Expert Medical And Dental Panel Affirm Link Between Oral Health And Overall Well-Being

Expert Medical And Dental Panel Affirm Link Between Oral Health And Overall Well-Being
March 1, 2007
Medical News Today

n a rare joint meeting of medical and dental experts sponsored by the Peninsula Institute for Advanced Dental Studies (PIADS) organization there was consensus that medical and dental professionals should work together to raise awareness about the connection between oral health and several common diseases and conditions.

The evening was hosted by Dr. Azeem Lakha, D.M.D., and Dr. Scott Baird, D.M.D., the co-founders of PIADS and leading Bay Area dental implant specialists. During the symposium the panel of experts discussed the science that continues to emerge daily associating gum disease to overall health such as diabetes, cardiovascular disease, osteoporosis and pregnancy complications (pre-term and low birth weight babies).

Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease and diabetes as those without periodontal disease. Effective treatment of periodontal disease has been shown to reduce blood sugar levels and improve glycemic control -- both of which can lead to reduced complications of diabetes.

J. Joseph Prendergast, M.D., an internal medicine, endocrinology, and metabolism specialist, elaborated, "Bacteria that form in the mouth, once believed to be simply a collection of pathogens, are now understood to be tenacious communities, referred to as 'biofilm' by microbiologists. These can travel through the bloodstream prompting a complex inflammatory response that can lead to various complications throughout the body."

"There is no longer doubt about the association," added Casey Herrera, D.D.S., a leading Bay Area periodontist, "the next step is to embrace a collaborative approach along with the medical community to improve patient health outcomes."

A perhaps more controversial topic discussed by the panel is the consequence of long-term use of bone-strengthening drugs (bisphosphonates) widely used to treat osteopenia and osteoporosis.

The most compelling information shared at this meeting was presented by Dr. Lakha who shared photographs of different cases related to the use of both IV and oral bisphosphonates. The photos clearly displayed the devastating consequences of long-term bisphosphonate use and the possible disfiguring effects on the bones of the jaw.

These drugs may lead to bone death when used intravenously for patients with cancer, yet the benefits of the therapy probably outweigh the risks of damaging the bone. However, the oral form of bisphosphonates -- commonly prescribed for osteoporosis -- remains a point of controversy when prescribed beyond 3 years. Some oral surgeons experienced in treating patients with problems related to bone death see clinical signs that this could also be occurring in patients who take oral long-term bisphosphonates. Signs of bone death include pain, infection, swelling, loose teeth and exposed bone.

In his presentation, Dr. Lakha, commented "In patients who have bone death due to oral bisphosphonate use, the bone does not heal properly, it also feels different when you drill into it, less dense and there is less bleeding."

With regard to prolonged oral bisphosphonate therapy, Dr. Lakha later stated, "The good news is that because the breakdown of bone is less when the drug is taken in the oral form than in its IV form, 6 months to a year after the oral bisphosphonate is stopped, it is possible for healing to begin and the condition to be reversed."

While rates of bone death (osteonecrosis of the jaw) in patients due to bisphosphonate use are low, dentists and physicians need to work collaboratively to raise awareness and increase understanding of the condition.

Dr. Herrera added, "With growing scientific support between oral health and systemic health, our view of oral health is changing. For the past decade our focus has been on beautiful smiles, now the public is learning that overall well being may not be possible without good oral health."

Following the three presentations, it was clear that the speakers agreed that it is imperative for the disciplines of medicine and dentistry, who have been worlds apart for decades, embrace a team approach to improve the health of their patients.