It's not about cleaning teeth!

May 1, 2004
There it was on the cover of the February 23 issue of Time magazine: "The Secret Killer — The Surprising Link Between Inflammation and Heart Attacks."

Annette Ashley Linder, BS, RDH

There it was on the cover of the February 23 issue of Time magazine: "The Secret Killer — The Surprising Link Between Inflammation and Heart Attacks." My phone and email went into hyper drive when that issue hit the streets. If you have not had the opportunity to see this issue of Time, do so as soon as possible. Dentists and hygienists cannot believe that on Page 46, the article actually states, "Keeping your mouth clean by flossing and brushing can reduce the risk of gum disease, a source of chronic inflammation"

In the past few years, we have seen a steady stream of scientific information discussing the link between chronic inflammation (anywhere in the body) and how the auto-immune system works to protect the body against invading pathogens. Heart disease remains the number one killer in the United States. Not long ago, most doctors thought that heart attacks were primarily due to fatty deposits building up (plaque) on the coronary arteries. The assumption was that anyone with high cholesterol was at a greater risk of developing heart disease. The problem with this theory is that half of all heart attacks occur in people with normal cholesterol levels. Researchers set out to find if other markers could be identified as risk factors for heart attack and stroke. Better imaging techniques, coupled with new scientific research, have led them to a whole new view of inflammation and its relationship to heart disease, diabetes, cancer, asthma, and Alzheimer's. To quote Time, "The damaging effects of inflammation can be kept to a minimum with drugs, diet, exercise, and even dental hygiene."

In a December 2003 study published in the Journal of Periodontology, Japanese researchers examined and measured the oral health of 7,452 men and women and tested their blood for 37 different items measured in general blood tests. Items tested included cholesterol, C-reactive protein (CRP) and diabetes. The results of the blood tests were compared to the oral health scores of the participants.

The study found that generally, if the blood was "healthy," so was the participant's oral health. Conversely, if the blood test detected certain "red flags," the person also had serious symptoms of periodontal diseases. The study also found that males were reported to have 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.

In another study reported in the JOP in August of 2003, CRP values were compared before and after periodontal treatment. Researchers found that CRP values significantly decreased after periodontal treatment.

So what is the practical application for all this information? Continue to have discussions with your patients and provide them with articles to make sure they are aware of the current research. This is all about moving patients beyond "it's just a tooth-cleaning." The more our patients know about the periodontal inflammation and systemic health link, the less we will have to nag them about compliance.

Here are more ideas for using this information to educate patients to value good oral health:

* Use a statement stuffer — Include some form of patient education in all of your statements.

* Offer to present a program on the topic in local schools, brown bag lunch seminars in your office and/or in various locations throughout your community.

* Provide an in-service program for the staff at your local hospital to attract new patients.

* Prepare an informational brochure and deliver it to local physician specialists in your area. Include cardiologists, endocrinologists, ob-gyn specialists, oncologists, orthopedists, and surgeons.

* Create an office newsletter highlighting this information and invite patients to call for a preventive dental hygiene appointment "which includes a periodontal health assessment."

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, via email at [email protected], or by phone at (804) 745-6015.

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