Dental practices, especially those committed to oral systemic
health, are uniquely positioned to improve the health of
America. Your patients and community, as well as your professional
referral network, all benefit when your practice adopts a
third-era model to enhance both physical and fiscal health.
Periodontal infection, whether inflammation is present, has
been associated with an impressive (and growing) number of
systemic conditions and diseases including: diabetes and pre-diabetes,
hypertension, heart attack, stroke, stillbirth, pre-term labor
and high blood pressure. Until insulin resistance is addressed and
treated, it is difficult to eradicate this infection.
Insulin resistance raises blood sugar and, eventually, might
lead to diabetes. Evidence suggests that a skilled hygienist can
administer expert therapy and yet, until glucose metabolism is
normalized, be unable to eliminate infection and inflammation.
Dietary and other health choices leading to obesity and preobesity
are the main causes of most insulin resistance (Fig. 1). In
fact, they are the mother and father of many preventable systemic
diseases.
Curing obesity can cure insulin resistance and prevent diabetes.
It also leads to greater success with eradicating periodontal
infection and inflammation. Few will argue with the goal and
benefit of achieving a healthy weight. The question for many
remains how to do it.
Physicians continue to react to diseases by prescribing medication
for high blood pressure, hypertension and diabetes.
Once a person is diagnosed with diabetes, there has been a significant
destruction or disabling of insulin-producing beta cells
in the pancreas.1
The medical community remains ineffective at treating
insulin resistance because most physicians lack the time and
ability to effectively treat obesity. In fact, 79 percent of primary
care physicians have never been trained to counsel a patient
about obesity.2 Patients are simply asked to eat less and move
more. Of equal concern, talking about obesity has become a
taboo subject to broach with many patients.
Fortunately, it is a simple matter to acquire and master the
verbal skills to incorporate this conversation into your patient
treatment protocol. Here is an example of a script to introduce
health coaching to a patient.
Doctor: As you know, our practice has made a commitment to
helping our patients achieve total health and wellness for themselves
and those they care about.
We’ve known for some time that it’s difficult to treat gum
inflammation in the presence of high blood sugar levels, and gum
inflammation can increase the risk of many systemic diseases such
as heart attack and stroke.
True Health is a solution to help patients reach and maintain
a healthy weight. Everyone gets a personal coach to guide them
through the program. It’s cost-neutral, safe, surprisingly easy and
highly effective. Would you like to learn more about it?
The graph3 (Fig. 2) illustrates the typical health path. People
are, for the most part, born healthy. Between birth and death,
we are either healthy, sick or (and this represents a revelation to
many) non-sick. Non-sick refers to the period of time, which
precedes the manifestation of disease symptoms. As we already
know, people do not suddenly acquire cardiovascular or periodontal
disease. It is a process. Were the consequences of poor
health choices, such as eating the wrong food in the wrong portions
immediately known, it’s likely people would not make
such choices.
When people make choices that lead them toward, instead
of away from, health, they follow what is termed the New
Health Path, one in which optimal health is maintained until
shortly before death. Unfortunately, assuming current trends,
the nation’s Forecasted Path predicts more illness occurring
sooner. The good news is that this can and must be reversed
and, by incorporating a Third Era of Medicine model into your
practice, you are part of this solution.
An Extremely Abridged History of Medicine
The practice of medicine may be characterized by three distinct
eras. The First Era ended with the advent of the germ theory
of disease, which led to cures for many infectious diseases
through the use of antibiotics, immunizations, medical hygiene
and improved public health. Regrettably, we remain largely
stuck in the Second Era of Medicine, as most in the medical profession
continue to focus on reacting to end-stage disease symptoms,
ranging from bleeding on probing and deep pockets in the
dental profession to a cardiac event in the medical setting.
This Second-Era mindset in the presence of the current diseasecausing
obesity epidemic is bankrupting our health-care system, as
well as our economy. The toll, in terms of suffering, diminished
quality of life and longevity, is truly incalculable.
It is incumbent upon all health professionals to move into the
Third Era of medicine where the focus is on creating health, not
just reacting to poor health and supervised neglect.
Curing obesity and pre-obesity by helping our patients first recognize
the numerous health choices being made on a daily basis,
then coaching them on how to make healthy choices to attain and
maintain a healthy weight, leads to a happy and appreciative patient,
one who not only makes a positive contribution to the productivity
of our society, but also serves as a walking billboard for the practice
that helped them succeed at achieving optimal health.
An oral systemic mindset is first and foremost about recognizing
that dentistry is as legitimate a medical sub-specialty as are orthopedics,
obstetrics, otolaryngology and ophthalmology. All health professionals
owe it to their patients to employ a collaborative approach
to care to the benefit patients, your practice and society.
Coaching your patients to health is one the best ways to foster
collaboration among your colleagues in the medical profession.
When one of their patients, with whom they had little
success achieving a healthy weight, presents for their next
appointment looking (and being) the picture of health, and the
patient shares that this was done by their dentist/hygienist, you
can imagine the positive impact this makes. The physician will
want to know more, and the door is open for you to grow your
collaboration (and referral) network.
In November 2011 the New England Journal of Medicine published
a study demonstrating that, when a person possesses both a
learning tool for achieving a healthy lifestyle and a health coach to work with and support them, they are significantly more
likely to maintain long-term weight loss than those provided
with only the learning tool. Yet, even with the benefit of a coach,
those patients with Class II obesity were only able to lose an
average of 10 pounds after two years.
Dr. Wayne Andersen intuitively understood this information
13 years ago when he left a lucrative job at the worldrenowned
Cleveland Clinic. He created an effective coaching,
and best-in-class learning system he calls The Habits of Health.
He knew studies* showed that people who use a portion-controlled
meal replacement (PCMR) program succeeded at losing
weight. However, 85 percent of these people regained the weight
they lost because they returned to the habits of disease that led
to their original weight gain.3
Dr. Andersen added safety studies and his coaching and learning
programs to the PCMR, and created a comprehensive optimal
health program. Individuals and practices can easily implement it
at virtually no cost (the patient/client merely shifts their grocery
budget from one basket of food to another). Health professionals
coach as little or as much as they wish, typically assigning the
responsibility for coaching to the hygiene department.
The effective oral-systemic practice need not be a financial
loss leader. On the contrary, it can create a healthy revenue
stream for all involved by offering a professional coaching service
to those of your patients, as well as prospective patients.
* More studies are available for review at www.dannybobrow.tsfl.com/?page=hp-clinical-studies
References
- http://www.bashaar.org.il/files/21408200682610.pdf
- Dr. Mark Nelson
- Habits of Health by Dr. Wayne Scott Anderson. Habits of Health Press. 5/15/2010
|