Should dentists offer health screenings?
December 15th, 2011
04:45 PM ET

Should dentists offer health screenings?

Each year, nearly 20 million men, women and children in the United States fail to see a family physician or similar health care professional, but they do pay at least one visit to the dentist, according to a new study in the American Journal of Public Health.

For this segment of the population, dentists may be the only doctors in a position to spot the warning signs of chronic illnesses, such as diabetes, and provide referrals or advice to prevent serious complications, says Shiela M. Strauss, Ph.D., the lead author of the study and an associate professor at New York University's Colleges of Dentistry and Nursing.

Oral or dental abnormalities can signal a broad range of body-wide health problems, including HIV, sexually transmitted diseases, eating disorders, and substance abuse, in addition to diabetes. In a previous study, for instance, Strauss and her colleagues found that 93% of patients with gum disease (such as gingivitis) also met the criteria that should trigger blood-sugar screening under American Diabetes Association guidelines.

Health.com: Signs and symptoms of type 2 diabetes

"I'm not advocating for dentists to become general health care providers," Strauss says. But, she adds, dentists can easily measure blood pressure and administer simple screening questionnaires - both of which could potentially make a big difference to the health of someone at risk for diabetes who hasn't seen a doctor recently.

In the new study, Strauss and her team analyzed data from the Medical Expenditure Panel Survey, a nationally representative government-sponsored survey of health care use. In 2008, the researchers found, roughly one-quarter of adults did not see a physician, nurse practitioner, or other general health care provider - but of that group, 23% did see a dentist. The pattern was similar among children.

It's not clear what's leading these people to see a dentist but skip medical care. Most of the adults - and nearly all of the kids - had health insurance, so lack of coverage can't fully explain it. In fact, the authors note, the dentist-only group was "quite diverse" ethnically, socioeconomically and geographically.

Health.com: 20 things that can ruin your smile

It could be that dental problems - unlike some chronic diseases - are often too painful to ignore, Strauss says, or it could be that dentists are simply better than doctors at reminding patients when it's time for a checkup.

Getting dentists in the habit of screening for health conditions will probably require changes to dental-school curricula, the researchers say. However, dentists and dental hygienists are typically already trained to check blood pressure and conduct other types of general medical screening.

Health.com: Natural ways to lower blood pressure

And while they might be hesitant to take on more patient responsibilities, Strauss says, doing so may have unexpected benefits. She points to the experience of some Swedish dentists who participated in an insurance plan that required them to implement diabetes screening for their patients.

"The reputation got out there that these were dentists that really cared about the patients," she says. "It was an initial investment of a bit more time on the part of the dentist, but it reaped great rewards for them in terms of growing their practice."

Copyright Health Magazine 2011

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Filed under: Dental health • Health.com

soundoff (525 Responses)
  1. Farhad

    As a dentist, maybe we should start developing a charge for health screening then more people will appreciate our service.

    December 17, 2011 at 15:21 | Report abuse | Reply
    • Chris


      It seems as though dentists have already found ways to charge exorbitant prices for their services. Big surprise here.

      Everyone needs a dose of radiation every six months whether they have an issues or not. Give me a break. All about lining your pockets. People complain about doctors. Give me a break

      December 17, 2011 at 18:53 | Report abuse |
    • SixDegrees

      Uh – this may come as a shock to you, Chris, but X-rays are performed to detect disease and other abnormalities BEFORE other symptoms develop – like the ones that involve excruciating, unbearable pain or that nasty, there's-something-dead-in-my-mouth taste and smell that makes co-workers shun you. If the cost really bothers you that much, why are you letting the dentist take X-rays in the first place? Just tell him not to do it. Just don't whine like a little girl when you need oral surgery instead of a simple filling as a result.

      December 18, 2011 at 06:39 | Report abuse |
    • Hire better staff

      Dental hygienists make a dentist great. People will far appreciate your service more than generating another unbundled charge.

      December 18, 2011 at 11:56 | Report abuse |
    • John Doe DDS

      As a dentist I understand your frustration with high prices, but first I want to clear a few things up about your statements, Exorbitant Prices- First off the overhead to run a dental practice is anywhere from 45-65% so just for easy math sake lets say an average of 50%, if you pay $1000 for a crown that means that the dentist takes home around $500 for the crown. but the time that it takes to complete this crown is usually 2 appoints (2 hours) and a good dentist will cover anything that goes wrong with that crown for 3-5 years. so now lets say the dentist made $250 per hour that he gets to take home, but don't forget about all the time spent in school and student loans that he/she is paying back, many times these days student loans from dental school loans are in the ballpark of $400,000. so those are not cheap student loan payments. So before you make statements about the dentist robbing you to get rich please know your facts!
      X-rays every 6 months- This answer is 2 fold, the ADA only recommends x rays 1 time every year and a panorex every 5 years, unless you are a high risk case, ie you have cavities every time you come in, have periodontal disease (bone loss) or other problem that would classify you as high risk. That being said you have the right to refuse x-rays at any time as long as you know the consequences. So my opinion is that if you dont feel like you need them talk with your dentist and if he either doesnt talk with you about it or you dont feel comfortable after you talked with him you should think about taking your records elsewhere. And on that note it is also illegal for a dentist to charge you anything more than a nominal fee of say $25 to get all records sent to another office.

      So in closing I think you should educate yourself about a profession before you begin bashing it, and secondly if you dont feel comfortable and confident at your dentist you should go somewhere you can feel good about the dentist and the procedures that they perform. My advice is ask people who you know about who they see and what they think about their dentist, because unfortunately, just like in any profession there are some bad dentists out there who do try to scam patients, however from my experience I know that there are many very good and caring people who are dentists.

      Thanks and good luck.

      December 18, 2011 at 12:05 | Report abuse |
  2. m

    This make too much sense the medical profess will fight it and the GOP = GREEDY OPPOSITION PARTY will surely vote against anything that might be beneficial to the public.

    December 17, 2011 at 23:55 | Report abuse | Reply
    • alan seago

      My goodness, m, why is it that in response to every article, on every topic, there are some commenters who just aren't happy unless they reply with political comments that are irrelevant to the issue at hand?

      The question about what services dentists should provide is interesting. The wider question is why does some branch of government feel it necessary to provide services to people who are too irresponsible to get those services themselves? Let's see: for people too negligent to see a doctor, we now consider whether dentists should provide the same services that doctors have heretofore provided. How about for people too negligent to see either a dentist or doctor? Should the pharmacist provide both medical and dental screenings, in addition to selling pharmaceuticals? Or should we simply expect people to take care of themselves, and get the dental and medical care they need (now that universal health insurance is the law), with the understanding that if someone doesn't get that care, the person will bear the consequences of his or her own negligence?

      December 19, 2011 at 16:43 | Report abuse |
    • Doudou

      Crown prices vary (in the same ffioce) due to the type of metal used in the crown. Precious metal crowns are gold,(the most expensive) semi precious metals include gold, platinum, silver, etc. Non-precious contain Nickel, palladium and few others metals (least expensive)Gold is always the best metal to use, gold has a tendency to flow better into the crevices and the wax burn-out of the crown form and least amount of voids. Non-precious are the hardest but don't always have the same great fit.If the price difference is from different ffioces, you may be paying that ffioces' operating and materials cost. Most ffioces are very particular about the crowns they make so they use high quality impression material and may take extra time for thoroughness, so the time in the chair could be extensive.If an all ceramic crown is used (not the ffioce made ones like Cerec,crowns that are sent to an actual lab, the porcelain and porcelain work can also be very expensive)

      April 7, 2012 at 23:05 | Report abuse |
  3. SixDegrees

    My dentist has always done this as a matter of course if something turns up during the normal exam. He doesn't go any further than ordinary dental practice, though; checking blood pressure and performing other exams seem far outside of scope, and I'd expect medical boards to rightly raise a stink over lack of certification.

    I do agree that dentists are good at reminding patients of pending appointments, and that other doctors are very, very bad at this. If you want me back, say, in a year, then make the appointment for me and badger me a couple of weeks ahead – don't toss it in my lap and expect me to keep track of when to return or to remember when my appointment is months or a year ahead.

    December 18, 2011 at 06:33 | Report abuse | Reply
    • qwerty11

      Be responsible for yourself and your health. Surely someone with 6 degrees can remember it's time for their annual checkup...

      December 18, 2011 at 06:56 | Report abuse |
    • student

      Usually they ask you to make a a follow up appt or another check-up even if it's a year away. Then they put it on a reminder card for your to keep in your wallet or the refridgerator. Most of my doctors will also call a couple of days before to remind you, usually it's automated, but it still gets the job done.

      December 18, 2011 at 22:29 | Report abuse |
    • IgM

      Seriously, take some responsibility for your health. Your doctor couldn't care less if you don't schedule your follow up appointment, except that it's more of a pain when a few months later you have a problem and try to squeeze a general check-up and 12 little issues you've been having into a 15 minute appointment.

      December 19, 2011 at 11:20 | Report abuse |
  4. Milton Platt

    Not against it, but I think it would meet with minimal success. There would be extra charges for this service and these people are already avoiding paying for a check-up. They might be tempted to avoid the dentist as well.

    December 18, 2011 at 07:49 | Report abuse | Reply
  5. Dr. Martin Adickman

    We were taught to screen for high blood pressure and diabetes in 1972. This is news?

    December 18, 2011 at 11:48 | Report abuse | Reply
  6. carol

    Any age demographics on this study? I'd be wiling to bet the same isn't true (or at least AS true) for seniors, simply because while we have Medicare many of us simply cannot afford dental insurance, let alone the sometimes staggering costs of dental care. I've been battling periodontal disease for over 30 years, and while I had dental insurance through work, it was an affordable battle. As a retiree, the situation has changed dramatically. How many of us have a spare $10k+ sitting around to have oral surgery (and don't start talking about pre-existing conditions relative to new dental insurance).

    December 18, 2011 at 12:29 | Report abuse | Reply
  7. Susan

    Our system should be treating the whole body. We'd have many more healthier people if medical professionals worked together to treat the entire person. Having dentists tuned into possible medical issues could help patients seek preventive care which would cost less than waiting until the conditions become a crisis. If the dentist can help start the conversation with the patient, than perhaps she/he will become more interested in their health. http://whatstherealcost.org/video.php?post=five-questions

    December 18, 2011 at 15:37 | Report abuse | Reply
    • alan seago

      Susan, you wrote that "Our system should be treating the whole body". Although you are making a reasonable point, I am uncomfortable with your use of "our system" as the subject of the sentence. I would suggest, with no disrespect to your comment, that each individual should take responsibility for his/her health, and take appropriate action. To say "our system should" be providing this or that type or care suggests that "our system", and not the individual, is primarily responsible for the individual's care. And that bothers me.

      December 19, 2011 at 16:48 | Report abuse |
  8. Doc ps

    Clinics exist at drug stores. That makes a lot more sense than a dentist's office. If you can afford a dental checkup, you can see your primary care for $100 follow up.

    December 18, 2011 at 20:32 | Report abuse | Reply
  9. student

    I agree that dentists should check blood pressure and ask their patients health questions that pertain to their oral health, like questions about mouth pain, diabetes symptoms, dry mouth, and the like. If the patient has not seen their doctor for a check-up within the past year or has symptoms of a health problem, the responsible thing would be to refer them to a medical doctor. Preferably a variety of providers, sliding scale clinics, a variety of high quality, non-judgmental primary care providers, various specialists,etc. If there is something potentially serious going on that the patient hasn't seen a doctor about it, then the dentist should strongly advise them to do so.

    Ideally, a dentists would want to practice in a multi-speciality clinic where a reluctant patient could simply be sent across the hall for health follow-up, perhaps even seen immediately for something serious.

    Anything than more than simple health questionaires or blood pressure checks is outside the competency of the dentist and therefore unethical.

    December 18, 2011 at 22:25 | Report abuse | Reply
  10. anti dentist

    Dentists are the most overpaid profession!!! Most dentists work 30-35 hour weeks, trained for 3 less years than a typical doctor, and make more than your average primary care physician. Most dentists are med school rejects who weren't smart enough to be real doctors. They make the big bucks because people have to pay ridiculous fees (mostly out of pocket) for this procedure based field. All fields where people pay out of pocket (dermatology, plastic surgery, dentistry) make mad cash. Plus they have convinced the public to pay for completely unnecessary cosmetic procedures (whitening)... don't get me started on fluoride washes (its in our freaking water... no one needs to be paying 50 extra bucks for that).

    December 19, 2011 at 00:47 | Report abuse | Reply
    • Amanda

      Not everyone has fluoride in their water – if you have well water there's no fluoride in it.

      December 19, 2011 at 14:54 | Report abuse |
    • Alan

      You don't know what you are talking about....sorry

      December 19, 2011 at 23:19 | Report abuse |
    • Kelly

      Wow you have no idea what you're talking about.

      January 29, 2012 at 15:38 | Report abuse |
  11. L

    I don't see a GP, but I do see my dentist regularly and my ob/gyn. I always have good blood pressure and rarely get sick. I would out 5-6 days a week (hard workouts – Insanity, Turbo Fire), take multi-vitamins, am a good weight. I don't personally feel it's necessary in my condition to see a GP unless I am ill (which is very rare).

    December 19, 2011 at 17:46 | Report abuse | Reply
  12. Stacey

    I love going to the dentist. The health of your mouth is just as important as the health of your heart; simple because, most of our good/bad health begins with what we eat.

    December 19, 2011 at 18:15 | Report abuse | Reply
  13. Y BOTHER?


    December 20, 2011 at 07:36 | Report abuse | Reply
  14. Diane

    Are they going to ban shared consultation rooms first? My GP doesn't examine me in front of other patients, why are dentists allowed to?

    December 29, 2011 at 23:20 | Report abuse | Reply
  15. Anthony Sanchez DDS

    I would say as a dentist that I do not think we should be giving health screenings because that is best left to the general health doctors. However if as a dentist I notice a health issue of concern, I would give the patient a referral of a specialist to go see. Many patients are already aware of the health issues that they have so I always look to see what issue they have mentioned in their chart. If there is something that they may not be aware of I think it is always best to send them to a specializing doctor.

    February 16, 2012 at 23:59 | Report abuse | Reply
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    April 16, 2012 at 04:16 | Report abuse | Reply
  17. Marielaina Perrone DDS

    As a dentist I am not sure I would feel comfortable giving a health screening but I have noted to my patients areas of con cern I might have for them based on oral evidence or even just talking to them how they feel.

    May 27, 2012 at 00:32 | Report abuse | Reply
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    September 3, 2012 at 06:59 | Report abuse | Reply
  19. Francine Kitagawa

    I think they should. I am going to bring it up to my dentist when i go in for Lumineers Pleasanton.

    May 10, 2014 at 21:54 | Report abuse | Reply
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    October 5, 2015 at 05:40 | Report abuse | Reply
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    October 5, 2015 at 05:42 | Report abuse | Reply
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