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Dr Charles Mayo, founder of the Mayo Clinic, said in 1934: ‘It is the little things like infected teeth and tonsils, for instance, that cause most of our serious ailments’.
In the past I have written about seeing ourselves as doctors of the oral cavity. I believe we owe it to our patients to provide them with excellent oral health treatment combined with education regarding the link between oral health problems and their general health.
Dental professionals need to ensure they are aware of the currently known links between oral health problems and general health problems, and then endeavour to educate the public about them.
It is important that dentists and our patients are aware of the following linked risk areas:
1. Periodontal disease and heart attack/stroke
2. Periodontal disease and low birth weight babies
3. Retruded mandible in snoring and sleep apnoea
4. TMJ dysfunction and chronic head and neck pain
5. Chronic bed-wetting in young children
6. Poor jaw position, ear infections and the provision of grommets.
The research into the link between periodontal disease and heart attack/stroke and low birth weight babies is ongoing and compelling.
Clearly, prevention of both heart attack/stroke and low birth weight babies is very much desired and improving gum health is essential to this. Both the general population and general medical practitioners must be made aware of the importance of regular, good dental care to improve and prevent problems.
Snoring and sleep apnoea is a growing area of concern in dentistry. In CPR a head tilt and chin lift is performed to move the lower jaw forward to improve oxygenation by opening a closed airway.
Wouldn’t it make sense then that improving the relationship of the mandible to the maxilla in the general population via functional jaw orthopaedics would improve oxygenation and thus the health of patients?
Snoring is linked to poor jaw position, enlarged tonsils and adenoids, and we need to be aware that these can lead to sleep apnoea, which can be fatal. This needs to be addressed by our profession in the first instance.
TMJ and head and neck pain with classic signs of pain on waking is a debilitating illness. Luckily this is one area where we as a profession have improved in diagnosis and treatment, but we must also educate both the public and medical profession about the problem.
Chronic bed-wetting in young children is an embarrassing and distressing condition for the sufferer. Typically by age three or four years there should be normal bladder control, with ADHD children 2.5 times more likely to wet the bed.
It has long been observed that palatal expansion, allowing forward movement of the mandible and opening the airway, improves the condition. This needs to be addressed by the dental profession and communicated to the medical profession.
Another area where improving the relationship of the mandible to the maxilla improves general health is in clearing up ear infections.
A ‘grommet’ operation improves hearing by clearing up a ‘glue’ ear. Children with deep overbites are 2.8 times more likely to have grommets placed. Many dentists have treated this problem by placing composite bands on deciduous molars to open the bite and relieve the symptoms, avoiding the necessity for general anaesthesia and surgery.
All of the topics I have mentioned in this article are possible avenues for us to follow to enhance the service we offer and improve the quality of our patients’ lives.
By doing so we develop our position from dentist as technician to physician. In my view, this will improve the public perception of the profession, and it is necessary for the leaders in dental education to embrace and provide continuing professional development in these areas.