Medicine and Dentistry

Publication: Montana Woman Magazine

Dentistry has long had the reputation of being medicine’s redheaded stepchild. Some people think that dentists aren’t real doctors. The first two years of dental school were very similar to medical school. My biology degree was part of a Pre- Med curriculum. Now that modern science has revealed the long ignored link between oral health and general wellness, the dentist’s role will become more aligned with the medical profession.

Some of the alarming new information about the role of oral inflammation and infection will now require Doctors to refer their patients for dental care, to reduce their risks for many conditions. The common thread that is being discovered to be an underlying danger to long term health is inflammation. Most of us think of bursitis or a swollen bug bite when we think of inflammation. Think again. Inflammation is an amazing cascade of biological and chemical events associated with tissue injury or infection. When it is present as a long term or chronic condition, inflammation has so many sneaky side effects, that it has been named, the “Silent Killer”, by the media.

Chronic inflammation has now been linked with nasty conditions like alzheimer’s, cancer, diabetes and atherosclerosis. One of the diagnostic items that you may have heard of lately, is “C”-reactive protein, or CRP. High levels of CRP indicate an increased risk for many serious diseases and conditions that are very difficult or impossible to treat. The reason for this discussion in a dental column is that periodontal disease is a major source of chronic inflammation that has been overlooked by doctors for years! More than 80% of adults have some degree of gum disease, or pyorrhea as it used to be called. Doctors can no longer ignore this significant health risk to their patients, and will be called upon to refer them to a dentist for treatment. Maybe, finally, our patients will do what we have been telling them all along, since they have the doctor’s orders!

Periodontal disease is a prototypical example of inflammatory pathology secondary to bacterial infection. Bacteria and their byproducts enter the general circulation through diseased gum tissue. The activation of immune cells and natural chemicals I will call chemokines, occurs, and is our body’s response to the inflammatory stimuli. The liver responds by releasing CRP, in response to the synergistic interplay between the body’s cells and chemicals. CRP has become a marker to measure inflammation by. It is much more than that, it is a biologically active chemical that has a direct effect on different cell types. This can be explained with lots of big words but I will say for now it increases the risk for atherosclerosis and blood clots. My uncle Emil just died from a blood clot following a sprained ankle. Other conditions work against you in the presence of inflammation as well. Obesity, arthritis, atherosclerosis, diabetes; well you get the idea.

Let me sum up the point of all this for you. C-reactive protein is the part of the body’s response to inflammation. CRP is more predictive of heart disease than cholesterol, and so is gum disease by the way! CRP is a causative agent in the disease processes, because of it’s direct effect on different cell types. CRP is an indication that inflammation and/or infection are present somewhere in the body. Periodontal disease and dental infections are a primary cause of inflammation. This disease can be managed and reduced by antimicrobial tissue therapy. It is now clear that your doctor has a duty to recommend dental care as a part of your health care.

Dentistry has other trends, that reflect the medical management of oral conditions. Recognizing the bacterial differences in people prone to tooth decay, has led to simple treatments to change the oral microflora in addition to repairing the holes in the teeth. I say it’s about time we can do something more than fix cavities and wag our fingers. Finally patients have options to greatly reduce the continual cavities. We also are developing simpler and more comfortable methods for the treatment of the evil gum disease. Lasers and antimicrobial techniques are showing great promise in this direction.

The future is coming and it will be amazing, and healthier too. Keep flossing and visit your dentist, it’s good for your heart, your breath and your life.