The Medical-Dental Connection

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The Medical-Dental Connection
Georgia Tech Educational series

• How dental health impacts your life
• Presented by Dawn Welch
• May 27, 2014

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What you will learn today

• What is the oral health connection?
• Medical conditions with oral symptoms
• What is periodontal disease and what is the link
  to overall health?
• Current research supporting the connection
  between medical conditions and dental disease
• What can I do?

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Did you know?

• Each year, children lose more than 51 million
  hours of school due to dental related illness
• Employed adults lose more than 164 million hours
  of work each year due to oral health problems or
  dental visits

Source U.S. Surgeon General
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Cost of Dental Disease

• Days lost from work money lost
• Todays average cost of a tooth from the time a
  cavity first appears to the end of life 3,500
• With the exception of accidental damage, dental
  treatment begins with relatively low-cost and
  non-traumatic diagnostic procedures, such as
  exams and x-rays
• Prevention and early intervention are the key to
  successful management of oral health and overall
  health

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The value of dental health in the workplace
Emotional Capital
Intellectual Capital
Employee engagement, commitment, motivation,
attitudes, work culture
Knowledge, talent, skills, experience
Health Capital
Health status (physical and behavioral/psychologic
al), functional capacity

• Skilled workers are essential to business success
  and not easily replaced
• Intellectual capital, emotional capital, health
  capital- combine to form a synergistic
  relationship responsible for high levels of
  productivity

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Healthcare and Todays Economy

• Todays business models are changing due to
  declining profit margins and global and domestic
  competition.
• The need to for companies to lower costs is
  inevitable.
• This is evident when it comes to employee
  benefits, especially healthcare.
• 1 concern for executives and CFOs double-digit
  healthcare cost inflation

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Toothy Trivia!
?

• A dentist was the inventor of

1.
A Grape juice
B Chewing gum
C Cotton candy
D All of the above
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The Oral-Systemic Health Connection

• Systemic refers to the involvement of many
  organs or systems of the whole body

Source American Academy of Periodontology
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The Mouth as a portal of entry for infection

• The mouth is a major entry point to the body with
  mechanisms to defend against toxins or invading
  pathogens
• If integrity of oral tissues is breached, the
  mouth can become a source of disease affecting
  other parts of the body
• Mouth may be the site for transmission of
  infectious microbes
• 700 strains of bacteria have been identified in
  the mouth
• Bacteria have been found to migrate from the
  mouth to the lungs or other organs

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Medical conditions with oral symptoms

• Pregnancy
• Osteoporosis
• Diabetes
• Heart Disease
• Pancreatic Cancer
• Respiratory Disease
• Kidney Disease

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The Oral Systemic Health Connection

• New research is pointing to associations between
  chronic oral infections and heart and lung
  diseases, stroke, low-birth-weight and premature
  births
• Periodontal disease is the most common chronic
  infection
• Periodontal disease has links to systemic
  disease, and affects 3 out of 4 people at some
  point in their life

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What happens in your mouth doesnt just stay in
your mouth

• Infection and inflammation in the mouth have been
  linked to a variety of systemic conditions
• Many medical illnesses manifest oral symptoms
• More research is needed to discover exactly how
  oral inflammation affects the rest of the body

University of Toronto Library Anatomy from the
1500s
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Oral Indicators

• Swollen gums
• Bleeding gums
• Ulcers
• Dry mouth
• Bad breath (Halitosis)
• Metallic taste
• Burning sensation
• Growths (tumors)

Swollen, red gums (gingivitis)
Sqaumous Cell Carcinoma
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Clues Dentists look for

• Many diseases are detectable through x-rays and
  by studying dental plaque
• Saliva and other oral cells can be used to assess
  health and disease- without the limitations and
  difficulties of obtaining blood or urine
• Saliva can be used to test for Alzheimers
  disease, mumps, measles, and rubella
• Simple cheek swab- scrapings of the inner cheek
  cells- may be able to detect cancer of head,
  neck, and lungs

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What the dentist may detect in your mouth

• More then 120 medical conditions can be detected
  by signs and symptoms in your mouth

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Oral Tissues can reflect the presence of

• Mononucleosis
• Addisons Disease
• Cystic Fibrosis
• Vitamin deficiencies
• Alcoholic cirrhosis

• Mumps
• Tuberculosis
• HIV
• Malignant Melanoma
• Parkinsons disease

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What is Periodontal Disease?

• The word periodontal means Around the tooth
• The periodontium refers to the tissues that
  surround and support the teeth including the
  periodontal ligament and bone.
• Gum disease (includes gingivitis and
  periodontitis) is a chronic bacterial infection
  effecting the gums and bone supporting the teeth.
• Gum disease can damage one or more teeth,
  resulting in their loss.

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Risk Factors for Periodontal Disease

• Bacterial plaque
• Smoking/tobacco use
• Genetics
• Stress
• Medications
• Clenching/grinding your teeth
• Poor nutrition

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Toothy Trivia!
?

• Which U.S. president had oral surgery done in
  secret to prevent a national panic?

1.
A Abraham Lincoln
B John F. Kennedy
C Grover Cleveland
D Franklin Roosevelt
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Effects of Pregnancy on Oral Health

• Pregnancy Gingivitis
• Pregnancy Tumors
• Pre-term delivery and low-birth weight

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Pregnancy Gingivitis

• Studies indicate approximately 50 of women
  experience some degree of pregnancy gingivitis

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Pregnancy Tumors

• Rare condition seen in the 2nd or 3rd trimester
• Also know as Pyogenic Granuloma
• A painless lesion that develops in response to
  plaque
• Requires treatment

Photos MUSOD Department of Oral and
Maxillofacial Pathology
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Association with pre-term birth

• Increasing evidence suggests a link between
  periodontal disease as a risk factor for pre-term
  birth, however, the studies are inconclusive.
• Results cannot be generalized to the entire
  maternal population for studies with a small
  sample size and skewed demographics.
• Research is ongoing.

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Womens Health and Osteoporosis

• Bone loss is associated with both gum disease and
  osteoporosis
• Estrogen deficiency and osteoporosis speed the
  progression of oral bone loss following
  menopause, which could lead to tooth loss
• Estrogen supplementation may lower gingival
  inflammation and help to protect teeth.

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Diabetes

• Diabetics are at higher risk for developing
  infections, including gum diseases
• Inflammatory diseases such as gum disease can
  increase insulin resistance, thereby affecting
  glycemic (blood sugar) control
• Poorly controlled type 2 diabetic patients are
  more likely to develop gum disease than diabetics
  under control with medication
• More than 50 of people in the United States
  diagnosed with diabetes are not achieving control
  of the disease, as defined by an A1C or blood
  sugar count of less than 7.

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Heart Disease and Stroke

• Theory 1
• Oral bacteria can affect the heart when entering
  the blood stream, attaching to the fatty plaques
  and contributing to clot formation
• Theory 2
• The inflammation caused by gum disease increases
  plaque build-up, contributing to swelling of the
  arteries.

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Heart Disease

• Periodontal disease can exacerbate existing heart
  conditions
• Patients at risk for infective endocarditis may
  require antibiotics prior to dental procedures
• Prosthetic cardiac valve
• Previous endocarditis
• Some types of congenital heart disease
• Cardiac transplantation recipients with cardiac
  valvular disease

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Heart Health

• Evidence continues to support an association
  among periodontal infections, atherosclerosis,
  and vascular disease
• Managing oral health may very well be key to a
  healthy heart
• The emergence of periodontal infections as a
  potential risk factor for cardiovascular disease
  is leading to a convergence in oral and medical
  care that will benefit patients.

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Pancreatic Cancer

• More than 30,000 Americans were expected to die
  from this disease in 2007.
• Established risk factors for pancreatic cancer
  are cigarette smoking and chronic pancreatitis
• The role of inflammation from gum disease may
  promote the cancer

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Respiratory Disease

• Gum disease increases bacteria in the mouth
• Inhaling germ-filled droplets from the mouth and
  throat into the lungs may cause bacterial
  infections
• People suffering from chronic obstructive
  pulmonary diseases (COPD) typically lack
  protective systems making it difficult to
  eliminate bacteria from the lungs
• Patients with respiratory diseases are more at
  risk for pneumonia

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Kidney Disease

• Patients with Kidney disease are considered an
  at risk population and are more prone to
  infections.
• Oral symptoms of kidney disease bad breath or a
  metallic taste in the mouth, dry mouth
• Maintaining a healthy mouth is crucial for these
  patients and they need to seek regular dental care

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Toothy Trivia!
?

• How many teeth do lions have? How many do great
  white sharks have?

1.
A Lions have 50, Great Whites have less than 500
B Lions have 150, Great Whites have about 1,000
C Lions have 80, Great Whites have over 5,000
D Lions have 30, Great Whites have over 3,000
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What can you do?

• Visit your dentist regularly
• Tell your dentist about your medical conditions
• Eat healthy
• Brush and floss daily
• Teeth are meant to last a lifetime
• Healthy teeth will keep you healthy!

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Value and Importance of Dental Insurance

• With dental insurance a patient is more likely to
  visit their dentist and have symptoms diagnosed
• People often visit their dentist more often than
  they visit their regular doctor. This means
  dentists have a greater opportunity to find
  symptoms and refer a patient to their general
  practitioner for diagnosis

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Dental Insurance Mission

• The goal for the dental insurance industry is to
  review research and findings and modify benefits
  accordingly when proven correlations are found
  between medical and dental conditions.

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Sources

• American Dental Association. Information
  gathered February 2007. www.ada.org
• American Academy of Periodontology. Information
  gathered February 2007. www.perio.org
• Periodontal Disease And Pancreatic Cancer
  Linked Article date 1/19/07, www.medicalnewstoda
  y.com
• Scientific American, a custom publication in
  collaboration with the Proctor Gamble Company.
  Information gathered February 2007.
• Colgate World of Care. Information gathered
  February, 2007, www.colgate.com

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Thank you for attending!
Georgia Tech Educational series