Inflammation is the key cause for most of our serious chronic diseases—cardiovascular disease, diabetes, cerebrovascular disease, rheumatoid arthritis, and Alzheimer’s disease, to name a few—and oral inflammation plays a major role.

Dental professionals know that periodontal disease is an inflammatory disease. Cardiologists know that cardiovascular disease is an inflammatory disease. Yet when was the last time you had a cardiologist refer a patient to your dental practice?

Periodontal disease and cardiovascular disease have been inextricably linked with level-A evidence, according to the American Heart Association. Recent research in Stroke showed that periodontal disease is an important risk factor for stroke. Most importantly, it showed that periodontal treatment reduces risk for stroke. A study published this year in Circulation showed a direct connection between oral pathogens (associated with periodontal disease, endodontic lesions, and caries) and acute heart attacks. Oral bacteria were found in every thrombus! It appears that up to one half of all heart attacks are being triggered by oral pathogens.

We now must look at oral inflammation from the viewpoint of bleeding sites, periodontal pocketing, and the microbial burden that exists in an individual’s oral apparatus. This inflammation is exacerbated by genetic predisposition in the 33% of us who are IL-1 positive.

We can reduce the inflammatory burden on our patients’ hearts by stepping into the role of disease-prevention specialists. Follow these simple steps:

• Advanced inflammatory testing
• Advanced periodontal therapy
• Advanced home care.

We now provide dental solutions to medical problems. This is without a doubt the most exciting era in our professional lives.

What tools do you currently use to reduce the inflammatory burden on your patients?

600: The number of doses of acetaminophen it takes to put a person at risk for kidney damage.

But for a person who has chronic headaches, it doesn’t take long to make it to 600.

Take my patient Nicole, for instance. Nicole came to see me after her physician, alarmed at the number of over-the-counter pain relievers she was taking to manage her headache pain, ordered blood work to test her kidney and liver functions.

Even though her tests were normal, Nicole was worried because, as a young woman in her early 20s, she admitted it was likely she had already surpassed that lifetime limit of 600 doses. She had previously been prescribed prescription migraine medicine, antidepressants, and even blood pressure medication in an effort to control her frequent headaches, but nothing helped. She wanted a non-pharmaceutical solution.

After a screening in my office, we found out that Nicole’s headaches were dental force-related. I wasn’t surprised, given the estimate that 80% of headaches, migraines, and jaw pain may be caused by dental force issues.

Now that we know her problems are dental force related, we have begun treatment through therapy and oral appliances, and Nicole is well on her way to a life with less pain.

And trust me, there is nothing your patients will love you more for than getting them out of chronic headache pain.

Whether you realize it or not, dental force related issues are an important part of all of our practices. And with a poor economy and increased stress, it’s more important than ever that we address this in our offices.

How many patients have told you they suffer from chronic headaches or migraines?

One of the subjects in healthcare that affects everybody is Alzheimer’s disease. You’d be hard-pressed to find someone who hasn’t been affected by this debilitating disease, which so often robs us of our precious Golden Years and costs us billions every year in healthcare expenses.

And unfortunately, it doesn’t appear that this problem is going away. It’s recently been estimated that by the year 2050, the number of Alzheimer’s disease patients will have tripled to over 13.8 million.

The subject of oral health-related dementia is nothing new, either. Several recent studies have concluded that periodontal disease and/or tooth loss early in life indicates an increased risk of dementia. But it appears that the correlation doesn’t end there. New research is finding that common oral pathogens may not only contribute to the development of Alzheimer’s—they may cause it.

So what does this mean for the dental profession? At this point, we can’t treat Alzheimer’s from a dental chair. With salivary diagnostic technology, however, we can test for these periodontal pathogens that increase our patients’ risk for Alzheimer’s disease, in the same way we test for P. gingivalis to assess risk for heart disease.

And of course, through awareness and education early in life, we can help our patients reduce their risk of developing diseases like Alzheimer’s instead of waiting for it to show up later. Once again, it’s all about that simple yet crucial conversation you have with patients while they’re in your office.

Do you talk to your patients about new research on oral systemic health?

In my journey to know as much as possible about the connection between oral health and overall health, I have become a bigger science buff than I would have ever thought possible. The mouth is my area of expertise, so when I see new research that shows how I can help my patients live longer, healthier lives, of course I get excited.

You can probably imagine my reaction, then, when I came across a study by University of Louisville scientists on the effects of Porphyromonas gingivalis on white blood cells. As you might know from my earlier blog posts, P. gingivalis is a periodontopathogen that has been found throughout the body—namely in heart plaque and the joints of rheumatoid arthritis patients.

This study, originally published in Science Signaling, found that P. gingivalis enters the bloodstream through the mouth, then proceeds to hijack the white blood cells to become a carrier for the bacteria. Not only are the white blood cells unable to destroy the bacteria, they are literally becoming a transportation system for P. gingivalis, carrying it throughout the body and inducing a potentially life-threatening inflammatory response.

Because we know that P. gingivalis plays a role in heart disease, rheumatoid arthritis, pancreatic cancer, and many other inflammatory diseases, it’s important that we stop this bacterium where it starts: in the mouth.

Studies like this show just how integral dental professionals are in preventing disease and gives us an amazing opportunity to protect the health of our patients. I use this information to help my patients, my team, and my referring physicians understand why we all need to work together to achieve the healthy mouth standard.

Do you have any questions about the science behind oral-systemic health?

Truth be told, we are in a “perfect storm” in regards to dentistry—trying to come out of a diminished economy, an enormous demographic group (Baby Boomers) transitioning into retirement and government health insurance without dental insurance, and the competitive stress from the recent build up of providers. The entire U.S. healthcare industry is in flux, dentistry included.

So it’s no surprise that the ADA just released a report that has shown a steady decline in adults seeking dental care.  As recently as 2010, only 37% of adults visited the dentist, the lowest in 10 years. At the same time ground-breaking research is coming out daily on how important a healthy mouth is to overall health. Recently, a research paper that reported as little as one professional dental cleaning per year reduced the risk for heart attacks by 25%. If over half of the adult population is not even having any dental visits, just imagine the cost! When we get into the subject deeper, there are huge costs to cutting back on dental visits, both our health and finances.

Unfortunately, the majority of our population believes oral care is a long-term problem with very little cost to putting it off for the short term. They are putting off their dental visits for the wrong reason. If a person is not in pain, it’s easy to put off dental visits just to have clean teeth. The gamble is easier for people to delay care when it’s just for oral health, when we include the information now available on how important oral health is to overall health, they are taking a greater risk.

Don’t be afraid of perfect storms. Perfect storms are not new; when I was in college in the late 70s, the dental profession had a similar cloud moving in. There was stagflation, rising unemployment, and skyrocketing oil prices. My dad was a dentist at the time. Dental visits were decreasing, and as fewer people came in for their regular visits, times got a little tougher.

As both a biology/chemistry and macroeconomics major, I’ve always followed the cycles of our profession. Society appears to move cyclically—each cycle lasting about 30-40 years.  The best innovations always show up right after a slow down. With the slow down in the late 70s, our industry took a cue from society and progressed into the Era of Esthetics.

And just like that, we experienced one of the greatest booms in our profession’s history. We weren’t just patching and fixing teeth; we were doing smile makeovers, esthetic restorations, and improving smiles. Patients wanted beautiful smiles, and we stepped right in to provide them.

Fast-forward to present day. It’s 2013, and a significant number of adult patients are foregoing dental care to save money. Healthcare costs are skyrocketing, and the economic climate is difficult at best. Credit Suisse recently released a report showing a downturn in revenues in the dental profession.

And just as our production slows down again, the most exciting era ever shows up. We now live in a society where wellness will play a key role in economic survival—it is the umbrella that shields us from the gale of rising healthcare costs. And as we embrace this Era of Health and Wellness, dental professionals are positioned to help save the day by doing their part as disease prevention specialists.

Don’t ever forget to mention to your patients just how important their dental visit is to their overall health. Get it into your company DNA. From the start to the finish of our patient’s experience, they know that what we are doing is very important to them. I once had a patient tell me that he didn’t care about an upper second molar as much as I did, but he would do anything to protect his health.

I agree with Howard Farran when he says there is pent-up demand in the dental profession. When that demand is unleashed we will be the greatest era of our profession. Today’s forecast may look gray, but as our profession progresses into this new Era of Health and Wellness, we will greet the most exciting time ever. And as awareness expands on the relationship between oral health and risk for chronic conditions like heart disease and diabetes, the building demand for disease prevention will release, pushing the storm clouds out from over us and launching us into the most successful times in our professional lives.

Our profession is known for our innovation, providing society just what it needs at the right time, usually occurring right after a perfect storm.

The storm will break, the clouds will part, and the sun will shine brighter than ever before. The best weather is always right after the storm.

A recent report from the American Dental Association showed that the number of adults visiting the dentist at least yearly has been declining over the past 7 years. As recently as 2010, it appears that more and more adults are putting off dental visits in an effort to save money. But it turns out that missing out on regular dental care bodes ill for your budget.

At the same time, research is coming out daily that shows one of the best ways to save money is to have a healthy mouth. New research from United Concordia determined that regular dental care not only improves overall health but can by extension reduce medical costs as well.

This newest study found that participants who had periodontal therapy saved an average of $1,814 from reduced hospital and office visits. The savings nearly doubled for patients with diabetes, and rheumatoid arthritis patients saved a staggering total of $3,964.

When the public perception is that putting off dental visits won’t hurt them, there’s little call to action to keep current visits up. So while most dental practices are focusing on a traditional approach to oral care and having a hard time getting patients in for re-care, they may be missing out on the most important side of keeping their patients healthy and happy.

With the research showing us the role of oral health in inflammatory diseases such as heart disease, stroke, diabetes, and Alzheimer’s, it’s possible for patients to come to the dentist to not only improve their smiles but also their lives.

Establish with your patients the importance of oral health and its effects on overall health.  Make patient education a team effort. Provide visuals. The result will be a triple win: improved care, increased savings for the patient, and productivity for the dental office.

I’m a big fan of looking back through history and seeing the progression of healthcare. Recently I was at a Civil War exhibit with my family, and many of the exhibits showed health problems that were relatively new at the time—cannonball and rifle wounds, shattered bones and general misery. But healthcare at the time rose to the occasion—mainly with amputee kits, which became a very important part of every physician’s regimen at the time.

When you look at history, you know that we must change our way of looking at things to move forward. Just like back in the Civil War days, healthcare professionals are facing unprecedented new challenges.  Existing protocols cannot address new problems like the rising numbers of patients with obesity, diabetes, cardiovascular disease that are reaching epidemic levels in the developed world.

I’m often asked why and how the American Academy for Oral Systemic Health (AAOSH) came to exist—but the more pertinent question is Why now?

My answer is this: We have unprecedented problems. They’re killing us. At the same time, we have the opportunity to live much longer and healthier lives! And, just like in the Civil War days, innovation shows up just at the right time.

The new paradigm shift in healthcare can essentially be expressed in the shape of a triangle. At the base of the triangle we have the first essential component: new tools. Many of these new tools are involved in genomics and genetic testing, which is quickly becoming a major part of what allows us to start recognizing problems and how to address them.

Also at the base is the second point: new research using these new tools. In the last five years, the research coming out has almost all been based on genetics and genomics. This new research completely trumps the old research, yet much of the world doesn’t know about it. If you look at the information explosion we have in this world, we have a momentous surge of information right now. And in healthcare, it’s still being formed. It’s not being communicated.

This became very obvious to me when I was at the Biofilm Innovations 2013 conference in Boston in January. On the trip there, I was outlining and going over a very compelling research paper following Koch’s and Hill’s Postulates for causality for neurospirochetosis being a cause if not the cause of Alzheimer’s disease. This research is outing oral bacteria Treponema denticola—a microbe that we can test for with salivary diagnostics—as being involved with if not causing Alzheimer’s disease.

All this leads up to the third and most important point of the triangle: awareness. At the Biofilm Innovations conference, I had a conversation with Dr. Garth Ehrlich, one of the top researchers in genomics. We had never met before this conference; yet he presents his own research on the influence of T. denticola in injured and diseased native knees. Dr. Ehrlich found that this common oral bacterium attacks knees but not hips. There’s a lot to be learned by this, they believe, because there is a vascular bed around the knee much more so than in the hip, allowing for easier communication in certain parts of the body (e.g. the brain).

So I believe the most important point we have to address is awareness, bridging together all of these areas of research and healthcare.

Healthcare is moving forward with unparalleled rapidity. Dental professionals will consistently progress to a more important spot in overall healthcare. A lot of that will be due to genomics. It’ll be due to genetic testing. It’ll be due to looking at everything through a new Lens. Prior to this we were looking at bacterial load, bacterial burden as simply a situation where the research used cultures. It was so outdated. As soon as we transformed into bacterial and microbial DNA testing…Look out—the world goes crazy.

So organizations like AAOSH exist because we are altering the future of healthcare. As that happens, I look at the whole discussion as an entity in itself. We are part of that entity. We are part of that evolution. AAOSH plays a very key role, and we will carry this out in an extraordinary way.

I’ve always said that dentists can help patients in the bedroom by providing a solution to obstructive sleep apnea. But current research suggests that that statement may be more than just a clever play on words.

A research team in Turkey found men with gum disease are more likely to have erectile dysfunction than those without inflamed gums. The study, whose findings were published in the Journal of Sexual Medicine, examined the periodontal condition of 80 men with the disorder and a control group of 82 men without it. The results were significant, as an article in Dental Tribune International reported:

When the results were adjusted for other factors, such as age, body mass index, household income and education level, the men with severe periodontal disease were 3.29 times more likely to suffer from erection problems than the men with healthy gums were.”

Of course, more research is needed to study the relationship between gum disease and erectile dysfunction. But once again, the arrow is pointed at oral inflammation as a key component of a chronic condition that affects the quality of patients’ lives. By treating oral inflammation on a microbial level, we can not only reduce our patients’ risk for life-threatening conditions like heart attacks, strokes, diabetes, and Alzheimer’s, but we can also reduce risk for life-altering problems including erectile dysfunction.

Have you noticed a reduction in chronic conditions as a result of periodontal therapy? Share your results below!

This may be the most festive time of the year, but it’s sure not the healthiest. Gorging on unhealthy holiday favorites; staying up all night to get to the best bargains on gifts; stressing about family get-togethers; neglecting healthy habits for lack of time and energy—it’s a wonder any of us makes it to January alive.

After Black Friday and Cyber Monday and all the chaos in between, let’s get back on track this year with the first-annual Wellness Wednesday™, a campaign created by AAOSH and myself that will take place the Wednesday after Thanksgiving each year and highlight specific areas to focus on to improve overall wellness. It’s exactly what it sounds like—a day to refocus on the importance of overall health and wellness before the next barrage of cookie tins and relatives comes around.

If you’ve been keeping up with my blog, you know that wellness starts in the mouth. The mouth is the gateway to the body—we eat, drink, breathe, and communicate via this small but vital portal—yet somehow the mouth is often seen as a separate entity. From diet and nutrition to sleep health; from stress management to disease prevention, the mouth plays an important part in every aspect of our lives.

As healthcare professionals, we know that what happens in the mouth doesn’t stay there, and that good oral health is so much more than white teeth. And it’s our job to work together to spread awareness and make sure our patients don’t forget health during the holidays.

To learn more about Wellness Wednesday™ or to sign up to be a part of the National Wellness Wednesday™ movement next year, visit the official Wellness Wednesday™ site.

There has been a lot of talk among health experts lately about pancreatic cancer, a cancer that will claim the lives of more than 37,000 people in 2012 in the United States alone.

New research links oral pathogens to pancreatic cancer, increasing men’s risk for the disease by a whopping 54%. This is substantial yet unsurprising to anyone who has been paying attention to the mounting evidence for oral health’s affect on risk for chronic disease like heart attack, stroke, diabetes, oral cancer, and Alzheimer’s disease. Oral bacteria’s role in the development of kidney and blood cancers has also been highlighted recently, making our job as dental professionals more important by the day.

I’d like to commend Dr. Oz, who recently highlighted the role of oral bacteria in pancreatic cancer development in Part II of his three-part series, Pancreatic Cancer Risk and Solutions. Dr. Sarah Thayer, director of pancreatic cancer research at Massachusetts General Hospital, explained in this episode that a study by Brown University recently linked Porphyromonas gingivalis—an oral bacterium already known to increase heart attack risk 13-fold—to the development and progression of pancreatic cancer.

“If you have signs and symptoms of gum disease—such as swollen gums, bleeding gums, when you see blood on your toothbrush—you should bring this to the attention of your dentist,” Dr. Thayer recommended.

But dentistry has always been about prevention, and Dr. Thayer reiterated this succinctly: “The most important thing is prevention. So before you get gum disease, before you get gingivitis… prevent it. The key thing is brush and floss twice a day and have your teeth professionally cleaned at least every six months.”

From a dental professional’s perspective, a simple salivary diagnostic rinse test can measure the presence of oral pathogens like Porphyromonas gingivalis and allow you to create a customized treatment plan to eliminate the bad bacteria and take that factor off the table for them.

The Dr. Oz Show has been instrumental in helping patients understand how to live longer, healthier lives; yet, many patients remain unaware of the degree to which their oral health affects their risk for chronic disease. Never before has it been so important to educate your patients on the oral-systemic link and your team’s role in reducing their risk.

I’d love to hear from you. How do you stay up-to-date on the latest research on the oral-systemic connection? Do you communicate new developments to your patients? Comment below.