January 21, 2025 • 20 mins
This week's podcast episode continues to explore the profound connection between oral hygiene and overall well-being and the relationship to the perinatal journey and early childhood growth and development. Guests from Cigna and Colgate dig deep into the critical ties between oral health and pregnancy risks as Dr. Maria Ryan sheds light on the unique challenges women face due to hormonal changes, especially during pregnancy.
Listen and Learn:
- About the disparities in dental care access between urban and rural communities and the cultural hurdles that can impede proper oral hygiene.
- The importance of preventive dental care in reducing pregnancy complications
- Statistics on the impact of oral health on maternal and child health and recommendations for early dental visits for children
Through real-life experiences and expert insights, this episode aims to enhance your understanding of the mouth-mind-body connection and its profound influence on holistic health.
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 Colgate Palmolive Company
- Kylie McElveen, Dental Strategy and Business Development for Cigna Dental
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 2 (00:06):
So when we talk about pregnant women and I will say
women throughout our lives weare different than men.
I have a friend who's acardiologist, anissa Goldberg,
and she wrote a book.
Women Are Not Little Men.
We have hormonal changesthroughout.
Yeah, yeah, yes.
Speaker 3 (00:29):
Right men.
We have hormonal changes.
Ada now recommends thatchildren start going to the
dentist as soon as they haveteeth come in, so a lot of times
that's before a year old.
Speaker 4 (00:39):
In the concluding episodes of season one of human
resilience changing the wayhealthcare is delivered we go
above the neck to learn aboutnew science that continues to
connect the brain and oralcavity with the rest of the body
.
In this second part on our oralhealth series, bob and our
special guests focus on therelationship between oral health
and pregnancy, dispelling a fewmyths in the process and
(01:01):
offering expert advice for momsand babies.
There are times in the worldand in life when a discovery
changes how we do things.
Hi, I'm Shelley 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
(01:24):
Delivered.
Bob's guests in this episodeare Dr Deb Fuller, national
Dental Director for Cigna Dental, after which he talks with
Kylie McKelvin, also of CignaDental, and finally with Dr
Maria Ryan, executive VicePresident and Chief Clinical
(01:45):
Officer at the Colgate.
Speaker 1 (01:47):
Palmolive Company.
I believe Cigna has done someresearch also into the effect
besides the human toll, theeffect of cost of care on
pregnant women, folks withdiabetes or cardiovascular.
And if the oral health is notaddressed the costs go up and it
(02:07):
exacerbates the issues on themedical side.
Maybe talk a little bit aboutthe correlation between either
chronic conditions and oralhealth and then also how it
could wreck havoc with yourpregnant on your oral cavity.
Speaker 5 (02:24):
There's research coming out all the time on the
mouth mind body connection andit really has to do with
inflammation from untreated gumdisease.
Gum disease is a chronicbacterial infection and our
body's reacting to that theinflammation and the bacteria.
I just read a study the otherday where oral bacteria were
(02:46):
found in the brains ofAlzheimer's patients.
It increases their risk fortheir hospitalized
non-ventilator pneumonia.
So oral bacteria gettinginhaled and causing respiratory
issues.
Research has shown that womenwhen they're pregnant, if they
have untreated gum disease, thatputs them at higher risk for
delivering a preterm or a lowbirth weight baby.
So there's just all the timeresearch is coming out about
(03:08):
that connection.
So when we're talking abouthealthcare, I think always in
that sentence we're alwaystalking about finances.
Healthcare here in the US it'snot cheap.
Whether it's medical care,dental care, vision care, mental
health care can be veryexpensive.
Fortunately, at Cigna we have alot of data, got a lot of
(03:33):
information, claims data andother data on our customers who
have our Cigna Medical and CignaDental and we've looked at the
connection, the financialconnection for customers getting
those preventive dental visits,checkups, radiographs,
cleanings, periodontalmaintenance, identifying disease
, early preventing disease isabsolutely most important.
We look at their oral health.
(03:53):
We look at their medical claimsdata and we just see what's
going on.
We did a study several yearsback and we looked at seven
years worth of claims data andit showed that routine
preventive dental care forindividuals with chronic health
conditions such as diabetes isjust so important.
We found that customers whoroutinely visited their dentist
(04:14):
for three consecutive years sawan average of over 4% I think it
was 4.4% savings on totalmedical costs per year for the
next five years.
The study also showed that thesame customers experienced fewer
emergency room visits andurgent care visits.
I think they dropped by 22% andthat's contributed to a lot
(04:35):
more medical cost savings and Ithink it could be pretty obvious
.
But you go into the dentist andyou receive that routine
preventive care.
You're going to prevent toothcare, you're going to prevent
tooth decay, you're going toprevent gum disease or catch it
early and that's going to save,obviously, dental dollars down
the road.
You won't need that root canal,for example, or that crown, but
(04:55):
we do see that individuals whojust don't get that preventive
care it increases their risksignificantly of developing
dental diseases down the road.
Speaker 1 (05:09):
You know it's interesting talk about
preventive care.
Let's migrate to children for asecond and parents.
So the two biggest reasons forabsenteeism in school in the
United States is cavities,caries and asthma.
So just your perspective ontips or parenting and oral
health and children and thosetypes of things.
Pediatric dentistry.
Speaker 5 (05:31):
Pediatrics is near and dear to my heart.
The recommendation is for thechild to have their first dental
visit within six months of thefirst tooth coming in or by one
year, whichever is sooner.
The youngest child I've everseen with tooth decay was a
seven-month-old infant.
He had four teeth and the toptwo had already started to decay
(05:52):
.
That's when I was in the infanttoddler program at the hospital
.
So you have a tooth, it can getdecayed, and I was a school
dentist in a couple of cities,low-income cities, in Providence
, when I was working at thehospital we would go in and we
would either do screenings oractually full dental exams,
depending on what the schoolcontracted with the hospital.
(06:12):
So I would go in and see thesechildren.
There were mandatory dentalscreenings here in the state.
So I saw a lot of children and Isaw individuals, these poor
children that had dentalabscesses that were just very,
very obvious and you can imagine, you know, as a parent, seeing
a child with significant levelof dental disease.
They can't proper nutrition,they're not eating properly,
(06:35):
they're not sleeping properly,they can't concentrate in school
, so it really does affect theirgrowth, development in their
learning.
You know, as you mentioned,tooth decay it's very, very
prevalent and a cause of lostschool hours.
And tooth decay is still thenumber one chronic disease in
childhood, more common thanasthma, more common than
childhood obesity.
(06:55):
So it's still significant.
You would think here we are in2024, community water
fluoridation has been on thescene since the 50s and advances
in science and technology, butthere still is a significant
burden of dental disease,especially with children.
The hospital I used to work atthey would run operating room
cases where we would takechildren to the OR because of
(07:18):
the extent of their dental needsand either their age or
developmental stage, where thework couldn't be done safely in
the operatory.
So the children would goobviously to the operating room,
which is expensive for one andthere's always a risk for
negative consequences whenyou're giving general anesthesia
.
Speaker 1 (07:38):
We do a program with Colgate, with one of the blue
crosses, for children under 10,pretty much, who need oral
surgery already because lack ofcaring for their oral health.
One of the interestingcomponents in our science that
we put in was getting parents tounderstand that there's a
(08:00):
relationship between helpingyour child develop routines,
disciplines by brushing twice aday that transcend to schoolwork
, sports, those things.
So what we've done is madebrushing larger than life for
them, because clearly most ofthem know the kids should be
brushing.
(08:20):
They're not.
But what we've done is create amindset shift that this could
be a great way for you to spenda little time with your children
and teach them discipline anddevelop and foster resiliency,
and it's actually worked prettywell by shifting it that it's
brushing and taking care oftheir oral health is larger than
(08:42):
the bathroom, so to speak.
Speaker 3 (08:47):
My name is Kylie McKelvin.
I live in Atlanta, georgia.
I grew up in the Ozarks inMissouri, so a really small farm
town.
So Atlanta was a huge, hugecity for me when I first moved
here, but it's become much morenavigable, especially with the
apps that are now in place.
I went to college in St Louis.
(09:09):
I went to WashU and majored inbusiness.
I did my MBA at the Universityof Georgia after I moved to
Atlanta.
So I've always had a bit on thebusiness side of things
marketing, sales type jobs.
I worked in legal marketingbefore I came to Cigna and here
I merged sort of those skills,whether it's business
development, marketing, sales,and I do sales and account
(09:33):
management for our nationaldental clients.
Speaker 1 (09:36):
So if you were talking to an HR or benefits
person or executive as anemployer, an HR or benefits
person or executive as anemployer, what would be the top
one, two or three things as towhy they should really focus on
not only oral health butintegrated medical dental care
as a whole Right.
Speaker 3 (09:55):
So for some reason we do consider your teeth and eyes
as separate from your body inthe insurance world.
So, as far as oral health goes,it impacts your whole body.
So it impacts your overallhealth.
If you have gum disease, thatmakes you more susceptible to
any type of infection.
So, just like if you had alarge cut on your hand or on
(10:15):
your body somewhere and it'sgetting infected, you would
immediately treat that, youwould try to close that
infection up.
But a lot of people are walkingaround with that in their
mouths and they don't realize itbecause they can't see it or
they don't feel it the same wayimmediately.
So whether it's complicationsfor pregnancy, whether it's
complications around diabetes,heart disease, other conditions
(10:39):
like that, it really does impact.
And maybe it's not this hugeimpact that you feel immediately
every day, but it adds up andit impacts your immune system,
your ability to fight off justgeneral infections.
Whether it's a cold, the flu,that may mean an extra day in
the hospital.
If you're in the hospital forsome medical condition and you
(10:59):
also have gum disease, thenmaybe your body's not able to
fight off whatever medicalcondition that is as well.
So we have to look at theemployer as a whole, the
employees in, maybe, ruralTennessee our neighbor to the
west a little bit they're goingto have a different experience
than those living in urbanAtlanta.
So we want to look at theiravailability or look at the
(11:21):
dentist's availability to them.
What does that network looklike?
There's some different plansfor whether you live in a city,
a suburban area, rural area,also thinking about cultures
there too.
That's where we especially needto make sure people understand
the importance of oral health.
If it's an hourly type position, it's more difficult for them
(11:42):
to get away to go see thedentist.
And I'm lucky enough that myjob allows flexibility that if I
have a dental appointment Ijust go in for my dental
appointment.
I'm not clocking in and out todo that, but a lot of people
have that as an obstacle.
So the type of job, thelocation and availability of
(12:05):
dentists Dr Deb probably sharedthis, but ADA now recommends
that children start going to thedentist as soon as they have
teeth come in.
So a lot of times that's beforea year old and most parents
whether it's just kind of theircommon sense to them or whether
it's what they grew up withusually you don't take your kids
to the dentist until they'resix, seven at least school age,
and sometimes later, andsometimes not, until there's
some type of issue that pops up.
(12:27):
So, whether it's education oravailability, we try to cater
some solutions around that.
Sometimes we'll bring thedentist to those areas,
sometimes we'll bring dentistsin to just provide education,
sometimes it's clinics toprovide some of those cleanings
and, while they're in there,give some education around that,
and sometimes even bring infamilies so you bring your
(12:50):
one-year-old in.
It's not this intensivecleaning exam.
About 80% of it is educatingthe parent about here's what
brushing pattern should looklike.
Here's what they should bedrinking, not drinking.
Here's what you do beforebedtime.
After you brush no more bottles, no more sugary drinks or
fluids.
So some things like that reallydo help make those experiences
(13:13):
at the dentist a little bitbetter.
As opposed to a child that mayhave some tooth decay and have
to get a filling early on,that's going to be a less fun
experience than going in sayingyou look great, get something
from the treasure chest.
Speaker 4 (13:32):
Dr Maria Ryan, the Executive Vice President and
Chief Clinical Officer of theColgate Palmolive Company,
expands our conversation withbehavioral technologist Bob Gold
to include a focus on pregnantwomen.
Dr Ryan draws on new sciencethat connects the dots between
periodontal disease andirregularities during pregnancy.
During pregnancy.
Speaker 2 (13:57):
So when we talk about pregnant women and I will say
women throughout our lives weare different than men.
I have a friend who's acardiologist.
Speaker 1 (14:13):
Anissa Goldberg and she wrote a book.
Speaker 2 (14:14):
Women Are Not Little Men.
We have hormonal changesthroughout.
Yeah, yeah, changes.
But throughout our lives wehave hormonal changes.
I mean during puberty, duringpregnancy, during menopause.
So women, throughout theirlives, are at greater risk for
developing gum disease.
Even during the monthly changesthat women have, right when
(14:38):
they get their periods, they aremore prone to developing
gingivitis.
And so, as a practitioner,sometimes I would say to my
patient oh, is it that time ofthe month?
And they'd go oh, my God, do Ilook bad?
I said, no, your gums lookterrible.
And so you know, right then,and there someone who probably
during pregnancy, will be atmuch greater risk.
(15:01):
So you have additional hormonalchanges that drive your risk
for gum disease and many womenare not aware of that.
And there's an old wives tale uh, with every baby you lose a
tooth.
Well, and people would tell methis.
I said, well, that's not, itdoesn't have to happen that way.
But the reason that came aboutis because women get very bad
(15:24):
gum disease during pregnancy.
Some women get it very bad, andparticularly those women who
have had gingivitis or someperiodontitis before, they
really get it very, very bad.
So it's important that theytake care of that before.
So if a woman is pregnant andshe develops periodontal disease
(15:47):
, those bacteria that can getinto the bloodstream have
actually been found in amnioticfluid, in fetal cord blood.
The inflammatory mediators thatcome out during periodontal
disease, those are the samemediators that drive
(16:08):
contractions.
So prostanoids drivecontractions, which is one of
those mediators, and the enzymesknown as matrix metoproteases
that break down the bone andconnective tissue.
Well, those are what allow forpremature rupture of the
membranes.
So if you have periodontaldisease, your risk for having a
(16:29):
baby sooner because ofcontraction, because of
premature rupture of themembranes, is much higher than
someone who doesn't haveperiodontal disease.
And so that's why you know.
Many studies have been donewhich show that if you treat gum
disease in women who arepregnant, it reduces their risk
(16:52):
for premature deliverysubstantially.
But many women don't know thatright.
So it's interesting.
I did a study when I was at theuniversity and we enrolled
women who had had earlydeliveries and we were looking
to see if they had periodontaldisease, and many of them almost
(17:12):
all of them, had verysignificant periodontal disease
and we were explaining to themthat this could have played a
role in their baby coming toosoon and many of them would say
no one ever talked to me aboutthis and I was very fortunate at
the time that the chair of theDepartment of Obstetrics and
Gynecology gynecology.
(17:39):
He was so upset about this thathe actually made the first
guidelines for obstetricians torefer their patients before even
they get pregnant right, so asthey're trying to get pregnant
to the dentist to kind of getclearance and make sure that
their oral condition is good.
But he certainly said that ifduring pregnancy someone has
periodontal problems, they needto be managed, they need to be
treated to avoid any of theseissues that we've seen in women
(18:04):
who don't have their periodontaldisease treated.
And unfortunately, I have afriend who did a lot of research
on this.
She's now at ColumbiaUniversity and there was a case
out in California where a womanhad a stillborn baby and she had
gone to many dentists actuallycomplaining that she had gum
(18:26):
problems and they were notaddressed because the dentist
was fearful of treating her atthat time and it ended up being
a lawsuit and the person who wasdoing this research actually
was able to show that thebacteria in the woman's mouth
were the same bacteria theyfound in the stillborn baby.
So I think a situation likethat, which is very unusual, but
(18:51):
it really made the point andpeople began to think, wow, I
need to treat this, I need totake care of this, and so the
initial reports that were cameout of New York State Department
of Health are now in manystates throughout the country,
because people don't know thisright.
Speaker 1 (19:09):
So it's good we're talking about it, because- yeah,
and I think we need to continueto spread the word, because
GOMO works with underservedcommunities in the US, africa
and other continents and whileit may be somewhere in the
guidelines for OBGYNs, I'm notso sure in practice that's
(19:30):
rising to front and center andbeing actualized in many
communities around the world.
Speaker 4 (19:38):
Thanks, bob, and thanks again to Dr Deb Fuller,
kylie McKelvin and especially DrMaria Ryan of Colgate-Palmolive
for sitting down with us toexplain the correlations among
oral health, pregnancy andpediatric dentistry.
Our next and final episode onthe oral and full body health
connection will focus on oralhealth's, diabetes and
(19:59):
cardiovascular health.
For more information, pleasevisit gomohealthcom.
Human resilience is nowavailable on all major podcast
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
(20:20):
Changing the Way Healthcare isDelivered.
So when we talk about pregnant women and I will say
women throughout our lives weare different than men.
I have a friend who's acardiologist, anissa Goldberg,
and she wrote a book.
Women Are Not Little Men.
We have hormonal changesthroughout.
Yeah, yeah, yes.
Speaker 3 (00:29):
Right men.
We have hormonal changes.
Ada now recommends thatchildren start going to the
dentist as soon as they haveteeth come in, so a lot of times
that's before a year old.
Speaker 4 (00:39):
In the concluding episodes of season one of human
resilience changing the wayhealthcare is delivered we go
above the neck to learn aboutnew science that continues to
connect the brain and oralcavity with the rest of the body
.
In this second part on our oralhealth series, bob and our
special guests focus on therelationship between oral health
and pregnancy, dispelling a fewmyths in the process and
(01:01):
offering expert advice for momsand babies.
There are times in the worldand in life when a discovery
changes how we do things.
Hi, I'm Shelley 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
(01:24):
Delivered.
Bob's guests in this episodeare Dr Deb Fuller, national
Dental Director for Cigna Dental, after which he talks with
Kylie McKelvin, also of CignaDental, and finally with Dr
Maria Ryan, executive VicePresident and Chief Clinical
(01:45):
Officer at the Colgate.
Speaker 1 (01:47):
Palmolive Company.
I believe Cigna has done someresearch also into the effect
besides the human toll, theeffect of cost of care on
pregnant women, folks withdiabetes or cardiovascular.
And if the oral health is notaddressed the costs go up and it
(02:07):
exacerbates the issues on themedical side.
Maybe talk a little bit aboutthe correlation between either
chronic conditions and oralhealth and then also how it
could wreck havoc with yourpregnant on your oral cavity.
Speaker 5 (02:24):
There's research coming out all the time on the
mouth mind body connection andit really has to do with
inflammation from untreated gumdisease.
Gum disease is a chronicbacterial infection and our
body's reacting to that theinflammation and the bacteria.
I just read a study the otherday where oral bacteria were
(02:46):
found in the brains ofAlzheimer's patients.
It increases their risk fortheir hospitalized
non-ventilator pneumonia.
So oral bacteria gettinginhaled and causing respiratory
issues.
Research has shown that womenwhen they're pregnant, if they
have untreated gum disease, thatputs them at higher risk for
delivering a preterm or a lowbirth weight baby.
So there's just all the timeresearch is coming out about
(03:08):
that connection.
So when we're talking abouthealthcare, I think always in
that sentence we're alwaystalking about finances.
Healthcare here in the US it'snot cheap.
Whether it's medical care,dental care, vision care, mental
health care can be veryexpensive.
Fortunately, at Cigna we have alot of data, got a lot of
(03:33):
information, claims data andother data on our customers who
have our Cigna Medical and CignaDental and we've looked at the
connection, the financialconnection for customers getting
those preventive dental visits,checkups, radiographs,
cleanings, periodontalmaintenance, identifying disease
, early preventing disease isabsolutely most important.
We look at their oral health.
(03:53):
We look at their medical claimsdata and we just see what's
going on.
We did a study several yearsback and we looked at seven
years worth of claims data andit showed that routine
preventive dental care forindividuals with chronic health
conditions such as diabetes isjust so important.
We found that customers whoroutinely visited their dentist
(04:14):
for three consecutive years sawan average of over 4% I think it
was 4.4% savings on totalmedical costs per year for the
next five years.
The study also showed that thesame customers experienced fewer
emergency room visits andurgent care visits.
I think they dropped by 22% andthat's contributed to a lot
(04:35):
more medical cost savings and Ithink it could be pretty obvious
.
But you go into the dentist andyou receive that routine
preventive care.
You're going to prevent toothcare, you're going to prevent
tooth decay, you're going toprevent gum disease or catch it
early and that's going to save,obviously, dental dollars down
the road.
You won't need that root canal,for example, or that crown, but
(04:55):
we do see that individuals whojust don't get that preventive
care it increases their risksignificantly of developing
dental diseases down the road.
Speaker 1 (05:09):
You know it's interesting talk about
preventive care.
Let's migrate to children for asecond and parents.
So the two biggest reasons forabsenteeism in school in the
United States is cavities,caries and asthma.
So just your perspective ontips or parenting and oral
health and children and thosetypes of things.
Pediatric dentistry.
Speaker 5 (05:31):
Pediatrics is near and dear to my heart.
The recommendation is for thechild to have their first dental
visit within six months of thefirst tooth coming in or by one
year, whichever is sooner.
The youngest child I've everseen with tooth decay was a
seven-month-old infant.
He had four teeth and the toptwo had already started to decay
(05:52):
.
That's when I was in the infanttoddler program at the hospital
.
So you have a tooth, it can getdecayed, and I was a school
dentist in a couple of cities,low-income cities, in Providence
, when I was working at thehospital we would go in and we
would either do screenings oractually full dental exams,
depending on what the schoolcontracted with the hospital.
(06:12):
So I would go in and see thesechildren.
There were mandatory dentalscreenings here in the state.
So I saw a lot of children and Isaw individuals, these poor
children that had dentalabscesses that were just very,
very obvious and you can imagine, you know, as a parent, seeing
a child with significant levelof dental disease.
They can't proper nutrition,they're not eating properly,
(06:35):
they're not sleeping properly,they can't concentrate in school
, so it really does affect theirgrowth, development in their
learning.
You know, as you mentioned,tooth decay it's very, very
prevalent and a cause of lostschool hours.
And tooth decay is still thenumber one chronic disease in
childhood, more common thanasthma, more common than
childhood obesity.
(06:55):
So it's still significant.
You would think here we are in2024, community water
fluoridation has been on thescene since the 50s and advances
in science and technology, butthere still is a significant
burden of dental disease,especially with children.
The hospital I used to work atthey would run operating room
cases where we would takechildren to the OR because of
(07:18):
the extent of their dental needsand either their age or
developmental stage, where thework couldn't be done safely in
the operatory.
So the children would goobviously to the operating room,
which is expensive for one andthere's always a risk for
negative consequences whenyou're giving general anesthesia
.
Speaker 1 (07:38):
We do a program with Colgate, with one of the blue
crosses, for children under 10,pretty much, who need oral
surgery already because lack ofcaring for their oral health.
One of the interestingcomponents in our science that
we put in was getting parents tounderstand that there's a
(08:00):
relationship between helpingyour child develop routines,
disciplines by brushing twice aday that transcend to schoolwork
, sports, those things.
So what we've done is madebrushing larger than life for
them, because clearly most ofthem know the kids should be
brushing.
(08:20):
They're not.
But what we've done is create amindset shift that this could
be a great way for you to spenda little time with your children
and teach them discipline anddevelop and foster resiliency,
and it's actually worked prettywell by shifting it that it's
brushing and taking care oftheir oral health is larger than
(08:42):
the bathroom, so to speak.
Speaker 3 (08:47):
My name is Kylie McKelvin.
I live in Atlanta, georgia.
I grew up in the Ozarks inMissouri, so a really small farm
town.
So Atlanta was a huge, hugecity for me when I first moved
here, but it's become much morenavigable, especially with the
apps that are now in place.
I went to college in St Louis.
(09:09):
I went to WashU and majored inbusiness.
I did my MBA at the Universityof Georgia after I moved to
Atlanta.
So I've always had a bit on thebusiness side of things
marketing, sales type jobs.
I worked in legal marketingbefore I came to Cigna and here
I merged sort of those skills,whether it's business
development, marketing, sales,and I do sales and account
(09:33):
management for our nationaldental clients.
Speaker 1 (09:36):
So if you were talking to an HR or benefits
person or executive as anemployer, an HR or benefits
person or executive as anemployer, what would be the top
one, two or three things as towhy they should really focus on
not only oral health butintegrated medical dental care
as a whole Right.
Speaker 3 (09:55):
So for some reason we do consider your teeth and eyes
as separate from your body inthe insurance world.
So, as far as oral health goes,it impacts your whole body.
So it impacts your overallhealth.
If you have gum disease, thatmakes you more susceptible to
any type of infection.
So, just like if you had alarge cut on your hand or on
(10:15):
your body somewhere and it'sgetting infected, you would
immediately treat that, youwould try to close that
infection up.
But a lot of people are walkingaround with that in their
mouths and they don't realize itbecause they can't see it or
they don't feel it the same wayimmediately.
So whether it's complicationsfor pregnancy, whether it's
complications around diabetes,heart disease, other conditions
(10:39):
like that, it really does impact.
And maybe it's not this hugeimpact that you feel immediately
every day, but it adds up andit impacts your immune system,
your ability to fight off justgeneral infections.
Whether it's a cold, the flu,that may mean an extra day in
the hospital.
If you're in the hospital forsome medical condition and you
(10:59):
also have gum disease, thenmaybe your body's not able to
fight off whatever medicalcondition that is as well.
So we have to look at theemployer as a whole, the
employees in, maybe, ruralTennessee our neighbor to the
west a little bit they're goingto have a different experience
than those living in urbanAtlanta.
So we want to look at theiravailability or look at the
(11:21):
dentist's availability to them.
What does that network looklike?
There's some different plansfor whether you live in a city,
a suburban area, rural area,also thinking about cultures
there too.
That's where we especially needto make sure people understand
the importance of oral health.
If it's an hourly type position, it's more difficult for them
(11:42):
to get away to go see thedentist.
And I'm lucky enough that myjob allows flexibility that if I
have a dental appointment Ijust go in for my dental
appointment.
I'm not clocking in and out todo that, but a lot of people
have that as an obstacle.
So the type of job, thelocation and availability of
(12:05):
dentists Dr Deb probably sharedthis, but ADA now recommends
that children start going to thedentist as soon as they have
teeth come in.
So a lot of times that's beforea year old and most parents
whether it's just kind of theircommon sense to them or whether
it's what they grew up withusually you don't take your kids
to the dentist until they'resix, seven at least school age,
and sometimes later, andsometimes not, until there's
some type of issue that pops up.
(12:27):
So, whether it's education oravailability, we try to cater
some solutions around that.
Sometimes we'll bring thedentist to those areas,
sometimes we'll bring dentistsin to just provide education,
sometimes it's clinics toprovide some of those cleanings
and, while they're in there,give some education around that,
and sometimes even bring infamilies so you bring your
(12:50):
one-year-old in.
It's not this intensivecleaning exam.
About 80% of it is educatingthe parent about here's what
brushing pattern should looklike.
Here's what they should bedrinking, not drinking.
Here's what you do beforebedtime.
After you brush no more bottles, no more sugary drinks or
fluids.
So some things like that reallydo help make those experiences
(13:13):
at the dentist a little bitbetter.
As opposed to a child that mayhave some tooth decay and have
to get a filling early on,that's going to be a less fun
experience than going in sayingyou look great, get something
from the treasure chest.
Speaker 4 (13:32):
Dr Maria Ryan, the Executive Vice President and
Chief Clinical Officer of theColgate Palmolive Company,
expands our conversation withbehavioral technologist Bob Gold
to include a focus on pregnantwomen.
Dr Ryan draws on new sciencethat connects the dots between
periodontal disease andirregularities during pregnancy.
During pregnancy.
Speaker 2 (13:57):
So when we talk about pregnant women and I will say
women throughout our lives weare different than men.
I have a friend who's acardiologist.
Speaker 1 (14:13):
Anissa Goldberg and she wrote a book.
Speaker 2 (14:14):
Women Are Not Little Men.
We have hormonal changesthroughout.
Yeah, yeah, changes.
But throughout our lives wehave hormonal changes.
I mean during puberty, duringpregnancy, during menopause.
So women, throughout theirlives, are at greater risk for
developing gum disease.
Even during the monthly changesthat women have, right when
(14:38):
they get their periods, they aremore prone to developing
gingivitis.
And so, as a practitioner,sometimes I would say to my
patient oh, is it that time ofthe month?
And they'd go oh, my God, do Ilook bad?
I said, no, your gums lookterrible.
And so you know, right then,and there someone who probably
during pregnancy, will be atmuch greater risk.
(15:01):
So you have additional hormonalchanges that drive your risk
for gum disease and many womenare not aware of that.
And there's an old wives tale uh, with every baby you lose a
tooth.
Well, and people would tell methis.
I said, well, that's not, itdoesn't have to happen that way.
But the reason that came aboutis because women get very bad
(15:24):
gum disease during pregnancy.
Some women get it very bad, andparticularly those women who
have had gingivitis or someperiodontitis before, they
really get it very, very bad.
So it's important that theytake care of that before.
So if a woman is pregnant andshe develops periodontal disease
(15:47):
, those bacteria that can getinto the bloodstream have
actually been found in amnioticfluid, in fetal cord blood.
The inflammatory mediators thatcome out during periodontal
disease, those are the samemediators that drive
(16:08):
contractions.
So prostanoids drivecontractions, which is one of
those mediators, and the enzymesknown as matrix metoproteases
that break down the bone andconnective tissue.
Well, those are what allow forpremature rupture of the
membranes.
So if you have periodontaldisease, your risk for having a
(16:29):
baby sooner because ofcontraction, because of
premature rupture of themembranes, is much higher than
someone who doesn't haveperiodontal disease.
And so that's why you know.
Many studies have been donewhich show that if you treat gum
disease in women who arepregnant, it reduces their risk
(16:52):
for premature deliverysubstantially.
But many women don't know thatright.
So it's interesting.
I did a study when I was at theuniversity and we enrolled
women who had had earlydeliveries and we were looking
to see if they had periodontaldisease, and many of them almost
(17:12):
all of them, had verysignificant periodontal disease
and we were explaining to themthat this could have played a
role in their baby coming toosoon and many of them would say
no one ever talked to me aboutthis and I was very fortunate at
the time that the chair of theDepartment of Obstetrics and
Gynecology gynecology.
(17:39):
He was so upset about this thathe actually made the first
guidelines for obstetricians torefer their patients before even
they get pregnant right, so asthey're trying to get pregnant
to the dentist to kind of getclearance and make sure that
their oral condition is good.
But he certainly said that ifduring pregnancy someone has
periodontal problems, they needto be managed, they need to be
treated to avoid any of theseissues that we've seen in women
(18:04):
who don't have their periodontaldisease treated.
And unfortunately, I have afriend who did a lot of research
on this.
She's now at ColumbiaUniversity and there was a case
out in California where a womanhad a stillborn baby and she had
gone to many dentists actuallycomplaining that she had gum
(18:26):
problems and they were notaddressed because the dentist
was fearful of treating her atthat time and it ended up being
a lawsuit and the person who wasdoing this research actually
was able to show that thebacteria in the woman's mouth
were the same bacteria theyfound in the stillborn baby.
So I think a situation likethat, which is very unusual, but
(18:51):
it really made the point andpeople began to think, wow, I
need to treat this, I need totake care of this, and so the
initial reports that were cameout of New York State Department
of Health are now in manystates throughout the country,
because people don't know thisright.
Speaker 1 (19:09):
So it's good we're talking about it, because- yeah,
and I think we need to continueto spread the word, because
GOMO works with underservedcommunities in the US, africa
and other continents and whileit may be somewhere in the
guidelines for OBGYNs, I'm notso sure in practice that's
(19:30):
rising to front and center andbeing actualized in many
communities around the world.
Speaker 4 (19:38):
Thanks, bob, and thanks again to Dr Deb Fuller,
kylie McKelvin and especially DrMaria Ryan of Colgate-Palmolive
for sitting down with us toexplain the correlations among
oral health, pregnancy andpediatric dentistry.
Our next and final episode onthe oral and full body health
connection will focus on oralhealth's, diabetes and
(19:59):
cardiovascular health.
For more information, pleasevisit gomohealthcom.
Human resilience is nowavailable on all major podcast
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
(20:20):
Changing the Way Healthcare isDelivered.
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