We don’t inform and educate the public around the benefits to their general health of taking care of their oral health. All too often they think that all we do is fix holes and extract teeth and apply expensive crowns; but of course we do much more and we should be shouting about it.
A perfect example of this is in the relationship between diabetes and periodontitis. There are clear, established links that reveal how the treatment of one can positively affect the other, but when was the last time you took the time to share this with a diabetic patient?
Recently, I met Dr Leticia Casanova, a Spanish Dentist who trained as a periodontist at New York University and has a PhD in Medicine, studying the connection between diabetes and periodontal disease, so she has a particularly relevant perspective. Dr Casanova recently published an article in the BDJ entitled, Diabetes and Periodontal Disease: A Two-Way Relationship.[i] The article says that if you can control people’s periodontal disease, you can actually see a genuine reduction in their diabetic condition.
A measure of how well a diabetic is coping is in their glycated haemoglobin levels and this is recorded as a percentage. Every drop of 1% reduces the risk of heart disease and damage considerably. The article explains that being diabetic leads to an increased risk of developing periodontitis and that having periodontitis can also affect the body’s glycaemic index (in people with or without diabetes). So if you control somebody’s periodontitis, through delivering first class periodontal treatment, and then measure their glycated haemoglobin, it is possible to see a drop of up to a half per cent and this will really make a difference to their life.
The article from Dr Casanova effectively shows the interrelationship between the two problems and explains how we can deliver dental treatment that positively affects systemic disease. This leads back to my initial point, that we don't highlight the positives that we do for our patients enough. If general dentists were seen to take a more active lead in the medical conditions of their patients, maybe this would raise the profession in the eyes of the public?
The prevalence of diabetes is phenomenal, and periodontitis is three times more likely to affect those who suffer, and a lot of diabetics become edentulous, effecting how they eat – and this is not to mention the already well established links between gum disease and heart disease. So, if through making changes in our approach we are able get a patient’s diabetes better under control, we would be performing a far greater public service.
We should therefore take every opportunity to play a bigger role in our patients’ general well being. Not just in performing oral cancer scans, which are vital and we should all already be doing, but maybe through routinely measuring blood pressure, iron and sugar levels too, so that people will begin to see us not just as people who fix holes, but as doctors that can help with a medical condition.
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[i] L. Casanova, F.J. Hughes and P.M Preshaw, Diabetes and Periodontal disease: a two-way relationship, British Dental Journal, 217, 433-437, available at: http://www.nature.com/bdj/journal/v217/n8/full/sj.bdj.2014.907.html [accessed 14.4.14]