Sir, I read with interest the recent publication in the BDJ entitled 'Diabetes mellitus and periodontal disease: the profession's choices' by C. Turner.1 The author emphasises the value of involving the medical profession in referral of diabetic patients in light of the association between periodontal disease and diabetes mellitus and discusses the BPE, CPITN as well as HbA1c levels.
Progress around educating and involving medical practitioners would greatly benefit from the incorporation of simpler and more straight-forward point of care testing technology as is readily available in the form of PerioSafe and ImplantSafe. These kits, based on the aMMP-8 levels have been multiply validated across different age groups, ethnicities and parts of the world.2
The aMMP-8 POCT has both a prognostic and diagnostic role to play in periodontitis and peri-implantitis. In fact, these kits have also been reported to act as an effective screening strategy for pre-diabetic and diabetic patients reporting to the dental office in order to enhance referrals.3 This application underscores the two-way relationship between diabetes and periodontal disease as discussed by the author.1
The aMMP-8 POCT has been observed to possess an enhanced ability to delineate initial/subclinical stages of periodontitis when compared to bleeding on probing in the adolescent population.4 The test is safe, standardised, non-invasive and is available in both full-mouth (PerioSafe) and site-specific (ImplantSafe) variants. The results can be made available in both the quantitative as well as qualitative forms, with the latter being as simple as two lines denoting a positive test while a single line indicating negative results.2
The aMMP-8 POCT has also been demonstrated to suitably enhance periodontal disease diagnosis when utilised as an adjunct to a questionnaire/interview conducted by medical practitioners.5
References
Turner C. Diabetes m us and periodontal disease: the profession's choices. Br Dent J 2022; 233: 537-538.
Sorsa T, Sahni V, Budeneli N et al. Active matrix metalloproteinase-8 (aMMP-8) point-of-care test (POCT) in the COVID-19 pandemic. Expert Rev Proteomics 2021; 18: 707-717.
Grigoriadis A, Räisänen I T, Pärnänen P, Tervahartiala T, Sorsa T, Sakelleri D. Prediabetes/diabetes screening strategy at the periodontal clinic. Clin Exp Dent Res 2021; 7: 85-92.
Räisänen I T, Sorsa T, van der Schoor G-J et al. Active matrix metalloproteinase-8 Point-of-Care (PoC)/chairside mouthrinse test vs. bleeding on probing in diagnosing subclinical periodontitis in adolescents. Diagnostics (Basel) 2019; doi: 10.3390/diagnostics9010034.
Räisänen I T, Lähteenmäki H, Gupta S et al. An aMMP-8 Point-of-Care and Questionnaire Based Real-Time Diagnostic Toolkit for Medical Practitioners. Diagnostics (Basel) 2021; doi: 10.3390/diagnostics11040711.
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Sahni, V. Periodontal testing. Br Dent J 233, 700 (2022). https://doi.org/10.1038/s41415-022-5214-6
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DOI: https://doi.org/10.1038/s41415-022-5214-6