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Best Kept Secret!
After the on/off/on/off evidence base for connecting periodontal health with the risk of heart disease and diabetes a new study has come down in favour of a strong link. The research looked at almost 350,000 patients with gum disease and discovered that after treatment hospital admissions were reduced for those with diabetes and heart problems. (M. Jeffcoat et al. Periodontal Therapy Improves Outcomes in Systemic Conditions: Insurance Claims Evidence).
Not surprisingly, in view of the title of the study, this was driven by cost savings in the American health care system. For instance, it found a 40.9 per cent reduction in cost of treatment for strokes simply by giving people at risk ongoing Periodontal treatment and Oral Hygiene Instruction. Quite impressive.
This is another confirmation of the link between Oral Health and General Health. There is strong evidence for informing patients that poor oral hygiene can place them at a higher risk of both heart disease and diabetes, as well as complications during pregnancy.
So why don’t we tell people?
The answer to this question is mostly because we are not in the habit of linking what we do to the whole person. There is a greater responsibility for providing ‘holistic’ care and this has been highlighted in the most recent Standards issued by the General Dental Council. If we are not doing this, we are –
- Not practicing to the standard expected through our professional registration.
- Letting patients down by not giving them important information.
- Ignoring a good fact for inspiring motivation in self care.
- Failing to achieve informed consent for even simple periodontal care.
We are also ruled by that Master of all of us – time. The pressure to keep appointments short is always there and superfluous chatter is kept to a minimum. However, place yourself in the position of the patient and analyse how you would feel if a dentist knew something that could help to protect us from a heart attack but failed to illuminate us!
Re-write the script
Recent research by the British Dental Health Foundation revealed that almost four in five (79 per cent) people thought strokes could not result from poor oral health. Only heart problems registered with those questioned, as two in five people (40 per cent) thought they could be brought on by poor oral health.
We need to re-examine our basic script and work out how we can add in this information. It would be so much easier if 100 per cent of people attending a dentist were to know about this link. It doesn’t need to be anything dramatic, just enough for patients to understand that they could do themselves a favour by looking after their gums.
Dr John Shapter – QCS Expert Dental Contributor