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Gastonia, North Carolina 28054

Resolutions, dental flossing, and oral inflammation. Oh, my!

The Kelly Good Luck Meal

I am a firm believer in New Year’ Resolutions (freeze) . . . I know what you are thinking! Most resolutions last a few weeks and then taper off. Almost every dentist is familiar with the cycle of, “I started flossing two days before this appointment and did it for about three weeks after.” Resolutions have become important and effective for me because I have made them a process of identifying 1) “what is going on” 2) “is this beneficial” 3) “how will it affect the future” 4) “what is a reasonable alternative” 5) “is it realistic to take on the new behavior/habit/goal” 6) “is there a way to be held accountable for this change?” At home, I make little resolutions about health, schedules, and relationships all year round. In our dental practice, the cycle and patterns of our businesses year coincide nicely with the calendar. The coming of a New Year and winter has become a time that we look inward on our practice, assess who we are and what we provide, discuss our vision, and make commitments as a team.

This year one theme we have focused on is educating our patients about the link between oral inflammation and other systemic diseases. The story about why I want to approach this more directly than ever is almost humorous. A few months ago, I was watching the movie, The Hangover. If you have seen this outrageously funny film you know that throughout the movie the character “Stu” is told by friends and other people he encounters that he isn’t really a doctor . . . he’s just a dentist. This wouldn’t have made me think so much except the next day I was reading a blog and the author said the same thing in response to their own real life experience with dental treatment. To be clear, I don’t correct kids when they call me “Mr. Kelly”, in fact I like it when my patients call me simply “Will”. I was not offended by hearing a jab at our profession twice in 24 hours, but it made me curious. What about the dental experience gives the perception that oral health is not medicine? For a few weeks I thought about it and came to two conclusions. Both have to do with the perceived value of maintaining (and perhaps investing in) optimum oral health. The first conclusion is that for some people, dentists are only providers of an emergency service. It may be related to discomfort and they rarely enjoy the benefits of the best our profession has to offer. As a dental professional, the best I can do for folks is continue to be an advocate for dental health and hope that I am heard. The second group of people that may not perceive dentistry as a true medical science make me the most curious. They are what spurred my resolution. You might be one of them, I know at one point in my life I was!

“YOU’RE TEETH LOOK GREAT!” “YOU ARE DOING SUCH A GOOD JOB, I DON’T EVEN NEED TO CHECK YOU!” “THIS IS GOING TO BE FAST BECAUSE YOU ARE PERFECT!”No wonder some patients think that dentists aren’t doctors! An appointment like this offers little value to the patient and the dental provider despite being in the presence of health does little for the patient—who knows maybe a conversation about health could save their mother’s life. No wonder these folks think of a cleaning appointment like a manicure or a haircut—it has nothing to do with health.

We try to meet patients where they are when they come to us for dental care. If they have a mouthful of cavities, sure the discussion is about cavities. Believe it or not the majority of my patients rarely, if ever, get tooth decay! So of course we talk to patients about other diseases that we prevent and treat as dentists. Naturally, patients begin to hear about gum disease or cracked teeth as it begins to be more likely for them. We have also changed many lives by acknowledging the major diseases that affect the entire chewing system in our practice’s focused CENTER FOR BITE DISEASE AND CRANIO-MANDIBULAR DISORDERS. My resolution for this year is specifically developing a focused CENTER FOR ORAL INFLAMATION in our practice for our community.

Studies that have linked oral inflammation and systemic diseases are not new, but they are finally becoming fully appreciated and understood by the whole medical community. I was very fortunate attend the Dental School in Chapel Hill and hear lectures by a pioneer researcher and theorist in this area, Dr. Steven Offenbacher. I am even more fortunate to have the periodontists in my larger team be part of this early research at UNC and continue to be advocates for reducing oral inflammation as it relates to total health.

Oral biofilm (a.k.a plaque and certain oral bacteria) is the largest cause of oral inflammation and generally oral inflammation is the number one cause of inflammation in humans. Leading cardiologists are now looking to periodontal disease as an important source of inflammation related to cardiovascular disease. The link between gum disease and diabetes is well established. It is likely that lifelong oral inflammation (rather common by the way) may present a risk factor similar to being a smoker. Wow!

So this is what you might hear me say if you come to my office with “no problems”:

“Suzie you smile looks great and your teeth are very structurally sound. Great job! You know, I wanted to talk to you about why improving how you floss and developing a few better habits at this point in your life may have a significant affect in your health as you age. . .”

-or-

“Mrs. Smith, I see that you have a new prescription here for a cardiovascular condition. I would like to talk to you about the best we can offer as dentists to help contribute to improving your overall health. Would you mind if we discussed the relationship between your heart condition and some things we are seeing in your mouth?”

When you come to see us we promise to be your “mouth doctor” (and you can still call me “Will”!). I have made a resolution to inspire those I encounter to live healthy and be a teacher of things I understand well. I am encouraging those that I meet and seek my advice to ask questions and resolve to take action on the answers. You’ve all heard the old saying, “only floss the teeth you want to keep”. Now you know a new one, “floss if you want to live longer.”

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American Dental Association           American Academy of Cosmetic Dentistry            Pankey Institute Alumni