Chronic diseases like heart disease, stroke, kidney disease, diabetes, and lung disease kill over 1 million Americans every year. Obesity was a contributing factor in over 520,000 American deaths. Rheumatoid arthritis affects 40 million Americans. Thirty million American men live with erectile dysfunction. Sixty-five million Americans have periodontal disease. Is there a link with all these conditions? Yes. The answer is chronic inflammation.
For the last 20 years, dentists have tried to demonstrate a causative link between periodontal disease and these chronic inflammatory diseases. This is another classic example of which came first: the chicken or the egg? While the answer to that question doesn’t really matter, there is no doubt that chronic inflammation is a significant issue in the healthcare world. We can do our part as dental professionals in addressing this issue by improving the evaluation and treatment of periodontal disease and educating patients on diet and lifestyle choices that can reduce their overall state of inflammation.
Earlier in my career, I viewed the health history questionnaire as an instrument to identify surgical risk. This was shortsighted. I now view the health history questionnaire as an opportunity to reinforce how important a patient’s health is to me. In order to accomplish this, I redesigned our health history questionnaire to facilitate a dialogue about health. For example, if an obese patient with diabetes is referred to our practice for an implant placement, I now have a discussion about how important diet and exercise are to their health. These conversations can be uncomfortable at first. We weren’t trained in dental school on how to have these conversations but they are so rewarding. As a result of health-based discussions with my patients, I have seen patients reduce the number of cigarettes they consume each day or quit smoking altogether. Others have now taken ownership of their diabetes and hypertension.
Patients who come to our practice seeking an implant are also motivated by a discussion about their health. As patients lose more teeth, masticatory function diminishes and patients have to look for foods that are easy to chew, like processed carbohydrates. By maintaining a greater number of teeth, patients are able to chew fresh fruits and vegetables and reduce their dependence on processed foods.
One of the challenges of having health-based discussions with our patients can be determining what type of diet we should recommend. Mounting research indicates that a diet rich in plant-based, whole foods can reduce chronic inflammation and improve long-term health 1 . Counseling patients to increase the amount of plant-based, whole foods in their diet while also decreasing their intake of sugar, processed foods and animal products will lead them in the right direction. Just like my patients, I too want to live a healthy, happy life. I also want to be authentic as I counsel my patients on their road to health. For these reasons, I personally converted to a plant-based, whole-food diet three years ago.
We all have patients in our practices who struggle with systemic health issues. As dental health professionals, we can do more than just treat their periodontal disease. We can also counsel our patients in their diet and lifestyle choices in order to address the source of chronic inflammation and help them move toward a healthier, happier life.
Dr. Christopher M. Bingham