Part Six "The Link Between Oral Health and Over-all Health"

 
This is part 6 of a fantastic series of articles explaining  the link between oral health and overall health. The article was written for dental professionals but really is great. So, please read through and remember to ask our team for any explanations that you may need.
Dr Brian Johnson

 It Is All Related

Why don’t we just get up on our soapboxes and scream at the top of our lungs, “It is all related!” For years, as a profession we have dabbled in the concept of the oral systemic relationships between the oral inflammatory processes that we have all worked with for decades and the systemic inflammatory processes. It is an exciting time in the field of dentistry right now. We are motivated about the future of dentistry and dental hygiene, and we have the ability to really make a mark in the history books! However, if we continue to allow others to educate patients about the oral systemic links, and we take a step back, we’re going to get left behind. There are professions now making the connections faster and with more excitement than we have been. Recently I had the opportunity to have a detailed conversation with an RN who was working with students, as well as within an ICU unit. She indicated she had been working with a group of CNNs, LPNs and PAs who were attempting to get more information about how to be preventive in regard to the respiratory illness that seem to be paramount with patients with NG tubes or intubated patients. If there is a tube down someone’s throat for any period of time, the likelihood that it will immediately begin to form a biofilm is high. This biofilm, which is not regularly removed, is then aspirated down into the lungs of the patient, who can then develop a respiratory illness on top of the original situation that hospitalized he or she in the first place. These professionals were discussing the options to reduce this occurrence – including products containing xylitol, controlling bacterial loads within the patient’s oral cavity and repopulating good bacteria. The RN was appalled by what she found when she researched all of this information. Neither her dentist nor her hygienist had ever mentioned all of the links before. Learning that these preventive measures had been around for years, she asked me what the dental profession is now doing with the information. There is quite a bit of information about the oral-systemic connection present in everyday media. However, much of the information is not from dentists or hygienists. What is this saying about our profession and the stand that we are taking about educating the public about this important topic? At the joint ADA/AMA conference in February 2006, it was stated that “oral health conditions and other health conditions are more closely related than many may once have thought, and viewing them as separate matters no longer makes sense.” At this point as a profession, we needed to band together and take collective action. But still professionals are not becoming educated on the link between the mouth and body. If it’s just a matter of not knowing where to look, check out some of the articles cited in the sidebar. How many times have you had an appointment with a patient and asked if he or she has had any changes in medical history? Most the time you get the answer that it’s the same. And sometimes you find out later that the patient has recently had stents placed, a joint replacement or even a mild heart attack. Unfortunately, most of the time that this happens, it is because we asked the question in an ambiguous way, which leads to ambiguous answers. We have trained the patient to participate in this.

The author is Sarah Cottingham, RDH, BS and the article was published in Dentaltown Magazine in the January issue.

Part Five "The Link Between Oral Health and Over-all Health" -Diabetes

This is part 5 of a fantastic series of articles explaining  the link between oral health and overall health. The article was written for dental professionals but really is great. So, please read through and remember to ask our team for any explanations that you may need.
Dr Brian Johnson

 Awareness of Diabetes’ Impact on Other Diseases

The incidence of diabetes is on the rise worldwide. Chronic systemic manifestations of diabetes are primarily seen in the vascular system, with specific issues related to the microvasculature including retinopathy, nephropathy and neuropathy. Oral complications of diabetes include gingivitis, periodontitis, xerostomia and consequently, caries. Diabetes is bi-directional, with uncontrolled diabetes leading to periodontitis and severe periodontitis impacting glycemic control.

A researcher at the University of Sharjah in the United Arab Emirates, used a written questionnaire to evaluate the attitudes and awareness of patients with diabetes. The 200 subjects were seeking care at the largest diabetic clinic in Benghazi, Libya. The questions related to oral health and oral care.

The majority of subjects, 71 percent, had Type 2 diabetes, with 18 percent reporting Type 1 and 11 percent unsure which type they had. Subjects ranged in age from 17 to 78 years and had diabetes from one week to 40 years.

Dry mouth was experienced by 84 percent of the group. Smokers accounted for 42 percent of the group. The majority had teeth, but 31 percent were edentulous with only 44 percent of them wearing full dentures. Only 17 percent brushed twice daily and only 12 percent reported daily flossing. The dentist was the primary source of information about oral complications of diabetes and oral care. Those reporting oral infections also had high glycemic control scores. Less than 50 percent were aware that dental diseases are complications of diabetes.

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Clinical Implications: Education is needed from both dental and medical professionals addressing the oral complications associated with diabetes and the importance of good oral hygiene and regular dental care.

  The author is Trisha O'Hehir, RDH, MS who is the Editorial Director at Hygienetown Magazine

Part Four "The Link Between Oral Health and Over-all Health" -Diabetes

This is part 4 of a fantastic series of articles explaining  the link between oral health and overall health. The article was written for dental professionals but really is great. So, please read through and remember to ask our team for any explanations that you may need.
Dr Brian Johnson

Diabetes Part of Multiple Risk Factor Syndrome

Periodontal disease is the sixth-most-common complication of diabetes. The primary cause of death for those with diabetes is cardiovascular disease with risk being three-times higher in people with Type 2 diabetes mellitus (DM). A recent study showed a one percent increase in hemoglobin A1c (HbA1c) level associated with an 18 percent increased risk of cardiovascular disease.

This case report follows the diagnosis and treatment of a 62-year-old Japanese woman presenting with severe periodontitis and diabetes. She was diagnosed 10 years earlier with DM, was receiving daily insulin injections and had no other complications of diabetes besides periodontitis. She was also a smoker and took oral medications for high blood pressure and high cholesterol.

Clinically, several teeth were missing, anterior teeth were flared and severe bone loss was evident around some teeth with severe mobility. Plaque and calculus levels were high throughout the mouth. Periodontal treatment was provided including surgery and oral hygiene instructions. Following treatment her HbA1c level, cholesterol levels and blood pressure improved. The patient was then followed and remained stable for four years while receiving periodontal maintenance therapy. She then developed myocardial infarction. During this time she showed continuous deterioration of her HbA1c level and also increased periodontitis. Following coronary bypass surgery and re-establishment of periodontal maintenance therapy, systemic markers improved. The long-term clustering of these risk factors is associated with development of heart problems.

  The author is Trisha O'Hehir, RDH, MS who is the Editorial Director at Hygienetown Magazine