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Profile in Oral Health by Sarah Cottingham, RDH, BS

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Why don’t we just get up on our soapboxes and scream at the top of our lungs, “It is all related!” For years, as a profession we have dabbled in the concept of the oral systemic relationships between the oral inflammatory processes that we have all worked with for decades and the systemic inflammatory processes.

It is an exciting time in the field of dentistry right now. We are motivated about the future of dentistry and dental hygiene, and we have the ability to really make a mark in the history books! However, if we continue to allow others to educate patients about the oral systemic links, and we take a step back, we’re going to get left behind. There are professions now making the connections faster and with more excitement than we have been. Recently I had the opportunity to have a detailed conversation with an RN who was working with students, as well as within an ICU unit. She indicated she had been working with a group of CNNs, LPNs and PAs who were attempting to get more information about how to be preventive in regard to the respiratory illness that seem to be paramount with patients with NG tubes or intubated patients. If there is a tube down someone’s throat for any period of time, the likelihood that it will immediately begin to form a biofilm is high. This biofilm, which is not regularly removed, is then aspirated down into the lungs of the patient, who can then develop a respiratory illness on top of the original situation that hospitalized he or she in the first place. These professionals were discussing the options to reduce this occurrence – including products containing xylitol, controlling bacterial loads within the patient’s oral cavity and repopulating good bacteria.

The RN was appalled by what she found when she researched all of this information. Neither her dentist nor her hygienist had ever mentioned all of the links before. Learning that these preventive measures had been around for years, she asked me what the dental profession is now doing with the information.

There is quite a bit of information about the oral-systemic connection present in everyday media. However, much of the information is not from dentists or hygienists. What is this saying about our profession and the stand that we are taking about educating the public about this important topic?

At the joint ADA/AMA conference in February 2006, it was stated that “oral health conditions and other health conditions are more closely related than many may once have thought, and viewing them as separate matters no longer makes sense.” At this point as a profession, we needed to band together and take collective action. But still professionals are not becoming educated on the link between the mouth and body. If it’s just a matter of not knowing where to look, check out some of the articles cited in the sidebar.

How many times have you had an appointment with a patient and asked if he or she has had any changes in medical history? Most the time you get the answer that it’s the same. And sometimes you find out later that the patient has recently had stents placed, a joint replacement or even a mild heart attack. Unfortunately, most of the time that this happens, it is because we asked the question in an ambiguous way, which leads to ambiguous answers. We have trained the patient to participate in this.

Many times when speaking with groups of hygienists I hear comments like “well, once they start talking then I will not have time to clean their teeth,” or “they never really know the names of the medications so I just do my best.” The truth is, I agree with them. This is what they are faced with every day. But we have an opportunity to handle the situation gracefully. If we educate patients about the importance of complete and accurate information, it can ultimately lead to a healthier patient. And getting them to think about the connections between their medical history and their oral health is the first step in educating the public!

There are mountains of information available to us. So how can we educate our profession, our teams, other professions and our patients about the mouth-body connection in a bold way? It’s simple – just start talking about it! Start the conversation. First, we must educate ourselves by reading the latest research materials and creating an understanding for the inflammatory process and why it is so destructive. Take the time to read up on the information available at your fingertips.

Companies like Heart Healthy Dentistry and OralDNA Lab make chairside tests for many conditions, including:
  • CRP (C-reactive protein) test
  • Diabetes risk assessment screening
  • Perio-pathogenic bacteria salivary test
  • Periodontal disease genetic susceptibility
  • Oral HPV virus screening
  • Complete perio metabolic profile
When we arm ourselves with a person’s health information, we can make stronger recommendations for follow-up visits with their primary medical provider of choice and have intelligent conversations on their behalf about what we see. This moves our simple conversations about health and wellness into referral for evaluation.

What if after patients entered your office, after they sign in but before they are called to the back, they are informed about the mouth-body connection? You could have multiple avenues for this because technology is abundant. Even a simple note that says, “See the latest updates about the mouth-body connection while we prepare for your visit” would get them thinking.

Even more inventive would be to create your own nicely done educational materials (or purchase any of the well-done materials available from many companies) and have them readily available for viewing in the reception area. The options are never ending in the arena of educating patients.

Once we have educated ourselves to understand the process, the testing available, the correlations and the overall details, we must create partnerships with the other medical specialties to create a “wellness” model for referral! What a concept, a disease-preventive model instead of a disease- treatment model. What an exciting time to be in the profession. Are you ready for the ride?
Author’s Bio
Sarah Cottingham, RDH, BS, graduated from Northern Arizona University in 1991. Her passion for helping people achieve optimum wellness has led her down a path of continuing education, including the use of the perioscope and lasers. She now shares her skills and expertise as a writer, speaker and practice consultant in BSC Leadership, LLC. To contact Sarah, e-mail sarah@bcsleadership.com or visit BSC Leadership’s Web site at www.bcsleadership.com.
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September 2025
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