Dr. John Sorrentino D.M.D

Family and Cosmetic Dentistry

1009 New York 82 Hopewell Junction, NY 12533
845 226 4100
845 226 3897

The Oral Systemic Link is Inflammation

Dentistry has many different treatment options and adjunct services but at the end of the day we are charged with treating three major conditions. Malocclusions, or crooked teeth; tooth decay, sometimes called caries; and periodontal or gum disease. With much of our profession researched based as you might imagine there is a huge volume of dental literature being produced every month. One of the hottest topics, especially in the periodontal literature is on something called the “Oral-Systemic Link,” or as I like to call it dentistry looking for more things to do. There are two things going on here. First is that dentists are trained separately from physicians and do not like to have what they do to be looked at in isolation. Most of us do not work in hospitals and even our insurance, medication use, and billing practices are different than the medical model. The fact that the mouth is connected to the rest of the body and that these systems interact and what happens in one part may affect other parts. The second is that if we can show a link between say diabetes or cardiovascular disease and periodontal disease or tooth decay we may be able to do something about it.
As you know all non-contagious chronic diseases (NCCD) can be linked in one way or another to the inflammatory response in the body. Even tooth decay demonstrates this link. This is why if you are diabetic it is important to monitor your A1c as it is a marker of inflammation as well as control your sugar intake, the cause of it.
Finding a connection and eliminating disease are noble goals but it seems some of our researchers have gone off the rails. For example, I have even seen articles showing routine dental x-rays that show narrowing of the carotid arteries and concluding that we should look for such things on a routine basis.   Here is another with some pretty good photos. While if I see such a thing I would make a referral but examining for and diagnosing such things would expose many patients to unnecessary radiation and are beyond the scope of dental training. They do not seem to understand that the inflammatory process is the problem and are spending a lot of time and financial resources looking for a link that does not exist.
toothAnatomy

What is periodontal disease? It is the disease that affect the supporting structures of the tooth such as the gum tissue and bone. In order for the disease to take hold the first thing that has to happen is they become inflamed. This initiates the immune response that tries to move the gum tissue away from the source of inflammation, thus receding gums. While other systemic factors are involved it is a LOCALIZED inflammation in the mouth. This is why dentistry is so big on oral hygiene, if you remove the inflammation, you remove the disease. Where you have inappropriate inflammation you have disease. Removing the dental plaque, the source of the inflammation, will make things better and may even resolve the situation but it will not do anything for inflammation in other parts of your body. Such as that caused by glycation or repetitive use trauma.
It is not a stretch to say that poor diets and poor lifestyle choices tend to run together. People who do not take care of their teeth can certainly correlate with people who do not eat well or control other stressors in their lives. One of the foremost rules of science is that correlation does not prove causation. While it is clear that the problem is inflammation the causes can be completely different and trying to link them can be an exercise in futility.

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Dr. John Sorrentino D.M.D

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