The leap between oral and systemic health may not be as great as some physicians once believed.
Is the mouth a window to patients’ health? For years, many dentists and their staff have recognized the link between their patients’ oral health and other diseases, including cardiovascular disease, diabetes, and arthritis. Today, more and more physicians are making the connection as well. In fact, one Pennsylvania-based physician, Dr. Charles Whitney, recently added dental hygienist Lisa Wadsworth to his team of medical caregivers at his practice, Revolutionary Health Services. Through education and community outreach, Whitney and Wadsworth hope to bridge the gap between medicine and dentistry and encourage collaborative care.
Dr. Whitney, who is an advocate of Third Era Medicine, which focuses on preventing illness through diagnostic testing, nutrition, exercise and collaborating with other healthcare practitioners to treat the whole patient, says Wadsworth’s clinical dental experience will help him educate patients on the threat of untreated periodontal disease to their health. Recently, Repertoire spoke with Whitney about his approach to patient care.
Repertoire: We understand you practice Third Era Medicine. Has oral healthcare been a part of your practice up to this point?
Dr. Charles Whitney: I didn’t realize the value prior to my Bale/Doneen training on heart attack and stroke prevention (an approach to cardiovascular disease prevention that includes patient education, identifying root causes of the disease and setting goals for modifying risk factors). That’s where I learned about what happens when oral bacteria enter the bloodstream, spray everywhere and influence many disease processes. Before that, all I knew was that dentists should do oral cancer screenings, and that a small handful of my patients needed antibiotics before dentists’ appointments because of diseased valves.
Repertoire: How can untreated periodontal disease impact your patients – particularly those with cardiovascular disease, diabetes and arthritis?
Dr. Whitney: I strongly believe that high-risk oral bacteria – both endodontic and periodontal – will directly cause inflammation and produce endotoxins locally at sites far distant from the mouth. The endotoxins and inflammation produced will drive many disease processes, including incurable ones like Alzheimer’s disease and pancreatic cancer. Regarding cardiovascular disease, I believe there are many risk factors building up, comparable to filling the arterial walls with gasoline. However, there will also be a small number of factors that act like a match to light the flame and cause a plaque rupture that causes a heart attack or stroke. An oral bacteremia event is clearly one of the matches!
Repertoire: In your experience, are medical schools currently addressing the oral-systemic gap?
Dr. Whitney: I think there is greater awareness among younger physicians, but I’m not sure if that’s through direct education or common sense and the press. I still see very minimal discussion about the oral-systemic connection, even among forward-thinking organizations that focus on proactive wellness.
Repertoire: What role will Lisa Wadsworth, RHD, BS, director of operations, play in your practice with regard to educating patients on the dangers of untreated periodontal disease? How will her presence change the diagnostic protocol at your practice?
Dr. Whitney: Lisa Wadsworth certainly will be [responsible for] educating my patients and our local community. I also hope to have her lead a national effort to bridge the gap between medicine and dentistry and encourage collaborative care. One problem that I frequently encounter is a patient whose medical profile suggests pathology from the oral cavity, but who is being told by their dental team that no problems exist. Blood in the sink is being tolerated at home and in the dental office, while blood inflammatory markers and saliva testing suggest the presence of high-risk oral bacteria. I believe Lisa will be very effective in leading a community and national effort to educate the consumers and health professionals alike that NO blood in the sink can be tolerated.
Repertoire: Do you expect to begin performing oral examinations in the office?
Dr. Whitney: We will not be able to diagnose oral pathology without a dentist in the office. Unfortunately for me, but fortunately for dentists, periodontal disease is a medical condition that physicians cannot treat. All I can do is suspect the diagnosis, educate [patients] and offer basic home oral care recommendations. However, we are considering having Lisa Wadsworth perform hygiene assessments, especially on patients like those described above, whose clinical profile and dental office assessments mismatch.
Repertoire: Can you tell me about your referral relationships with local-area dentists?
Dr. Whitney: It’s building gradually through a grass roots effort, as the need for collaboration arises. Although the local dental professionals are at first surprised that a physician is contacting them, they are very happy once they understand why. I’m trying to identify dental professionals who truly understand that periodontal disease is an infectious disease that needs both mechanical debridement as well as protocols to eliminate the infection.
A revolutionary approach
Bridging the oral-systemic gap calls for new ways of thinking, both on the part of dentists and physicians. Which is why Charles Whitney, M.D., owner of Revolutionary Health Services, has adopted a Third Era approach to medical practice. Rather than treating patients with a Second Era mindset, which focuses on treating symptoms of disease, he believes in empowering patients to create a personal health plan – including oral healthcare.
Through Projection Diagnostics ™, Whitney works to project his patients’ health trajectory. Third era screening includes tests such as:
- Carotid-IMT ultrasound
- Visceral fat measurement
- Oxidative stress estimate
- Blood inflammatory markers
- NT-Pro BNP
Whitney works to determine root causes of abnormal test measurements and provide each patient with a personalized health plan. Projection diagnostics not only helps determine when intervention is necessary, it informs clinicians when certain prescription medications can be avoided, according to Revolutionary Health Services. For more information, visit www.revolutionaryhealthservices.com.
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