Annette Ashley Linder, BS, RDH
If you still think it's just a cleaning, think again. Share these three, current studies with your patients. They offer strong evidence about the impact of periodontal infection on the human body.
1) Journal of Clinical Periodontology (Dec. 2003) — Japanese researchers examined and measured the oral health of 7,452 men and women, and tested their blood for 37 different items used in general blood tests. Items tested included cholesterol, C-reactive protein (CRP — commonly linked to heart disease), and diabetes. The results were compared to the oral-health scores of the participants.
The study found that, generally, if the blood was "healthy," the oral health was healthy. Conversely, if the blood test detected certain "red flags," the person also had serious symptoms of periodontal diseases. It also found that males had more serious symptoms of periodontal diseases in the same age group. A specific reason could not be identified, however researchers are suggesting differences in endocrine conditions between men and women. The only item in the blood test that showed a significant relationship with periodontal diseases and women was CRP.
2) Journal of Periodontology (Aug. 2003) — CRP values were compared before and after periodontal treatment. Researchers found that CRP values significantly decreased after periodontal treatment. Since the treatment of periodontitis in this study appears to be effective in reducing CRP levels, patients at risk for coronary heart disease may want to visit a periodontist to control their periodontitis. (Source: AAP)
3) Study: "Gum disease raises death risk in diabetes" — Severe gum disease may hasten death in people with diabetes, new study findings suggest. This study was presented at the American Diabetes Association Meeting in New Orleans (Reuters Health News, July 2003).
"Diabetic people with periodontal disease had increased death rates due to cardiovascular disease and renal (kidney) failure, which are two major complications of Type 2 diabetes," said study author Dr. William C. Knowler. The findings underscore the need for good oral hygiene in diabetics who are particularly prone to periodontitis or gum disease, Knowler said in an interview with Reuters Health. Studies have indicated that infections and inflammation can promote blood vessel damage in the heart and kidneys, said Knowler, chief of the diabetes and arthritis epidemiology section of the National Institute of Diabetes and Digestive and Kidney Diseases in Phoenix. While gum disease might not be diagnosed until mid-life or later, infection with the bacteria that cause it can occur decades earlier. Combined with years of inadequate oral hygiene, infection can result in gingivitis, an early form of gum disease characterized by inflamed gums that often bleed easily. As the more aggressive periodontitis develops, the gums and bone surrounding the teeth can become seriously damaged, and teeth may loosen or fall out. After adjusting for factors such as age, sex, duration of diabetes, obesity, and cholesterol levels, the researchers found that diabetics with severe gum disease were twice as likely as those without it to die from either heart disease or kidney failure.
In addition to making sure your patients are aware of the latest information and research, consider formulating an action plan beginning with these questions:
* Are your periodontal protocols current and up-to-date?
* Are you (and your hygienist) regularly and routinely assessing the periodontal health of all of your patients, not just the new patients?
* Are you assessing risk factors for periodontal susceptibility?
* Are you updating the patient medical history routinely?
* Are you intercepting, in the early stages, and treating infection and inflammation site-specifically, as needed?
* Are you using mechanical therapies, as well as chemical (locally delivered anti-microbial agents and or antibiotics)?
* When was the last time you held a team meeting to review and go over all of the above?
Annette Ashley Linder, BS, RDH, is a recognized leader in the field and an award-winning speaker and consultant. Since 1989, she has presented more than 350 seminars and consulted in dental practices throughout the world. She is a featured speaker at dental meetings and provides in--office consulting services with her team of business and clinical consultants. She may be reached at her Web site at AnnetteLinder.com, via email at Annette@annettelinder.com, or by phone at (804) 745-6015.