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Dental Update for Medical Practitioners
Dear Colleague,
Our practice, located on White Horse Pike for over twenty years, has
produced a newsletter for our family of patients on a regular basis. We
pride ourselves on the quality of services we provide, in the tradition
of the finer Center City practices, and practice preventive, esthetic
dentistry with an accent on patient comfort. Periodontics, the preservation
of the bone and gum which supports the teeth is the foundation of our
dental education. Since 1981, we have had a periodontist in our office,
maintaining our patients' high level of dental health. With recent research pointing towards a link between periodontal disease
and medical conditions (diabetes, cardiovascular disease - heart attack
and stroke), it would be evident that we have been practicing preventive
medicine as well. We recently published an article for our patients entitled
"Floss, or Die!" A substantial portion of our patients are in the medical
field, and felt that the dissemination of this information to physicians
and medical staffs in the area was essential.
Consequently, the idea for this "Dental Update for Medical Practitioners"
was born. I invite you to share the information provided with your staff
and patients. Our entire staff will always be there for you to discuss
any of the items presented here by calling us at 856 528-3464, or by
fax
at 856 546-2993, or by e-mail
at care@cent4dent.com.
In addition to information about the links between periodontal disease
and cardiovascular and diabetic problems, I plan to cover (in as succinct
a manner as the length of this update will allow) some other aspects
of dentistry that are relevant to the practice of medicine including:
managed
care - how we have kept our practice totally free of alliances with any
HMO, and how we have educated our patients to the pitfalls of managed
care. We will be announcing a program to help turn the medical profession
around.
Snoring
- how we can help your patients and their spouses get a good night's
sleep
My buddy Dr. Tom Hedge presents Oral Obstructive Sleep Apnea Appliances
Mercury toxicity
- what we are doing to lessen the effects on our patients, and on
the environment
Instant orthodontics
- bonding has totally revolutionized the practice of dentistry - view
some amazing cosmetic makeovers achieved with porcelain
Nutritional
supplementation
- we can show you a way to develop healthier patients,
and an additional center of income
A recent study presented at the American Association for the Advancement
of Science meeting suggests that the bacteria present in gum disease may
trigger blood clots which can contribute to a heart attack or stroke. Gum disease, also known as periodontal disease, is one of the most common
infections - often more prevalent than the common cold. Common signs of
gum disease include bleeding gums, red or inflamed gums, or, obviously,
pus between the teeth. The tonicity of the tissue should be tight, pink,
and stippled. Left untreated, this chronic infection can destroy the bone
that supports the teeth and may lead to tooth loss.
The National Institutes of Health recently approved a grant of $1.3 million
to further study the link between periodontal (gum) disease and cardiovascular
disease. This funding will support the most comprehensive research to
date to define the link between these two diseases. According to the grant
recipient, Dr. Robert Genco, Distinguished Professor and Chairman at State
University of New York at Buffalo and Editor of the Journal of Periodontology,
emerging research has identified infection and inflammation caused by
periodontal disease as significantly increasing the risk for coronary
heart disease. Supporting one of Genco's theories, a recent study in the
New England Journal of Medicine found that men with high levels of a marker
for inflammation are at an increased risk for a heart attack.
Periodontal Disease and Diabetes
Past studies have correlated Insulin Dependent Diabetes Mellitus (IDDM)
with periodontal disease and vice versa. Changes in the micro-circulation
of a diabetic patient can either block or delay the normal immune response
within periodontal tissues.
Compromised circulation will reduce cell level oxygen supply, interfere
with metabolic waste removal and leukocyte migration into the area. As
a result, tissue repair and regeneration may be hindered. From the other
side, periodontal infection may actually result in resistance to insulin,
thus increasing needed insulin dosages. Control of periodontal infection
has resulted in lowered insulin requirements for diabetic patients. Naturally, we will appreciate the referrals of any patients you screen
as requiring a periodontal consultation, or as a result of visual symptoms
or of your suspicions based on breath odor. (Firatli, E. : The Relationship Between Clinical Periodontal Status and
Insulin-Dependent Diabetes Mellitus. results After 5 Years. J of Periodontology
68: 136, 1997 )
Educating your patients about the pitfalls of managed care.
I wore my Just Say No to HMO T-shirt while taking a long walk on the
beach. I was stopped more than 10 times by people who wanted to know
where
to get one. In fact, wherever I go, if I am wearing that shirt, people
want to talk to me.
Most are MD's or hospital personnel frustrated with
the system. Some
are patients with horror stories to tell. The tide of public sentiment
has turned 180º. In the beginning everyone thought the MD's were
making too much money. Did you see "As Good As It Gets?" I realized that
my crusade against managed care had reached fruition when Helen Hunt
received
a loud cheering round of applause when she said the words you've all
been saying for too many years:
"Goddamned HMO Bastards!"
So what can be done? Check out the Web site's managed
care page, and the links. There is a new movie being produced
as we speak, tentatively titled "Roswell
and Alistair." It is a satire of the managed care system, and
was written by two MD's.
I became aware of it when I received an e-mail this week announcing that
the movie's website was now linked to mine (with advice to be sure to
check out the link between the 3 Stooges and Mangled
Care which I offer), and praising me for my
work to limit the incursion of M.C. into my practice. Something needs to be done to reverse the trends in medical insurance. Come to the open house, and I will be offering-up a program to first turn
things around in our area, and then to use it as a pilot program to be
modeled in other areas of the country.
Vis-à-vis Snoring
Having personally been through a sleep study, and being told that I don't
have sleep apnea, and that I was a candidate for palato-uvuloplasty, I
sought a non-surgical remedy. What I have discovered is a dental appliance
called Silent Nite. It positions
the mandible downward and forward to increase airway space, and. . .it works!!!
My wife and I sleep in the same bed again. We will have one displayed
at the Open House, and welcome your referrals of patients who want to
sleep with their wives, but don't want to go through surgery to do so. Try this yourself: Bring your lower jaw forward so that the front teeth
are edge-to-edge. Now open about 1/2 inch from this position. Try to make
a snoring sound. You shouldn't be able to do so.
The battle has been raging in dentistry for almost 150 years, since amalgam
fillings containing mercury were introduced. In fact, did you know that
the expression "quack" is derived from the German for mercury - quacksolder?
It's what the anti-amalgamists called the pro-amalgamists. Many foreign governments have banned the use mercury in fillings. The
A.D.A. tells us it's still safe to use in American's mouths. For the past
10 years I have preferred to err on the side of caution, until definitive
studies are produced that show that mercury has no cytotoxic effects. Alternative materials include composite resin, porcelain, and gold. We have taken things a few steps further. Recognizing the potential for
environmental contamination, our new office has been equipped with a special
filtration system, which removes all mercury from the effluent water,
before going out to the sewer system. Our concern is also for the patient. When old fillings are removed, a slurry of mercury is created in the mouth. To prevent the sublingual uptake of mercury and its vapors, we strive
to use a rubber dam where and whenever possible to prevent that possibility.
In Conclusion
This newsletter, and the Web site are all self-produced on a PC. If
you would like to learn more, just ask. I look forward to meeting you.
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