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Implementing Chair-Side Blood Testing
By Kimberly R. Miller, RDH, BSDH
June 2011

There is no doubt that doing chair-side blood testing is a stretch for most clinicians! It’s just not in our current frame of reference as Dental Health Care providers. In fact I can list many reasons or excuses to decide not to do chair-side blood testing:

  • I don’t have enough time to add something else into the dental (hygiene)visit.
  • This should be done in a medical office, not a dental office.
  • Patients are not going to want to do blood testing in a dental office.
  • Patients aren’t going to want to pay for it.
  • It’s too expensive.
  • Dental insurance won’t cover it and I don’t want to bill medical insurance.

You must admit, that’s a pretty good list, and I bet you could add one or two more obstacles. On the other hand, let’s pause for a moment and refocus our train of thought to consider how blood testing in the dental office could be beneficial for diagnosis, treatment planning and above all else, case acceptance. There are many ways chair side blood testing could help us help our patients achieve a higher level of overall health. In fact we often hear from our patients that they haven’t had a comprehensive physical in years. This reason alone should prompt us to consider adding chair side blood testing to the other services we offer.

Healthy Heart Dentistry offers a series of easy to use, non-invasive, FDA approved and accurate finger-nick collection method testing kits:

Diabetes Risk Assessment
  • Instant Glucose Result (8 hour fasting)
  • HbA1c (mail-in)
High Sensitivity C-Reactive Protein (mail-in)
Perio Metabolic Profile (8 tests in 1 ~ mail-in & instant)
  • Total Cholesterol
  • LDL
  • HDL
  • Triglycerides
  • CRP
  • Glucose
  • HbA1c
  • Fasting Insulin
Vitamin D Test for naturally occurring & dietary forms of vitamin D (mail-in) Vitamin D deficiency is a major factor in the etiology of:
  • Rickets
  • A variety of cancers
  • Hypertension
  • Stroke
  • Heart Attack
  • Diabetes
  • Bone Fractures
  • Periodontal Disease
  • Multiple Sclerosis

Understanding and recognizing the evolving medical/systemic relationships affecting our patients is an ongoing challenge. Take some of the mystery out of the equation by implementing chair side blood testing. Here’s how!

Step one: get your entire team on board with the concept and the validity of testing. You may want to utilize some of the research on to validate the concept.

Step two: visit and learn more about the testing process and types of tests available. Order tests and brochures to get started, save 5% by entering promo code ‘frogz’.

Step three: create an introduction letter (or use one of their brochures) introducing the concept to your patients and hand it to each patient as they arrive, regardless of the reason for their visit. Note in the patients’ chart that they received this information.

Step four: immediately following ‘risk assessment’, which should be done with every patient, discuss any medical systemic links, and determine which of the chair side blood tests may benefit your patient and / or serve as a third party validator which can increase case acceptance. It’s a good idea to decide during your morning patient care meeting which patients are candidates for chair side blood testing.

For example, every diabetic is a candidate for the HbA1c test on a quarterly basis. We can conveniently offer HbA1c testing to these patients during their 3-month hygiene visits. When the diabetic patient requires periodontal therapy HbA1c should be checked before and after therapy to track HbA1c improvements.

For patients with heart disease and periodontal disease, you would consider testing CRP levels before and after therapy and many of your male and female patients will be interested in having their Vitamin D levels checked.

If your patient is here for a New Patient Visit, and you diagnose periodontal disease, diagnose the need for the appropriate blood tests at the same time as if it was a matter of wrote. If testing is not performed today, include it in the treatment plan to be completed in the appropriate time frame but before periodontal treatment is started.

If you have doubts about how your patients will respond to the option of chair side blood testing, or any other service for that matter, survey every adult patient who walks through your door for a few weeks asking them to respond to 3 or 4 simple questions. Here are some sample survey questions to get you started:

1)  When having a blood test, would you prefer a ‘finger nick’ rather than a ‘traditional’ blood draw? YES / NO
2)  If your dental health professional asked you to have a blood test for accurate diagnosis, treatment planning and successful therapy results, would you do it? YES / NO
3)  If you could have a blood test performed with a finger nick in our dental office, would you take advantage of this convenience? YES / NO
4)  From the list of tests below, please check the ones you might be interested in:
  • Diabetes Risk Assessment (instant glucose & HbA1c)
  • Metabolic Profile (Total Cholesterol, LDL, Triglycerides, HDL, Glucose, CRP, HbA1c & Fasting Insulin)
  • CRP or C-Reactive Protein (tests for high levels of inflammation)
  • Vitamin D test
The following is a sample introduction letter for chair side blood testing:

To You, Our Valued Patient, June 2011

As you know, researchers continue to uncover medical conditions that are related to periodontal disease. In light of this fact, our intention is to work cooperatively with your physician to offer you the best care available when it comes to managing chronic diseases like periodontal disease, cardiovascular diseases and diabetes. In addition, many patients are unaware that they are at risk for the development of disease.

With that in mind, we are pleased to be able to provide you with four safe, convenient and affordable finger-nick blood tests:
  • Diabetes Risk Assessment (instant glucose & HbA1c)
  • CRP or C-Reactive Protein (tests for high levels of inflammation)
  • Metabolic Profile (Total Cholesterol, LDL, Triglycerides, HDL, Glucose, CRP, HbA1c & Fasting Insulin)
  • Vitamin D test

During your appointment today, your clinician will talk with you about your level of risk and answer any questions you may have about chair side blood testing.

With your good health in mind,
Dr. Richard Nagelberg