January 8, 2025 • 22 mins
Join us for an enlightening conversation with top experts in the fields of dentistry and medicine. Dr. Deb Fuller, Dr. Maria Ryan, and Dr. Judith Haber discuss the historical divide between oral health and overall healthcare, and how we can begin to bridge that gap with strategic collaboration between nursing, dentistry, and medicine.
As we navigate through systemic challenges like insurance disparities and the urgent need for accessible dental care, you'll gain a new appreciation for how crucial it is to integrate oral health into a holistic healthcare approach.
Listen and Learn:
- The power of oral health literacy through the "Know Your OQ" initiative, designed to combat the widespread prevalence of periodontal disease
- The deep connections between mental and physical health and how this ties into oral health as well
- Progress that has been made to connect oral and general healthcare and ways to bridge the gap further
This episode is a call to action for healthcare professionals and patients alike, advocating for a unified approach that recognizes the integral link between oral health and overall well-being.
Hosts
- Bob Gold, Chief Behavioral Technologist, GoMo Health
- Shelley Schoenfeld, Chief Strategist, GoMo Health
Featured Guests
- Dr. Deb Fuller, National Dental Director for Cigna Dental
- Dr. Maria Ryan, Executive Vice President and Chief Clinical Officer at the ColgatePalmolive Company
- Dr. Judith Haber, Professor Emerita at NYU Rory Myers College of Nursing, and Executive Director, Oral Health Nursing Education and Practice Program
Thanks for tuning in. Subscribe today to receive alerts of new weekly episodes and follow @GoMoHealth on social for the latest in healthcare engagement.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 3 (00:05):
50% of people throughout the world have this
disease.
It's the most common chronicdisease in the world, yet many
people do not know that theyeven have it.
Speaker 2 (00:16):
The nursing profession is 4.7 million strong
.
It is the largest component ofthe healthcare workforce and we
have the capacity tosignificantly impact the oral
health and overall health ofindividuals, families and
communities.
Speaker 4 (00:35):
I actually did a little bit of research on this
because I really wanted to knowwhen did this divide actually
happen?
And it was actually back in1840.
Speaker 5 (00:44):
actually happen, and it was actually back in 1840.
In the concluding episodes ofseason one of Human Resilience
Changing the Way Healthcare isDelivered, we go above the neck
to learn about new science thatcontinues to connect the brain
and oral cavity with the rest ofthe body.
There are times in the worldand in life when a discovery
(01:04):
changes how we do things.
Hi, I'm Shelly Schoenfeld.
Join me and my podcast partner,behavioral technologist Bob
Gold, on this journey ofdiscovery as we unfold a whole
person health delivery sciencefor people in need.
Welcome to Human ResilienceChanging the Way Healthcare is
Delivered.
Bob's first and last guest inthis episode is Dr Deb Fuller,
(01:27):
national Dental Director forCigna Dental.
After speaking with Dr Fuller,bob talks with Dr Maria Ryan,
executive Vice President andChief Clinical Officer at the
Colgate Palmolive Company, andthen with Dr Judy Haber,
professor Emerita at NYU RoryMyers College of Nursing and
Executive Director Oral HealthNursing Education and Practice
(01:49):
Program, who literally wrote thedefinitive university textbook
on psychiatric mental healthnursing and has long since
focused on the mouth bodyconnection.
Let's hear first from Judy onthe integration of oral health
care with whole body health.
Speaker 2 (02:09):
In 2005, the nursing program at NYU formed an
organizational partnership withthe NYU College of Dentistry,
and the College of Nursing atthe College of Dentistry was a
school within a school model,and the partnership was built on
(02:30):
a vision of two primary careprofessions having the
opportunity to advance a wholeperson care paradigm by putting
the mouth back in the body andin the head, thereby creating an
innovative interprofessionalclinical education, practice and
research model.
And we created a model whereby,in addition to the traditional
(02:56):
primary care services that wereoffered, we integrated oral
health as one of the keyelements of the history of the
physical assessment.
Speaker 4 (03:14):
Working with physicians over the years,
whether it was when I wasworking at the hospital or the
health department I think a lotof their frustration was okay, I
talked to a patient about theirdental health.
They don't have a dentist.
Who do I refer them to?
It's obviously a little biteasier if they've got
employer-based commercialinsurance or they've got
something off of the exchange.
But if someone is uninsured orthey're covered by Medicaid,
(03:37):
especially as adults, it can bevery, very challenging and I
think that's been a lot of thefrustration that I've heard from
medical colleagues over theyears is I don't have a referral
network, especially if somebodyhas Medicaid.
How to find a local providerthat may either speak their
language or that's accessible tothem location-wise and also
(03:57):
will take whatever insurance orself-pay or the US safety net,
the community health centers andthe hospital-based programs
they're flooded.
I actually did a little bit ofresearch on this because I
really wanted to know when didthis divide actually happen?
And it was actually back in1840.
And it was actually referred toby dentists as the historic
(04:20):
rebuff.
So that's where the dividebetween medicine and dentistry
began, when physicians at theUniversity of Maryland College
of Medicine rejected a proposalfrom colleagues to include
dental instruction in themedical curriculum.
They said no, and that's whenthe university formed its
separate college of dentistry.
So it dates way back to 150,well, more than that way, way
(04:43):
back.
And then dentists they said wehave different insurance
reimbursement mechanisms,different forms.
Dentistry doesn't currently, forthe most part, use diagnostic
ICD codes when dentists submitclaim forms to carriers for
reimbursement.
So there's a lot of informationthat we're just not capturing
(05:03):
as a profession.
So there's a lot of informationthat we're just not capturing
as a profession.
Our patient health records,totally different systems.
There are some dentists thatare connected in an FQHC or a
hospital-based system wherethey're on the medical record,
which is fantastic.
But for the most part dentistryis still a cottage industry,
individual practices or smallgroup practices that are just
(05:25):
operating independently fromtheir medical colleagues.
So hopefully it'll change Idon't know if it will in my
lifetime, but just having thatintegration again, putting the
mouth back into the body.
Dentistry is a specialty, justlike cardiology, ophthalmology,
gastroenterology, but dating wayback, we kind of got pushed off
(05:45):
to the side and it's remainedso.
Speaker 1 (05:48):
As a cognitive behavioral science guy.
I only came into healthcare now, about nine years ago, and it
seemed healthcare cut offeverything above the shoulders
from the body oral health andthen never gets to the brain,
even though the brain decideswhether to brush your teeth or
eat a lot or not eat a lot.
You know your brain kind of ismanaging your body, not the
(06:11):
other way around.
Tell me a little bit about ayour challenge and the
opportunity to integrate medicaldental care into a holistic
program for people, and some ofthe thoughts that you see both
within the dental community andthe medical community to do that
.
Speaker 4 (06:28):
I've been a dentist for almost 30 years and dental
always has been off to the side.
The mouth has really beenseparate from the body and
definitely over the last severaldecades we're trying to put it
back in Physicians, doctorsthey're over here, dentists were
over here.
We have different training.
We have different reimbursementschedules or mechanisms.
(06:49):
We have different healthrecords.
Dentists tend to be solo orsmall group practices in their
own building, not connected to alarger health system, either
physically or electronically.
And I've talked to so manypeople over the years and
gauging do they understand whydental health is so important?
(07:10):
Oral health and I like to sayuse the term oral health instead
of dental health because ouroral health is more than just
our teeth how it's related towhat's going on behaviorally,
mentally, physically, thatconnection to the rest of the
body.
And I think we're gettingbetter as a country, as
(07:31):
healthcare providers, ashealthcare systems and really
educating consumers andeducating our patients the
importance of whole personhealth mind, body, mental health
.
I'm just so proud to be part ofthe Cigna dental clinical team.
Specifically for me.
I lead the development andreally the expansion, the
enhancement of our oral healthclinical programs that are
(07:54):
integrated with whole personhealth.
So I also work with our CignaDental Innovation Studio and
we're just looking at andscanning the marketplace what's
new out there, what's coming onthe scene, what challenges and
barriers our customers arefacing and what we can do to
overcome those barriers.
I also have responsibilities inour quality management program
to ensure regulatory complianceand how well our providers are
(08:16):
performing for our customers.
I love educating people on oralhealth and how they can improve
their oral health, well-beingand vitality.
So I do a lot of education, Iwork with our sales partners, I
work directly with our clientsand do a lot of lunch and learns
Oral Health 101.
Speaker 3 (08:35):
My name is Dr Maria Ryan, and I am a periodontist
and a former academician.
I am a scientist as well.
I have oversight of ourclinical operations worldwide,
as well as our knowledgemanagement team and our
scientific communications team,and I've had the pleasure of
(08:56):
working with you, bob, and theGOMO group on several very
exciting projects.
As the worldwide leader in oralhealth, colgate is constantly
innovating and bringing newproducts to consumers for
prevention, as well as topractitioners.
Speaker 1 (09:16):
So where did you do your little academic stint, by
the way?
Speaker 3 (09:20):
I was at Stony Brook University for a little over 20
years, where I served inmultiple positions.
I was the director of clinicalresearch there, I was associate
dean for strategic planning andexternal affairs and I was chair
of the department of oralbiology and pathology, where we
actually developed one ofColgate's main technologies,
(09:43):
which is based on arginine,which is an amino acid that is
found in the saliva of people,which is a natural protectant
against cavities, and I came andtook a look at the great
science that was going on hereand the wonderful people who
work here.
I mean the company's over 200years old, so it's like a family
(10:04):
, and so I got to meet a lot ofthe scientists here and the
marketers and everyone that isreally working together to
really reimagine a healthierfuture for all people, their
pets and our planet, and that isour purpose as a company.
Speaker 1 (10:21):
So, before we get into the oral systemic health
and the medical dentalintegration, I know there's some
initiatives that you've workedon that are near and dear to
your heart, so to speak.
Talk a little bit about Knowyour OQ.
Speaker 3 (10:38):
So people know about white teeth and white smiles,
but when it comes to cavitiesand periodontal disease, it's
not so sexy, and so people areoften unaware of the diseases
they may actually have, and theyare certainly often unaware of
the connections betweenuntreated dental disease,
(11:00):
particularly periodontal diseaseor gum disease, and their
overall health and well-being.
And we have an awesomemarketing team here and I said
how can we make this moreinteresting for people and more
sexy?
And so they came up with knowyour OQ or know your oral health
quotient, like you know your IQor your EQ.
Take a quiz and what kind ofscore do you get?
(11:23):
And it was amazing to see thata lot of people don't know the
things that they should knowabout their oral health.
Oral health literacy is very lowand so many people do not know
about the conditions that theyface and what the signs and the
symptoms are, and the fact thatcertain diseases like gum
disease, periodontal disease isoften a silent disease, yet 50%
(11:47):
of people throughout the worldhave this disease.
It's the most common chronicdisease in the world Yet many
people do not know that theyeven have it.
So through this quiz, we teachthem about these conditions and
the signs and the symptoms.
So what are the preventivestrategies that they can take?
And the exciting thing aboutKnow your OQ is, of course, I'm
(12:09):
a scientist.
We had to do a study.
And the exciting thing aboutKnow your OQ is, of course, I'm
a scientist.
We had to do a study.
We looked at a population ofpeople who took the quiz and had
access to the materials to seeif it really changed their
knowledge, their oral healthliteracy and it did.
They had a much betterunderstanding of the diseases
that they may get.
They changed their attitudesabout buying products that have
(12:33):
actives in it like fluoride tohelp prevent cavities, and it
changed their practices.
Many people don't brush theirteeth every day, so by taking
the quiz, more people werebrushing their teeth twice a day
, which is what is recommendedfor two minutes, and using floss
(12:56):
, which many people do not usefloss and mouthwashes, and so
they really came to a betterunderstanding of what they could
do to help prevent the disease.
Speaker 1 (13:03):
So how do they?
Do you go to knowyouroqcom, howdo you find yeah, yeah, that's
it Bob.
Speaker 3 (13:08):
Yeah, go to knowyouroq dot com and you can
take the quiz, and I think thatyou'll learn a lot.
You have to start first of allunderstanding that periodontal
disease, or gum disease, which,as I said, 50 percent of people
may have at some point in theirlife, is a disease of infection
(13:29):
and inflammation.
It means that if you getbacteria around the teeth and
you are susceptible and we'lltalk about how some of these
people that we just talked about, who might be pregnant or might
have diabetes, might be evenmore susceptible to developing a
disease like periodontaldisease right, you end up
(13:50):
developing gingivitis, whichmany people have heard of, which
is a reversible form of thedisease, right?
So you have, your gums get red,they may bleed when you brush,
but if you really take care ofit and clean up the mouth, it
goes away.
If you don't treat that disease, then it can progress to
(14:10):
something more severe calledperiodontal disease, and that's
when you lose the bone andconnective tissue that supports
the tooth and you start to.
Actually people can see theirteeth start to move, they get
spaces, they might get loose,and if you don't treat it,
eventually you'll lose the tooth.
Right, the tooth will get looseand it will come out, and so
(14:34):
that more severe form of thedisease can really cause very
profound systemic inflammationand the infection can get into
the body.
Speaker 5 (14:54):
Dr Haber, whom we heard from at the beginning
about the mouth-body connection,provides us with a deeper
perspective on some of the stepsshe helped spearhead over the
past 50 years to integratebehavioral health, oral health
and overall health as a leadingnear in the field.
Speaker 2 (15:11):
Psychiatric nursing is my core specialty, so I am
supposedly retired.
I am Professor Emerita at NYURory Myers College of Nursing
and I am a psychiatric nursepractitioner.
And I am a psychiatric nursepractitioner.
I've been an academic and aclinician throughout my more
(15:34):
than 50-year career and myinterest in the integration of
mental health and overall healthdates back 30 or more years
when I, among others, was apioneer in focusing on the
integration of behavioral healthand overall health and for 10
(15:57):
years I was an NIH-funded breastcancer researcher where
integration was the focus of theresearch and focused on women
with breast cancer and theirpartners and investigating their
emotional, social and physicaladjustment to breast cancer.
(16:19):
And we called our programJourney to Recovery and really
assessed women and theirpartners.
It was really the first studyof its kind and we assessed them
at the point of diagnosis,recovering from surgery, during
their adjuvant therapy chemo,radiation or both and at the
(16:43):
point where they were finishedwith all of that and into their
ongoing recovery.
So it was really a nationallyrecognized program, it was
award-winning and it reallysolidified my interest in
integration.
Speaker 1 (17:04):
I've noticed that in general, healthcare cut off the
body from the head, the headfrom the body, and that hearing
is ancillary insurance andvision and dental and it never
even got to the brain.
Everyone who has chronicconditions diabetes,
(17:24):
cardiovascular has a lot ofanxiety, stress, depression and
yet nursing and doctors andpharmacists are still not
addressing a lot of the mentalside of the house.
So what inspired you?
Speaker 2 (17:37):
Well, it does continue to be a health
disparity, there's no questionabout that.
We had our clinical experienceat a state psychiatric hospital
and the patients were soprofoundly interesting in their
array of mental illnesses orpsychiatric disorders, if you
(18:00):
will it was a real challenge torelate to them in a way that
bridged the gap betweenconsensus reality and their
reality.
And the integration of theirmental health with their overall
(18:20):
health was another shocker,because their physical health
was often extremely poor,including their oral health, and
it was in the age of profoundcigarette smoking, which, of
course, was an anxiety reducerfor them.
They were allowed to smoke onthe units or the wards, whatever
(18:45):
they were called at the time.
Their teeth, their hands, theirbreath reeked of cigarette use
and most of them eventually,because of that, had rotted
teeth, if you will.
We developed the He-Notapproach to expand on the
(19:06):
traditional H-E-E-N-T head, ears, eyes, nose and throat.
Well, we created the HeNotmodel, adding oral health, so
that you cannot forget toinclude oral health in the care
of your patient or in theconsideration of their physical,
(19:27):
social or mental health.
The nursing profession is 4.7million strong.
It is the largest component ofthe health care workforce and we
have the capacity tosignificantly impact the oral
health and overall health ofindividuals, families and
(19:48):
communities.
Maria Ryan and her leadershiprole at Colgate were very
interested in expanding thereach of their Know your OQ
initiative, which is all byitself such a powerful
initiative.
But the nursing workforcebecause nurse practitioners,
(20:13):
registered nurses, nursemidwives are so perfectly
positioned to include oralhealth screening assessment
using the HENOT approach, usingit in their intervention
portfolio with acute andchronically ill people and
making appropriate referrals andhaving these oral health
(20:36):
components of practice as partof their standard of care.
How we could reach out to thenursing community to develop
nursing oral health champions.
And this was important becausenurses have that
direct-to-consumer contact.
So it's like getting a doublebang for your buck if you are
(21:01):
going to engage with aprofession that can also engage
consumers, and consumers werethe first and ongoing focus of
the Know your OQ program.
Speaker 1 (21:14):
Because clearly, to me as an outsider coming into
the medical, dental world, thelogical arguments have been
there for a thousand years andyet, while we're making progress
, clearly right, it just seemsto be maybe the way we're
approaching why do it and how todo it, and the reimbursements
(21:36):
and the incentives and all thosethings need a different look,
almost from the mind of thephysician, so to speak.
Speaker 5 (21:45):
Thanks, bob, and thanks to Dr Maria Ryan, dr Deb
Fuller and Dr Judy Haber forsitting down with us to explain
the correlations between oraland full body health today.
Our next episode will focus onoral health and pregnancy and
pediatric dentistry.
For more information, pleasevisit gomohealthcom.
Human Resilience is nowavailable on all major podcast
(22:09):
engines, including Apple Music,spotify and iHeart Radio.
On behalf of my podcast partner, bob Gold, and myself, thank
you all for listening to thisepisode of Human Resilience
Changing the Way Healthcare isDelivered.
50% of people throughout the world have this
disease.
It's the most common chronicdisease in the world, yet many
people do not know that theyeven have it.
Speaker 2 (00:16):
The nursing profession is 4.7 million strong
.
It is the largest component ofthe healthcare workforce and we
have the capacity tosignificantly impact the oral
health and overall health ofindividuals, families and
communities.
Speaker 4 (00:35):
I actually did a little bit of research on this
because I really wanted to knowwhen did this divide actually
happen?
And it was actually back in1840.
Speaker 5 (00:44):
actually happen, and it was actually back in 1840.
In the concluding episodes ofseason one of Human Resilience
Changing the Way Healthcare isDelivered, we go above the neck
to learn about new science thatcontinues to connect the brain
and oral cavity with the rest ofthe body.
There are times in the worldand in life when a discovery
(01:04):
changes how we do things.
Hi, I'm Shelly Schoenfeld.
Join me and my podcast partner,behavioral technologist Bob
Gold, on this journey ofdiscovery as we unfold a whole
person health delivery sciencefor people in need.
Welcome to Human ResilienceChanging the Way Healthcare is
Delivered.
Bob's first and last guest inthis episode is Dr Deb Fuller,
(01:27):
national Dental Director forCigna Dental.
After speaking with Dr Fuller,bob talks with Dr Maria Ryan,
executive Vice President andChief Clinical Officer at the
Colgate Palmolive Company, andthen with Dr Judy Haber,
professor Emerita at NYU RoryMyers College of Nursing and
Executive Director Oral HealthNursing Education and Practice
(01:49):
Program, who literally wrote thedefinitive university textbook
on psychiatric mental healthnursing and has long since
focused on the mouth bodyconnection.
Let's hear first from Judy onthe integration of oral health
care with whole body health.
Speaker 2 (02:09):
In 2005, the nursing program at NYU formed an
organizational partnership withthe NYU College of Dentistry,
and the College of Nursing atthe College of Dentistry was a
school within a school model,and the partnership was built on
(02:30):
a vision of two primary careprofessions having the
opportunity to advance a wholeperson care paradigm by putting
the mouth back in the body andin the head, thereby creating an
innovative interprofessionalclinical education, practice and
research model.
And we created a model whereby,in addition to the traditional
(02:56):
primary care services that wereoffered, we integrated oral
health as one of the keyelements of the history of the
physical assessment.
Speaker 4 (03:14):
Working with physicians over the years,
whether it was when I wasworking at the hospital or the
health department I think a lotof their frustration was okay, I
talked to a patient about theirdental health.
They don't have a dentist.
Who do I refer them to?
It's obviously a little biteasier if they've got
employer-based commercialinsurance or they've got
something off of the exchange.
But if someone is uninsured orthey're covered by Medicaid,
(03:37):
especially as adults, it can bevery, very challenging and I
think that's been a lot of thefrustration that I've heard from
medical colleagues over theyears is I don't have a referral
network, especially if somebodyhas Medicaid.
How to find a local providerthat may either speak their
language or that's accessible tothem location-wise and also
(03:57):
will take whatever insurance orself-pay or the US safety net,
the community health centers andthe hospital-based programs
they're flooded.
I actually did a little bit ofresearch on this because I
really wanted to know when didthis divide actually happen?
And it was actually back in1840.
And it was actually referred toby dentists as the historic
(04:20):
rebuff.
So that's where the dividebetween medicine and dentistry
began, when physicians at theUniversity of Maryland College
of Medicine rejected a proposalfrom colleagues to include
dental instruction in themedical curriculum.
They said no, and that's whenthe university formed its
separate college of dentistry.
So it dates way back to 150,well, more than that way, way
(04:43):
back.
And then dentists they said wehave different insurance
reimbursement mechanisms,different forms.
Dentistry doesn't currently, forthe most part, use diagnostic
ICD codes when dentists submitclaim forms to carriers for
reimbursement.
So there's a lot of informationthat we're just not capturing
(05:03):
as a profession.
So there's a lot of informationthat we're just not capturing
as a profession.
Our patient health records,totally different systems.
There are some dentists thatare connected in an FQHC or a
hospital-based system wherethey're on the medical record,
which is fantastic.
But for the most part dentistryis still a cottage industry,
individual practices or smallgroup practices that are just
(05:25):
operating independently fromtheir medical colleagues.
So hopefully it'll change Idon't know if it will in my
lifetime, but just having thatintegration again, putting the
mouth back into the body.
Dentistry is a specialty, justlike cardiology, ophthalmology,
gastroenterology, but dating wayback, we kind of got pushed off
(05:45):
to the side and it's remainedso.
Speaker 1 (05:48):
As a cognitive behavioral science guy.
I only came into healthcare now, about nine years ago, and it
seemed healthcare cut offeverything above the shoulders
from the body oral health andthen never gets to the brain,
even though the brain decideswhether to brush your teeth or
eat a lot or not eat a lot.
You know your brain kind of ismanaging your body, not the
(06:11):
other way around.
Tell me a little bit about ayour challenge and the
opportunity to integrate medicaldental care into a holistic
program for people, and some ofthe thoughts that you see both
within the dental community andthe medical community to do that
.
Speaker 4 (06:28):
I've been a dentist for almost 30 years and dental
always has been off to the side.
The mouth has really beenseparate from the body and
definitely over the last severaldecades we're trying to put it
back in Physicians, doctorsthey're over here, dentists were
over here.
We have different training.
We have different reimbursementschedules or mechanisms.
(06:49):
We have different healthrecords.
Dentists tend to be solo orsmall group practices in their
own building, not connected to alarger health system, either
physically or electronically.
And I've talked to so manypeople over the years and
gauging do they understand whydental health is so important?
(07:10):
Oral health and I like to sayuse the term oral health instead
of dental health because ouroral health is more than just
our teeth how it's related towhat's going on behaviorally,
mentally, physically, thatconnection to the rest of the
body.
And I think we're gettingbetter as a country, as
(07:31):
healthcare providers, ashealthcare systems and really
educating consumers andeducating our patients the
importance of whole personhealth mind, body, mental health
.
I'm just so proud to be part ofthe Cigna dental clinical team.
Specifically for me.
I lead the development andreally the expansion, the
enhancement of our oral healthclinical programs that are
(07:54):
integrated with whole personhealth.
So I also work with our CignaDental Innovation Studio and
we're just looking at andscanning the marketplace what's
new out there, what's coming onthe scene, what challenges and
barriers our customers arefacing and what we can do to
overcome those barriers.
I also have responsibilities inour quality management program
to ensure regulatory complianceand how well our providers are
(08:16):
performing for our customers.
I love educating people on oralhealth and how they can improve
their oral health, well-beingand vitality.
So I do a lot of education, Iwork with our sales partners, I
work directly with our clientsand do a lot of lunch and learns
Oral Health 101.
Speaker 3 (08:35):
My name is Dr Maria Ryan, and I am a periodontist
and a former academician.
I am a scientist as well.
I have oversight of ourclinical operations worldwide,
as well as our knowledgemanagement team and our
scientific communications team,and I've had the pleasure of
(08:56):
working with you, bob, and theGOMO group on several very
exciting projects.
As the worldwide leader in oralhealth, colgate is constantly
innovating and bringing newproducts to consumers for
prevention, as well as topractitioners.
Speaker 1 (09:16):
So where did you do your little academic stint, by
the way?
Speaker 3 (09:20):
I was at Stony Brook University for a little over 20
years, where I served inmultiple positions.
I was the director of clinicalresearch there, I was associate
dean for strategic planning andexternal affairs and I was chair
of the department of oralbiology and pathology, where we
actually developed one ofColgate's main technologies,
(09:43):
which is based on arginine,which is an amino acid that is
found in the saliva of people,which is a natural protectant
against cavities, and I came andtook a look at the great
science that was going on hereand the wonderful people who
work here.
I mean the company's over 200years old, so it's like a family
(10:04):
, and so I got to meet a lot ofthe scientists here and the
marketers and everyone that isreally working together to
really reimagine a healthierfuture for all people, their
pets and our planet, and that isour purpose as a company.
Speaker 1 (10:21):
So, before we get into the oral systemic health
and the medical dentalintegration, I know there's some
initiatives that you've workedon that are near and dear to
your heart, so to speak.
Talk a little bit about Knowyour OQ.
Speaker 3 (10:38):
So people know about white teeth and white smiles,
but when it comes to cavitiesand periodontal disease, it's
not so sexy, and so people areoften unaware of the diseases
they may actually have, and theyare certainly often unaware of
the connections betweenuntreated dental disease,
(11:00):
particularly periodontal diseaseor gum disease, and their
overall health and well-being.
And we have an awesomemarketing team here and I said
how can we make this moreinteresting for people and more
sexy?
And so they came up with knowyour OQ or know your oral health
quotient, like you know your IQor your EQ.
Take a quiz and what kind ofscore do you get?
(11:23):
And it was amazing to see thata lot of people don't know the
things that they should knowabout their oral health.
Oral health literacy is very lowand so many people do not know
about the conditions that theyface and what the signs and the
symptoms are, and the fact thatcertain diseases like gum
disease, periodontal disease isoften a silent disease, yet 50%
(11:47):
of people throughout the worldhave this disease.
It's the most common chronicdisease in the world Yet many
people do not know that theyeven have it.
So through this quiz, we teachthem about these conditions and
the signs and the symptoms.
So what are the preventivestrategies that they can take?
And the exciting thing aboutKnow your OQ is, of course, I'm
(12:09):
a scientist.
We had to do a study.
And the exciting thing aboutKnow your OQ is, of course, I'm
a scientist.
We had to do a study.
We looked at a population ofpeople who took the quiz and had
access to the materials to seeif it really changed their
knowledge, their oral healthliteracy and it did.
They had a much betterunderstanding of the diseases
that they may get.
They changed their attitudesabout buying products that have
(12:33):
actives in it like fluoride tohelp prevent cavities, and it
changed their practices.
Many people don't brush theirteeth every day, so by taking
the quiz, more people werebrushing their teeth twice a day
, which is what is recommendedfor two minutes, and using floss
(12:56):
, which many people do not usefloss and mouthwashes, and so
they really came to a betterunderstanding of what they could
do to help prevent the disease.
Speaker 1 (13:03):
So how do they?
Do you go to knowyouroqcom, howdo you find yeah, yeah, that's
it Bob.
Speaker 3 (13:08):
Yeah, go to knowyouroq dot com and you can
take the quiz, and I think thatyou'll learn a lot.
You have to start first of allunderstanding that periodontal
disease, or gum disease, which,as I said, 50 percent of people
may have at some point in theirlife, is a disease of infection
(13:29):
and inflammation.
It means that if you getbacteria around the teeth and
you are susceptible and we'lltalk about how some of these
people that we just talked about, who might be pregnant or might
have diabetes, might be evenmore susceptible to developing a
disease like periodontaldisease right, you end up
(13:50):
developing gingivitis, whichmany people have heard of, which
is a reversible form of thedisease, right?
So you have, your gums get red,they may bleed when you brush,
but if you really take care ofit and clean up the mouth, it
goes away.
If you don't treat that disease, then it can progress to
(14:10):
something more severe calledperiodontal disease, and that's
when you lose the bone andconnective tissue that supports
the tooth and you start to.
Actually people can see theirteeth start to move, they get
spaces, they might get loose,and if you don't treat it,
eventually you'll lose the tooth.
Right, the tooth will get looseand it will come out, and so
(14:34):
that more severe form of thedisease can really cause very
profound systemic inflammationand the infection can get into
the body.
Speaker 5 (14:54):
Dr Haber, whom we heard from at the beginning
about the mouth-body connection,provides us with a deeper
perspective on some of the stepsshe helped spearhead over the
past 50 years to integratebehavioral health, oral health
and overall health as a leadingnear in the field.
Speaker 2 (15:11):
Psychiatric nursing is my core specialty, so I am
supposedly retired.
I am Professor Emerita at NYURory Myers College of Nursing
and I am a psychiatric nursepractitioner.
And I am a psychiatric nursepractitioner.
I've been an academic and aclinician throughout my more
(15:34):
than 50-year career and myinterest in the integration of
mental health and overall healthdates back 30 or more years
when I, among others, was apioneer in focusing on the
integration of behavioral healthand overall health and for 10
(15:57):
years I was an NIH-funded breastcancer researcher where
integration was the focus of theresearch and focused on women
with breast cancer and theirpartners and investigating their
emotional, social and physicaladjustment to breast cancer.
(16:19):
And we called our programJourney to Recovery and really
assessed women and theirpartners.
It was really the first studyof its kind and we assessed them
at the point of diagnosis,recovering from surgery, during
their adjuvant therapy chemo,radiation or both and at the
(16:43):
point where they were finishedwith all of that and into their
ongoing recovery.
So it was really a nationallyrecognized program, it was
award-winning and it reallysolidified my interest in
integration.
Speaker 1 (17:04):
I've noticed that in general, healthcare cut off the
body from the head, the headfrom the body, and that hearing
is ancillary insurance andvision and dental and it never
even got to the brain.
Everyone who has chronicconditions diabetes,
(17:24):
cardiovascular has a lot ofanxiety, stress, depression and
yet nursing and doctors andpharmacists are still not
addressing a lot of the mentalside of the house.
So what inspired you?
Speaker 2 (17:37):
Well, it does continue to be a health
disparity, there's no questionabout that.
We had our clinical experienceat a state psychiatric hospital
and the patients were soprofoundly interesting in their
array of mental illnesses orpsychiatric disorders, if you
(18:00):
will it was a real challenge torelate to them in a way that
bridged the gap betweenconsensus reality and their
reality.
And the integration of theirmental health with their overall
(18:20):
health was another shocker,because their physical health
was often extremely poor,including their oral health, and
it was in the age of profoundcigarette smoking, which, of
course, was an anxiety reducerfor them.
They were allowed to smoke onthe units or the wards, whatever
(18:45):
they were called at the time.
Their teeth, their hands, theirbreath reeked of cigarette use
and most of them eventually,because of that, had rotted
teeth, if you will.
We developed the He-Notapproach to expand on the
(19:06):
traditional H-E-E-N-T head, ears, eyes, nose and throat.
Well, we created the HeNotmodel, adding oral health, so
that you cannot forget toinclude oral health in the care
of your patient or in theconsideration of their physical,
(19:27):
social or mental health.
The nursing profession is 4.7million strong.
It is the largest component ofthe health care workforce and we
have the capacity tosignificantly impact the oral
health and overall health ofindividuals, families and
(19:48):
communities.
Maria Ryan and her leadershiprole at Colgate were very
interested in expanding thereach of their Know your OQ
initiative, which is all byitself such a powerful
initiative.
But the nursing workforcebecause nurse practitioners,
(20:13):
registered nurses, nursemidwives are so perfectly
positioned to include oralhealth screening assessment
using the HENOT approach, usingit in their intervention
portfolio with acute andchronically ill people and
making appropriate referrals andhaving these oral health
(20:36):
components of practice as partof their standard of care.
How we could reach out to thenursing community to develop
nursing oral health champions.
And this was important becausenurses have that
direct-to-consumer contact.
So it's like getting a doublebang for your buck if you are
(21:01):
going to engage with aprofession that can also engage
consumers, and consumers werethe first and ongoing focus of
the Know your OQ program.
Speaker 1 (21:14):
Because clearly, to me as an outsider coming into
the medical, dental world, thelogical arguments have been
there for a thousand years andyet, while we're making progress
, clearly right, it just seemsto be maybe the way we're
approaching why do it and how todo it, and the reimbursements
(21:36):
and the incentives and all thosethings need a different look,
almost from the mind of thephysician, so to speak.
Speaker 5 (21:45):
Thanks, bob, and thanks to Dr Maria Ryan, dr Deb
Fuller and Dr Judy Haber forsitting down with us to explain
the correlations between oraland full body health today.
Our next episode will focus onoral health and pregnancy and
pediatric dentistry.
For more information, pleasevisit gomohealthcom.
Human Resilience is nowavailable on all major podcast
(22:09):
engines, including Apple Music,spotify and iHeart Radio.
On behalf of my podcast partner, bob Gold, and myself, thank
you all for listening to thisepisode of Human Resilience
Changing the Way Healthcare isDelivered.
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