Assessing Systemic Disease Risk in a Dental Setting: A Public Health Perspective
Section snippets
Prevention and screening
The integration of oral health care providers into strategies to enhance early identification of individuals at risk of developing chronic disease may be a future public health strategy aimed at preventing and controlling the growing chronic disease epidemics. The purpose of disease prevention and control is to identify individuals who have an increased likelihood of developing disease or experiencing increasing disease severity. Successful prevention is predicated on several underlying tenets,
Why screen for medical conditions in a dental setting?
Screening for risk of developing disease can alert patients to potential disease risks or health issues of which they are unaware. On average, 65% to 70% of adults visit the dentist in a given year, 10% to 20% of whom have not seen a physician in the preceding year, suggesting a potential role for oral health care providers in public health strategies to prevent the onset of, or control the severity of diseases of important public health significance.2, 3, 4 Cardiovascular disease (CVD) and
Burden of CVD and DM
Coronary heart disease (CHD), which constitutes 50% of CVD, is the leading cause of death for both men and women in the United States.17 According to the American Heart Association (AHA), approximately 13 million Americans have symptoms of CHD.17 As the life expectancy and obesity rate increase in the population, CVD and DM are becoming increasingly more prevalent, with 80 million people recognized as having some type of CVD and 26 million with DM; 90% to 95% are type 2 diabetes.18 The
CVD
In December of 2012 the US Department of Health and Human Services released Healthy People 2020, the comprehensive set of national public health goals and objectives. One of the primary goals states: “Improve cardiovascular health and quality of life through prevention, detection, and treatment of risk factors for heart attack and stroke; early identification and treatment of heart attacks and strokes; and prevention of repeat cardiovascular events.”50
In 2012, the AHA presented its new
Is there a role for oral health care professionals?
In previous studies, we developed and pilot-tested a CHD and DM screening strategy for use in a dental setting to identify asymptomatic individuals who are at increased risk for developing DM- and CHD-associated events.3, 65 Demographic (age, gender, smoking history) and clinical data (reported history of hypertension, hypercholesterolemia, CHD, heart attack, stroke, angina, medication use for high blood pressure or high cholesterol) were abstracted from National Health and Nutrition
Summary
In recent years, there has been much written advocating for the creation of a health home to facilitate more effective, coordinated evidence-based health care that integrates medicine dentistry and social/environmental factors.1, 82, 83 As part of this health home concept, screening and monitoring for systemic disease risk in a dental setting are valuable components for more effective disease prevention and control, and health care delivery. Data suggest that this can be an effective strategy
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Cited by (36)
IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance
2019, Diabetes Research and Clinical PracticeCitation Excerpt :Since glucose levels in venous blood obtained by a finger stick and in blood in the gingival crevicular space between the tooth and the gingiva are strongly correlated, it has been suggested to use the latter as a less intrusive method for screening for hyperglycemia [132]. Chair-side screening for diabetes in the dental office is generally well accepted by dental care providers [133–135], physicians [136], medical and dental authorities and professional organizations (although uncertain about the concept) [137], and dental patients [138], inclusive older minority groups [139]. Physicians and other medical care professionals could also play a more active role in addressing the oral health of adults [140].
Intimate partner violence screening in the dental setting: Results of a nationally representative survey
2018, Journal of the American Dental AssociationCitation Excerpt :This level of acceptance of IPV screening as part of the dentists’ professional role is lower than has been reported about dentists’ acceptance of substance misuse screening20 (53.9%) and tobacco screening26 (77.9%) and similar to that for human immunodeficiency virus (HIV)21 (40%). Because HIV and IPV are both sensitive and life-threatening issues and because it can be uncomfortable to broach stigmatized conditions, dentists’ support of rapid HIV testing and IPV screening may likely be lower than that for less-stigmatized conditions that are easier to discuss, such as hypertension, cardiovascular disease, and diabetes.25,27-34 These results suggest that barriers exist because of dentists’ attitudes and practices specific to IPV which need to be overcome for dentists to play an active role in screening and referring patients who are experiencing IPV.
Interprofessional Collaborative Practice Models in Chronic Disease Management
2016, Dental Clinics of North AmericaCitation Excerpt :Periodontal and now endodontic infections have been linked to CVD, including atherosclerosis and systemic inflammation, extensively in the literature.57–61 The incorporation of oral health care professionals in strategies to identify individuals at risk for coronary heart disease and diabetes will compliment preventive and screening efforts necessary to decrease the progression and development of these chronic illnesses and provide a portal for individuals who do not see a physician on a regular basis to gain access to the general health care system.62 The dental practitioner sees these patients on a regular basis for oral health needs and can more readily monitor CVD status, that is, blood pressure status.63
The feasibility of a digital health approach to facilitate remote dental screening among preschool children during COVID-19 and social restrictions
2023, International Journal of Paediatric Dentistry