The physician and oral health

“ If balance is symbiosis then the loss of balance is dysbiosis… you can call it disease. Asthma, obesity, rheumatoid arthritis, colitis, even depression and autism, can be understood in terms more familiar to ecologists than doctors. “

This is an excerpt from a recent opinion letter published in the British Medical Journal, January 14, 2019. It was written by a physician who understands that the vast populations of microbes in the human body play a vital role in the onset and management of chronic diseases.

This physician-author failed to mention poor oral health as a chronic disease resulting from dysbiosis. Physicians tend to ignore oral health even though poor oral health is the most common chronic disease, is the most expensive chronic disease, and is increasingly inter-related with other chronic disorders. Silos and traditions between dentistry and medicine are hard to overcome.

But overcome we must. Because those with poor oral health are most commonly found in the physician’s waiting room, not the dentist’s. Older diabetics with inflamed gums and/or recurrent root decay often don’t seek dental services because of habit, cost, anxiety, inconvenience or other reasons. But they do visit the physician regularly and under the right circumstances, will learn about their oral health and pursue more preventive oral healthcare at much less cost.

Expecting these high risk older adults to visit the dentist is unrealistic. But integrating preventive oral health services while visiting the doctor, is entirely realistic. And consequential too. Studies show that that those with periodontal disease spend much more on hospital and ER services and on medication than those who have good oral health.