Linking Dental With Medical Presentation by Dr. Carl Stoel DDS
Linking Dental With Medical Presentation by Dr. Carl Stoel DDS
Linking Dental With Medical Presentation by Dr. Carl Stoel DDS
Agenda
Making the Link to Overall Health Roles and Responsibilities: Health Plans BCBSM Physician Dental Professional
BCBSM
Dental
Medical
You may understand but your customers may not: 12 percent of the adult population cant understand health information that doctors, hospitals and insurers use
Medical
Diabetes Hypertension Ischemic Heart Disease Low Birth Weight Osteoporosis
Gingivitis
Inflammation of gingival tissue without loss of connective tissue
Periodontal disease
Bacteria and toxins that invade tissues around the tooth Causes gum inflammation Brings about tooth loss Bacteria and toxins enter blood stream and invade other areas of the body 34% of people over 30 years old have periodontal disease
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Frequent teeth cleanings and complex periodontal services reduce the incidence of periodontal disease
Oral cancer Radiation and chemotherapy - osteoradionecrosis Pulmonary disease (aspiration pneumonia) Stroke Heart valve replacement Joint replacement Post cancer surgery complications Pancreatic cancer in men Medications and xerostomia Auto-immune diseases
HIV Lichen planus Gingival infiltration in acute myelogenous leukemia Bulimia Bisphosphonate-related osteonecrosis Chronic kidney failure/renal insufficiency Sjogrens syndrome
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2600 BC - Death of Hesy-Re, an Egyptian scribe, often called the first dentist
An inscription on his tomb includes the title, the greatest of those who deal with teeth, and of physicians. This is the earliest known reference to a person identified as a dental practitioner.
500 to 1000 AD - During the early Middle Ages in Europe, medicine, surgery, and dentistry are generally practiced by monks, the most educated people of the period
Source: ada.org
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Adding Value
Middle and later years
Effects of systemic disease treatment on oral health Effects of medications on oral health Identifying risks associated with oral health as one ages
Some Medicare HMO plans are recognizing the link and adding basic dental benefits to their plans
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Patients visit the dentist more frequently than their regular physician.
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What is the annual direct cost of diabetes in the U.S.? A) $500 million B) $1.8 billion C) $27 billion D) $92 billion
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Centers for Disease Control data for the year 2002 shows direct costs of $92 billion, and total costs of $132 billion BCBSM (a large health plan) data indicates average annual costs of $8,600 per member Affects 7 percent of the U.S. population
Source: cdc.gov
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Periodontal disease worsens diabetes bacteria released into the blood stream contributes to the inflammatory process Diabetes worsens periodontal disease weakening of connective tissue structure affects gums
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What is the percentage of deaths in the U.S. due to heart disease? A) 15 percent B) 19 percent C) 26 percent D) 29 percent
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Heart disease accounts for 29 percent of deaths in the United States BCBSM data shows average annual cost of ischemic heart disease of $10,500 per member CDC projects cost of heart disease in the U.S. at $393 billion
Source: cdc.gov
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Bacteria found in the plaque of the arterial walls include many of the same types found in the periodontal pockets Bacteria creates an inflammation that causes plaque build-up in the small arteries of the heart, restricting blood flow to the heart muscle, which can lead to a heart attack
Source: cdc.gov
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What is the average cost of a preterm birth? A) $5,000 B) $7,500 C) $9,000 D) $10,500
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How many people are diagnosed with oral cancer in the U.S. each year? A) 15,000 B) 20,000 C) 25,000 D) 30,000
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According to the CDC, 30,000 people in the U.S. are diagnosed with oral cancer every year Oral and pharyngeal cancer account for 2% to 4% of cancers diagnosed in the U.S. Oral cancer occurs twice as often in males as females Tobacco users have a high incidence of oral cancer
Source: cdc.gov
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Early detection of oral cancer enables less invasive treatment, higher survival rate Early stage survival rate is 80% Late stage five-year survival rate is 20%
Source: cdc.gov
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Some health plans cover dental oral brush biopsy, an early detection tool Some plans like BCBSM offer smoking cessation programs to members and have developed specific tools to help medical providers discuss tobacco with atrisk patients
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Oral piercing involving the tongue, lips, cheeks, uvula or a combination of sites implicated in adverse oral systemic conditions Following piercing certain symptoms are common
Pain and swelling Infection Increased salivary flow Injuries to the gum tissue
Additional risks
Obstructed airway due to pronounced edema Aspiration of jewelry
Source: ada.org
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Innovative plan designs Use of evidence-based dentistry guidelines Additional benefits for at-risk patients Work with societies to encourage dentists to donate their time to free clinics
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Be aware of link between oral disease and systemic diseases including diabetes, heart disease, and pregnancy complications Ask patients if they are seeing a dentist regularly Observe oral soft and hard tissues Work with dentist to manage co-morbidity associated with systemic inflammation and oral periodontal disease Make appropriate referrals
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Recognize the risk status of the patient Educate the patient Provide counseling Distribute brochures and information
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Intervention is key
Referrals to periodontal specialists Referrals to physicians Develop relationships with physician colleagues
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Insurance carriers have stepped up to the plate. Now its the dental professionals turn.
Embrace the new information Stay on top of patient recalls Fill your appointment books Use your people skills to influence patients
Improved oral and overall health = better quality of life Better oral health could reduce overall health care cost
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BCBSM
Dental
Medical
Questions?
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