Periodontal Disease and Overall Health: A Clinician's Guide

More documents

Recommendations

Info

290 Periodontal Disease and Overall Health: A Clinician's Guide• Elaborate upon the professional developmentprocess that will distinguishindividual dentists and dental hy -gienists as authoritative experts in evi -dence of oral-systemic relationships.• Identify ways in which dentists anddental hygienists can influence thepublic’s perception of the importanceof oral health outside the practicesetting.THE PROCESS OF CHANGEIN INFLUENCING THEPUBLIC’S PERCEPTION OF THEIMPORTANCE OF ORAL HEALTH“Because oral diseases in general aretreatable and usually not life threatening,they have been erroneously perceived ashaving little relationship to other aspects ofhealth, often being viewed as of minor importancein the social and economic context.”17 This opinion reflects the all-too-realdisconnect between oral and overall healthand therefore has far-reaching implications.Segregation of the oral cavity from the restof the body—and consequently the historicalschism between dentistry and medicine—has helped contribute to the disparities thatcurrently exist in oral health among Americans.4 The failure to recognize oral health asintegral and essential to general health hasalso adversely impacted healthcare policy. 18In 2009, greater appreciation of the significanceof inflammation in prevention andmanagement of chronic diseases and mountingevidence in support of oral-systemic interrelationshipsat genetic and molecular levelsare changing nondental healthcare providers’perceptions of the importance of oral health.Indeed, the shift from an infection model toan inflammation model relative to the threatthat perio dontal disease poses to overall health,has gar nered the attention of the medical community.Medical journals—including some ofthe most prestigious—are reporting evidenceof oral-systemic relationships with increasedfrequency. In addition, governmental reports, 4,19educational institutions, 20,21 and professionalassociations 22 have called for educational reformthat would increase nondental healthcareproviders’ knowledge of oral health,and collaborative models of care that wouldbring together dental and nondental healthcareproviders to focus on interprofessional,comprehensive chronic disease managementthat includes oral care.The insurance industry has investigatedthe potential cost savings associated withtreatment of periodontal disease, and foundthat medical costs associated with chronicdiseases such as CVD and diabetes may besignificantly reduced when patients aretreated for periodontal disease. 23,24 Althoughthese studies do not prove cause and effect,they are sufficient for insurance companiesto be more liberal in their coverage for periodontaltherapy and maintenance for theirclients with diabetes and CVD. In addition,various guidelines created by health departmentsof state agencies have begun to addressthe importance of oral health in theoverall health of their citizenry. 25,26Changes in public policy, increased insurancereimbursement, and improved medical/dentaleducation undoubtedly will facilitateinterprofessional collaboration betweenthe healthcare professions; however, thismagnitude of change is unlikely to happen inthe short term. In the interim, educating thepublic through commercially supported mediacampaigns, outreach from professionalorganizations and universities, and individualpractitioner-to-patient education are essentialin helping the public reprioritize theimportance of oral health and its implicationto overall health.The answers to the following fourquestions provide a reference point to guidepractitioner-to-patient communication andarticulate messages that are essential tosuccessful patient education in oral-systemichealth:
Chapter 18Chapter 18 The Role of the Professional in Educating the Public About the Importance of Oral Health 2911. How much do consumer-patientsknow about the threat inflammationposes to whole body health and oralsystemicrelationships?2. How important do consumer-patientsbelieve oral health is to achievingand sustaining overall health?3. How well are dental practitioners doingregarding educating patientsabout oral-systemic relationships andwhat are the hurdles to effectivelycommunicating this information toconsumer-patients?4. What research should be credibly communicatedto patients about the relationshipbetween periodontal diseaseand inflammatory-driven diseasestates, such as coronary heart disease,stroke, diabetes, and adversepregnancy outcomes?5. In addition to individual practitionerto-patientcommunication, what typesof activities could dental practitionerspursue to change the perception ofnondental healthcare providers aboutthe importance of oral health, therebyincreasing the public’s awareness oforal-systemic relationships?CONSUMER-PATIENTS’KNOWLEDGE ABOUTORAL-SYSTEMIC LINKS, THESIGNIFICANCE OF ORAL HEALTH,AND THE THREAT INFLAMMATIONPOSES TO GENERAL HEALTHHelp from Mainstream MediaOver the last decade there have beennumerous sources of information from mainstreammedia about the relationship betweenoral and systemic health, including lay publications,27,28 television, 29 and radio. 30 In2004, Time Magazine 27 committed an entireissue, “The Secret Killer,” to help readers explorethe link between inflammation and variouslife-threatening conditions such as heartdisease. The article introduced readers tosome fairly sophisticated scientific conceptsthat describe how the body’s efforts to healthe damage produced by infection and inflammationoften end up causing permanentdamage to certain organs and increasing therisk for various systemic diseases. The articlespecifically discussed the potential of periodontaldisease to elicit such a cascade ofevents: “It appears that some people are moresensitive to plaques and tangles than others.Perhaps they have a genetic predisposition.Or perhaps a long-running, low-grade bacterialinfection, like gum disease, keeps theinternal fires burning and tips the balancetoward chronic infection.” 27 If readers cancomprehend such sophisticated information,it is reasonable to assume the public is becom -ing increasingly aware of the relationship be -tween periodontal disease and inflammatorydrivendisease states.CNN News jump-started the year 2009with a segment on “How to Live Longer,”which aired on January 2 and was hosted byDr. Sanjay Gupta, CNN’s Chief Medical Correspondent.29 Gupta discussed several simplemodifications to lifestyle that he proposedwould net increased longevity. He cited usingdental floss as the number one recommendation,explaining that oral care could reduce inflammation,a known contributor to increasedrisk for heart disease. These are only a few ofthe many examples of information on oralsystemichealth that have been generatedthrough mainstream media sources.A Snapshot of What the Public KnowsPiecing together data compiled by variousprofessional and nonprofit organizationsand the insurance industry provide a snapshotof how well the consumer-patient publicunderstands the importance of oral health inachieving and maintaining overall health.Findings of a survey conducted in the year2000 by the American Dental Associationindicated that the vast majority of consumer-
Page 1 and 2: Periodontal Diseaseand Overall Heal
Page 3 and 4: iiPeriodontal Disease and Overall H
Page 5 and 6: ivCONTRIBUTORSSrividya Kidambi, MDA
Page 7 and 8: CHAPTER 1From the EditorsDear Colle
Page 9 and 10: viiiCONTENTSCHAPTER 1Overview 1Robe
Page 11 and 12: “A person can’t have good gener
Page 13 and 14: Chapter 13 Oral Health, Periodontit
Page 22 and 23: 206 Periodontal Disease and Overall
Page 33 and 34: CHAPTER 17 Dental and Medical Coman
Page 51: Chapter 18Chapter 18 The Role of th
Page 55 and 56: Chapter 18Chapter 18 The Role of th
Page 67: Renowned clinicians and scientists

Periodontal Disease and Overall Health: A Clinician's Guide

Create successful ePaper yourself

Delete template?

Save as template?