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Massachusetts Medical Society's Physician Focus

May 2014

Oral Health


  • Research shows that oral health and physical health are linked, and that infections in the mouth are associated with conditions such as heart disease, diabetes, and pneumonia.

  • Tooth decay is one of the most common diseases in children, according to the Centers for Disease Control.

  • Populations vulnerable to poor oral health include very young children, those with special needs, pregnant women, and the elderly.

  • Recognizing that the mouth and body are connected, physicians and dentists are collaborating for the overall health of their patients.

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Research showing the connection between poor oral health and serious medical conditions such as heart disease, stroke, diabetes, and pneumonia is prompting physicians and dentists to engage in more collaborative efforts for the overall health of their patients.

“What we’re learning,” says Hugh Silk, M.D., M.P.H., a family physician, “is that inflammation around the teeth starts to drift into the rest of the body, and the rest of the body starts to create even more inflammation. What starts off as a mouth problem becomes a full body problem. If the mouth is affecting heart attacks or diabetes, then we want physicians to know more about that.”

Adds Michael Wasserman, D.D.S., a general dentist in Pittsfield: “Everything is related. The mouth is related to the body, the body is related to the mouth. Some diabetic patients, for example, may have increased inflammation in the mouth, yet if they don’t take care of themselves, the inflammation in the mouth increases, and that relates back to how their diabetes is controlled.”

Dr. Silk, Chair of the Massachusetts Medical Society’s Committee on Oral Health and a Clinical Associate Professor at the University of Massachusetts Medical School, and Dr. Wasserman, President of the Massachusetts Dental Society, are the featured guests on the May episode of Physician Focus. With host and primary care physician Bruce Karlin, M.D., the doctors discuss the importance of oral health, its connection to physical health, and how their respective professions are working together to raise awareness of oral health.

Programs such as the Massachusetts Dental Society’s Connect the Dots between Medical and Dental Care and the establishment of the Committee on Oral Health by the Massachusetts Medical Society mark the beginning of a growing relationship between physicians and dentists.

Physicians are now being trained to examine the mouth, and efforts like the Age One program, to encourage parents to bring their children to see a dentist within six months of the eruption of their first tooth, are paying dividends.

While early efforts are showing results, the doctors recognize that improving oral health requires overcoming many barriers. Economic, cultural, and social obstacles, as well as lack of dental insurance and fear of the dentist, still prevent many from seeking care. Even transportation issues pose obstacles, especially in rural areas of the state where few dentists practice.

And Dr. Wasserman notes the important role of education. “Some people have just never been taught the importance of going to the dentist or the importance of oral health.” Good oral health, he says, is an educational process that has to start at a very young age.

From the physician’s perspective, one of the keys to success of the collaboration is teaching physicians the importance of reviewing oral health with patients. “We need physicians to give the same good advice about oral health as we do about car seats and other preventive measures,” says Dr. Silk, “because physicians see children when they’re very young before or while they’re establishing dental care.”

Despite the challenges, both doctors are enthusiastic about the collaboration. Future efforts may focus on specific areas, such oral cancer, or the impact of dental disease on emergency room usage.

As the physicians and dentists increase their cooperation, the doctors are fully aware that their patients hold the key to the success of their efforts. And their messages to them are simple and direct:

“The basics are most important,” says Dr. Silk, “brushing, flossing, and seeing the dentist twice a year.”

Adds Dr. Wasserman: “A lot of dental disease is completely preventable, and preventable in an easy way.”

View the video above for more conversation, including discussion about the most susceptible groups to poor oral health, the importance of dental insurance, how poor oral health can lead to oral cancers, the role of diet in oral health, and the benefits of fluoridation.

MMS/Richard Gulla

American Dental Association

Massachusetts Dental Society

National Institute of Dental Research

Centers for Disease Control

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"Oral health" PSA

From left, Bruce Karlin, M.D.; Hugh Silk, M.D., M.P.H.; Michael Wasserman, D.D.S.
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