04 April 2022

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How honest are our patients about their general health?

Lara Figini

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It is often said that the oral cavity is the window to overall health, and systemic conditions have many oral manifestations. Inaccurate or incomplete medical information provided to dental professionals can reduce the quality and outcomes of care and may even lead to life-threatening adverse events. Diabetes and hypertension are the two most important and frequent chronic systemic diseases that can interfere during dental treatment. It is known that patients with uncontrolled diabetes have a low-level tolerance for bacterial load and may require an antibiotic regimen before and after surgical procedures to compensate for the compromised immune system response.

Materials and Methods
In a study published on JDR Clinical and Translational Research, September 2019, the authors tried to determine how much a patient's erroneous statement about his general health condition can create problems for dentists. The authors considered and evaluated the two most common health conditions, hypertension and diabetes, and compared the general health data reported by patients at the time of the first dental visit, during the collection of medical history, with those present in the medical records of the same patients previously visited at the University of Texas medical clinic and then treated at the University of Texas Health Science Center in Houston School of Dentistry.

The authors identified 1,013 patients with common conditions of diabetes, hypertension or both and identified the percentage of those patients previously diagnosed with diabetes and/or hypertension by their physicians who failed to report these conditions to their dental clinicians.

Results
Of those patients with diabetes, 15.1% misreported their diabetes condition to their dental clinicians, while 29.0% of patients with hypertension also misreported. There was no relationship between sex and misreporting of hypertension or diabetes, but age significantly affected reporting of hypertension, with misreporting decreasing with age.

Conclusions
From the data of this study, which must be confirmed in other similar studies, it can be concluded that a not inconsiderable part of patients reports incorrectly or incomplete data about his systemic medical condition to dentist during the compilation of the anamnesis.

Clinical implications
Because these conditions affect treatment planning in the dental clinic, misreporting of underlying medical conditions can have negative outcomes for dental patients. We conclude that policies that support the integration of medical and dental records would meaningfully increase the quality of health care delivered to patients, particularly those dental patients with underlying medical conditions.