title: A pilot study of an HbA1c chairside screening protocol for diabetes in patients with chronic periodontitis: the dental hygienist's role.
abstract: OBJECTIVE
  To assess effectiveness, convenience and cost of point-of-care diabetes screenings performed by a dental hygienist for patients with periodontitis, using a diabetes risk questionnaire, periodontal findings and a glycosylated haemoglobin (HbA1c) analyser.
  
  
  METHODS
  A purposive sample of 50 participants with periodontitis, never diagnosed with diabetes, reporting ≥one diabetes risk factor, were administered an HbA1c test. Spearman's correlation measured relationships between HbA1c and diabetes risk test scores, numbers of missing teeth, percentage of deep pockets ≥5 mm and percentage of bleeding sites (BOP). Cost and time were assessed. Analyses used 0.05 alpha levels.
  
  
  RESULTS
  Thirty-two per cent (n = 16) of participants presented HbA1c values indicating prediabetes; one HbA1c value indicated type 2 diabetes, totalling 34% (N = 17). No relationships existed between HbA1c values and diabetes risk scores (rs = 0.153; P = 0.144), numbers of missing teeth (r = 0.190; P = 0.093), percentage of deep pockets (rs = -0.048; P = 0.370) or percentage of BOP sites (rs = 0.066, P = 0.324). Direct cost for each HbA1c was $9US, excluding follow-up medical diagnosis. Mean screening time including patient education was 14 min (SD = 6.2). Fifty-three per cent (n = 9 of 17) of participants with elevated HbA1c values contacted their primary healthcare provider within 2 weeks as recommended.
  
  
  CONCLUSIONS
  Point-of-care HbA1c screenings by dental hygienists were effective and convenient for identifying undiagnosed prediabetes and provide opportunity for interprofessional patient care; cost or lack of dental insurance may inhibit implementation. Identification of patients at risk for diabetes requires further evaluation.
authors: Boise State University, Department of Community and Environmental Health, Boise, ID, USA.|Department of Dental Hygiene, College of Southern Idaho, Twin Falls, ID, USA.
authors: M
authors: M
authors: Bossart
authors: Department of Dental Hygiene, Idaho State University, Pocatello, ID, USA.
authors: K H
authors: KH
authors: Calley
authors: Department of Dental Hygiene, Idaho State University, Pocatello, ID, USA.
authors: J R
authors: JR
authors: Gurenlian
authors: College of Pharmacy, Idaho State University, Meridian, ID, USA.
authors: B
authors: B
authors: Mason
authors: Department of Dental Sciences, Idaho State University, Meridian, ID, USA.
authors: R E
authors: RE
authors: Ferguson
authors: Idaho Center for Health Research, Idaho State University, Pocatello, ID, USA.
authors: T
authors: T
authors: Peterson
mesh_terms: D000328:Adult; D055113:Chronic Periodontitis / Q000150:complications*; D003756:Dental Hygienists; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D024382:Professional Role; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin
keywords: HbA1c; diabetes risk factors; glycosylated haemoglobin; periodontitis; prediabetes; screening; type 2 diabetes