Oral Health and Systemic Health – The Great Disconnect


    • Bartold PM. Oral health and systemic health. Aust Dent J 1999;44:211.
    • The opinions expressed in this Editorial are those of the writer and do not necessarily reflect those of the Australian Dental Association.

    Many years ago, 12 years ago to be exact, I wrote an Editorial on oral health and systemic health. In that Editorial I outlined how this emerging area of interest could have the potential to impact significantly on the daily practice of dentistry. I outlined how it may become possible that systemic conditions such as cardiovascular disease, stroke, low birth weight, diabetes and probably a host of other conditions would be linked to oral health and that we would become integral in the holistic management of these diseases. As time went by, the list grew and when I last looked periodontal disease had been implicated or associated with the following conditions – listed alphabetically:

    Alzheimer's diseaseFeverMultiple sclerosis
    AnaemiaFibromyalgiaMyocardial infarction
    AtherosclerosisGastro-oesophageal Obesity
    Autoimmune disease reflux diseaseObstructive sleep
    CancerHypertension apnoea
    Chronic obstructiveInfertilityOsteoporosis
    pulmonary diseaseInflammatory bowel Pneumonia
    Colon cancer diseasePolycystic ovaries
    Crohn's diseaseIntellectual functionPre-eclampsia
    DeathLeukaemiaPremature birth
    DementiaLow birth weightPsoriasis
    DiabetesLung cancerRenal disease
    Dry mouthLupusRheumatoid arthritis 
    EndometriosisMetabolic syndrome Stroke
    Erectile dysfunctionMiscarriageStomach ulcers
    FatigueMouth cancer 

    Now that's a list! Whether all of these ‘associations’ are real or not, only time will tell. As all of these associations were emerging, so was another concept – the idea that dentists might actually have a role to play in the management of chronic diseases. We all know what happened. A programme, funded by the Federal Government, was established to attempt to deal with the oral health of those with chronic diseases. In its purest form, it was a great idea. But like all good ideas, and for a wide variety of reasons, this programme had its faults that caused it to miss the target in some cases and it is now to cease. What a pity it was not fixed rather than thrown away. For the first time dentistry was given an opportunity to play a role in general health but something happened and we have watched it disconnect. Time will tell if this is right or wrong but I know from my own experience, having to tell my patients who were being managed under this programme that all the good work we did together in getting their periodontal infection and inflammation under control has, alas, been to little avail. This has been a golden opportunity and unfortunately it seems politics got in the way and our patients have been disconnected.image