Reuniting Dentistry and Medicine: Are We Ready to Bridge the Health Gap?

Oops! It smells like a burning haystack and sounds like a controversy here today!

The irony: it is not.

The connection between dentistry and medicine has been acknowledged throughout human history.

From ancient times, medical texts have highlighted the link between oral health and overall health. Molecular technologies have advanced at a rapid pace. We can read our DNA or that of other species at rocket speed today!

Despite significant contributions from researchers, especially since the 18th century, most dentists and doctors still overlook or are unaware of the link between oral infections and overall health.         

By spreading more knowledge about this connection, both in dentistry and medicine, we could greatly improve global health.

Bridging this gap can significantly improve global health by promoting a deeper understanding of oral infections and their systemic implications.

More From Ancient Insights on Oral Health

In ancient times, epidemics were rampant, oral health often took a backseat.

Historical texts reveal some fascinating insights!

For example, Egyptian medical records suggested that tooth extractions could improve overall health. A Middle Dynasty papyrus even linked tooth pain to women's reproductive issues.

King Ashurbanipal of Assyria’s health records indicated tooth-related pain affecting his head, arms, and feet.

Hippocrates also believed that tooth removal could treat 'rheumatism.'

These early observations show that the connection between oral health and overall health is not new.

Modern Understanding of Oral Infections

Fast forward to the 20th century, and the concept of focal infection—where local infections like those in the mouth could cause systemic diseases—began to gain attention.

In 1989, a pivotal study by Mattila et al. found a strong link between poor dental health and heart attacks, regardless of other risk factors!

This rekindled interest in how oral health affects overall health, with numerous studies exploring this connection.

Advances in Molecular Biology

The evolution of molecular biology techniques, including genomic sequencing, has revolutionized our understanding of oral microbiology.

For example:

Estimates suggest that up to 700 species can colonize the gums (subgingival biofilms).

Microarray techniques can detect up to 600 bacterial species in individual samples.        

These advances have helped us understand the complex behaviours of oral bacteria, their immunoinflammatory responses, and their roles in transient bacteremias.

Periodontal Medicine: A New Discipline

In 1996, the World Workshop in Periodontics introduced 'Periodontal Medicine' to validate how periodontal disease affects systemic diseases.

Since then, numerous studies have explored how periodontal pathogens contribute to conditions like atherosclerosis and diabetes.

The term 'biofilm' has replaced 'bacterial plaque,' reflecting a deeper understanding of oral microbial behaviour.

Oral Health's Broader Impact on Systemic Diseases

Modern studies have investigated how treating periodontal disease can improve conditions like diabetes, respiratory infections, and even pregnancy outcomes (e.g., preterm birth, low birth weight, fetal growth restriction, and preeclampsia)

Preliminary results suggest that treating periodontal disease can help improve these conditions.

Researchers are now looking at the genetic similarities in chronic diseases, including periodontal diseases and heart disease!

Challenges and Future Directions

Despite these advancements, integrating oral disease prevention into chronic disease prevention programs remains limited.

The prevalence of oral diseases and their systemic consequences continues to be underestimated worldwide.

Dental caries and periodontal disease are widespread, with dental caries being the most common chronic disease. Lack of access to dental care and high treatment costs make the problem worse, especially in developing countries.

Changing Perceptions and Public Health Integration

Thankfully, perceptions of oral health are changing!

Tooth loss is no longer seen as an inevitable part of ageing, and tooth retention is becoming more common.

In 2007, a World Health Assembly resolution called for oral health to be integrated into chronic disease prevention programs.

Health workers now deliver prevention messages about fluoride use and oral disease risk factors.

Reuniting Dentistry and Medicine: A Need of the Hour

Looking back at the historical evolution of the concept of oral infections and their systemic implications, it’s clear that modern technology has illuminated the complexities of these connections.

Yet, the gap between dentistry and medicine persists. Integrating knowledge about oral infections into medical practice and public health programs is crucial for improving both oral and overall health.

As Dr. Frank Billings noted in 1914: "Modern bacteriology and clinical research are adding day by day incontestable proof that bacterial invasion and infection of tissue is the fundamental cause of many of the systemic diseases."

Similarly, in 1930, Dr Russell envisioned a future where dentistry assumes its logical place in the medical clinic, emphasising the strategic importance of the mouth as the body’s point of entrance.

The final chapter in this story is yet to be written! And we must nurture hopes!

By uniting dentistry and medicine, we can more accurately assess the connection between oral and overall health, ultimately leading to integrated preventive programs that benefit public health worldwide.

After all, it is like a car and engine combination - isn't it?

The car has no value without the engine and the engine will operate to its full potential only when it is inside the car. Isn't it?

Would you like to guess what depicts the car and the engine?

Post inspiration: Vieira, Carolina & Caramelli, Bruno. (2009). The history of dentistry and medicine relationship: Could the mouth finally return to the body? Oral diseases. 15. 538-46. 10.1111/j.1601-0825.2009.01589.x.

A Special Thank You note to Dr Carolina L Zilli Vieira for providing me with this paper.

Dr Carolina presently works as a Research Associate and Instructor at Harvard T.H. Chan School of Public Health, Greater Boston, USA.