Clinical and laboratory diagnosis of nutritional problems

The objective of this article is to familiarize the dentist with clinical signs and laboratory methods used in diagnosing nutritional deficiencies, and to indicate which laboratory methods may be useful to the clinician in cases of suspected nutritional deficiency. It should be noted that the suggested laboratory methods were selected on the basis of their applicability for the clinical situation as well as their reliability as indicators of nutritional status. Therefore these suggested methods of choice may not in every instance be the most accurate of all indicators of nutritional status for a particular nutrient. The dentist who wishes to utilize one of the laboratory methods has a number of options. He can take the appropriate sample in his office, or refer the patient directly to a clinical laboratory for the simpler analyses, or refer his patient to a physician for appropriate metabolic testing. The first option may be more appropriate for the dentist practicing in areas where a clinical laboratory is not within reasonable distance. In this instance the dentist should contact the laboratory for specific information, such as sample volume and special instructions for taking, handling, and shipping the sample. The second option is available to the dentist practicing in an urban area where clinical laboratory facilities are readily available. Finally, the dentist should work in conjunction with a physician when complex metabolic testing is required.