The Good Life: Health: Oral Fixation

Lou Rose is a Center City dentist who’s also a doctor — which may be why he’s extra-sensitive to how the mouth relates to the rest of the body. Years ago, while examining an obese man whose dental X-rays showed a 30 percent bone loss, Rose saw a red flag. “My instinct said it was diabetes. I urged him to see his physician, and sure enough, he was diagnosed with Type I diabetes.”

Rose was way ahead of his time. Today, more Philly dentists are tuning in to the relationship between dental and physical health. And this past winter, the American Medical Association and the American Dental Association held a major conference to report on the connection between periodontal disease and diseases of the body. Periodontal disease, which affects some 80 percent of American adults, is a bacterial infection caused by plaque, the filmy stuff that lodges in your teeth and gums when you eat. In most cases, it can be controlled by a hygienist’s deep cleaning. But left alone, periodontal disease can wreak havoc on your teeth and gums, and fuel or signal other health problems as well.

Problem 1: Diabetes
When a diabetic’s sugar levels start spiking, it may not occur to a physician that the culprit is gum disease. And yet, says Joseph Fiorellini, chairman of periodontics at Penn’s School of Dental Medicine, “We now know that diabetics who’ve had their gum disease treated with as little as one deep cleaning usually need lower doses of their medication. We also know it’s a two-way street; diabetes increases the incidence of gum infections. That’s why it’s especially important for diabetics to get regular dental care.”

Problem 2: Pregnancy
There’s also definitive evidence that women with periodontal disease are seven times more likely to have low-birth-weight, premature babies. Marjorie Jeffcoat, dean of Penn’s dental school, first noticed this connection 20 years ago. Among new mothers she’d been called to treat at a local maternity hospital, the ones who’d delivered preemies — about 12 percent of American births — were far more likely to have periodontal disease. In studies since, she’s found that just one dental cleaning during a pregnancy can cut this risk in half.

Problem 3: Osteoporosis
Other studies suggest that the mouth may be a natural place to screen for osteoporosis. Because patients on oral osteoporosis drugs have fewer mouth infections and less tooth loss, Jeffcoat is working on a computer program that will scan the dental X-rays of peri-menopausal women and assign numerical ratings according to the degree of jawbone loss; depending on their scores, they might be referred for more comprehensive diagnoses.
The eyes may metaphorically be the window to the soul, but practically speaking, the mouth is the window to the body.