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The Oral Systemic Link and the Future of Patient CareJamie Toop, DDS

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About Me…

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“I would give all my possessions for a moment in

time”WHAT ARE THE 7 LEADING CAUSES OF DEATH IN AMERICA? (according to the CDC)

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Leading Causes of Death

1. Heart Disease2. Cancer3. Chronic Lower Respiratory Diseases4. Stroke5. Accident6. Alzheimer's7. Diabetes

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WHAT DO THESE CONDITIONS HAVE IN

COMMON?Six of the top seven leading causes of death in America have been associated with conditions in the mouth.

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• https://www.youtube.com/watch?v=XLDL8NhNxWA

“The View” on Oral Systemic Link

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1. Heart Disease Associations

Research Has Shown:

• Brushing < 2x/day = ↑ risk • Gum disease → 60% ↑ risk of heart disease• Gum disease → heart disease death 2x as likely• Gum disease and cholesterol levels predictors

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Gum Disease—Heart Disease Mechanism

Infection/inflammatory components in gums• Enter blood stream• Can be carried to heart/coronary

arteries• Limits blood flow

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2. Cancer Associations

Research Has Shown:

• Gum disease → 62% ↑ risk (pancreatic/kidney)• Pancreatic cancer

• 4th leading cause of cancer-related death• Detection difficult • 5 year survival rate 21.5% if detected early• Pancreatic cancer ↑ bacteria levels in saliva

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Other Cancer Associations

Research Has Shown:

Men with gum disease • ↑ associations of gum disease and cancer • 30% ↑ risk to develop cancers of the blood• ↑ risk of prostate cancer• ↑ level of prostate-specific antigen secretion• Saliva test in development may detect sooner

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3. Chronic Lower Respiratory AssociationsResearch Has Shown:

•Oral cavity may play central role•Relationship between oral hygiene and COPD•Gum disease bacteria can be aspirated in lungs•Respiratory pathogens can colonize in teeth

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4. Stroke Association

Research Has Shown:

• Gum disease →3x ↑ likelihood to die from stroke• Severe gum disease 4.5x ↑ risk of stroke • Correlation ↑ in men and in those under 60• Gum disease bacteria enters blood stream

• Plaques form, can dislodge and enter brain

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5. Alzheimer’s (AD) AssociationResearch Has Shown:

• AD irreversible - prevention key• Declines in oral hygiene shown in AD patients• Loss of teeth from gum disease ↑ AD risk• Gum disease bacteria enters blood stream

• Can cause neuroinflammation• Limits neurotransmitter activity

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6. Diabetes Association

Research Has Shown:

• Diabetics with gum disease 3.2x ↑ risk of death• Diabetic control ↑ with improved oral hygiene• Infection/inflammatory components move in blood• More research to establish causal relationship

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Causal vs. Correlative Relationship of Oral/Systemic Link

Can we establish a causal relationship?

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GINGIVITIS—MATH AND VERBAL RECALL ASSOCIATIONAccording to webmd.com, using antimicrobial mouthwash or toothpaste can make you less bad at math.

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LET’S DO SOME “CALCULUS”

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• Pick a number between 1 and 10 (though this will work with any number)

• Double it• Add 10• Divide by 2• Subtract your original number

WHAT NUMBER DO YOU HAVE?

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IF YOU DON’T HAVE…

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WHAT TO WATCH OUT FOR…

• Credibility of the publication• Parameters of the study• Repeatability

• Be careful to throw out what you know is true

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Erectile Dysfunction (ED)

Research Has Shown:

• Men in 30s with gum disease 3x ↑ risk of ED• Infection/inflammatory components in gums

• Travels in blood stream, forms plaques• Limits blood flow• Can cause impotence - blood vessel damage

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Pre-term Birth

Research Has Shown:

• Mothers with gum disease • 85% chance pre-term/low birth weight • Gingivitis 3x ↑ risk • Moderate gum disease 8x ↑risk• Oral bacteria in pre-term placentas

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Oral Systemic Link and the Future of Patient Care

• More research to establish causal relationships

• Draw conclusions from existing data• Detection/prevention of disease far from

oral cavity• Nothing to lose in treating gum disease

•Eliminating can ↑ life by 6.5 years!

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So, tell your patients to:

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Then, tell them to:

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And finally, tell them: