Consultation with a dentist will help identify hypertension

Early evidence suggests that a dental consultation can detect more than a third of cases of hidden high blood pressure and up to half of undiagnosed prediabetes/diabetes.

This project developed SEPA Foundation for Periodontics and Dental Implantshas strategic support dental hygiene expert company Dentaid. and is approved by various scientific societies in the field of dentistry and medicine, as well as by the General Council of Dentistry of Spain and various professional associations.

A year after the launch, the main work was focused on dissemination among dental clinics in the country, conducting training events for specialists from participating centers.

“After these necessary and preliminary steps, we are now really starting to document both the good reception that the project has among dental clinics in our country and the first the enormous opportunities that open up for us in identifying important and common diseases such as diabetes or high blood pressure.as well as promoting oral and general health through dental consultation,” emphasizes Dr. Miguel CarasolPromoSalud coordinator.

First results

At the moment, as reported Dr. Eduardo MonteroProfessor at the Complutense University of Madrid (UCM) and PromoSalud Data Analysis Coordinator”“Almost 1,500 clinics have joined the initiative and are currently able to analyze data from more than 700 patients.”. The results are said to “show the important role that the dental clinic can play in screening patients with high blood pressure or prediabetes/diabetes that has not previously been diagnosed.”

While these are still estimates, preliminary data allows us to predict that It is possible to identify from 30 to 50% of undiagnosed cases of both pathologies.. “The impact of these results on public health is enormous,” says Dr. Eduardo Montero, since “early identification of these patients allows for preventive and therapeutic measures to be taken that avoid complications and side effects of these diseases, including the eventual mortality associated with both pathologies.” Moreover, according to this expert, “the impact in economic terms will be enormous, as has been observed in other countries both in public health systems and based on data from private health insurers.”

A detailed analysis of the first observations in 733 patients shows that In 37.2% of cases, values ​​of undiagnosed hypertension were recorded. (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg). Likewise, the percentage of patients potentially having prediabetes or diabetes were 4% and 3%, respectively, based on the FindRisc questionnaire and outpatient determinations of glycosylated hemoglobin (HbA1c). These data, as interpreted by Dr. Montero, “are particularly striking and transcendental because the percentage of undiagnosed diabetes in the Spanish population (according to the study) Di@bet.es) is estimated at approximately 6%, i.e. that half of these cases can be examined in a dental clinic”

40% do not know they have hypertension

Currently in Spain, 40% of people with hypertension are unaware of their condition, and an estimated 15 million adults suffer from high blood pressure. There are also more than 5 million people with diabetes, of which 45% are unaware that they have it, that is two million three hundred thousand people. 50% of people visit the dental office once a year, but many of them do not see a doctor..

Therefore, as stated Patricia Anton, national medical director of Dentaid, “the dental office is a place of health promotion where certain pathologies can be detected at an early stage.” For Dentaid, he adds, “prevention and the work in clinics to improve early detection data is very much in line with our goal, which is to promote and improve the oral health of people at all stages of lifealso taking into account that it affects overall health.”

This is just the beginning

The collection and detailed analysis of information from the hundreds of patients expected to be enrolled in the coming months could be of great clinical and socio-medical importance, according to supporters of the initiative.

For this reason, Sepa President Dr. José Nart believes that “It is time for dental clinics and the entire oral health care team (dentists and hygienists) to start acting as health centers and specialists. “in the broadest sense of the word”. On the one hand, it is believed that they may be fundamental to promote a healthy lifestyle (eg, smoking cessation, encouraging exercise and education about healthy eating); but, in addition, it seeks to encourage, optimize and expand its role in caring for health problems that patients may have that have not previously been diagnosedas Promosalud suggests.

Thanks to its complexity and ambitious goals, the practical application of Promosalud is now beginning to bear its first fruits and allows decision-makers to make a first assessment, emphasizing “ Very good acceptance of the projectwho is in very good health,” says Dr. Montero, emphasizing that “the goal is to make Promosalud part of the normal operating hours of all dental clinics in Spain.” So he adds: “We continue to work on distributing it and signing agreements with professional associations”.

And, thanks great team work, “was reachedor that numerous professional dental associations have joined the initiative”reports Dr. Montero, although “our intention is that eventually they will all do this, and not only that, but that clinics will actually incorporate this into their normal operating protocols in daily practice.”

Moreover, it is also considered viable and feasible. international translation of this protocol developed by Sepa experts. According to Dr. Jose Narta, “We are confident that this protocol will scale well internationally.”. In fact, as already noted, “there are many scientific societies from European and Latin American countries that have expressed interest in this initiative.”

Euskadi, great welcome

The professional dental associations of Euskadi took an active part in this project.with the accession to the throne of the Illustrious College of Dentists of Vizcaya (CODBI) and Illustrious Official College Dentists and dentists in Alava (Official collaboration with the College of Dentists of Guipuzcoa is also expected soon).

“As healthcare professionals, we are proud to be able to help with an initiative that represents an improvement in the general health of the populationusing our consultations so that we can carry out preventive work as important as early detection of diabetes and high blood pressure,” says Dr. Agurtsane MerueloPresident of the College of Dentists of Vizcaya and Secretary of the General Council of Dentists, who emphasizes that “Currently it is difficult to calculate the number of participating clinics, since it This is a private initiative, but we believe that as it becomes more well known, it will be implemented in more clinics.”

Estimated approximately 600,000 residents of Vizcaya visit a dental clinic at least once of the almost 650 that there are in Vizcaya, which has 1,050 dentists registered, to whom “information from the Promosalud program is sent and therefore ready to detect the signs that these diseases may exhibit.” In this sense, the President of the Official College of Dentists of Vizcaya recalls that “ Basque Country implemented a Child Care Program in 1990 (mainly with the support of private dentists) which, combined with water fluoridation, allowed us to achieve privileged position in terms of oral health of the populationas seen in epidemiological studies.”

From my side, Dr. Monica Muñozmember of the board of directors of the College of Dentists of Alava and participant in the Promosalud project, assures that “this initiative highlights the work of the dental clinic team, caring for the general health of the population and, in addition, it can serve to support the public health system in screening for two hidden pathologies such as diabetes and hypertension.” In his opinion, “Promosalud can have a very positive impact on Euskadi. among dental clinic users, as it helps to identify and treat these diseases, the response to treatment of oral pathologies such as periodontitis will significantly improve, as well as improve the health of the population as a whole, which will have associated and additional benefits. for the healthcare system.”

Between necessity and opportunity

There are more than 23,000 dental clinics in Spain.. Only if each of them could include a dozen patients a year in that Promosalud protocol (by identifying them as possible risk patients), the health system could be alerted and targeted over two hundred thousand potential cases of undiagnosed diabetes and/or hidden high blood pressure. These are the assessments and considerations of the main people responsible for this initiative.

V Promosalud websiteA simple and clear protocol is available to all dentists in Spain completely free of charge. You simply need to register and you will receive both this protocol and a supporting infographic explaining how to implement it in your dental office. Through visual infographics, it is indicated which population group the initiative is specifically targeting, when to implement the developed protocol, in what order the recommended tasks should be performed, what should be recorded at the dental consultation, and what to do with the results obtained. .

He Promosalud’s immediate goal is threefold.: 1) promote the prevention, diagnosis and treatment of periodontal diseases; 2) increase public awareness of the importance of periodontitis as an indicator of the risk of diabetes mellitus or cardiovascular disease; 3) identify the risk of developing prediabetes, diabetes, or hypertension in individuals receiving dental care in dental offices.

General health of the patient

“At Sepa, we believe in the power of a dental consultation to have a positive impact on a patient’s overall health, not just their oral health.especially with new data showing how prevention or optimal treatment of gum disease (gingivitis, periodontitis) is associated with improved overall health,” says Dr. Nart, who reminds that “patients with periodontitis.” higher blood pressure levels and worse diabetes control.”

In this sense bidirectional relationship between diabetes and periodontitis This is especially important: the presence of diabetes mellitus triples the risk of periodontitis, and complications associated with it (cardiovascular diseases, nephropathy, retinopathy, etc.) are more common in people with periodontitis; People with diabetes tend to develop periodontitis earlier and have a harder time effectively treating this gum disease; In addition, periodontal treatment has been shown to improve glycemic control in people with diabetes.