Printer-friendly format

If the eyes are the window to the soul, could the mouth be the window to the body?

A growing stack of research tells us that at the very least, the mouth gives dental professionals warning signs of larger, systemic health issues and can provide valuable clues to physicians willing to make the connection.

Sally Cram, DDS, a practicing periodontist in Washington, D.C., and a consumer advisor for the American Dental Association, said there is a lot of room for physicians and dentists to work more closely together.

Although many pediatricians, family practitioners and internists routinely conduct hearing and vision screens, it is much less common for physicians to sit down and discuss oral health with their patients.

“Dentists don’t often get referrals from physicians,” Cram said. “On the flip side, as a periodontist who sees a lot of gum disease, I generally refer quite a bit to physicians.”

Cram noted, “Perhaps one of the problems is, in medicine, there are so many specialties now … so we’ve sort of lost that overall health approach, and then I think there has always been a bit of a divide between physicians and dentistry.”
However, she continued, with today’s healthcare focus moving toward overall wellness, dentistry could serve as a model for prevention.

She said that dentistry “is one of the health-related professions that has really made tremendous strides in prevention.”

Cram noted that dental professionals work with patients to institute relatively simple measures of dental hygiene that are known to ward off much bigger problems down the road. Disease, inflammation and infection in the oral cavity are warning signs not only of poor oral health but potentially poor overall health.

“If you have an infection in your mouth, that infection isn’t just staying in your oral cavity but is getting in your bloodstream,” she pointed out.

Cram said a significant number of studies have linked poor oral health with uncontrolled diabetes. She added that additional research indicates a potential tie to cardiac issues, and a growing body of evidence suggests a possible association between gum inflammation in pregnant women and the delivery of preterm babies.

Osteoporosis is another issue that is often spotted first by a dentist as bone loss becomes apparent on dental X-rays. Other diseases and conditions also make their presence known in the oral cavity, including certain cancers, substance abuse, eating disorders and some venereal diseases.

One of the most researched mouth-body connections is among diabetics.

“With diabetes, it goes both ways,” Cram explained. “Having a healthy mouth can help you to keep your diabetes under control and more stable … and having your blood sugar under control can better ensure a healthy mouth.”

As the incidence rate for diabetes continues to rise in America, physicians and dentists have the opportunity to work together to help improve outcomes. Cram urged physicians to ask diabetic patients about bleeding or swollen gums.

“Diabetics are three to four times at greater risk for developing periodontal disease than non-diabetics,” she pointed out. By working together, physicians and dentists could help patients stabilize blood sugars and allow medications, diet and exercise to be more effective.

With cardiovascular disease, Cram said there have been some conflicting reports as to the links between oral health and heart health.

“I think that’s one of the areas where we probably need more information and controlled studies,” she said. However, she added, it certainly doesn’t hurt to take a “better safe than sorry approach” when it comes to taking care of your teeth and gums.

Cram pointed out that there is a growing spirit of cooperation. She said the American Dental Association and the American Medical Association have increasingly conferred about ways to work together to benefit patients.

Physicians can help out by asking questions and making simple recommendations — brush teeth twice a day, floss once a day and visit a dentist for regular check-ups. Cram said that, in generally healthy patients, a good teeth cleaning twice a year is usually sufficient. For those with obviously poor oral health, diabetes or a history of periodontal disease, more frequent cleanings are probably indicated.

As with most health issues, attacking problems early on is not only more cost effective but also less invasive.

“The take-home message here is an ounce of prevention is worth a pound of cure. I think the biggest thing is recognizing the connection between what goes on in your mouth and what goes on in the rest of your body,” Cram concluded.



June 2008

Tags:

None

Login and voice your opinion!