Today, we’re going to talk about the health epidemics currently affecting the United States. There are three or four of great significance, and they directly relate to dentistry.

The Epidemic of Obesity

The level of obesity in the United States today is over 40%, reaching 42% as of the year 2000. Less than 25 years ago, obesity levels were only 30%, marking a significant increase. This epidemic impacts not only adults but also young people.

The leading causes of obesity are changes in lifestyle, particularly diet and lack of exercise. Most notably, it’s driven by diet, including the consumption of simple sugars and fast food.

The Coupled Epidemic of Diabetes

Alongside obesity, we’re seeing an epidemic of diabetes, particularly type 2 diabetes, at levels previously unheard of. Greater than one out of every 10 people you meet on the street is now diabetic. This rise in diabetes, coupled with obesity, has led to another major problem: an increase in inflammatory markers and atherosclerotic plaques, which cause coronary artery disease.

Coronary Artery Disease: The Leading Cause of Death

Coronary artery disease, or heart disease, is the leading cause of death in the United States for adults. These three issues—obesity, diabetes, and coronary artery disease—are deeply interconnected.

The Epidemic in the Oral Cavity

In addition to these systemic health issues, there is an epidemic within the oral cavity: periodontal disease. It’s the sixth most common infection in the world. In the United States, one out of every two people has some form of periodontal disease. For individuals over the age of 60, the likelihood of having undiagnosed periodontal disease is close to 70%.

The Interplay Between Oral and Systemic Health

There is a strong relationship between inflammatory markers in the mouth and those in the blood. This connection can lead to systemic problems, including atherosclerotic plaques. For example, research from Sweden has identified certain bacteria, such as Bacteroides, in blood vessel plaques. These findings suggest a potential link to conditions like dementia, although this is not yet fully proven.

The Concordia Study: Evidence Supporting Periodontal Treatment

An interesting study by Concordia, a large insurance company, examined over 60,000 patients. They studied the effects of treating periodontal disease on other systemic diseases, including coronary artery disease, diabetes, and stroke.

The study divided participants into two groups: one received scaling and root planing, while the other did not. Over the following year, the group that underwent scaling and root planing saw a decrease in hospitalizations for these systemic diseases. This evidence indicates that treating periodontal disease not only improves oral health but also benefits systemic health and reduces healthcare costs.

The Role of Dentists in Treating Periodontal Disease

So, why don’t insurance companies universally cover scaling and root planing if it can yield such benefits? The research suggests that periodontal treatment can improve systemic health and save money for patients and insurers. However, less than 10% of all dental insurance claims are for periodontal treatment, even though the prevalence of periodontal disease is alarmingly high among older adults.

Dentists can play a pivotal role in addressing this issue by performing comprehensive examinations, diagnosing periodontal problems, and educating patients. Many patients are willing to undergo treatment, such as scaling and root planing, when they understand the risks and benefits.

Fixing the “Leaky Roof” of Dental Health

I often compare treating periodontal disease to fixing a leaky roof. If you address the problem early, you prevent it from escalating into a much larger issue. With proper care, such as brushing, flossing, and regular cleanings, patients can prevent decay and periodontal disease altogether.

We’ve known the importance of good oral hygiene for over 50 years, yet periodontal disease remains undertreated. This is often due to habit—we aren’t in the habit of treating it until it becomes severe. However, as dentists, it’s our responsibility to educate and treat patients proactively.

The Wisdom of Past Mentors

Bob Barkley, a renowned dentist who passed away in 1974, emphasized the importance of patient education. He charged his patients $10 per visit to teach them how to brush and floss effectively. His approach ensured better oral hygiene, improved treatment outcomes, and greater patient value.

Barkley’s philosophy resonates today: “The goal of dentistry is to make patients worse at the slowest possible rate.” While tongue-in-cheek, his point highlights the need for preventative care and education.

A Call to Action for Dentists

If we don’t address the epidemic of periodontal disease, who will? It’s our responsibility as dental professionals to educate and treat patients, improving their oral and systemic health. By doing so, we can truly be a gift to those who trust us with their care.

Let’s take this responsibility seriously and be the gift to our patients. Remember: small actions in dentistry can lead to significant, life-changing outcomes.