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Science forum explores question of medical tests

Should dentists screen for medical conditions in their offices?

That was the central question Thursday afternoon at the first of two Open Clinical and Scientific Forums that took place this week at Annual Session.  The second forum was held Friday and focused on medication-associated osteonecrosis of the jaw. A report on that forum will appear on ADA.org.

Now in its third year, the forum series is hosted jointly by the ADA Council on Scientific Affairs and The Journal of the American Dental Association.

These forums help bring new issues, including controversial issues, to the forefront of dentistry, Dr. Daniel Meyer, senior vice president, ADA Division of Science and Professional Affairs, told a crowd of about 400 gathered in the Moscone West.

"This is a great opportunity to share what you know and what we know," said Dr. Michael Glick, JADA editor.  Drs. Glick and Meyer moderated the forum discussion, which included brief presentations from an expert panel, followed by questions from the audience.

Dr. Sally Hewitt, a general dentist from Bainbridge Island, Washington, and one of the four panelists, said she emphasizes prevention and health promotion with her patients, monitoring such health issues as blood pressure, tobacco use and diet and nutrition. 

Dr. Donald Giddon, a clinical professor at the Harvard School of Dental Medicine, described research he and his colleagues have conducted on how patients see the respective roles of various health care providers.

"What we found is that people are more willing now to have dentists ask about [general] health issues," he said, noting that their willingness is higher if they suffer from the disease in question.

Dr. David T.W. Wong, director of Dental Research at the University of California at Los Angeles, described his research on the use of saliva for risk assessment, screening and diagnosis.

Saliva, he said, can be "the mirror of the body."  He said dentists seem to know that, but many physicians are skeptical.

Dr. Ron Inge, vice president of professional services and dental director for Washington Dental Service, stirred the crowd with what he sees as a need for dentists to cultivate greater respect from their medical colleagues.

"We have to step forward and demand that respect," he said.

Later, he added, "You have to decide if you are going to be a steward of your patients’ health—or just take care of their teeth."

The conversation touched on the need for dental schools to address curriculum changes that could facilitate expanded services, and the need to address attendant legal issues.

On whether performing in-office medical tests could open dentists to increased liability, a lawyer-dentist in the audience offered a carefully worded answer.

Speaking as a lawyer, she said, "let me say, maybe yes, and maybe no."