Here are some reasons why we provide more than just a “cleaning”.
Dentistry and Medicine have been historically separated as the doctors of these professions have had their own colleges since 1840. Although oral care remains an independent entity when it comes to health insurance, its importance in overall wellness is paramount. A mouth free of disease and discomfort keeps children in school and family members productive at work and at home. The split between medical and dental has been based on tradition rather than science.
As you know, our team takes continuing education seriously and we are constantly learning about new methods of treatment and connections between oral and systemic health. In a course I took in Seattle, Washington with the internationally known Dr. John Kois, we discussed how over 50 systemic diseases are linked to oral disease. We are able to screen for some connections by taking your blood pressure at dental visits. If your blood pressure is higher than 120/80, then you should follow up and track your readings at home and discuss further with your primary care physician. On occasion, a patient may have a blood pressure higher than 180/110, which if sustained at this dangerous level, can place one at risk for heart attack or stroke. In these unfortunate cases, we will recommend you immediately see a medical provider who can help you manage this to lower your risk, and we will reschedule your dental visit. Safety is very important to our team.
Along with routine blood pressure readings prior to your care, we have included a Mallampati score with your medical record. This gives an assessment of how much your tongue obstructs your airway. The higher the score on a 1-4 scale, the more risk that when sleeping (especially on your back), you could have lower oxygen saturation due to obstructive sleep apnea. If you snore and do not feel rested upon waking, we encourage you to discuss this further with your medical team and obtain a sleep study. Another sign that you may have sleep disturbances includes worn dentition (or shortening of your teeth) from grinding. Alternatively, this could also be from erosion, which can happen when either acid from your stomach (reflux/GERD) or acidic beverages (soda, coffee, Gatorade, juice) are frequently consumed. Being a dentist or provider of health is a bit like being a detective. There may be many elements involved in how disease and dysfunction occur. We enjoy learning more about you so that our findings can lead to providing advice and treatment to lower your risk into the future.
It is important to inform our team as soon as possible when you have had a Stroke, Heart Attack, or Joint Replacement. These medical events and/or surgeries require a waiting period before you can be seen by our office for non-urgent care. We can work closely in communication with your medical team to verify that you stay on track 6 months after these events and determine if you need to take an antibiotic prophylaxis one hour prior to dental care, and for how long.
In general, everyone’s mouth has a plethora of bacteria. Some are beneficial and some are pathogenic. Caries (cavities) and Periodontal disease (gum/bone loss) are contagious diseases, just like the common cold. The bacteria or microflora of our childhood care-providers, often our parents, is passed down to us by kissing, sharing food, etc. If your family has a lot of cavities/fillings or gum problems/missing teeth, you are likely at higher risk. We fight against this by advising you how to constantly remove bacteria in your mouth via brushing at least twice a day (including your tongue), and inter-dental care at least once a day. This includes using a C-wrap technique with string floss or small brushes in between the teeth. I am sure you have heard about this benefit from our amazing hygienists! So, the next time we are mentioning seeing bleeding or plaque/calculus, you know the reason. We are encouraging you to remove bacteria biofilm because that can decrease the risk of pre-term labor and gingivitis if pregnant; lower your hA1c for diabetics; and reduce inflammation, which is also seen in Cardiovascular and Alzheimer’s Disease. Of course, this is also aiding in reducing cavity formation and loss of bone foundation around your teeth, which will keep you smiling and eating your favorite foods!
As a “physician of the mouth” so to speak, I am glad you have taken the time to read this important information to help explain how collaborative care and managing chronic inflammatory disease can benefit your overall health! We look forward to answering your questions at your next appointment and hopefully this helps you see dentistry from a new perspective.
Sincerely,
Dr. Kristen E. Harvey, DDS, MAGD - Your Partner in Wellness