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In Office Blood Testing
The first step in advanced periodontal care is superior diagnostics.
After determining the presence of periodontal infection, it is time to
determine the possible effects of periodontal disease on total health...
Introducing the HealthPoint minimally invasive in-office blood test for
Glycated Hemoglobin hb-a1c and C-reactive protein.
The test results reveal important biomarkers that help dentists
determine the extent of periodontal infection by determining the
presence of infection in the body (C-reactive protein) and possible
co-factor diabetes presense or susceptability.
In-office blood testing for C-Reactive Protein (CRP) and Glycated
Hemoglobin (A1c) may be the most important tool for the practice that
would like to take the step to the New Paradigm of Oral-Systemic
Medicine.
HealthPoint In-Office Blood Test Kit. Easy to use, affordable, and
essential for determining the damage to systemic health
What is C-Reactive Protein and how does it affect Oral-Systemic
Dentistry?
C-Reactive Protein is a substance made by the liver in response to
inflammation anywhere in the body. It is measured by the mg. of CRP per
liter of blood. It is of interest to the Center for Dental Medicine
because:
- It has been shown to be more predictive of heart attacks than
high cholesterol.
- Periodontal disease has been shown to significantly increase
CRP, thereby increasing heart attack risk.
- Treatment of periodontal disease has been shown to reduce CRP
thereby lowering heart attack risk.
- Ultra-High CRP has warned MD of serious disease including cancer
thereby saving lives.
Comparison of C-Reactive Protein and Low-Density Lipoprotein Cholesterol
Levels in the Prediction of First Cardiovascular Events" New England
Journal of Medicine, Nov. 14 (vol. 347, issue 20), Ridker, et. Al.
http://content.nejm.org/cgi/content/full/347/20/1557
Elevation of systemic markers related to cardiovascular disease in
peripheral blood of periodontitis patients. Loos BG, Craandijk, et al
J Periodontology, 2000 Oct;71(10):1528-34
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&lis
t_uids=11063384&dopt=Abstract
Test Results Can Reveal The Possible Damage To Systemic Health. Post Periodontal Treatment
Follow-up Test Can Alert Physicians To The Real Threat of A Serious Systemic Disease
The blood samples are mailed to the laboratory with results returned
within ten days. Initial testing establishes a health history baseline
for both infection in the body and the possible presence of improper
sugar processing (diabetes). These baseline figures can be compared to
post treatment testing and reveal successful therapy.
The essence of science is the ability to measure. HealthPoint gives
dentists and hygienists the opportunity to assess the effectiveness of
their periodontal therapy with an affordable testing protocol.
The HealthPoint HbA1c and C-Reactive Protein Tests only require a simple
finger prick and can be taken in the dental office. The test is
affordable and the results are highly accurate.
Blood draws in the dental practice are less invasive and less expensive
than traditional blood draws taken at phlebotomy testing facilities.
According to Dr. Gordon Christensen, 60% of prescriptions go unfilled.
if you want a patient to take a prescription, you had better fill it in
your dental practice. The same would hold even more true when
prescribing a blood test.
What is
Glycated Hemoglobin (A1c) and how does it affect Oral-Systemic
Dentistry?
It is well known that diabetics, because of their impaired immune
systems, are twice as likely to get periodontal disease. Diabetics with
perio infection face a greatly increased risk to their health and
decreased life expectancy than diabetics with little or no gum disease.
Diabetes and periodontal infection work in combination... one condition
adversely affecting the other. The effect of periodontal bacteria
challenge blood sugar control and increase the rate of diabetes. It has
been shown that periodontal disease greatly increases diabetes
complications; it also increases mortality rates by a factor of 7 or
more in later years. The good news is that treating periodontal disease
can significantly lower HbA1c, the definitive measure of blood sugar
control. Several studies help support these assessments.
It is imperative for the dental team to know if a periodontal patient
has diabetes before beginning treatment.
In 2004 Saito, et al, published the results of The Hisayama Study, which
examined the relationship between periodontal disease and glucose
intolerance in non-diabetics. The Severity of Periodontal Disease is
Associated with the Development of Glucose Intolerance in Non-diabetics:
The Hisayama Study
T. Saito1,*, Y. Shimazaki1, Y. Kiyohara2, I. Kato2, M. Kubo2, M. Iida2,
and T. Koga1,3
2 Department of Medicine and Clinical Science, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan; J Dent Res 83(6):
485-490, 2004 http://jdr.iadrjournals.org/cgi/content/full/83/6/485
It demonstrated that people with normal glucose tolerance who 10 years
later developed impaired glucose tolerance were also much more likely to
have deep pockets. Deep pockets, current glucose tolerance levels, and
the development of glucose intolerance were related, according to the
study.
The results of a study published a year later suggested that periodontal
disease is strongly predictive of mortality from ischemic heart disease
and diabetic nephropathy in Pima Indians with type 2 diabetes. .P
eriodontal Disease and Mortality in Type 2 Diabetes Aramesh, Sarami,
Nelson et.al. DIABETES CARE, VOLUME 28, NUMBER 1, JANUARY 2005
Results indicated that Pima Indians with little or no periodontal
disease had a much lower death rate (3.7%) compared to those with severe
periodontal disease (28.4%).
Finally, results from a study examining the relationship between
periodontal therapy and blood sugar control demonstrated that perio
treatment (ie, scaling and root planning) in diabetic patients could
improve metabolic control and reduce HbA1c levels up to 20 percent 3 and
6 months after treatment (from 7.2 to 5.7). The study results were
published in a 2006 article in the Journal of Periodontology. A healthy
level of HbA1c is between the ranges of 4.0 to 6.0; in diabetics this
number is greater than 7.0, and 6.0 to 7.0 is pre-diabetic.14
Over the past two decades hemoglobin A1c has become an accepted and
reliable measure of long-term glycemic control in diabetics. In fact,
venerable organizations like the American Diabetes Association (ADA)
recommend that diabetics have their HbA1c levels checked routinely as
part of continuing care. Today, the growing epidemic of diabetes has
focused attention on early identification of the disease before the
multiple complications set in. Recent strides in standardizing the HbA1c
test, along with the medical community’s desire to identify and
intervene earlier in the continuum between normal glycemic levels and
frank diabetes, has focused attention on a broader role for HbA1c. Now
an independent panel of diabetes experts has proposed using HbA1c as
both a screening and diagnostic tool for diabetes, placing it alongside
the two principal diagnostic measures, the oral glucose tolerance test
(OGTT)— considered the gold standard—and fasting plasma glucose test
(FPG).
A1c is now often referred to as “Average Glucose” being a measure of the
average blood glucose reading over the last 2-3 months. The relationship
is fairly simple. Essentially multiply the A1c number by 20 to get the
equivalent fasting glucose:
A1c Reading Equivalent Glucose Interpretation
5.0 100 Normal
6.0-7.0 120-140 Pre Diabetic
7.0+ 140+ Diabetic
The Practical benefit in the dental practice of using A1c rather than a
fasting glucose, is that no fasting is necessary. Therefore no
preparation is required and the test can be administered at any recall
visit.
So what impact could you have on your patient population by finding and
successfully treating diabetics?
A dental practice with 2,000 active patients could save 40 people from
becoming type 2 diabetics a year, adding 8.2 years to their life
expectancy. Of your 2,000 patients 20% (400) have HbA1c scores between
6.0 and 6.9, meaning that if you didn’t intervene and stop their
periodontal disease, then they would likely become diabetics within the
next 10 years. That totals 40 people per year for 10 years that you
could save from diabetes.
Discover 60 people who have diabetes now and don’t know it, adding years
to their life. Of your existing patients, 3% (60) have diabetes now and
don’t know it. Co-management now with their primary care medical doctor
can greatly increase their survival rate.
For more information on advanced periodontal disease testing and
screening, phone 866-546-5444. Ext. 1.
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