Improve Your Patients’ Health and Your Bottom Line

by Ron Schefdore, DDS

and

Jack Maggiore, DDS

Many health care professionals are turning to blood screening test kits to quickly and accurately screen current and potential patients to help improve their health and possibly save their lives. These tests can be used at home by the patient or can be administered by a health care professional using only 1-4 drops of blood. Within the dental community, these tests have proven to improve treatment acceptance and increase quality referrals of patients by health care professionals (1). This is an example of a major paradigm shift occurring in a health care profession not accustomed to serving a leading role in systemic disease detection, whereby the outcome is the improved overall health of patients. While many dental offices have seen their incomes decrease over the past two years, offices that have implemented in-office blood screenings and follow the Healthy Heart Dentistry® program have realized sustained growth in revenues, patient base, and referrals. We describe below two such strategies for achieving this level of success.

Strategy 1: The patient with active periodontal disease Periodontal disease affects 70%+ of Americans over 35 of age (2). This high incidence is due to a combination of poor compliance of home hygiene, poor nutrition, and lack of diagnosing and treating periodontal disease at the dental office. Periodontal disease can elevate glucose, cholesterol, and the inflammatory marker C-reactive protein (CRP) (3-11). This well-established connection provides an opportunity to open a discussion with the patient how periodontal disease can affect overall health. The dental professional staff is taught the proven Healthy Heart Dentistry® ten-step patient presentation program resulting in an increase of patient acceptance into treatment. Healthy Life Labs has developed a menu of laboratory accurate and inexpensive blood tests for the dentist to perform in their office or to dispense to their patients to use at home. Each kit contains a patient consent form, and a professional report is provided to the patient and to the dentist within 1-2 weeks. The suggested blood screening test used before starting treatment for periodontal disease is a customized screening panel called the Perio-Metabolic Profile (www.healthyheartdentistry.com). This profile examines the effects that glucose and lipid metabolism may have on periodontal inflammation, and likewise checks for the effects that periodontal disease may have on the body's metabolism. If blood glucose is elevated the dentist refers the patient to their physician for further clinical evaluation and diagnosis. Our physician letter is faxed to the patients' primary care physician. The letter contains the blood test results and our office information. If other blood chemistries such as cholesterol or CRP remain elevated after treatment for gum disease, a referral letter from the dentist to the patient's physician is similarly submitted for possible further testing and a diagnosis. Disclaimer: This is not treatment advice given by the authors. Each health professional must decide when a referral is appropriate for their patient. This communication has successfully started a mutually referring relationship between dentists and physicians.

Strategy 2: For dental patients undergoing a cleaning at their dentist office Bleeding gums are now recognized as a first sign of diabetes (12), so dental professionals are in the perfect position to identify those at early risk for diabetes. Upon arrival to the dental office, a diabetes risk questionnaire is completed by the patient, typically when updating insurance information. The questions are designed to qualify those at risk to diabetes for testing, including those who are over 45 years of age, overweight, hypertensive, having a family history of diabetes, or those among ethnic groups with increased diabetes risk (African American, American Indian, or Latin American). Any "YES" answer to one of the 6 questions on the diabetes risk questionnaire from the American Diabetes Association qualifies a patient for a Diabetes Risk Assessment test. Even in the absence of an affirmative answer, if a patient has bleeding gums during their dental cleaning or upon a periodontal examination, a Diabetes Risk Assessment blood screening test is advised. The dentist utilizes the professional report sent from Healthy Life Laboratories to establish a relationship with physicians to initiate a mutually referring relationship, and to increase quality referrals from patients.

In this authors' dental office, 5 different cancers were diagnosed by physicians due following our referrals (go to www.pharmaden.net to view the video "Early Cancer Detection" located on the home page). In addition to the early detection of cancer, diabetes, pre-diabetes, increased risk to heart disease and stroke, and other medical conditions were diagnosed and treated by physicians due to our referrals. Our patients are very grateful for this level of service and recommend friends and family to us. On a professional basis, physicians continuously refer quality patients directly to our office, and the staff boasts to everyone how we not only help people maintain a great looking smile for life, but that we also help them become healthier. All of this occurs because we incorporated simple and inexpensive blood screening test and added an evidence based nutraceuticals (www.pharmaden.net) as an adjunct to treatment of periodontal disease. Addressing the nutritional deficiencies of disease and blood screening tests to help patients achieve long term health makes sense to patients. A simple, efficacious, and compliant home hygiene program called the Healthy Heart Dentistry® home program was also developed to improve patient compliance and treatment outcomes.

While we speak directly from our experience with dental professionals, any health care provider can follow this successful referral formula to help their patients improve their health and grow their practice with quality and grateful patients.

Glycemion Strategies and Healthy Life Laboratories: "Helping grow your office by improving your patients' health"

REFERENCES:

1. Schefdore RL, Maggiore JA. Dentistry meets medicine to provide better healthcare. (Dental Organization for Conscious Sedation) DOCS Digest. Spring 2009; 19-24.

2. American Dental Association: http://www.ada.org/prof/resources/topics, posted December 2006.

3. Slade GD, Offerbacher S, Beck JD, et al. Acute-phase inflammatory response to periodontal disease in the US Population. J Dent Res. 2000;79:49-57.

4. Noack B, Genco RJ, Trevisan M, et al. Priodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol. 2001;72:1221-1227.

5. Buhlin K, Gustafsson A, Pockley AG, Et al. Risk factors for cardiovascular disease in patients with periodontitis. Eur Heart J. 2003;24:2099-2107.

6. Craig RG, Yip JK, So MK, et al. Relationship of destructive periodontal disease to the acute phase response. J Periodontol. 2003;74:1007-1016.

7. Slade GD, Ghezzi EM, Heiss G, et al. Relationship between periodontal disease and C-reactive protein among adults in the Atherosclerotic Risk in Communities study. Arch Intern Med. 2003;163:1172-1179.

8. Oz SG, Fentoglu O, Kilicarslan A, et al. Beneficial effects of periodontal treatment on metabolic control of hypercholesterolemia. South Med J. 2007;100:686-691.

9. Katz J. Elevated blood glucose levels in patients with severe periodontal disease. J Clin Periodontol. 2001;28:710-712.

10. Fredriksson MI, Figueredo CM, Gustaffson A, et al. Effect of periodontitis and smoking on blood leukocytes and acute phase proteins. J Periodontol. 1999;70:1355-1360.

11. Loos BG, Craandijk J, Hoek FJ, et al. Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. J Periodontol. 2000;71:1528-1534.

12. Lamster IB, Lalla E, Borgnakke WS, et al. The relationship between oral health and diabetes mellitus. J Am Dent Assoc. 2008; Oct;139 Suppl:19S-24S.

For more information visit: www.HealthyHeartDentistry.com and www.Parmaden.net.