Change is Needed to Save Lives; the role of dentistry and medicine

I was privileged to attend a recent course with Dr. Bale and Dr. Doneen focused on Heart Attack, Stroke and Oral Health. Bringing to the fore-front once again, the work dental professionals provide matters when it comes to cardiac health.

The collaboration between medical and dental professionals is continuing to strengthen as science recognizes what is happening in the mouth directly impacts the rest of the body, and vice versa.

Current research is demonstrating more than a casual association between oral health and cardiovascular health, with a direct cause and effect relationship. This means it's time to make a change!

Screening for both diseases more aggressively and more frequently in both the medical and dental field is required.

How does one impact the other?

We know inflammation in the oral cavity will lead to ulcerations in the epithelium tissues, allowing bacteria to travel a distance systemically. The bacteria present in the oral cavity triggers the inflammatory process causing the release of inflammatory mediators, also going directly into the bloodstream, all leading to health issues such as cardiovascular disease.

Currently 206 people in Canada die every day from heart attack and stroke2. This is the leading cause of death and we need to be doing more!

What can we be doing to to help decrease the incidence of heart attack and stroke?

After looking into this subject matter deeper, I strongly believe both medical and dental professionals can be making some changes in their mission, and their day-to day practice to aid in decreasing the leading cause of death.

The future of dentistry must be aware of and integrate the following into practice;

• Dental professionals need to be utilizing all tools to address oral inflammation and host inflammation ( in-office adjuncts and home care regimens). The more risk factors one has the more aggressively we need to be combining in-office and home care treatments. We know there are numerous evidenced based treatment options to address inflammation and disrupt the microscopic biofilm. Such as ultrasonic scaling, air flow/guided biofilm therapy, diode laser, oral rinses, interdental brushes, and sub-antimicrobial low dose doxycycline (Periostat/non-antibiotic level).

• Both oral care providers and their patients need to make it a top priority to stabilize periodontal disease. Just a little bit of bleeding is NOT okay! We need to be continually asking ourselves are there signs of inflammation in the oral cavity. 

• We need to look deeper into our patients medical histories to identify the red flags and risk factors for cardiovascular disease, and make the appropriate referrals. 

• Monitoring blood pressure in the dental office is a must, and needs to be taken more regularly at preventative, restorative, and surgical procedures.

• Be aware white coat hypertension should still be noted and appropriate referrals made, as it is a red flag for possible cardiovascular disease.

• While assessing panoramic x-rays take time to look for signs of calcium deposits in the caroid artery and make the appropriate referrals. 

• Take time with your extra oral assessments. We are in the perfect situation to look at the skin, ears, nails and eyes as each could show signs of cardiovascular disease. The book "Beat the Heart Attack Gene" by Bale & Doneen, as well as a webinar by CDHA & Irene Iancu - Understanding Cardiovascular Condition, further explores these extra oral red flag in detail. 

• Become a dental office that is specialized in vascular inflammation! 

The future of medicine needs to expand on the following key areas; 

• More cardiovascular departments need to have a strong oral health component in order to make a difference and provide exceptional care to their patients. 

• The collaboration between medical and dental needs to be streamlined to benefit the patient and we cannot be working in silos. Very clear and welcomed communication is critical for both parties. 

• We need to have a health care system that is focused on prevention as their #1 goal. A system that is utilizing the most effective screening tools to identify cardiovascular issues earlier. If our healthcare system remains focused intervening at the level of treating the sick we are in trouble.  

In closing, I wholeheartedly recommend dental professionals, medical professionals and the public read " Beat the Heart Attack Gene" by Bradley Bale and Amy Doneen. It is a book that can help change our perspective on how important it is to ask the right questions and dig a little deeper to get the information needed to keep the heart and brain healthy.  And ultimately saves lives! 

References and further information: 
1. https://baledoneen.com/

2.  http://www.hricanada.org/about-heart-disease/facts-about-heart-disease

3. https://www.cdha.ca/cdha/Education/Webinars/CDHA/Education/Webinars/Default.aspx?hkey=98077c45-00cd-49d0-ac40-6cb2ef199253

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