The Medical-Dental Connection

Georgia Tech Educational series
The Medical-Dental Connection
How dental health impacts your life
Presented by Dawn Welch
May 27, 2014
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?
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
Cost of Dental Disease
• Days lost from work = money lost
• Today’s 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
The value of dental health in the
Emotional Capital
Intellectual Capital
attitudes, work
talent, skills,
Health Capital
Health status (physical and
behavioral/psychological), functional
•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
Healthcare and Today’s Economy
• Today’s business models are changing due to
declining profit margins and global and
domestic competition.
• The need to for companies to lower costs is
• This is evident when it comes to employee
benefits, especially healthcare.
• #1 concern for executives and CFO’s: doubledigit healthcare cost inflation
Toothy Trivia!
A dentist was the inventor of…
A: Grape juice
B: Chewing gum
C: Cotton candy
D: All of the above
The Oral-Systemic Health Connection
“Systemic” refers to the involvement of many
organs or systems of the whole body
Source: American Academy of Periodontology
The Mouth as a portal of entry for
• The mouth is a major entry point to the body with
mechanisms to defend against toxins or invading
• If integrity of oral tissues is breached, the mouth can
become a source of disease affecting other parts of the
– 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
Medical conditions with oral symptoms:
Heart Disease
Pancreatic Cancer
Respiratory Disease
Kidney Disease
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
• Periodontal disease has links to systemic disease,
and affects 3 out of 4 people at some point in their
What happens in your mouth doesn’t
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 1500’s
Oral Indicators:
Swollen gums
Bleeding gums
Dry mouth
Bad breath (Halitosis)
Metallic taste
Burning sensation
Growths (tumors)
Swollen, red gums (gingivitis)
Sqaumous Cell Carcinoma
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 Alzheimer’s disease, mumps,
measles, and rubella
• Simple cheek swab- scrapings of the inner cheek cellsmay be able to detect cancer of head, neck, and lungs
What the dentist may detect in your mouth:
More then 120 medical conditions can be
detected by signs and symptoms in your mouth
Oral Tissues can reflect the presence
Malignant Melanoma
Parkinson’s disease
Addison’s Disease
Cystic Fibrosis
Vitamin deficiencies
Alcoholic cirrhosis
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.
Risk Factors for Periodontal Disease
Bacterial plaque
Smoking/tobacco use
Clenching/grinding your teeth
Poor nutrition
Toothy Trivia!
Which U.S. president had oral surgery done in secret to prevent
a national panic?
A: Abraham Lincoln
B: John F. Kennedy
C: Grover Cleveland
D: Franklin Roosevelt
Effects of Pregnancy on Oral Health
• Pregnancy Gingivitis
• Pregnancy Tumors
• Pre-term delivery and low-birth weight
Pregnancy Gingivitis
Studies indicate approximately 50% of women
experience some degree of pregnancy gingivitis
Pregnancy Tumors
• Rare condition seen in the 2nd or 3rd trimester
• Also know as Pyogenic Granuloma
• A painless lesion that develops in response to
• Requires treatment
Photos: MUSOD Department of Oral and Maxillofacial Pathology
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
• Results cannot be generalized to
the entire maternal population for
studies with a small sample size
and skewed demographics.
• Research is ongoing.
Women’s 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.
• Diabetics are at higher risk for developing infections, including gum
• 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%.
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.
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
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.
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
Respiratory Disease
• Gum disease increases bacteria in the
• 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
Kidney Disease
• Patients with Kidney disease are considered an
“at risk” population and are more prone to
• 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
Toothy Trivia!
How many teeth do lions have? How many do great white sharks have?
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
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
Value and Importance of Dental
• With dental insurance a patient is more likely to
visit their dentist and have symptoms
• 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
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
American Dental Association. Information gathered: February 2007.
American Academy of Periodontology. Information gathered: February
“Periodontal Disease And Pancreatic Cancer Linked” Article date:
Scientific American, a custom publication in collaboration with the
Proctor & Gamble Company. Information gathered: February 2007.
Colgate World of Care. Information gathered February, 2007,
Georgia Tech Educational series
Thank you for attending!

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