” It’s now clear that inflammation is part of the problem in many, if not all, diseases of the body. “ excerpt from The Guardian, January 19, 2020
Over the past 10 years, the number of scientific papers per year, connecting oral health with inflammation has grown tenfold (see the following chart). Moreover, controlled studies now show bilateral causation between poor oral health and other major chronic diseases such as diabetes, COPD, hypertension, atherosclerosis and cognitive decline. A primary connection is chronic oral inflammation.
In other words, the scientific and medical argument for improving oral health is rapidly strengthening. And so is the community’s need. 4 in 10 adults past mid-life have one or more inflammatory chronic disorders, and many do not regularly visit the dental practice. This is a big opportunity.
Yet the practice of oral healthcare, and its reimbursement, remains largely unchanged and unresponsive to advances in medical science and changing community needs. Dental professionals continue to be paid for expensive restorative surgery and hygienists for cleanings, neither of which are proven effective in managing chronic oral inflammation and associated chronic diseases. Dental insurers and their benefit consultants are commonly preoccupied with spending rather than on outcomes.
So if inflammation is the next big thing, how can the oral healthcare professions and their insurers best respond? Some starting points for consideration are:
- The location of oral healthcare services needs broadening. In the past few weeks, family medicine has made a major transformation to online delivery. So why not oral healthcare too, and why not integrate into more convenient, less surgical venues such as the pharmacy and the family doctor’s office?
- If chronic oral inflammation results primarily from a shift in the bacteria in the plaque, why not manage this shift with antiseptics?
- The cost of oral healthcare and its perceptions of discomfort and pain, need assessment. The fact is that oral healthcare is by far the most expensive medical service, and not so coincidentally, the most invasive.
In short, new models of oral healthcare are needed to manage chronic oral inflammation, the next big thing.