Th Readers 1009rdh 01

Reader’s Forum

Oct. 1, 2009

To Submit letters to the editor, send to:
RDH, P.O. Box 340, Tulsa, OK 74101; [email protected]; or (918) 831-9804 (fax).

Dear RDH:

The article by Ann-Marie DePalma in the July 2009 issue of RDH magazine (“Front Line RDH”) addresses the important role of dental hygienists in early diagnosis and screening of systemic diseases. We are hygienists in a periodontal practice in New York that places great emphasis on the connection between oral and systemic health.

A recent article in the Journal of Periodontology, “The potential use of crevicular blood for measuring glucose to screen for diabetes: An examination based on characteristics of the blood collection site,” describes a technique in which gingival crevicular blood could be used to screen for diabetes. The author believes this painless and quick screening tool could potentially be integrated into a dental examination.

Recent estimates indicate that 7.5 million people with diabetes are undiagnosed. Because periodontal disease may predispose individuals to diabetes, the dental office may provide a unique opportunity to screen an “at risk” population.

In order to ascertain if this was a service that our patient population was interested in, a brief survey was designed. It was given to 115 consecutive recall patients seen by the hygiene staff in a suburban periodontal private practice.

The results were:

  • The overwhelming majority (93%) felt that it is appropriate for dentists and hygienists to be involved in systemic medical health.
  • The majority (76%) would want this service provided by their dentist.
  • 53% of the patients who would consent to the screening were willing to pay up to $15.

This brief survey, in a private practice setting, seems to show that patients understand that the role of oral care providers has expanded beyond the oral cavity. Further, patients feel comfortable having the oral care team screen for common medical conditions.

Deborah Campsey, RDH
Veronica Carlson, RDH
Benjamin Kerpen
Great Neck, New York 11021

Stephanie Baker from New Paltz, N.Y., correctly guessed the flavor of a mystery lip balm that was distributed as part of a contest during the RDH Under One Roof contest last July. Baker was one of 14 attendees who guessed pomegranate as the flavor. Stephanie was chosen in a random drawing from the correct entries as the winner of a Philips Sonicare Flex Care power toothbrush and sanitizer.

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A reader questioned statements in the “Periodontal Therapy” column in the July 2009 issue of RDH. The article stated, “It’s important to separate patients … who are prescribed an oral bisphosphonate from those who are taking or have taken an oral bisphosphonate … patients taking oral bisphosphonates for less than three years have little risk for osteoporosis." The reader asked the column’s author, Lynne Slim, RDH, if she could “expound” on those statements.

Slim responded, “It is important to know the dose and length of time a patient has taken an oral bisphosphonate for osteopenia or osteoporosis. For example, alendronate (Fosamax) is usually taken at twice the dose of residronate (Actonel) or ibandronate (Boniva) and has caused the greatest number of ONJ cases. As Marx, Cillo, and Ulloa reported, the risk for developing ONJ increases with each pill ingestion and the greatest risk and most severe cases occur after three years of use.”