Good news for dentists and health care.

[groundhog]

An MD who does a regular healthcare column that appears in our local newspaper recently wrote "More and more physicians are advising their patients to get regular dental checkups." The increase in such advise has mainly to do with the fact that solid research is associating poor dental hygiene and various medical problems that physicians routinley encounter amongst their patients. Its encouraging to know that the health care community is willing to work across "party lines" for the comprehensive benefit of us folks who rely on their expertise to maintain our health.

---

Members don't see this ad.

 

[capisce?]

An MD who does a regular healthcare column that appears in our local newspaper recently wrote "More and more physicians are advising their patients to get regular dental checkups." The increase in such advise has mainly to do with the fact that solid research is associating poor dental hygiene and various medical problems that physicians routinley encounter amongst their patients. Its encouraging to know that the health care community is willing to work across "party lines" for the comprehensive benefit of us folks who rely on their expertise to maintain our health.

The research that links systemic disease with dental conditions, such as periodontal disease with cardio issues, is hardly "solid". Have you read any of that research? What makes you say it's solid? I'd like the references to said solid research if you could please provide it.

Again, these are party lines you are not a part of. You're the third party, the patient, in both cases. People aren't going to start going to the dentist all of a sudden because their MD suggests it. Once again, I can make this statement because I'm a dentist, and I actually see patients.

 

[cdmOMR]

The research that links systemic disease with dental conditions, such as periodontal disease with cardio issues, is hardly "solid". Have you read any of that research? What makes you say it's solid? I'd like the references to said solid research if you could please provide it.

Again, these are party lines you are not a part of. You're the third party, the patient, in both cases. People aren't going to start going to the dentist all of a sudden because their MD suggests it. Once again, I can make this statement because I'm a dentist, and I actually see patients.

Ouch. But not false.

I wonder how much they figure in the fact that people who dont take care of their teeth probably dont take care of their bodies.

 

[DDSY]

The research that links systemic disease with dental conditions, such as periodontal disease with cardio issues, is hardly "solid". Have you read any of that research? What makes you say it's solid? I'd like the references to said solid research if you could please provide it.

Again, these are party lines you are not a part of. You're the third party, the patient, in both cases. People aren't going to start going to the dentist all of a sudden because their MD suggests it. Once again, I can make this statement because I'm a dentist, and I actually see patients.

Just wondering, I know that various medical conditions manifest symptoms through the mouth, b/c the mouth is such a sensitive organ. The body is after all, all interconnected, which is why I heard that dental schools are emphasizing studying the entire body, not simply the mouth. How much do you identify patients with medical problems and refer them to MDs? Anyone could answer this question.

 

[S Files]

The research that links systemic disease with dental conditions, such as periodontal disease with cardio issues, is hardly "solid". Have you read any of that research? What makes you say it's solid? I'd like the references to said solid research if you could please provide it.

Again, these are party lines you are not a part of. You're the third party, the patient, in both cases. People aren't going to start going to the dentist all of a sudden because their MD suggests it. Once again, I can make this statement because I'm a dentist, and I actually see patients.

agree the early research wasn't solid, but has progressed significantly.
some stuff published over the last couple years are controlled, blinded and randomized....very solid. jeffcoat at upenn dental with ob/gyn dept look it up (pre-term delivery and birth weight). respiratory relationships i agree has found a relationship but not controlled well enough studies. cardiovascular relationship w/ perio some decent studies - yes b/c all the smokers and other confounding factors makes it fuzzy but shouldn't disregard these studies. c reactive protein interesting connection, but so many darn factors involved tough to isolate a direct connection.

 

[capisce?]

Just wondering, I know that various medical conditions manifest symptoms through the mouth, b/c the mouth is such a sensitive organ. The body is after all, all interconnected, which is why I heard that dental schools are emphasizing studying the entire body, not simply the mouth. How much do you identify patients with medical problems and refer them to MDs? Anyone could answer this question.

doesn't happen much but there are a lot of things you can pick up on orally that have not been diagnosed yet...diabetes, leukemia, bleeding deficiencies to name a few.

 

[groundhog]

The research that links systemic disease with dental conditions, such as periodontal disease with cardio issues, is hardly "solid". Have you read any of that research? What makes you say it's solid? I'd like the references to said solid research if you could please provide it.

Again, these are party lines you are not a part of. You're the third party, the patient, in both cases. People aren't going to start going to the dentist all of a sudden because their MD suggests it. Once again, I can make this statement because I'm a dentist, and I actually see patients.

You could use a remedial course in English. I was taught that words have specific connotations. I realize that many folks these days just blab out words without giving much thought as to what they intend to convey. However, it is unfortunate when professionals such as yourself do so.

First, I said "associating" which has a much different connotation than "links." "Link" implies a direct connection whereas "associating" implies a mutulality. For example, We don't say "a chain is only as strong as its weakest associate." We say "a chain is only as strong as its weakest link"

Second, as for the example you are seeking. There are numerous ones. Here is one. Go to google and search periodontal cardio disease research. Scroll down to Clinical Trial: Impact of Gum Infection on Heart Disease. Quote from that report. "We have recently demonstrated a strong ASSOCIATION between severe periodontal disease and endothelia vasomotor dysfunction in a case control study of otherwise healthy human subjects...We now propose to determine whether effective treatment of periodontal disease improves endothelial function (Aim 1) and reduces inflammation (Aim 2) in a randomized intervention study...we hypothosize that comprehensive treatment of periodontal disease will improve endothelium-dependent dilation and reduce local and systemic inflammation. Such results would provide much stronger evidence for causal LINKS between periodontal disease, systemic inflammation, and endothelial dysfunction, a recognized surrogate for cardiovascular risk." It is obvious that these researchers also place significant importance on the difference between the words "ASSOCIATION" and "LINKS." Thank you all the same, but I'll go with their usages of those words. Not the ones you try to put in my mouth.

Third. I don't understand your logic in having some issue with my saying "Its encouraging to know that the health care community is willing to work across 'party lines' for the comprehensive benefit of us folks who rely on their expertise to maintain our health." I don't know what you were taught in English, but I've always assumed that I automatically include myself whenever I use the word "us".

Finally, I don't get your point about patients not paying any attention to what their physicans might recommend in the way of dental treatment. Many patients don't follow the advice of their primary care physicians to see a gastroenterologist for a scope of their large intestines once every five years after turning fifty. Still I believe not offering such advice would be a disservice to both the patients and the field of gastroenterology.

 

[gryffindor]

The research that links systemic disease with dental conditions, such as periodontal disease with cardio issues, is hardly "solid". Have you read any of that research? What makes you say it's solid? I'd like the references to said solid research if you could please provide it.

Put the name "Robert Genco" into a medline search and you will find plenty of references linking periodontal disease and cardiovascular disease.

 

[capisce?]

Put the name "Robert Genco" into a medline search and you will find plenty of references linking periodontal disease and cardiovascular disease.

I never said there wasn't a link between the two... I've read the research. I said there isn't strong direct evidence to support it. Association does not necessarily mean cause and effect.

 

[capisce?]

You could ...blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah

I'm not sure what that diatribe has to do with my post.

I never disputed the association between systemic disease and oral health. There is plenty of research to show a link. Just because there is an association, however, does not infer a cause and relationship effect. That is the gold standard and hasn't been done yet.

What I posted was about the ridiculousness of your point that this is "good news for us dentists". Just because MDs acknowledge the assocation is not going to change the type of person who seeks out dental care. Just because that one MD values the connection does not show a national trend of awareness. How are you making such a generalization?

Do you know what % of a general practice's patient population comes from MD referrals? Before you go ask your brother's sister's friend who is a dentist, do you know? People are either going to value their oral health and see a dentist, or they are not. A diabetic who is uncontrolled and never visits the dentist is not going to all of a sudden because her physician tells her to. You don't understand patient motives and the breakdown of patient-types because you don't treat patients. So do us all a favor and stop acting like you have even the tiniest clue about how this will effect our profession.

It's application and interview time. Why don't you go prey on unsuspecting predents and tell them what application committees are looking for on their applications. There's a new crop who actually might buy the bs you preach.

 

[capisce?]

: )

 

[JavadiCavity]

I agree that there is more and more research associating perio disease with systemic disease. Seems like the hot item in that research is C-reactive protein. However, while dental researchers are eager to show perio disease, c-reactive protein and heart disease (as well as other systemic diseases) are linked, the American Heart Association usually issues rebuttals claming that the assoication between those three factors is purlely circumstantial.

Honestly, it seems both parties are a little biased in their claims. If the dentists are right, then it means perio disease will have to be taken a lot more seriously by our physician counterparts. On the other side of the issue, the American Heart Association has it in their best interest to discredit any claims that perio disease is linked to heart disease so that medicine can continue to horde all of the public research money from NIH, et al.

On the downside, if dentists are right, it means that dentistry might be under more pressure to fall under the managed health care umbrella so that people have better access to all of the care they need to treat heart disease affordably. I'm not sure that I want the government/general public to start putting pressure on dentists to become part of managed health care. I don't want to suffer the same fate as physicians (i.e. having some suit dictating to me what I can or can't treatment plan for a patient because the insurance company has to stay focused on their bottom line).

 

[groundhog]

What I posted was about the ridiculousness of your point that this is "good news for us dentists". Just because MDs acknowledge the assocation is not going to change the type of person who seeks out dental care. Just because that one MD values the connection does not show a national trend of awareness. How are you making such a generalization?

Do you know what % of a general practice's patient population comes from MD referrals? Before you go ask your brother's sister's friend who is a dentist, do you know? People are either going to value their oral health and see a dentist, or they are not. A diabetic who is uncontrolled and never visits the dentist is not going to all of a sudden because her physician tells her to. You don't understand patient motives and the breakdown of patient-types because you don't treat patients. So do us all a favor and stop acting like you have even the tiniest clue about how this will effect our profession.

.

In hopes that you are still ammenable to leaning instead of just spouting off at the mouth (my wife says never give up on anybody miracles happen every day), I'll refer you to yet another source. Below are extractions from of a recent AMA/ADA combined media briefing that was held in New York City on February 2006.

Dr. Rose spoke today at the American Medical Association and American Dental Association media briefing, Oral and Systemic Health: Exploring the Connection.

Dr Rose, whose dental practice sees the largest diabetic patient population in the Philadephia area, said he previously had very little interaction with his patients' primary care physicians, endocrinologists, and cardiologists. But recently, he's noticed a change. "Thanks to research, physicians are much more proactive when it comes to their diabetic patients and their oral health," he said. "I find that now, more than ever, they're calling and referring their patients to me when there's even the slightest indication of periodontal inflammation." He added, "It's a step in the right direction. With more education and awareness about the link between oral and systemic health, the more likley the overall health of the patient will benefit."

Louis Rose DDS MD
Professor of Surgery Drexell University School of Medicine
Professor of Periodontics University of Pennsylvania School of Dental Medicine

So capisce, which mask will you put on this time if decide to put one of your spins on this rebuttal? Will it be Ann Coulter right wing mudslinger, or Jerry Falwell devil hunter?

 

[MsPurtell]

Exactly.

I never said there wasn't a link between the two... I've read the research. I said there isn't strong direct evidence to support it. Association does not necessarily mean cause and effect.

 

[capisce?]

Dr Rose, whose dental practice sees the largest diabetic patient population in the Philadephia area, said he previously had very little interaction with his patients' primary care physicians, endocrinologists, and cardiologists. But recently, he's noticed a change. "Thanks to research, physicians are much more proactive when it comes to their diabetic patients and their oral health," he said. "I find that now, more than ever, they're calling and referring their patients to me when there's even the slightest indication of periodontal inflammation." He added, "It's a step in the right direction. With more education and awareness about the link between oral and systemic health, the more likley the overall health of the patient will benefit."

You just don't get it, do you. On the internet it is possible to find an example of anything. The person you quoted is probably someone who chooses to "specialize" in treating diabetic patients. Just because there is awareness in one place in Philly doesn't translate to middle america. What's next...are you going to tell us amalgam causes cancer and arthritis and quote some online references? Get your head out of the sand.

Get it through your thick skull...this will not really affect joe-average dentist.

 

[capisce?]

Exactly.

Groundhog should take note of this, since MsPurtell had probably the strongest medical training as a background at UCONN out of all of us.

 

[groundhog]

Capisce, I just got word from my guardian angel that I'm doomed to spend a significant amount of time in root canal purgatory during my next life unless I lighten up on you. I hate root canals. So, go with God my good friend.

 

[lnn2]

...(my wife says never give up on anybody miracles happen every day)...

Did she say that before or after she married you?!

interesting link:
http://www.perio.org/resources-products/posppr2.html

 

[groundhog]

Did she say that before or after she married you?!

interesting link:
http://www.perio.org/resources-products/posppr2.html

Likley after. Besides that, even though she does not prefer the look of beards on men, she prays that I won't shave mine for fear of what I really look like. She says if she had to to it over again, she would have gotten a pre-nup regarding the beard issue.