dental health advice edinburgh

Holistic Dentistry- putting the mouth back into the body

On Friday 3 November Yann attended the Fellowship of General Dental Practitioners Symposium  “Holistic Dentistry- putting the mouth back into the body”. 

This was particularly interesting for us as we are a preventive practice who always approach each patient in a holistic way, looking at the whole story, aiming for great gum health, which we stress leads to better general health, and keeping intervention to a minimum so we can preserve remaining tooth as much as possible.

 

Yann Maidment Edinburgh dentist
So this was an illuminating day and built upon his knowledge. We thought it would be interesting to report on the general themes of the day.

 

More confirmation of links between oral disease and other diseases

The strength of links between oral (mouth and gum) diseases and others were explored. 

Heart disease-The common inflammatory features of a number of chronic diseases was noted including the  association  between cardiovascular (heart) disease and periodontal (gum) disease. Cardiologists are now very interested in this area- with many cardiac teams asking for periodontal assessments to be carried out and  gum health improved before  procedures such as by-pass surgery. 

 

 

Diabetes– Increases in a fair number of inflammatory initiators in people with diabetes has been shown to correspond to some of them having poor gum health and poor glycaemic control. An identifiable group with “pre-diabetes ” had intervention to control previously uncontrolled gum disease. Those just tipping into diabetes, who would be being prescribed Metformin were tipped back to diet control only —So having healthier gums can make  the difference between taking medication and not.

 

Other conditions- Fusobacterium Nuclatum is a periodontal pathogen, found in severe gum disease, which  researchers have found is associated with a type of colorectal cancer.They demonstrated that the FN population in the gut was genetically identical to that found in their mouths and that the route to the colon was via the blood. The immunologists also have worked out how the FN effectively “protects” the tumour from the body’s immune defences. (for more information, ask Yann!) 

More detail on the passage of inflammatory markers from gum disease showing up elsewhere is now causing rheumatologists  to take an interest.

 

Minimal intervention dentistry

 Minimal intervention dentistry advocates treating the patient first and trying to manage the course of the disease, leaving “treatment” as the last recourse. The first minimal intervention is to change the conditions that allowed the disease to arise in the first place. This means lifestyle change- so behaviour management , 

  • changing diet, 
  • moving to a high fluoride toothpaste,
  • brushing more often,
  • spit out but don’t rinse away the toothpaste so the fluoride has a better effect, 
  • fluoride varnish applications, 
  • tooth brushing advice tailored to the individual and their mouth,

Minimally interventive treatment is only then  deployed where matters are beyond retrieval.

 

Improving dental health

The main cause of improved dental health among children is the introduction of fluoride into toothpastes, followed by an increase in their use by children (who are now adults!) over the last 40 years. 

 

Making things last

Trevor Burke explored how long tooth restorations last  and argued for more minimal interventions in the first place, 

  •  smaller fillings last longer than larger ones.
  •  inlay/onlays  last longer than crowns 
  • non-rootfilled  teeth last better than rootfilled teeth

 

Changing methods of working

Nairn Wilson gave an impassioned plea to changing methods of working, using newer technologies and getting the whole dental team working better. 

We feel we are doing quite well on this front, and  that we will continue to work as holistically as possible.

 

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