Oral-systemic health and the role of the dental team

by Karen Davis, RDH, BSDH
[email protected]

Front office administrators, dental assistants, dentists, and dental hygienists have one thing in common: Patients will approach any of them to ask about something they just read or heard on TV regarding how the oral cavity impacts the rest of the body. They don't discriminate. We're all part of the dental team, and we all should be prepared to inform and answer questions about oral-systemic health.

There is so much information out there that it seems impossible to keep up with the latest studies, but a few resources can go a long way in keeping dental team members well informed.

• The American Academy of Periodontology's Web site, www.perio.org, is a great place for health professionals and the general public alike. A recent posting in the AAP Newsroom, "Healthy gums may lead to healthy lungs," is a sample of the types of oral-systemic updates available.
• www.PerioFrogz.com is a Web site that publishes summaries of current literature related to periodontal and systemic health complete with "implementation strategies" and patient education handouts. "Periodontal disease as a risk-marker in coronary-artery disease and chronic kidney disease" is a sample of pertinent literature available.
• www.dentalantioxidants.com is a clearinghouse for research related to antioxidants. A section of research related to oral-systemic health highlights current literature such as this article: "Link between gum inflammation and Alzheimer's."
• www.oralsystemicconnection.com is a Web site that gives an overview on the current understanding between oral and systemic health and is written in lay terms that are easy to understand. Patients wanting more information on the links between oral health and cardiovascular disease, diabetes, pulmonary health, and fetal development can link to a Web page devoted to each of these conditions.
• An emerging Web site that should prove to be powerful in providing pertinent resources for both dental and medical professionals is the one managed by the American Academy for Oral Systemic Health, www.AAOSH.org.

Your team's update

The hectic schedules in most dental practices are not conducive to team discussions throughout the day. But including an "oral-systemic update" on the agenda of regularly scheduled team meetings can allow teams to stay well informed. A brief update can be given by any member of the team. In fact, it would be beneficial to rotate the person in charge of bringing an update to share with everyone else.

If you don't have regularly scheduled team meetings, you can still rotate the monthly assignment of who shares a brief oral-systemic update via email to all other team members. Administrators, clinical assistants, dental hygienists, and dentists can all do acquisition of pertinent research. The references I listed above have easy-to-understand summaries of current literature.

The following bullets are suggestions on how team members can initiate communication to patients to help them make the connection that the oral environment can and does impact overall health.

• Front office administrators: When instructing new patients or asking existing patients to update a health history form, ask them to give current phone numbers for their general physician, internist, or any specialists. Inform patients that sometimes the dental practice will co-manage a dental condition with a physician since periodontal disease has been implicated in adverse health conditions such as diabetes, cardiovascular disease, and new studies are investigating the link with Alzheimer's disease.
• Clinical assistants: When asking patients to pre-rinse with an antimicrobial prior to dental procedures, inform them that new studies have shown that periodontal disease may increase the risk of respiratory infections due to the inhalation of pathogens. Antimicrobial rinses help reduce oral pathogens, but having healthy gums does too. Be proactive in checking the status of the patient's last dental hygiene visit before they leave. If not scheduled, offer to make their next appointment.
• Dentists: When making a restorative or esthetic diagnosis, tell the patient you want to check the current health of the gum tissue around the area requiring treatment for two reasons: 1. Active periodontal disease can have adverse effects on oral and systemic health, and you want to determine if any disease is present in the tissue or surrounding bone, which may require attention prior to additional treatment. 2. You want to ensure there is a healthy foundation to support restorative or esthetic treatment.
• Dental hygienists: When reviewing a patient's health history, look for personal or family risk factors that increase a patient's susceptibility to chronic inflammatory conditions such as diabetes and cardiovascular disease. Ask patients when their last complete physical was and remind them that reduction of risk factors through diet, exercise, stress management, and treatment of any periodontal disease has the potential to work both ways in improving oral health and overall health.

These are only a few samples of ways to engage patients in conversations that help them realize the importance that oral health has on overall health and vice versa. A great team meeting exercise is to brainstorm together various methods that members of the dental team can initiate oral systemic conversations with patients. We want to give our patients good reasons to keep coming back to our practice. Proactively informing patients about recent studies or news related to periodontal health and cardiovascular health, diabetes, respiratory diseases, pregnancy, or Alzheimer's disease reminds them that your office maintains a commitment to stay abreast of important information about their health.

Imagine the impact your patients might have if, when they return to work following their dental visit, they say something like, "Wow, you'll never believe what I learned at my dental visit today. Did you know that gum infection might increase a person's risk for Alzheimer's disease?"

Initiating discussions about oral-systemic health with your patients is an investment, so to speak, that can have many returns.

PerioTeam Takeaways

1. Teams that want to give patients reasons to keep coming back will be well informed about oral-systemic health, and pass that information on to patients.
2. Create a monthly rotation list for each team member to be involved in seeking out and sharing pertinent information with the rest of the team using resources listed in this article.
3. Brainstorm ideas on how to weave oral-systemic information into patients' dental visits so that team members are initiating that communication rather than responding to patients' questions.

Karen Davis, RDH, BSDH, is the founder of Cutting Edge Concepts, an international continuing education company, and practices dental hygiene in Dallas, Texas. She is also a trainer for the JP Institute and serves on the Review Board for Dentalantioxidants.com. Her website is www.Karendavis.net.