Monday, July 13, 2009

OPEN UP? Periodontal Disease-A Growing Cardiovascular Concern

OPEN UP? Periodontal Disease-A Growing Cardiovascular Concern
Posted Jun 04, 2009 at 10:56 PM, EDT by Melissa Walton-Shirley

Maybe it’s time for a little cross marketing……….between the dentist’s office and the cardiology exam room that is.

When earlier studies linked gingivitis to cardiovascular disease, we as cardiologists began to agree over small talk in doctors’ lounges or medical meetings that the finding was remotely “interesting”. I’ve even gone so far as to tell a modest number of patients staring at me from behind toothless grins that poor dental habits could be associated with heart disease. Now with the recent publication from the University of Kiel, Germany suggesting a genetic link between periodontal ills and atherosclerosis, it’s apparent that I should do more than just mention it in casual conversation.

There is one huge obstacle however. I don’t think cardiologists know much about the oropharynx. About the only time I ever look in someone’s mouth is when I’m forced to fill out that ridiculous ASA criteria prior to a cath (I know just enough to be able to check the box if I can see the Uvula). Occasionally, I inspect the soft palate for petechia in a patient with a FUO. Other than that, I’m content to listen to the carotids, check for facial asymmetry or JVD, note the thyroid and call it an HEENT exam. So, I’ve taken a little time to ask folks who are “in the know” about periodontal disease and what exactly we as cardiologists should look for. As for the cross marketing approach mentioned above, maybe dentists should place information packets on their waiting room tables informing their patients of the risk factors for coronary disease. Maybe we should approach our respective national associations about taking a more aggressive stance on campaigns for better periodontal health. It seems imperative that we join together to drive a change in our culture that would cause us to view poor dentition as not something shameful but potentially deadly. No doubt, our current economic downturn in America and the lack of universal coverage for dental insurance will continue to take its toll. Universal coverage for dental health would be another lofty goal.

From the cardiologist’s perspective, it’s time we tuck something more than just Viagra (or Lipitor) into those much coveted give-away-bags that sometimes takes so much courage to obtain. Maybe we should surprise our patients with something really practical……….. like a toothbrush, dental floss and toothpaste as well.

Comments

"Beautiful Smile brings beauty to the Beating Heart" had been my motto in recent years. It is clear now that gum infection and root canal abscess of teeth including gingivitis and pyorrhoea; apart from causing discomfort to the sufferrer, has detrimental effects on the heart. As such let us the cardiologists and our dental doctor collaegues, have a common strategy to combat Heart & Tooth Disease.
Dr. V. P. Nair, MD, FRCP, FACC. Cardiologist, Singapore,
dr.vpnair@gmail.com lordsiva@starhub.net.sg

Posted by Dr. V. P. Nair, Jun 09, 2009
Reply to this comment

For my daughter's 21st birthday, I gave her two braclets, a yoga block, a yoga tape and two packs of dental floss. She laughed. I had her to read my blogg. I hope it will be the birthday gift that will keep on giving!!
thanks for your post Dr. V.P.

Melissa Posted by Melissa, Jun 12, 2009

good and bad cholesterol