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A Healthy Young Man Has a Dental Extraction: Why Do All These Tests?

Neal Little, MD
JAMA. 1991;265(14):1825. doi:10.1001/jama.1991.03460140053016.
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To the Editor. —  I read with interest the question1 and answer2 concerning innocent enzyme elevations. Dr Fenton requested an explanation for some enzyme elevations in creatine kinase and alanine aminotransferase in a patient who was otherwise healthy and had been referred for medical clearance before a dental procedure.While Dr Zimmerman's answer was an interesting discussion of these two enzyme levels, the fundamental question that needs to be answered here is, "Why are these tests ordered in the first place in someone about to undergo a dental procedure?" These tests seem like an enormous waste of time, money, and effort in an otherwise healthy 21-year-old. They also illustrate the principle that if screening is done in a population at low risk for the disease being screened, then abnormalities are more likely to represent false positives than true positives.Wasteful and unnecessary testing such as this should not


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