The mouth is, and forever will be, part of the body. The traditional medical model is treating symptoms and body parts in isolation. A new approach called functional medicine is emerging. Functional medicine pioneers such as Dr. Mark Hyman, Dr. Mike Roisen, Dr. Josh Axe, Dr. Joel Fuhrman, Dr. Amy Doneen, Dr. Brad Bale, and a host of others, are leading the charge. They do not ask questions like “What do we have?” but rather “Why do we have it?” They understand that body parts and organ systems are connected via the bloodstream, the lymphatic system, the endocrine system, the gastrointestinal system, the nervous system, and the immune system –separation of organ systems and body parts does not exist. They understand that what happens in one part of the body affects the entire being. The mouth is just one example, albeit a very important one.
Inflammation is a key driver of metabolic syndrome.1 In order to get at the basis of this disease and many others, one must address all sources of inflammation in the body. The most common inflammation, the most easily observed, and importantly the easiest to treat, is periodontal inflammation. Periodontal disease is not a local disease, as it is often mistakenly treated. For instance, evidence suggests that “periodontal changes are the first clinical manifestation of diabetes,” and “periodontitis is a significant risk factor for poor glycemic control.”2 In clinical practice, we are sometimes guilty of overlooking a host of other oral signs of diabetes beyond gingival/periodontal changes, such is salivary dysfunction, candidiasis, taste interference, neurosensory disorders, and oral infections.
Periodontal pathogens and the subsequent inflammatory mediators travel throughout the entire body as is referenced in a variety of scientific, peer-reviewed literature.3 The consequences of periodontal disease are widespread and often devastating beyond the mouth. To ignore this premise and the emerging research can be putting our patients’ health, and possibly their lives, at risk. Therefore, it is up to all of us as healthcare providers to look for the signs, document changes, and be able to communicate those findings with patients as well as other providers. The mouth is an excellent arena to identify physical risk factors for obstructive sleep apnea, xerostomia from poly-pharmacology influences, caries, erosion, chronic gingival inflammation and candidiasis. Food sensitivities and allergies often show mucogingival manifestations, in addition to gastrointestinal disturbances such as pain, bloating, diarrhea, or constipation. Healthcare providers need to be looking for risk factors at every exam.
As AAOSH team members, we have heard and read evidenced based research from scientists studying infertility and pre-term birth, heart attack and stroke prevention, cognitive decline and Alzheimer’s disease prevention, cancer prevention, metabolic syndrome prevention and more. If underlying inflammation is not treated, we have observed there will be no long-term successful outcomes of systemic disease treatments.
This is a profound time in healthcare reform and it’s important to not only be informed on the latest knowledge and facts regarding oral systemic health, but to know what to look for and to help your patients understand their role in treating and preventing disease. AAOSH, the American Academy of Oral Systemic Health is a great resource. If you are interested in learning more, please consider attending the 2019 AAOSH Annual Scientific Session.
- Targeting inflammation in metabolic syndrome, Welty, Francine K. et al.Translational Research, Volume 167, Issue 1, 257 – 280
- Relationship Between Oral Health and Diabetes Mellitus, October 2008, Lamster Et al.).
- Li, X et al. “Systemic diseases caused by oral infection.” Clinical microbiology reviews vol. 13,4 (2000): 547-58. doi:10.1128/cmr.13.4.547-558.2000
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