Prevention & Wellness: Patient Education in the Oral-Systemic Practice
As dental health practitioners, we often see patients at their dental visits who assume that their mouths are healthy because they don’t feel any pain; and yet, upon examination and testing discover that they have severe oral infection and disease. The truth is that how healthy you are can be a tricky question in the absence of physical pain or symptoms.
The Importance of Prevention
Chronic inflammation is a multi-factorial disease. As dental health professionals, our goal should be to help our patients steer clear of periodontal disease by educating them about the dangers of periodontal disease and assisting them in taking active steps to improve their oral health (and thus their overall health), so that they may live long, active, disease-free lives.
This includes utilizing predictable assessment tools such as salivary testing to help guide individual patient treatment.
When Prevention is Too Late
Unfortunately, some patients come into the office already suffering from periodontal disease, and the prevention conversation comes too late. In that case, it is our job as dental healthcare professionals to not only treat the disease, but also give the patient education and actionable steps they need to keep it from significantly impacting their overall health.
Step #1 Destroying the Bacteria
In order to prevent the unhealthy live bacteria from entering your bloodstream, we must first render them useless by killing them. This may be accomplished by the use of periodontal gel trays, lasers, antibiotics or a combination of antimicrobial therapies.
Step #2 Removing the Bacteria
By carefully cleaning the root surfaces of the teeth, (deep scaling, root planing) the gum tissue may regain health and grasp onto the now clean root services. The result is a decrease in the gum pocket and the restoration of healthy gum tissue connection to the teeth where bacteria cannot thrive.
Step #3 Keeping the Bacteria away—Mounting the Defense
Effective Home Care
Effective home care strategies are the first line of defense. The use of a power toothbrush has been shown to be much more effective than manual brushing. Regular daily flossing to remove the thin layer of plaque that develops between the teeth is essential and the use of an oral irrigator to flush out bacteria from within the gum space best cleans deeper gum pockets. One such irrigator uses ionic energy to help keep plaque bacteria from adhering to the tooth surfaces. Using a mouth rinse with a neutral pH may also hinder bacterial growth and is proven effective in reducing volatile sulfur compounds that cause bad breath.
pH Balance
The second line of defense is education of the patient to the nutritional and environmental component of proper pH balance in the mouth. The pH of the mouth is regulated by saliva, which has a mean pH of 6.75–7.25. For healthy bacteria to grow, the mouth must maintain its neutral pH by being bathed in saliva. Shifts in the proportions of bacteria within the dental plaque from healthy to unhealthy occur following fluctuations in environmental pH. For patients that have risk factors leading to a bacterial imbalance, targeted pH neutralizing dental products used daily can greatly aid in preventing a bacterial shift in their oral biofilm. This is would be particularly important for individuals that present with risk factors such as use of prescription medications, restricted diet or salivary issues. It is always better to prevent the bacterial shift from healthy to unhealthy in the first place than to try to reverse it after the alteration has taken place.
Nutrition & Supplementation
Next is the education to the role that dietary intake and supplementation plays in fending off inflammation. Research points to a specific dietary intake that play an important role in reducing inflammation, namely supporting your body with an abundance of plant based foods, and incorporating fish and olive oil. This is commonly referred to as the Mediterranean diet.
Antioxidant levels in the body are important to counteract and fend off free radicals produced by the inflammatory process. Nutritional antioxidant supplementation while undergoing periodontal treatment has been shown to improve gum tissue attachment, decrease bleeding, and produce overall better outcomes.
In the oral-systemic community, we know that risk of chronic systemic disease can be reduced by regular dental evaluations by an oral health specialist who understands the mouth-body connection. We also know that the oral condition does not exist inside a vacuum and is impacted by many modifiable environmental and lifestyle factors.
It is our job to stay abreast of the latest advances in oral-systemic healthcare and to work to prevent and/or mitigate the effects of periodontal disease through wellness-based patient education.