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Hygiene Tribune Middle East & Africa Edition No.3, 2017

C6 HYGIENE TRIBUNE Dental Tribune Middle East & Africa Edition | 3/2017 Interview: “A preventative health care system is also a cost-efficient system” By Kristin Hübner, DTI On the occasion of this year’s World Oral Health Day (WOHD) on 20 March, Prof. Jörg Eberhard from the University of Sydney will be pre- senting the Australian WOHD lec- ture, titled “#PuttingTheMouthIn- toHealth—Time for a paradigm change in dentistry!”. Dental Tribune Online had the opportunity to speak with Eberhard, who was appointed the university’s first Chair of Lifes- pan Oral Health in 2015, about the role of preventative care in research and clinical practice and the gen- eral need for a more holistic view on medical conditions and oral health. Dental Tribune Online: Can you explain what is meant by the title of your lecture, “Put- ting the mouth into health”? Prof. Jörg Eberhard: Research over the last several decades has shown that oral disease is linked to general health and other diseases, including cardiovascular disease, diabetes mellitus and rheumatoid arthritis. The available evidence demonstrat- ing this association is based on epidemiological studies, clinical in- tervention trials and knowledge of sound biological mechanisms. Irre- spective of this body of knowledge, a holistic view on medical conditions that includes oral health has not been established in clinical medical practice. “Putting the mouth into health” stands for the strategic vision of overcoming this shortcoming and is aimed at improving the commu- nity’s health. Do you think there is enough awareness among the pub- lic about the relationship between oral health, overall well-being and quality of life? There is very limited awareness of the link between oral and general disease among the public; however, many health care professionals too are not aware of the association be- tween oral and general health, even though it may significantly affect the well-being of patients. Oral health lit- eracy education of the community and health care professionals is a major challenge for the dental pro- fession. Furthermore, teaching of the association between oral and general health to medical students is neces- sary to establish a holistic view of health in the future. What is the dental communi- ty’s role and that of national health care policies in this matter? The dental community must realise that dentistry is not limited to caries and infected root surfaces; the work of the dental community should be aimed at easing a significant global disease burden and improving the health of the community. Policies must recognise oral health as an integral part of general health and “Putting the mouth into health” stands for the strategic vision of overcoming this shortcoming and is aimed at improving the community’s health. health services, inseparable if the population’s health is to be main- tained or improved. Do you think that there should be an increased interdiscipli- nary exchange between den- tistry and medicine? The exchange between dentistry, medicine and other health profes- sions is fundamental to make sub- stantial contributions to medical re- search and clinical health care in the future. A holistic view on health and disease is obviously highly relevant for clinical decision-making, since medical research has repeatedly demonstrated the interdependence of the various organ systems owing to similar generalised mechanisms. With the rising burden of diseases such as periodontitis and diabetes on one hand and increasing awareness of pre- vention on the other, where does dentistry stand today? Since the introduction of fluorida- tion, the dental research commu- nity and the dental profession have neglected preventative pathways for decades, and research and clinical ac- tivities have focused on restorative treatments. This trend is epitomised by the use of artificial materials like dental implants to restore natural teeth, which have to be extracted be- cause of the lack of adequate preven- tative treatment. This development is advanced by policies that reward restorative treatments and do not support preventative dental treat- ments. What role does the increasing use of highly advanced and complex technology in dentistry play in achieving the goal of retaining the natural dentition for as long as possi- ble? Highly advanced and complex tech- nologies should be limited to those patients who have suffered trauma or who have severe disease or genetic deteriorations. Health care systems are not able to provide these tech- nologies to the broader community and therefore these cost-intensive technologies are limited to the privi- leged. A preventative health care sys- tem is also a cost-efficient health care system, relieving individuals and the public from suffering and high costs. Thank you very much for the inter- view. Editorial note: This is an abridged ver- sion of an interview published in Den- tal Tribune Asia Pacific Edition, Vol. 15, No. 3. Study links periodontal disease, tooth loss and higher risk of death By DTI BUFFALO, N.Y., USA: A new study has suggested that overall mortal- ity in the general population and older women in particular could be reduced by improving periodon- tal health. Evaluating data on over 57,000 postmenopausal women, re- searchers at the University at Buffalo found that presence of periodontitis and tooth loss is associated with a significantly higher risk of death. The women in the study were aged between 55–89, had no known car- diovascular disease events and were originally enrolled in the Women’s Health observational study. In the study population, the prevalence of periodontitis and edentulism was 26 percent and 5.9 percent, respectively. Initiative During a mean follow-up period of 6.7 years, the researchers recorded 3,589 cardiovascular disease events and 3,816 deaths. They also found that a history of periodontal disease was associated with a 12 percent higher risk of death and the loss of all natural teeth was associated with a 17 percent higher risk. In women who saw the dentist less than once a year, edentulism was more strongly associated with cardi- ovascular disease events compared with those with more dental visits per year. “Our findings suggest that older women may be at higher risk for death because of their periodontal condition and may benefit from more intensive oral screening meas- ures,” said Dr. Michael J. LaMonte, lead author and research associate professor in the university’s Depart- ment of Epidemiology and Environ- mental Health. “However, studies of interventions aimed at improving periodontal health are needed to determine whether risk of death is lowered among those receiving the intervention compared to those who do not. Our study was not able to es- tablish a direct cause and effect.” According to the Centers for Disease Periodontal diseases can affect the tooth-supporting structures, resulting in tooth loss. They may also increase the risk of death as a new study has shown. (Photograph: Wetmount/PixaBay) Control and Prevention, almost 50 percent of adults in the U.S. aged 30 and over have some form of peri- odontal disease. It is estimated that about 20 percent of adults aged 65 and over in the country are edentu- lous. The study, titled “History of perio- dontitis diagnosis and edentulism as predictors of cardiovascular disease, stroke, and mortality in postmeno- pausal women,” was published in the April issue of the Journal of the American Heart Association.

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