Trip to dentist may soon include heart disease, diabetes tests

When Betty Scott goes to the dentist, it's not just her teeth and gums that get a checkup.

As a patient at the dental school clinic at the University of Illinois at Chicago, she knows the exam will start with a check of her blood pressure.

Because she's a diabetic, she'll always have her glucose levels checked as well.

It's becoming the standard of care here, where they're training the dentists of the future.

Betty, whose father and aunt are diabetics, has never had care like this at a dentist's.

While she watches her diet and takes medicine for her chronic condition, she hears on this day that her sugar levels are a little high.

"They're trying to keep it under control," she said of the UIC clinic staff.

She explains she came here for dentures, but when she gets them, she'll also be urged to go to the doctor, and reminded of ways to control her disease.

The associate dean for research at UIC, Dr. Phil Marucha, says half of all Americans are overweight, and a third of the population is now obese.

"It's predicted about 25 percent of people over 60 years old will have either detected or undetected diabetes," he said.

And yet, Marucha said it's not unusual for people to avoid the doctor for years.

"Frankly, a lot of people see their dentists more frequently than they see their physician," he said. "So that being the case, why shouldn't we be screening for fairly ubiquitous and serious diseases like diabetes, and why shouldn't we be counseling patients on smoking and obesity?"

Patient Richard Mueller would wholeheartedly agree.

In fact, he thinks his dentist, Ronald Schefdore may have saved his life.

Mueller said he hadn't seen a doctor in years, but as a long time patient of Dr. Schefdore's, he did get dental checkups regularly.

At one recent visit, the dentist noticed something he hadn't seen before in Richard's other dental exams.

"He never had periodontal disease," he said. "But this one checkup he had bleeding gums that were very bad."

Schefdore immediately gave his patient three blood tests: one for glucose, one for cholesterol, and one for a measure of inflammation called C-reactive protein.

Some experts believe that's a predictor of heart attack risk.

Schefdore also suggested Richard get a primary care physician: but first, he urged him to go immediately to a hospital and get more blood tests.

A few days later, a shocked Mueller discovered that he had Type 2 diabetes.

Now, he sounds like a doctor himself sometimes as he talks about diabetes.

"You got to do things, cut the lawn, take a walk, get more active," he said. "You do have to change your lifestyle."

He believes it could have been worse if his dentist hadn't caught it in its early stages.

Schefdore, meanwhile, has turned the concept of chairside testing into a business: he now markets the Biosafe tests for glucose, cholesterol and C reactive protein to other dental practices.

He says it's a business he believes in.

"Dentists are in the perfect position to identify and help with early detection of some of the worst health problems we have in America," he said.

In his own practice, Schefdore says he's helped identify patients with cancer, diabetes, and both high heart attack risk and stroke.

In fact, he asserts, "Over 2 million people could be helped if dentists were to incorporate these tests in their office."

Dentists who agree said this is not practicing medicine without a license; it's an offer of an early warning system for patients and their doctors.

Most people go to the dentist when they feel well, so a dentist may know before the patient that he or she is at risk for diabetes: just by examining the gums.

Then, there's the growing research showing links between periodontal disease and other conditions.

In the case of pregnant women, for example: there's a strong connection between gum disease and pre (hyphen) term labor.

If all this sounds promising, there is one warning from diagnostics experts.

They see the value of blood pressure and glucose checks, but they say other tests are still in their infancy.

The chairman of the periodontics department at the University of Texas Health Science Center in San Antonio points to the test for inflammation known as the C reactive protein, CRP.

He describes it as a general test for inflammation in the body, much like taking someone's temperature.

He said like having a high temperature, high inflammation can mean anything: it doesn't necessarily mean the patient has heart disease.

"We certainly can't say at this point time that measuring something as general as C reactive protein can, be diagnostic for any other chronic disease in the body" said Dr. David Cochran.

He worries that a positive CRP test result will unduly worry patients.

That's why he thinks internal medicine doctors are better equipped to offer more complicated testing, because they're trained to walk the patient through the diagnostic process.

For now, it's still unusual to get this kind of care at the dentist's office.

But Marucha at the UIC dental clinic said, "We're trying to train dentists for the future, so we see this as the beginning of many tests that may be done chairside."