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Is it time to re-unite the mouth with the rest of the body?

The link between periodontal disease and other health issues might be the perfect platform to connect dentistry and medicine in a more cohesive manner. (Photograph: schankz/Shutterstock)
Dental Tribune International

Dental Tribune International

Mon. 28. August 2017


LEIPZIG, Germany: Breaking through the barrier between dentistry and medicine could be a crucial step towards better all-round health. Since the practice of dentistry was founded, the two professions have largely been seen as separate entities; however, twenty-first-century science has established that oral health is intrinsically connected with overall health, making a joint working relationship between them seem like an obvious step.

Periodontal disease is maybe one of the best examples of this link. According to the European Federation of Periodontology (EFP), the disease affects half of all people over 35. Associated with high blood pressure, cardiovascular disease and even the development of diabetes—preventable conditions—the result is a negative impact on the quality of life for millions of people and increased expenditure on public health resources.

“European Gum Health Day 2017 is the only international initiative aimed at raising public awareness of periodontology, a branch of dentistry that is already officially recognised as a dental speciality in many countries,” said EFP President Dr Gernot Wimmer. “It is also a call upon authorities, policymakers, health organisations, and public opinion across Europe to come to a better understanding of how gum health can improve general health and well-being and save a huge amount of public money in health expenditure.”

The idea of re-uniting the mouth with the rest of the body has been debated for some time. In a report written in the 1920s, the biological chemist Dr William Gies, after visiting nearly every dental school in America and Canada, recommended dentistry to be considered a fundamental aspect of the health care system. “Dentistry can no longer be accepted as mere tooth technology,” said Gies, suggesting the two professions be integrated. However, this was met by strong resistance in the dental industry, which fought to keep them separate.

In America, that resistance continues. From 2009 to 2012, the American Dental Association (ADA) spent US$39 million on lobbying efforts, largely, as the Wall Street Journal put it, to protect its turf and prevent competition. This investment in professional autonomy may seem like a marketplace issue that does not have patients’ best interests at heart; however, the ADA argues that only dentists can provide dental care, thus ensuring the best care possible.

Nevertheless, opinion changes at an international level could be the impetus for change at national levels. The FDI World Dental Federation regards oral health as an important contributor to overall health and well-being and has stated it needs to be clearly positioned within health. The Harvard School of Dental Medicine in the US has recognised the importance of this by launching the Initiative to Integrate Oral Health and Medicine. It aims to improve general health, lower medical costs and fully integrate oral health into health care education. Other initiatives include the Oral Physician Program, a general practice dental residency program implemented through the Cambridge Health Alliance, a health care provider that integrates oral health, primary care and family medicine training.

Although it is still some time away until routine taking of patients’ blood pressure and weight before their teeth are cleaned and radiographed, the acknowledgement by both parties of the importance of open dialogue and active measures could go a long way towards improving millions of lives around the world.

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