The Oral Connection

The mouth is, was, and forever will be part of the body. The old model in traditional medicine of treating symptoms and body parts in isolation is flawed. Pioneers in functional medicine like Dr. Mark Hyman, Dr. Mike Roisen, Dr. Axe, Dr. Fuhrman, Dr. Amy Doneen, Dr. Brad Bale, and a host of others are leading the charge in functional medicine. They do not ask questions like “what do we have,” but rather “why do we have it”. They understand that the body parts and organ systems are connected via the bloodstream, the lymphatic system, the endocrine system, the gastrointestinal system, the nervous system, 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 potent one.

In order to get to the basis of inflammation, which is a key driver of metabolic syndrome, one must address all sources of inflammation in the body. The most common site of 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 treated. For instance, evidence suggests that “periodontal changes are the first clinical manifestation of diabetes,” and “evidence indicates that periodontitis is a significant risk factor for poor glycemic control” (these quotes are from Relationship Between Oral Health and Diabetes Mellitus, October 2008, Lamster Et al.). In clinical practice, we are guilty of overlooking a host of other oral signs of diabetes beyond gingival/periodontal changes, such as salivary dysfunction, candidiasis, taste interference, neurosensory disorders, and oral infections. Enamel changes are often the first clinical manifestation of silent reflux.

Periodontal pathogens and the subsequent inflammatory mediators go off site throughout the entire body as is referenced in a variety of scientific, peer-reviewed literature. The consequences of periodontal disease are widespread and often devastating. To ignore this premise and the emerging research is putting our patient’s health and possibly their lives at risk. Therefore, it is up to all of us as healthcare providers to look for the signs and document changes, then be able to communicate those findings with patients. The mouth is the very best arena to identify physical risk factors for obstructive sleep apnea, Xerostomia from polypharmacology influences, caries, erosion, chronic gingival inflammation and Candidiasis. Food sensitivities and allergies often show mucogingival manifestations before G.I. disturbances such as pain, bloating, diarrhea, or constipation and you must be looking for those risk factors on 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. Every scientist has shown data that if we don’t treat underlying inflammation, we will not have long term successful outcomes of systemic disease.

This is a profound time in healthcare reform and it’s important not only to get informed on the latest knowledge and facts regarding oral systemic health but to know what to look for and help your patients understand their role in treating and preventing disease.

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