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

In 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.



Peninsula Institute for Advanced Dental Studies (PIADS), a
Multidisciplinary Study Group, has been a forum for the introduction of
state-of-the-art techniques and important updates on current methods. For
more information, visit: piads,
endocrinemetabolic, cmhperiodontics.


Peninsula Institute for Advanced Dental Studies

piads