a patient might be aware a heart disease problem, can help save lives. The usual charge for this testing is about $250 per test and can be done by a dental assistant. Just a couple tests a month will pay for the lease cost on the machine.

The non-invasive nature of the Endo-Pat 2000 allows for follow up testing for evaluating the effectiveness of various treatments. Dental practices that use the Endo-Pat 2000 can also begin to generate referrals to MD’s and cardiologists that may lead to cross referral relationships. In addition, physicians may be willing to send patients to these dental practices for this non-invasive and affordable endothelia function testing. Dentists and hygienists have a responsibility to help their patients understand the relation of oral infection to endothelial dysfunction. When patients understand the heart attack risks associated with endothelial dysfunction will find that most of them are ready to accept advanced periodontal care to help safeguard their heart health. Dentists who help people avoid disease and prolong lives will be sought out by people who value their health.



Special sensors are placed on the test person’s fingers and measure arterial flow variations. The entire process is painless, non-invasive, and extremely accurate.The Endo-PAT2000 has over 50 publications and abstracts validating its efficacy as a diagnostic tool for early diagnosis of endothelial dysfunction, The Endo-Pat 2000 is the leading technology for non-invasive endothelial function assessment. The device measures endothelium function by establishing a five-minute baseline of blood flow followed by a five-minute obstruction (restricted blood flow) similar to taking one’s blood pressure, and followed by a five-minute response phrase.



There is ample evidence regarding endothelial dysfunction that it is reasonable to believe that there is diagnostic and prognostic value in its evaluation in preventing future cardiac events. The presence of increasingly high numbers of at-risk individuals in our society demands that health professionals begin screening for this important risk factor. There is no question that endothelial dysfunction contributes to the initiation and progression of atherosclerotic disease. Dental practices that utilize this important diagnostic tool can provide their patients a valuable potentially life-saving screening. Patients exhibiting abnormal endothelial function should be referred to a cardiologist or other medical specialist for further diagnostic evaluation.

To view a replay of the CDM International webinar on the EndoPAT2000 featuring Professor Giora Pillar of Haifa Israel and Dr. Michael Gelb of New York City click on the link below:

Endothelial.wmv