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Modifiable Risk Factors in Periodontal and Implant Care

As more evidence emerges that oral and systemic health are linked, we are now moving into a new era where dental and medical teams need to work together for the benefit of the patient.

Effective counseling in issues - such as smoking cessation, diabetes control and general nutrition - will improve outcomes for implants and periodontal therapy. This doesn’t have to be a lengthy discussion. Evidence shows that health behaviour change can be instigated very quickly if guidance is delivered by a health professional using effective motivational techniques.

The links between oral health, atheroschlerosis, strokes and aspiration pneumonia are largely going unnoticed in teams caring for the elderly. Wider information for carers of elderly and vulnerable patients needs to be more accessible and their involvement in better oral care encouraged. The impetus for change may well come from dental teams at a local level. Increased activity, such as oral health educational visits in local communities, can significantly raise the profile of a dental practice. As many practices are happy to send a team member to give oral health advice in local schools and nurseries, it may be worth considering an expansion of this outreach service to care homes as well.

It is now essential to have good communication with medical teams to alter medication that may be having a detrimental effect, and to set up two-way referral pathways between local clinics and GP surgeries. For example, as a dental team, we would hope that GPs and diabetic teams would be able to identify when poor periodontal health is affecting the stability of the glycaemic control in a patient and refer them to us for treatment. We must, therefore, feel confident in approaching the medical team to request necessary information such as HbA1c levels, which would then enable us to work synergistically for the patients benefits. There is a letter template in the DoH document Delivering Better Oral Health. 

Should practices be asking; “Is it feasible for one of us to meet some of the local teams to discuss their concerns regarding their patients oral health and what they can do to help?” This can be a platform to encourage appropriate referrals to general dental practice and help develop guidelines on how to differentiate between general practice and hospital or specialist referral.

A multidisciplinary approach is required for the management of many health conditions and the dental team has an important role to play in this.

Author Jo Dickinson

Posted by Gemma

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