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Page 1: Complete blood count and its importance in dentistry
Page 2: Complete blood count and its importance in dentistry

“A basic screening test that evaluates the cells that circulate in blood.”

A complete blood count (CBC), also known as full blood count (FBC) or full blood exam (FBE) or blood panel.

Page 3: Complete blood count and its importance in dentistry

Screen for a wide range of conditions and diseases

Help diagnose various conditions, such as anemia ,infection, inflammation, bleeding disorder or leukemia etc

Monitor the condition and/or effectiveness of treatment after a diagnosis is established

Monitor treatment that is known to affect blood cells, such as chemotherapy or radiation therapy

Page 4: Complete blood count and its importance in dentistry

• A CBC is a panel of tests that evaluates the three types of cells that circulate in the blood and includes the following:

Evaluation of white blood cells

Evaluation of red blood cells

Evaluation of platelets

Page 5: Complete blood count and its importance in dentistry

• White blood cell (WBC) count is a count of the total number of white blood cells in a person's sample of blood.  All the white cell types are given as a percentage and as an absolute number per litre.

• White blood cell differential

may or may not be included as part of the panel of tests. It identifies and counts the number of the various types of white blood cells present. The five types include neutrophils, lymphocytes,monocytes, eosinophils, and basophils.

Page 6: Complete blood count and its importance in dentistry

WBC: 4,000 – 10,000/cubicmm

WBC DIFFERENTIAL: Neutrophil 40-75% Lymphocytes 15-75% Monocytes 1-10% Eosinophils 1-6% Basophils 0-2%

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Test Full Name

examples of causes of a low count

examples of causes of a high count

WBC White Blood Cell Count

Known as leukopeniaor damage

•Autoimmune conditions•Severe infections (sepsis)•lymphoma or other cancer that spread to the bone marrow•Diseases of immune system (e.g., HIV)

Known as leukocytosis

•infections most commonly bacterial or viral•Leukemia, myeloproliferative disorders•inflammation•Allergies , Asthma•Tissue death (trauma, burns, heart attack)•Intense exercise or severe stress

Page 8: Complete blood count and its importance in dentistry

Test Full Name examples of causes of a low count

examples of causes of a high count

Neu, PMN, polys

Absolute neutrophil count, % neutrophils

Known as neutropenia•Severe,over whelming infection (sepsis)•Autoimmune disorders•Reaction to drugs, chemotherapy•Immunodeficiency•Bone marrow damage (e.g., chemotherapy, radiation therapy)

Known as neutrophilia•Acute bacterial infections•Inflammation•Tissue death (necrosis) caused by trauma, heart attack, burns•leukemia

eos Absolute eosinophilcount, % eosinophils

 not medically significant. Parasitic infections, asthma,allergic reaction.

baso Absolute basophil count, % basophils

not medically significant bone marrow related conditions such as leukemia or lymphoma

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TEST Full Name examples of causes of a low count

examples of causes of a high count

mono Absolute monocyte count, % monocytes

not medically significant.

bacterial infection, tuberculosis, malaria, monocytic leukemia

lympho Absolute Lymphocyte count, % lymphocytes

Known as lymphocytopenia•Autoimmune disorders (e.g., lupus rheumatoid arthritis)•Infections (e.g., HIV, viral hepatitis , typhoid fever, influenza)•Bone marrow damage (e.g., chemotherapy, radiation therapy)•Corticosteroids

Known as lymphocytosis •Acute viral infections (e.g., chicken pox,cytomegalovirus (CMV), Epstein-Barr virus (EBV),herpes)•Certain bacterial infections (e.g. tuberculosis•Lymphocytic leukemia, lymphoma•Stress (acute)

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Page 11: Complete blood count and its importance in dentistry

Red blood cell (RBC) count is a count of the actual number of red blood cells in a person's sample of blood.

Hemoglobin measures the amount of the oxygen-carrying protein in the blood.

Hematocrit measures the percentage of a person's blood that consists of red blood cells.

Red blood cell indices are calculations that provide information on the physical characteristics of the RBCs:• (RDW), which may be included in a CBC, is a

calculation of the variation in the size of RBCs.• Mean corpuscular volume (MCV) is a

measurement of the average size of RBCs.• Mean corpuscular hemoglobin is a

calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell.

• Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average percentage of hemoglobin inside a red cell.

 reticulocyte count which is a measurement of the absolute count or percentage of young red blood cells in blood.

Page 12: Complete blood count and its importance in dentistry
Page 13: Complete blood count and its importance in dentistry

Test Full Nameexamples of causes of low result

examples of causes of high result

RBC Red Blood Cell Count

Known as anemia•Acute or chronic bleeding•RBC destruction (e.g.hemolytic anemia,etc.)•Nutritional deficiency (e.g., iron deficiency, vitamin B12 or folate deficiency)•Bone marrow disorders or damage•Chronic inflammatory disease•Kidney failure

Known as polycythemia• Dehydration•Pulmonary disease•Kidney or other tumor that produces excess erythropoietin•Smoking•Genetic causes (altered oxygen sensing, abnormality in hemoglobin oxygen release)

Hb HemoglobinUsually mirrors RBC results, provides added information

Usually mirrors RBC results

Hct Hematocrit Usually mirrors RBC resultsUsually mirrors RBC results; most common cause is dehydration

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TestFull Name

examples of causes of low result

examples of causes of high result

MCVMean Corpuscular Volume

Indicates RBCs are smaller than normal (microcytic); caused by iron deficiency anemia or thalassemia, for example.

Indicates RBCs are larger than normal (macrocytic), for example in anemia caused by folate or vit B12 deficiency

MCHMean Corpuscular Hemoglobin

Mirrors MCV results; small red cells would have a lower value.

Mirrors MCV results; macrocytic RBCs are large so tend to have a higher MCH.

MCHC

Mean Corpuscular Hemoglobin Concentration

May be low when MCV is low; decreased MCHC values (hypochromia) are seen in conditions such as iron deficiency anemia and thalassemia.

Increased MCHC values (hyperchromia) are seen in conditions where the hemoglobin is more concentrated inside the red cells, such as autoimmune hemolytic anemia, in burn patients, and hereditary spherocytosis, a rare congenital disorder.

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Test Full Name

Examples of causes of low result

Examples of causes of high result

RDW

RBC Distribution Width

Low value indicates uniformity in size of RBCs

Indicates mixed population of small and large RBCs; immature RBCs tend to be larger. For example, in iron deficiency anemia or pernicious anemia, there is high variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis), causing an increase in the RDW.

Reticulocyte count

Reticulocytes (absolute count or %)

In the setting of anemia, a low reticulocyte count indicates a condition is affecting the production of red blood cells, such as bone marrow disorder or damage, or a nutritional deficiency (iron, B12 or folate)

In the setting of anemia, a high reticulocyte count generally indicates peripheral cause, such as bleeding or  hemolysis, or response to treatment (e.g., iron supplementation for iron deficiency anemia)

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Page 17: Complete blood count and its importance in dentistry

The platelet count is the number of platelets in a person's sample of blood.

Mean platelet volume (MPV) may be reported with a CBC. It is a calculation of the average size of platelets.

Platelet distribution width (PDW) may also be reported with a CBC. It is a measurement of the variation of platelet size.

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• Platelet count : 140,000 to 450,000 /cubic mm

• Mean platelet volume: 7.5 – 11.5 fL

• Platelet distribution width: 10% - 17.9%

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TestFull Name

examples of causes of low result

examples of causes of high result

plt Platelet Count

Known as thrombocytopenia:•Viral infection (mononucleosis,hepatitis)•Rocky mountain spotted fever•Platelet autoantibody•Drugs (acetaminophen, quinidine, sulfa drugs)•cirrhosis•Autoimmune disorders•Sepsis•Leukemia, lymphoma•Myelodysplasia•Chemo or radiation therapy

Know as thrombocytosis:•Cancer (lung, gastrointestinal,lymphoma)•Rheumatoid arthritis, inflammatory bowel disease, lupus•Iron deficiency anemia•Hemolytic anemia•Myeloproliferative disorder (e.g., essential thrombocythemia)

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Test Full Name

Examples of causes of low result

Examples of causes of high result

MPVMean Platelet Volume

Indicates average size of platelets is small; older platelets are generally smaller than younger ones and a low MPV may mean that a condition is affecting the production of platelets by the bone marrow.

Indicates a high number of larger, younger platelets in the blood; this may be due to the bone marrow producing and releasing platelets rapidly into circulation.

PDWPlatelet Distribution Width

Indicates uniformity in size of platelets

Indicates increased variation in the size of the platelets, which may mean that a condition is present that is affecting platelets

Page 21: Complete blood count and its importance in dentistry
Page 22: Complete blood count and its importance in dentistry
Page 23: Complete blood count and its importance in dentistry

Reviewing clinical laboratory test results about a patient's condition can provide valuable information for

Diagnosis and management of orofacial conditions

Guidance on assessing the patient's ability to tolerate the proposed dental treatment

A prognosis based on a particular treatment

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EVALUATION OF WBC

• when a patient is being treated with a medication that suppresses WBC production (such as antineoplastic agents), the patient is at a greater risk for postoperative infection, and dental treatment should be deferred until the WBC result is back to normal.

•  For invasive dental treatment, perioperative antibiotics are indicated in patients with ANC less than 1,000 cells/mm3 in order to minimize the risk of infection. When the ANC falls below 500 cells/mm3, intravenous antimicrobial therapy may be necessary to prevent sepsis resulting from invasive dental treatment.

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EVALUATION OF RBC• Patients with polycythemia

may experience orthopnea in the dental chair, dizziness, headache, red facial coloring, and dyspnea.

• Hgb and Hct are necessary parts of the assessment for anemias and in patients with burning mouth disorders and aphthous stomatitis.

• Differ routine dental treatment in Patient with severe anemia

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EVALUATION OF PLATELETS• Bleeding disorders or

bone marrow diseases, such healthcare provider to determine as leukemia, require the dental the number of platelets present and/or their ability to function correctly prior to invasive surgery.

• Minor dentistry: counts should be greater than 50,000/cubicmm

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