can be managed conservatively with soft diet and IMV/closed reduction.

Clinical Significance.—Patients should befully evaluated preoperatively to detect condi-tions that might predispose to the developmentof a mandibular fracture. Dentists then mustfully inform the patient of the risks and benefitsof the procedure and describe arrangements forthe immediate transfer of the patient to a maxil-lofacial unit should a fracture occur intraopera-tively. The maintenance of meticulous, accurate

notes is an important part of themanagement ofthis complication.

Ethunandan M, Shanahan D, Patel M: Iatrogenic mandibular frac-tures following removal of impacted third molars: An analysis of130 cases. Br Dent J 212:179-184, 2012

Reprints available from M Ethunandan, Dept. of Oral andMaxillofacial Surgery, St. Richards Hosp., Western SussexHospitals NHS Trust, Spitalfield Ln., Chichester, PO19 6SE, UK;e-mail:mgethu@hotmail.com

Oral/Systemic ConsiderationsBlood glucose testing in dental offices

Background.—Diabetes mellitus (DM) is increasing inthe United States and other countries, with many patientsgoing undiagnosed. Both poor control of DM and the pres-ence of prediabetes can contribute to increased physicalmorbidity. The dental office is a site where patients can bescreened for various conditions, including DM. Most dentalpractitioners, however, consider blood glucose testing(BGT) as outside their scope of practice, with few officesowning and using a glucometer. A study was conductedto determine the feasibility of screening patients in commu-nity dental practices who are either at risk or who have beendiagnosed with DM or prediabetes. Glucose monitorscreening and finger-stick tests were conducted, then theattitudes of the oral health care providers and of the pa-tients tested were surveyed.

Methods.—The study was done as part of The DentalPractice-Based Research Network. Practitioners and staffat 28 practices were trained to use the glucometer beforetesting patients over age 19 years. A total of 498 patientswere screened. Patients and dental office personnel com-pleted questionnaires to determine barriers to BGT andbenefits perceived from such testing.

Results.—Eighty-four percent of the dental staff be-lieved BGT benefits patients and may lead to better controlof blood glucose levels. The majority also felt that BGT re-sults would help determine the timing of invasive proce-dures and that BGT results would identify patients at riskof developing periodontal disease, promote the perceptionthat dentists care about patients’ general health, and in-crease patients’ confidence in the dental practice. Most staffmembers also believed that neither duration of BGT nor

cost were significant barriers to performing BGT in the den-tal practice.

Eighty-three percent of the patients tested believedBGT in the dental office was a good idea and felt it showedthe level of caring offered in the office. Sixty-two percent ofpatients said they were more likely to refer friends and fam-ily to the practice because it offered BGT. Nearly all the pa-tients believed the BGTwas easy and provided them withuseful information.

Discussion.—Both patients and practitioners foundthat BGT done in the dental office was a positive movethat offered important information. Barriers to such screen-ing appear to be minimal or readily overcome.

Clinical Significance.—Using BGT in a com-munity dental practicemay improve the diagno-sis and control of DM among patients. The readyacceptance of the patients and professional staffwho completed the surveys indicates that suchan offering would be feasible.

Barasch A, SaffordMM, Qvist V, et al: Random blood glucose testingin dental practice: A community-based feasibility study from TheDental Practice-Based Research Network. J Am Dent Assoc143:262-269, 2012

Reprints available from A Barasch, Dept. of Dental Medicine, Win-throp Univ. Hosp., 222 Station Plaza N., Suite 408, Mineola, NY11501, USA; email: abarasch@winthrop.org

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