Dentistry has long operated alongside mainstream medicine, considered a stand-alone specialty, however, contemporary medicine is starting to recognize the importance of a more integrated approach. Just as the mouth is not a separate entity from the body, oral health issues cannot be considered localized and unrelated to overall systemic health. Multiple research studies point to unequivocal relationships between disease, bacterial infection, and inflammation in the mouth, to heart disease, rheumatoid arthritis, diabetes, inflammatory bowel disease and various cancers.(i)
Conversely, some of these conditions, such as diabetes, also predispose a patient to oral health issues like periodontal disease.(ii) In fact, the World Health Organization now recommends that oral disease prevention should be integrated with chronic disease prevention.(iii)
It is not hyperbole to state that what your hygienist notices in a patient’s mouth may prevent serious health complications, or even save someone’s life. An experience of mine was with a patient I’ll call Elaine. I started Elaine’s hygiene appointment by taking her blood pressure, a routine practice. Her blood pressure was elevated, which concerned me. As we reviewed her health history, Elaine claimed there had not been any changes. However, as I probed a little deeper, she shared that she was exhausted and felt like she couldn’t get enough rest. Moving on with her hygiene check, I noticed her gums were very red and inflamed, and her saliva was sticky and ropey. Combined with her high blood pressure and fatigue, her symptoms indicated that something was not right. I proceeded to do a non-fasting glucose test, which returned a reading over 300. I referred Elaine to her physician, who diagnosed her with type 2 diabetes. Luckily we caught it early enough to avoid serious complications.
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It’s time for dental practices to shift from simply saving teeth to saving lives, and your hygienist is positioned to help you drive that transformation. Dr. Charles Whitney, a primary care provider who actively encourages doctors to partner closely with their dental colleagues, said, “When you present the problem through the lens of it being a medical disease, and your patients understand the impact the health of their mouth can have on the risk of some devastating diseases, your patient smay be more accepting of your treatment plan and more compliant with your hygienist’s home hygiene recommendations.”(iv)
My experience with Elaine changed the way I practice hygiene. I ask different questions now, and consider the broader impact of what I see during routine cleanings. I am researching the oral-systemic health connection and I’m taking continuing education so that I’m equipped to better serve my patients as whole human beings, not just disembodied mouths. On a personal level, this shift has increased my sense of purpose and job satisfaction, and has bolstered my engagement and contribution to the practice overall. That in itself is no small thing. In 2014, a survey in RDH magazine indicated that half of the participants were already burned out or could see it happening in the next five years.(v) Improved engagement and purpose on the job for your hygienist can help counter that, and contribute to your practice’s bottom line by reducing turnover and other negative effects of burnout.
The profession of dental hygienist is evolving and practice owners can get behind this evolution by encouraging CE and coaching to growing the hygienist’s medical knowledge as well as his or her patient advocacy skills. By investing in your hygienist, you not only improve the morale in the practice, but you also boost patient loyalty and treatment compliance. Dentistry is no longer a stand-alone profession, but an integral part of the move toward a more holistic, wellness-based approach to patient care. Getting ahead of that curve will help your bottom line, and it might just save some lives.
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REFERENCES
i. “The Mouth, the Oral Microbiome, and Systemic Inflammation” by Cass Nelson-Dooley, MS © 2016 Institute for Functional Medicine. - See more at: www.functionalmedicine.org/home/Focus_On/oral_microbiome/#sthash.Fbg3bodb.dpuf.
ii. “Periodontal disease and diabetes -Review of the literature” - Bascones-Martinez A1, Matesanz-Perez P, Escribano-Bermejo M, González-Moles MÁ, Bascones-Ilundain J, Meurman JH. In Med Oral Patol Oral Cir Bucal. 2011 Sep 1;16(6):e722-9. – See more at: www.medicinaoral.com/pubmed/medoralv16_i6_p722.pdf.
iii. Petersen PE. World Health Organization global policy for improvement of oral health--World Health Assembly 2007. Intl Dent J. 2008;58(3):115-121 - See more at: www.functionalmedicine.org/home/Focus_On/oral_microbiome/#sthash.Fbg3bodb.dpuf.
iv. “Enough talk about the oral-systemic link: It's time to bridge the gap between dentistry and medicine” By Charles Whitney, MD on DentistryIQ – See more at: www.dentistryiq.com/articles/2014/01/enough-talk-about-the-oral-systemic-link-its-time-to-bridge-the-gap-between-dentistry-and-medicine.html.
v. “How to avoid burnout as a dental hygienist” by Diana Macri, RDH in Dentistry IQ – See more at: www.dentistryiq.com/articles/2014/07/rdhgrad-how-to-avoid-burnout.html.
