POINT-of-care screening by dentists for other diseases is long overdue.
Because the mouth is a window to the body, dentists have detected diseases such as oral cancer.
In fact, dentists conduct medical screenings when evaluating patients. These include, for example, checking a patient’s blood pressure.
It’s about time that dentists should have a larger role in the early identification of possible medical conditions, including COVID-19, according to a new policy issued by the American Dental Association (ADA) on Nov. 4.
Before that, in October, the ADA urged in a resolution that point-of-care screening tests should be allowed when dentists conduct patient evaluations.
The ADA is America’s largest dental association, representing 163,000 dentist members. The not-for-profit has promoted the art and science of dentistry since 1859.
The ADA resolution provides dentists another mechanism to assess the relative risks or benefits of providing dental care when patients have medical co-morbidities or even clinical evidence that indicates a possible underlying undiagnosed illness, said Dr. Duc M. Ho who chairs the ADA Council on Dental Practice.
“Dentists are alert to clinical evidence that indicates a possible underlying undiagnosed illness,” the resolution’s background states.
Advances in point-of-care testing have produced screening tests that are reliable, easy-to-use and can be quickly performed in a dental office, the resolution observes.
Findings from a point-of-care test can be shared with the patient and the patient’s physician for appropriate diagnoses and treatments, according to the resolution. This can result in more collaborative and comprehensive care for the patient, it said.
Point-of-care testing, Dr. Ho said, can be used during the current pandemic to screen patients for the SARS-CoV-2 virus which causes COVID-19.
Dentists can then refer patients to specialized health care for diagnosis and management.
The screening has the potential to play an important role in preventing the spread of the virus and allow dentists to safely provide complete oral care treatment to their patients, according to the ADA Health Policy Institute.
To put that in context, over 27 million Americans a year visit a dentist but do not see a physician.
“Although there are obvious state and federal requirements to abide by, this policy provides a foundation for future advocacy, which could help to prevent the spread of the virus while safely providing complete oral care treatment to their patients,” Dr. Ho said.
The ADA, in consultation with its Advisory Task Force on Dental Practice Recovery, released in October the COVID-19 & Lab Testing Requirements Toolkit to help guide dentists interested in offering their patients rapid response, point-of-care COVID-19 testing within their practices.
Some dentists have expressed interest in offering patients rapid response COVID-19 testing once reliable point-of-care testing is available at a level that makes it feasible for it to be used in individual dental practices, according to the toolkit.
Tests for COVID-19 have received Emergency Use Authorization from the US Food and Drug Administration.
Dentists have to register for a Clinical Laboratory Improvement Amendments certificate of waiver from the Centers for Medicare & Medicaid Services for the specific tests they want to perform, which are typically simple procedures and laboratory examinations that have a low risk for error.
It may well be worth the effort for our own Department of Health to look at this.
Point-of-care screening by dentists is worth the attention that it deserves here.
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Dr. Joseph D. Lim is the former Associate Dean of the UE College of Dentistry, former Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515./PN
