CONTINUINGEDUCATION
Urine, Blood and Salivary Tests That Bridge Medical-Dental Collaboration
ELLIE W. CAMPBELL DO Campbell Family Medicine, Cumming, GA
their patients.Once any kind of oral infection is found, it must be determined if the infection is confi ned to the oral cavity, OR if that infection is oral- systemic – potentially putting the patient’s health and life at risk. Urine, blood, and salivary tests are powerful diagnostic tools that can reveal critical insights into a patient’s level of risk. When interpreted correctly, these tests oſt en highlight the urgent need for collaboration between medical and dental professionals. T e connection between oral health and overall body wellness is a cornerstone of integrative practice, and it’s a concept that underscores the importance of these diagnostic tests. Let’s dive into how these leading indicator
Dental professionals have a tremendous responsibility to
CRP levels are a marker of systemic infl ammation. While CRP can be elevated due to various conditions, including cardiovascular disease and autoimmune disorders, it is also strongly associated with periodontal disease. If a patient presents with persistently high CRP levels with no obvious medical causes, it’s time to investigate their oral health. Periodontal infections can function as a chronic source of infl ammation, driving up CRP levels and increasing the risk of heart attacks and strokes. Medical-Dental collaboration to address gum disease can signifi cantly reduce systemic infl ammation and improve overall health.
tests can signal an urgent need for inter- disciplinary care and why this collaboration is essential for the best patient outcomes.
Exam: Oral or Oral-Systemic? • If a patient has a bloody prophy, oral bacteria are mixing with the patient’s blood and lymphatic system, and they should be referred to establish care with an enlightened physician who is prepared to further investigate with blood and urine tests and radiology imaging to determine if systemic infl ammation, infection or atherosclerosis is connected to their oral health.
• If a patient is a mouth breather, snores, or has a Mallampati score of 3 or 4, referral for a sleep test to rule out sleep disordered breathing is suggested.
Blood Tests: The Red Flags for Collaboration Serum markers tests are a cornerstone of medical diagnostics, patients are accustomed to using actionable data from blood tests, and serum biomarkers can point directly to oral health issues that require dental intervention. Here are some key examples: • C-Reactive Protein (CRP): Elevated
12 | Sept 2025
• Myeloperoxidase (MPO): MPO which used in cardiology to identify vulnerable atherosclerotic plaque is an infl ammatory marker that can also indicate endodontic infections. T ese infections oſt en go unnoticed during routine dental exams but can be found through advanced imaging techniques like cone beam CT scans. If a patient has elevated MPO levels, it’s a red fl ag for potential dental pathology. A medical professional should refer the patient with the combination of high hsCRP plus high MPO to a dentist trained in oral-systemic health to fi nd and treat the underlying infection.
• Lipoprotein-Associated Phospholipase A2 (Lp-PLA2): T is enzyme, made by aggravated white blood cells is a marker of vascular infl ammation, but is oſt en elevated in patients with periodontal disease. Like CRP and MPO, elevated Lp-PLA2 levels warrant a closer look at the patient’s oral health. Addressing periodontal infections can help lower this marker and reduce the risk of cardiovascular events.
• Galectin-3: Galectin-3 is a biomarker associated with tissue fi brosis and chronic infl ammation. While cardiologists see this marker increase when heart muscle is remodeling in heart failure, elevated levels can indicate osteonecrosis of the jaw, a condition oſt en linked to bisphosphonate use or untreated dental and tooth root infections. T is is also seen when
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