KUMJ | VOL. 24 | NO. 1 | ISSUE 94 | JANUARY - MARCH, 2026

Are Routine Blood Investigations Mandatory before Periodontal Surgical Procedures? A review of literature and informed view
David K, Shetty M, Karmakar S

Abstract:
The routine recommendation of preoperative blood investigations before periodontal surgical procedures remains controversial. Traditionally, laboratory tests have been advised to identify occult systemic diseases and minimize perioperative complications. However, increasing evidence questions the utility of indiscriminate testing in clinically healthy individuals undergoing elective periodontal surgery. To critically evaluate the current evidence regarding the necessity and clinical utility of routine preoperative blood investigations in patients undergoing periodontal surgical procedures and to provide evidence-based recommendations for clinicians. A narrative review of the literature was conducted using electronic databases including PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and the Cochrane Library. Literature published between January 1975, and January 2026 was searched. Medical Subject Headings (MeSH) and free-text terms including “Preoperative Care,” “Periodontal Surgical Procedures,” “Laboratory Tests,” “Blood Glucose,” “Hemostasis Tests,” “Coagulation Tests,” “Medical History Taking,” “Risk Assessment,” and “Personalized Medicine” were used individually and in various combinations. Systematic reviews, narrative reviews, observational studies, randomized controlled trials, clinical guidelines, consensus statements, and relevant textbook chapters published in English were considered. Available evidence consistently demonstrates that routine laboratory investigations in clinically healthy individuals undergoing minor and moderate periodontal surgical procedures rarely influence treatment planning or improve postoperative outcomes. Comprehensive medical history taking and physical examination remain the most effective methods for identifying patients requiring additional investigations. Selective laboratory testing may be indicated in patients with significant systemic diseases, suspected bleeding disorders, diabetes mellitus, anticoagulant therapy, immunosuppressive conditions, or when extensive regenerative or implant procedures are planned. Current evidence does not support mandatory routine blood investigations for all periodontal surgical patients. An individualized risk-based approach integrating medical history, clinical examination, systemic health status, medication profile, and procedural complexity should guide the decision to request laboratory investigations. Future periodontal practice should increasingly incorporate personalized dentistry principles and point-of-care diagnostics.
Keyword : Blood coagulation tests, Laboratory tests, Periodontal surgical procedures, Precision medicine, Preoperative care, Risk assessment