How dentists can collaborate with physicians to bridge the oral-systemic gap

April 16, 2014

My name is Dr. Charles Whitney. I’m a physician who works closely with dental professionals to provide my patients with an optimal level of care. I know that sounds like a support group introduction, but it truly explains how I practice medicine in the simplest of terms.

I have to confess that I didn’t always think of dentists and hygienists as my strongest allies in treating patients with chronic conditions such as cardiovascular disease, diabetes, Alzheimer’s disease, etc. That’s because my oral health training in medical school consisted of one lecture.

Not only couldn’t I connect the oral-systemic dots, I didn’t know where the dots were!

 

I had my oral systemic epiphany in 2010 when I completed the training program for Bale-Doneen method of heart attack and stroke prevention. It was there that I learned the many root causes that cause vulnerable soft plaque in the arteries to rupture and cause a stroke or heart attack. Up to 85% of these events occur in completely asymptomatic small plaques that would not cause a stress test to be abnormal!

Want to guess where that vulnerable soft plaque originated? You already know the answer, but I didn’t. That newfound insight prompted me to fly home to Bucks County, Pa., and completely overhaul my practice to focus on heart attack and stroke prevention … with the help of dental professionals.

Physicians need to refer to dental professionals as we do other medical specialists. In fact, if it were not for dental professionals, I would not be able to offer this guarantee to my patients.

"If you suffer a heart attack or stroke while under my care, I will refund fees you've paid in the past year."

This is a powerful pact with great potential financial risk, because I have a direct primary care practice that charges a monthly fee for the highly personalized level of care that I provide.

Many dental professionals I meet say that they just can’t seem to connect with the medical professionals in their local communities, so they too can bridge the oral-systemic gap. It will take some effort, because this is a fairly new concept for physicians. However, here are some outreach tactics that may be helpful.

 

Start with your personal physician

The MD you know best in your community is probably the one who treats you and your family. Why not schedule a lunch meeting where you can explain some of the latest findings on the oral-systemic connection and how you can collaborate on providing an optimal level of care to your respective patients?

You can also suggest conducting a lunch-and-learn meeting at his office for the benefit of his or her team. You can download some educational tools that will help you communicate with physicians and bridge the oral-system gap on our web site, www.RevolutionaryHealthServices.com.

Dig deep into your patients’ health history

Look at your current patient medical history forms to make sure they ask questions about family history, current prescriptions, etc. Revise them if needed.

If your patient has signs of periodontal disease, connect the dots for them between that periodontal diagnosis and their risk of conditions such as cardiovascular disease, diabetes, dementia, preterm labor, arthritis, etc.

Communicate your periodontal disease finding and its inherent risk with your patient’s primary care MD or specialist. Take the opportunity to educate them on the oral disease-medical disease associations.

Step up your screening

In recent years, several screening tools have been introduced that place the dentists on the front line of systemic health. Whether it is salivary diagnostics, carotid IMT ultrasound, blood tests, or other adjunct screening tools, do not be afraid of being accused of playing doctor. You are an oral health specialist!

Here is something you need to seriously consider and take ownership of: Periodontal disease is a medical condition of the mouth that physicians can’t treat!

In addition, dentists see their patients far more frequently than their physicians. You can act as an early warning system, providing your patients’ physicians with screening results that may be of potential concern. It should be considered a professional courtesy that is in the best interest of the patient. You may find that, in turn, physicans will refer patients to you.

Develop co-management case studies

This is where I believe we can get a lot of traction. If you can demonstrate how a patient’s overall health benefitted from co-managed treatment by a like-minded dentist and physician and have it published in local and national dental and medical journals, more dental and medical clinicians will take notice.

Conclusion

These are just a few suggestions of what can be done to forge relationships with physicians and bridge the oral-systemic gap in the name of establishing a new, optimal standard of patient care. It’s all part of what I call the “Third Era of Healthcare,” the era of empowering an individual to create personal health, not just react to disease.

Please feel free to share your challenges, experiences, and suggestions on working with the medical community. Although I will not be able to answer all questions individually, I may be able to incorporate your thoughts and comments in future articles, lectures, and on social media. Send me an email at ccw@RevolutionaryHealthServices.com.