Hardly a day goes by in the world of dentistry without some mention of the role of oral health in the overall health of patients, and the potential for poor oral health to increase risk for systemic disease. It has never been more important for practitioners to diagnose and assess these risk factors, and then implement appropriate plans for prevention and treatment.

Education is paramount to successful implementation. As with all other clinical issues, the dentist and staff must be fully informed and work synergistically to develop evidence-based diagnostic and treatment protocols.

Although patients are now generally better informed about their health, we still see misinformation or misunderstanding regarding the oral-systemic relationship. In our office, we schedule monthly in-office training for both clinicians and support staff in order to stay current with new information and distinguish evidence-based research from vague suspicions. We focus on the relationship of periodontal disease to cardiovascular disease, diabetes, and pregnancy, and emphasize to patients that good oral health is important to overall health, longevity, and well-being. We have found several patient education tools to be useful, including pamphlets that explain the significance of risk factors, useful links from our website, special issues of our patient newsletter, and individual letters to patients in high-risk groups. Through these educational tools, we have been effective in communicating that poor dental health does not necessarily CAUSE systemic illness, but it can contribute to the risk of developing or worsening of certain interrelated chronic conditions associated with periodontal disease.

By inviting physicians on staff at local hospitals and laboratories, we have extended our educational programs to the local medical community. We found that hosting “lunch and learn” programs and speaking at physician conferences is effective in increasing the awareness of the oral-systemic message within the medical community. This process has served to build relationships that are integral to implementing collaborative oral-systemic healthcare services.

Above all, dental professionals must lead the way in providing service that first and foremost benefits the patient, while also considering medico-legal implications. Our office is one of 40 Centers for Dental Medicine™ within the United States. As such, our office is set up to screen, test, and appropriately treat patients with elevated health risks. Our protocol begins with identifying patients who are either pregnant, who have active cardiovascular disease or diabetes, or who present clinically with bleeding on dental probing. These patients are screened for DNA genotype, C-reactive protein levels, and glycated hemoglobin levels. In pregnant patients or those considering pregnancy, we determine elevated maternal IgG antibodies. Additionally, we perform a Florida Probe® exam, and then determine the category of risk from the results of all these tests. With this information, we can determine and implement an appropriate treatment protocol. Protocols range from little or no change in treatment plan (perhaps simply increasing the frequency of their home or office-based preventive procedures), to 12-month programs that involve scaling and root planing, laser decontamination and debridement, advanced homecare and preventive procedures, and nutrient supplements to aid in healing. This information also allows us to identify patients who need to be referred to physicians.

In summary, it is important not only to be well informed about the latest research on oral-systemic health, but also to take a leading role in educating our counterparts within the medical community. This type of collaboration may provide great promise in ensuring the overall health of our patients.

Michael O’Brien, DMD, Private Practice General Dentistry; Auburn Dental Associates, Auburn, AL