Episode Details

Your patient brushes well, avoids sweets — and still keeps getting decay. What if the answer isn’t in their mouth at all?

What if two inexpensive finger-prick tests told you more about a patient’s gum disease and implant prognosis than anything on the radiograph?

And here’s the uncomfortable one: if the science is this clear, is not checking starting to look like a medico-legal risk? Especially for imlpant surgery!

This is a conversation with Dr Tif Qureshi — the dentist who changed how the profession thinks about the lifelong patient, the envelope of function, and Align, Bleach, Bond. He’s gone down a new rabbit hole: metabolic health. In general practice he’s now doing blood tests — HbA1c and vitamin D — and making the case that the mouth isn’t connected to the body, it is the body. This isn’t about becoming a “biological dentist” (as you’ll hear, Tif is refreshingly blunt about the wilder end of that world). It’s about respecting the biology, screening sensibly, and helping patients where we’re genuinely placed to help.

Protrusive Dental Pearl: Test Yourself First

Before you even think about introducing blood tests for your patients, ask whether you’re checking your own biomarkers at a sensible interval. The deepest way to understand this topic is to learn it on yourself and your family first — run your own HbA1c, vitamin D, iron, and liver and kidney markers, and see what the data tells you.

Start quarterly, like hygienist visits, then stretch to six-monthly or annual once things look good. Getting invested in your own numbers is what makes better food and lifestyle choices actually stick — and it’s the honest starting point for ever offering this to a patient.

What You’ll Take From This Episode

• The metabolic lens — why one disordered glucose-and-insulin system sits under so much chronic and dental disease, and why dentistry is well placed to act on it.
• Sugar, redefined — why patients who avoid sweets still get decay, and how frequency of starchy carbs drives the problem.
• The two biomarkers that matter most — what HbA1c and vitamin D each tell you about caries, perio and healing.
• How to run it in practice — finger-prick logistics, what to test, and how to raise it on the medical history form.
• The medico-legal case — why documenting these markers can protect you before implant, graft and perio work.

Highlights of This Episode

• 00:00  Why Dentists Should Care About Blood Tests
• 06:00  Metabolic Disease: The Root Cause Dentists Miss
• 13:00  Why Starchy Carbs Cause Decay, Not Just Sugar
• 15:50  HbA1c and Caries: What the SHIP Study Shows
• 21:00  Insulin Resistance: The Hidden Driver of Gum Disease
• 26:00  How to Talk to Patients About Diet Without Scaring Them
• 31:00  Why Vitamin D Deserves a Place in Dentistry
• 34:00  Vitamin D, Implant Failure and Perio Risk
• 37:00  Blood Tests as Medico-Legal Defence
• 42:00  What Dentists Should Test: HbA1c and Vitamin D
• 44:00  How In-Practice Blood Testing Actually Works
• 50:00