February 4, 2025 • 21 mins
Unlock the secret to a healthier life as we explore the often-overlooked connection between your mouth and your overall health. Esteemed experts Dr. Deb Fuller and Dr. Maria Ryan join us to unravel how neglecting your gums could be affecting your heart, complicating diabetes management, and even impacting your mental health. We promise you'll walk away with a new understanding of why a good oral hygiene routine is more than just keeping your teeth clean—it's a vital part of managing chronic diseases.
Listen and Learn:
- Economic benefits of prioritizing oral health
- The critical need to integrate oral care into medical protocols, especially for cancer patients
- The importance of educating both patients and healthcare providers on these connections, urging a holistic approach to healthcare that considers the mouth an essential part of the body
Don't miss out on this enlightening conversation that could change how you think about your health forever.
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
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):
We always say, unfortunately most physicians.
They depress the tongue andlook straight down the throat,
but they don't look at the teeth.
Speaker 3 (00:14):
Oral health really is the window to the rest of the
body.
What goes on in the mouth doeshave impacts systemically.
If someone has untreated gumdisease and diabetes, they're
going to have a harder timecontrolling their blood sugar.
Speaker 4 (00:35):
Welcome to our third and concluding episode centered
around oral health.
This also marks the finalepisode of season one of Human
Resilience changing the wayhealthcare is Delivered.
Today's themes are the linkagebetween oral health and diabetes
, and cardiovascular health.
We're fortunate to be rejoinedby some of the world's leading
experts in the field, whocontinue to emphasize the proven
(00:58):
connection between the brainand the oral cavity with the
rest of the human body.
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 deliveryscience for people in need.
(01:18):
Welcome to Human ResilienceChanging the Way Healthcare is
Delivered.
Bob's guests in this episodeare Dr Deb Fuller, National
Dental Director for Cigna Dental, and then Dr Marie Ryan,
Executive Vice President andChief Clinical Officer at the
Colgate Palmolive Company.
Speaker 1 (01:42):
About four or five years ago we spoke to the
Rutgers Dental School in NewJersey because it was just
happenstance and they mentionedthat, wow, we get an inordinate
amount of cancer patients.
So we happen to be the digitaltherapeutic or digital care
management platform for manycancer centers, including that
(02:03):
one, for many cancer centers,including that one.
So we worked with Judy Haber atNYU and the NIH and a couple
other leaders and we developedthe first ever oral health
program for cancer, which we'venow deployed the last few years.
But the fascinating thing aboutthat is, when I went to the
medical side, it was justnothing they would have ever
(02:26):
actively promoted at the timebecause they didn't think of it,
even though if you look at themeds oral oncolytics, infusion,
other things it does wreck areasonable amount of havoc in
your oral cavities.
If you were saying the topthree reasons why a medical
practice or you want to focus ononcology should really
(02:47):
integrate oral health into theclinical protocols, what would
be your top three or things youwould want to summarize for a
medical practice as to whyinclude?
Speaker 3 (02:57):
oral health really is the window to the rest of the
body.
What goes on in the mouth doeshave impacts systemically.
If someone has untreated gumdisease and diabetes, they're
going to have a harder timecontrolling their blood sugar.
Untreated gum disease putssomeone at risk for stroke,
(03:18):
cardiovascular disease.
There are so many chronicmedical conditions that are
intimately tied and themedications that are intimately
tied and the medications thatare used to treat them also
increase your risk for toothdecay or gum disease.
A lot of them cause xerostomia,dry mouth, behavioral health
conditions, depression.
Some people who areexperiencing depression just
(03:39):
don't take care of themselves.
They're twice as likely not tobe brushing their teeth.
So having good oral healthreally is going to have
tremendous positive impacts onthe rest of the body.
Managing those medicalconditions and helping them you
know helping patients, theirbehavioral health, their mental
health you know dealing withchronic pain in the mouth is
(04:01):
very, very difficult, so you canimagine what that does to
someone's mental health andwellbeing, also their
employability.
So if someone is experiencingoral health problems and they
have medical conditions thatthey're also managing, having a
job, being employed, getting apromotion, getting hired is
intimately tied and that meanshaving health insurance to help
(04:23):
with their treatment and managethat.
So that's absolutely critical.
Put the mouth back into thebody.
Speaker 4 (04:34):
Dr Maria Ryan of Colgate-Palmolive, who
contributed so much in the firsttwo episodes of this three-part
series on oral health, sharedwith Bob some of the
cutting-edge science she's beeninvolved with and the paper she
published in conjunction withthe World Economic Forum.
Speaker 1 (04:53):
On another thought, I know you guys spent a lot of
time and energy and you workedwith the World Economic Forum
and their chief economist andproduced a white paper that came
out.
Tell us a little bit about that, and how could someone get a
hold of it as well?
Speaker 2 (05:09):
Yes, I'm really excited about this paper, bob,
work from a lot of really reallysmart, smart people that went
into putting together a paperwhich is about the economic
rationale for a globalcommitment to invest in oral
health.
And really this paper cameabout from a talk I gave down in
(05:32):
Mexico where former SenatorBeshear not the son, but his dad
, who was the governor ofKentucky, governor Steve Beshear
he listened to all of ustalking about the importance of
oral health and how often it'sneglected and governments may
not cover it.
We just talked about.
You know, in Medicare there wasbasically no coverage for oral
(05:55):
care.
As people got older and, as weknow, as you get older, your
chances of getting disease areeven greater, and so there have
been movements to try andconvince governments and others
employers to ensure that theycover, have dental insurance and
help people to get the helpthat they need.
And so, as we talked about whyit was so important which is
(06:18):
because of these oral systemicconnections, et cetera he came
to me at dinner and we sat andhe said unless you give an
economic rationale for this, youcould talk about the science
all day, but nobody's going tostep up to the plate and in the
end, that's what really reallywill move the needle.
And in the end, that's whatreally really will move the
(06:38):
needle.
And because of his advice andbecause at Colgate we joined the
Global Health Equity Network ofthe World Economic Forum and
(07:01):
within that network they formeda zero health gaps plan was to
get employers throughout theworld to really buy into the
fact that the health of theiremployees and the communities
that they serve has a very, verysignificant impact on the
world's economy.
And so they created a zerohealth gaps pledge that CEOs of
companies would sign all overthe world to say yes, we are
very, very involved and careabout the health of our
(07:23):
employees and we are reachingout to the communities that we
serve to tell them that yourhealth is so important to the
world's economy.
And so, when I read the plan, Isaid this is a wonderful plan
and it talks about so manychronic diseases like diabetes
and cardiovascular disease, etcetera.
I said but there's not one wordin here about oral health,
(07:45):
about teeth, about anything inyour oral cavity.
And so, in their wisdom, theysaid okay, maria, we agree.
We shared data with them, wetalked to them about why oral
health is so important and theysaid you can form the first ever
affinity group in the WorldEconomic Forum.
And we formed the Oral HealthAffinity Group, which I'm really
(08:07):
proud that you're a member of,bob.
Speaker 1 (08:10):
I love that.
Speaker 2 (08:11):
Yes, I'm very happy you joined us.
I love that.
Yes, I'm very happy you joinedus.
And our first charge as part ofthis group was to get world
economists together fromthroughout the world and to put
together this white paper todevelop an economic rationale
for a global commitment toinvest in oral health, to
address the oral health issuesthat 50% of the world's
(08:34):
population faces.
And so we now are sharing thatpaper and it is on the World
Economic Forum website, but italso, we believe, is the first
of many papers because we'rejust beginning to collect that
data on oral health because, aswe just talked about, it's often
forgotten and neglected, and sosometimes that data is not
(08:58):
collected in the way it shouldbe.
And that's one of the calls fromthe paper as well is to
continue to build the argumentby collecting data from programs
that exist throughout the worldto really show those
connections.
Now, insurance companies havedone a pretty good job at it,
and insurance companies havedone a pretty good job at it and
particularly insurancecompanies that have both dental
(09:18):
and medical to show that whenyou and this is some of the data
given in the paper that whenyou address oral health issues
in the people who have thesedental insurance and medical
insurance in the same companythat the medical costs come down
significantly, and particularlyfor certain diseases like
(09:39):
diabetes and cardiovasculardisease, and even during
pregnancy, for adverse pregnancyoutcomes.
It's been shown that thesavings are very significant in
cost of covering thoseindividuals when the oral care
is optimal.
Speaker 1 (09:53):
We need to continue to 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
rising to front and center andbeing actualized in many
communities around the world.
(10:14):
So I think this is criticalwork, that we do this.
Speaker 2 (10:17):
Yes, absolutely.
So I mean that's an area whereyou know, I think very, very
important for women.
And you know, I would just sayalso for women, as we get older
and we go to menopause, you'realso at greater risk.
So you're at greater risk thinkabout it for osteoporosis.
(10:38):
Well, you're also at greaterrisk for periodontal disease,
you know, because that's a bonedisease.
You're losing bone around yourteeth.
So it makes sense when youthink about it, in the long run,
and to your point.
Speaker 1 (10:46):
that's why, from a human resilience point of view
and education to modifybehaviors, it takes a lot to
help people do that and it takesconsistency and some discipline
and we need to do that and helpmore people and the
professionals who serve them aswell.
So, speaking of that, let'stalk a little bit about diabetes
.
As we know, it's a majordisease around the world obesity
(11:09):
, diabetes and those things.
So talk a little bit about theoral cavity, oral health and
diabetes and those things.
So talk a little bit about theoral cavity, oral health and
diabetes and the relationship.
Speaker 2 (11:17):
Yeah, that was actually my area of research
when I was a professor at theuniversity and, like many people
, I studied that because myfather was diabetic and his
sister and his brother.
So I really became veryinterested in the connections
between oral health and diabetes.
And it's really a two-waystreet when it comes to diabetes
(11:41):
, in that if you have diabetes,most people with diabetes know
about long-term complications ofthe disease, right.
So they know that they're moreprone to eye disease,
retinopathy.
They know that they're moreprone to cardiovascular disease.
In fact, most people withdiabetes don't die from diabetes
itself, but they die fromcardiovascular disease and so
(12:05):
that's one of the well-knownlong-term complications of
diabetes.
They are more prone to woundhealing problems.
They have ulcers that may notheal.
They're more prone toneuropathy and nephropathy,
kidney disease.
So I used to go out and lecturewith the American Diabetes
(12:26):
Association, with a cardiologistand an ophthalmologist and here
I am the dentist on the panelright A nephrologist, and I
would say and there's a paper onthis by one of my former
mentors, harold Lowe that thesixth long-term complication of
diabetes is periodontal diseaseand gum disease.
(12:47):
And so I would bring this upand almost everyone in the
audience, all the patients wouldsay I knew about all the others
, but no one ever explained tome why I'm having all these
problems in my mouth.
So it was very interesting tome to learn that many people
with diabetes did not know thatthis is another complication of
(13:08):
their disease.
And what we have found is thatif you don't manage the
periodontal disease, which isinfection and inflammation, it's
very hard for that person toget their blood glucose under
control.
They can't get their A1C undercontrol.
So there are many studies thatshow that if you have
periodontal disease, your A1Csmay be higher than someone
(13:32):
without periodontal disease,which is the long-term marker of
diabetic control over the pasttwo to three months.
And if you manage theperiodontal disease, you can
bring the A1C levels down, whichis very important because the
lower the A1C levels, the lesslikely you are to get all these
other long-term complications.
And so there have been studiesdone that have shown that in
(13:56):
people with periodontal diseasewho have diabetes, their risk
for developing nephropathy,kidney disease and
cardiovascular disease or evendeath is much higher than in
people without periodontaldisease.
And many of these studies weredone in many of the indigenous
(14:17):
populations in the US, wherediabetes is much, much higher,
and so treating periodontaldisease can be very, very
helpful to the person withdiabetes.
I mean.
So we get a lot of medicaltraining.
You have to in order to treatthe patient, and so you know I
think maybe that leads into youknow some of this division that
(14:41):
we see.
But I just wanted to make onelast statement on the diabetes
side.
We talked about if you'rediabetic, you're more prone to
periodontal disease, et cetera.
What if you have periodontaldisease for a long, long time?
What if you have periodontaldisease for a long, long time?
They have done studies showingthat if you follow someone with
periodontal disease for 20 years, they're twice as likely to
(15:02):
actually become diabetic.
So it actually can increaseyour risk for developing
diabetes, because that chronicinflammation and infection
really can drive people todevelop diabetes in the long run
.
You know it's not just ifyou're diabetic and you get
periodontal disease.
(15:23):
You have a problem, that's forsure.
But if you have untreatedperiodontal disease for many
years, your risk for developingdiabetes goes up as well.
Speaker 1 (15:32):
Yeah, it's fascinating.
So talk a little bit aboutthose types of relationships in
cardiovascular area.
You know what are things thatpeople should look out for,
what's the relationship and whatcauses what?
Speaker 2 (15:46):
to your point, yeah, it's actually very similar to
you know, the discussion we hadin adverse pregnancy, in that
the bacteria, if you haveperiodontal disease, it gets in
the bloodstream and we talkabout plaque around teeth, but
when you're talking aboutcardiovascular disease you're
talking about atheroscleroticplaques, right, that develop in
(16:06):
the vessels.
And if you look in thoseatherosclerotic plaques you can
actually find oral bacteria inthose plaques, right, and so it
drives inflammation within theplaques.
And you know, one of thegreatest risk factors, other
than cholesterol, forcardiovascular disease is an
(16:30):
acute phase protein calledC-reactive protein.
And that C-reactive proteingoes up in people who have
chronic inflammation.
So if you have periodontaldisease, crp is elevated.
If you have atheroscleroticplaques, particularly if you
have bacteria in them, like fromthe oral cavity, you have
(16:50):
inflammation coming out of thoseplaques themselves and those
same enzymes I mentioned beforethat caused the breakdown of
bone and connective tissue thatcaused premature rupture of
membranes, they cause rupture ofatherosclerotic plaques and
that's how you know you have astroke, you have a major heart
(17:11):
attack.
You know the widow makers,right, that happens when you
have rupture of those plaques.
We know that people withperiodontal disease are twice as
likely to have a heart attackand three times as likely to
have a stroke, and so it'simportant that we address their
(17:31):
periodontal disease to reducetheir risk for cardiovascular
disease and stroke.
We always say, unfortunatelymost physicians, they depress
the tongue and look straightdown the throat, but they don't
look at the teeth.
You know what's happening.
So that's part of the education.
When we talk about oral healthliteracy, we were talking about
(17:52):
consumers in general, but wehave programs to educate nurses
and physicians.
We're working with Dr Hugh Silk, who's up at Harvard in the 100
Million Mouths program, wherehe is educating other healthcare
professionals to do those kindsof screens and to do exactly
what you're talking about, bob,because he feels, as a physician
(18:14):
, that this is something thatneeds to be addressed and it
makes it more difficult for thephysician to manage the patient
if they're not aware of thisinfection and inflammation
that's ongoing.
I mean, could you imagine ifyou have a person who is
diabetic and you're sittingthere and giving them all these
medications and they're doinginsulin injections and you can't
(18:36):
get and giving them, you know,all these medications and
they're doing insulin injectionsand you can't get their A1C
down and they have ragingperiodontal disease?
You know, and gee, doesn't thatmake life difficult for you and
the patient.
Speaker 1 (18:45):
Exactly.
Speaker 4 (18:47):
We hope you've enjoyed hearing from our
wonderful, engaging guests onthis third and final episode on
Oral Health and GOMO Health'spodcast series Human Resilience.
Special thanks to Dr Deb Fullerof Cigna Dental and Dr Marie
Ryan, of course, from theColgate-Palmolive Company.
For more information, pleasevisit gomohealthcom.
Human Resilience is nowavailable on all major podcast
(19:11):
engines, including Apple Music,spotify and iHeartRadio.
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.
Hosting this podcast seriesHuman Resilience, along with my
podcast partner, bob Gold, hasreally been a lot of fun.
(19:32):
We've covered everything fromsubstance use disorder to
teenage drug, alcohol andtobacco education to caregivers'
challenges in caring for lovedones and remembering to care for
themselves too.
Stay with us and visit us atgomohealthcom for more to come
in this podcast series HumanResilience Changing the Way
(19:52):
Healthcare is Delivered you, you, you.
We always say, unfortunately most physicians.
They depress the tongue andlook straight down the throat,
but they don't look at the teeth.
Speaker 3 (00:14):
Oral health really is the window to the rest of the
body.
What goes on in the mouth doeshave impacts systemically.
If someone has untreated gumdisease and diabetes, they're
going to have a harder timecontrolling their blood sugar.
Speaker 4 (00:35):
Welcome to our third and concluding episode centered
around oral health.
This also marks the finalepisode of season one of Human
Resilience changing the wayhealthcare is Delivered.
Today's themes are the linkagebetween oral health and diabetes
, and cardiovascular health.
We're fortunate to be rejoinedby some of the world's leading
experts in the field, whocontinue to emphasize the proven
(00:58):
connection between the brainand the oral cavity with the
rest of the human body.
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 deliveryscience for people in need.
(01:18):
Welcome to Human ResilienceChanging the Way Healthcare is
Delivered.
Bob's guests in this episodeare Dr Deb Fuller, National
Dental Director for Cigna Dental, and then Dr Marie Ryan,
Executive Vice President andChief Clinical Officer at the
Colgate Palmolive Company.
Speaker 1 (01:42):
About four or five years ago we spoke to the
Rutgers Dental School in NewJersey because it was just
happenstance and they mentionedthat, wow, we get an inordinate
amount of cancer patients.
So we happen to be the digitaltherapeutic or digital care
management platform for manycancer centers, including that
(02:03):
one, for many cancer centers,including that one.
So we worked with Judy Haber atNYU and the NIH and a couple
other leaders and we developedthe first ever oral health
program for cancer, which we'venow deployed the last few years.
But the fascinating thing aboutthat is, when I went to the
medical side, it was justnothing they would have ever
(02:26):
actively promoted at the timebecause they didn't think of it,
even though if you look at themeds oral oncolytics, infusion,
other things it does wreck areasonable amount of havoc in
your oral cavities.
If you were saying the topthree reasons why a medical
practice or you want to focus ononcology should really
(02:47):
integrate oral health into theclinical protocols, what would
be your top three or things youwould want to summarize for a
medical practice as to whyinclude?
Speaker 3 (02:57):
oral health really is the window to the rest of the
body.
What goes on in the mouth doeshave impacts systemically.
If someone has untreated gumdisease and diabetes, they're
going to have a harder timecontrolling their blood sugar.
Untreated gum disease putssomeone at risk for stroke,
(03:18):
cardiovascular disease.
There are so many chronicmedical conditions that are
intimately tied and themedications that are intimately
tied and the medications thatare used to treat them also
increase your risk for toothdecay or gum disease.
A lot of them cause xerostomia,dry mouth, behavioral health
conditions, depression.
Some people who areexperiencing depression just
(03:39):
don't take care of themselves.
They're twice as likely not tobe brushing their teeth.
So having good oral healthreally is going to have
tremendous positive impacts onthe rest of the body.
Managing those medicalconditions and helping them you
know helping patients, theirbehavioral health, their mental
health you know dealing withchronic pain in the mouth is
(04:01):
very, very difficult, so you canimagine what that does to
someone's mental health andwellbeing, also their
employability.
So if someone is experiencingoral health problems and they
have medical conditions thatthey're also managing, having a
job, being employed, getting apromotion, getting hired is
intimately tied and that meanshaving health insurance to help
(04:23):
with their treatment and managethat.
So that's absolutely critical.
Put the mouth back into thebody.
Speaker 4 (04:34):
Dr Maria Ryan of Colgate-Palmolive, who
contributed so much in the firsttwo episodes of this three-part
series on oral health, sharedwith Bob some of the
cutting-edge science she's beeninvolved with and the paper she
published in conjunction withthe World Economic Forum.
Speaker 1 (04:53):
On another thought, I know you guys spent a lot of
time and energy and you workedwith the World Economic Forum
and their chief economist andproduced a white paper that came
out.
Tell us a little bit about that, and how could someone get a
hold of it as well?
Speaker 2 (05:09):
Yes, I'm really excited about this paper, bob,
work from a lot of really reallysmart, smart people that went
into putting together a paperwhich is about the economic
rationale for a globalcommitment to invest in oral
health.
And really this paper cameabout from a talk I gave down in
(05:32):
Mexico where former SenatorBeshear not the son, but his dad
, who was the governor ofKentucky, governor Steve Beshear
he listened to all of ustalking about the importance of
oral health and how often it'sneglected and governments may
not cover it.
We just talked about.
You know, in Medicare there wasbasically no coverage for oral
(05:55):
care.
As people got older and, as weknow, as you get older, your
chances of getting disease areeven greater, and so there have
been movements to try andconvince governments and others
employers to ensure that theycover, have dental insurance and
help people to get the helpthat they need.
And so, as we talked about whyit was so important which is
(06:18):
because of these oral systemicconnections, et cetera he came
to me at dinner and we sat andhe said unless you give an
economic rationale for this, youcould talk about the science
all day, but nobody's going tostep up to the plate and in the
end, that's what really reallywill move the needle.
And in the end, that's whatreally really will move the
(06:38):
needle.
And because of his advice andbecause at Colgate we joined the
Global Health Equity Network ofthe World Economic Forum and
(07:01):
within that network they formeda zero health gaps plan was to
get employers throughout theworld to really buy into the
fact that the health of theiremployees and the communities
that they serve has a very, verysignificant impact on the
world's economy.
And so they created a zerohealth gaps pledge that CEOs of
companies would sign all overthe world to say yes, we are
very, very involved and careabout the health of our
(07:23):
employees and we are reachingout to the communities that we
serve to tell them that yourhealth is so important to the
world's economy.
And so, when I read the plan, Isaid this is a wonderful plan
and it talks about so manychronic diseases like diabetes
and cardiovascular disease, etcetera.
I said but there's not one wordin here about oral health,
(07:45):
about teeth, about anything inyour oral cavity.
And so, in their wisdom, theysaid okay, maria, we agree.
We shared data with them, wetalked to them about why oral
health is so important and theysaid you can form the first ever
affinity group in the WorldEconomic Forum.
And we formed the Oral HealthAffinity Group, which I'm really
(08:07):
proud that you're a member of,bob.
Speaker 1 (08:10):
I love that.
Speaker 2 (08:11):
Yes, I'm very happy you joined us.
I love that.
Yes, I'm very happy you joinedus.
And our first charge as part ofthis group was to get world
economists together fromthroughout the world and to put
together this white paper todevelop an economic rationale
for a global commitment toinvest in oral health, to
address the oral health issuesthat 50% of the world's
(08:34):
population faces.
And so we now are sharing thatpaper and it is on the World
Economic Forum website, but italso, we believe, is the first
of many papers because we'rejust beginning to collect that
data on oral health because, aswe just talked about, it's often
forgotten and neglected, and sosometimes that data is not
(08:58):
collected in the way it shouldbe.
And that's one of the calls fromthe paper as well is to
continue to build the argumentby collecting data from programs
that exist throughout the worldto really show those
connections.
Now, insurance companies havedone a pretty good job at it,
and insurance companies havedone a pretty good job at it and
particularly insurancecompanies that have both dental
(09:18):
and medical to show that whenyou and this is some of the data
given in the paper that whenyou address oral health issues
in the people who have thesedental insurance and medical
insurance in the same companythat the medical costs come down
significantly, and particularlyfor certain diseases like
(09:39):
diabetes and cardiovasculardisease, and even during
pregnancy, for adverse pregnancyoutcomes.
It's been shown that thesavings are very significant in
cost of covering thoseindividuals when the oral care
is optimal.
Speaker 1 (09:53):
We need to continue to 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
rising to front and center andbeing actualized in many
communities around the world.
(10:14):
So I think this is criticalwork, that we do this.
Speaker 2 (10:17):
Yes, absolutely.
So I mean that's an area whereyou know, I think very, very
important for women.
And you know, I would just sayalso for women, as we get older
and we go to menopause, you'realso at greater risk.
So you're at greater risk thinkabout it for osteoporosis.
(10:38):
Well, you're also at greaterrisk for periodontal disease,
you know, because that's a bonedisease.
You're losing bone around yourteeth.
So it makes sense when youthink about it, in the long run,
and to your point.
Speaker 1 (10:46):
that's why, from a human resilience point of view
and education to modifybehaviors, it takes a lot to
help people do that and it takesconsistency and some discipline
and we need to do that and helpmore people and the
professionals who serve them aswell.
So, speaking of that, let'stalk a little bit about diabetes
.
As we know, it's a majordisease around the world obesity
(11:09):
, diabetes and those things.
So talk a little bit about theoral cavity, oral health and
diabetes and those things.
So talk a little bit about theoral cavity, oral health and
diabetes and the relationship.
Speaker 2 (11:17):
Yeah, that was actually my area of research
when I was a professor at theuniversity and, like many people
, I studied that because myfather was diabetic and his
sister and his brother.
So I really became veryinterested in the connections
between oral health and diabetes.
And it's really a two-waystreet when it comes to diabetes
(11:41):
, in that if you have diabetes,most people with diabetes know
about long-term complications ofthe disease, right.
So they know that they're moreprone to eye disease,
retinopathy.
They know that they're moreprone to cardiovascular disease.
In fact, most people withdiabetes don't die from diabetes
itself, but they die fromcardiovascular disease and so
(12:05):
that's one of the well-knownlong-term complications of
diabetes.
They are more prone to woundhealing problems.
They have ulcers that may notheal.
They're more prone toneuropathy and nephropathy,
kidney disease.
So I used to go out and lecturewith the American Diabetes
(12:26):
Association, with a cardiologistand an ophthalmologist and here
I am the dentist on the panelright A nephrologist, and I
would say and there's a paper onthis by one of my former
mentors, harold Lowe that thesixth long-term complication of
diabetes is periodontal diseaseand gum disease.
(12:47):
And so I would bring this upand almost everyone in the
audience, all the patients wouldsay I knew about all the others
, but no one ever explained tome why I'm having all these
problems in my mouth.
So it was very interesting tome to learn that many people
with diabetes did not know thatthis is another complication of
(13:08):
their disease.
And what we have found is thatif you don't manage the
periodontal disease, which isinfection and inflammation, it's
very hard for that person toget their blood glucose under
control.
They can't get their A1C undercontrol.
So there are many studies thatshow that if you have
periodontal disease, your A1Csmay be higher than someone
(13:32):
without periodontal disease,which is the long-term marker of
diabetic control over the pasttwo to three months.
And if you manage theperiodontal disease, you can
bring the A1C levels down, whichis very important because the
lower the A1C levels, the lesslikely you are to get all these
other long-term complications.
And so there have been studiesdone that have shown that in
(13:56):
people with periodontal diseasewho have diabetes, their risk
for developing nephropathy,kidney disease and
cardiovascular disease or evendeath is much higher than in
people without periodontaldisease.
And many of these studies weredone in many of the indigenous
(14:17):
populations in the US, wherediabetes is much, much higher,
and so treating periodontaldisease can be very, very
helpful to the person withdiabetes.
I mean.
So we get a lot of medicaltraining.
You have to in order to treatthe patient, and so you know I
think maybe that leads into youknow some of this division that
(14:41):
we see.
But I just wanted to make onelast statement on the diabetes
side.
We talked about if you'rediabetic, you're more prone to
periodontal disease, et cetera.
What if you have periodontaldisease for a long, long time?
What if you have periodontaldisease for a long, long time?
They have done studies showingthat if you follow someone with
periodontal disease for 20 years, they're twice as likely to
(15:02):
actually become diabetic.
So it actually can increaseyour risk for developing
diabetes, because that chronicinflammation and infection
really can drive people todevelop diabetes in the long run
.
You know it's not just ifyou're diabetic and you get
periodontal disease.
(15:23):
You have a problem, that's forsure.
But if you have untreatedperiodontal disease for many
years, your risk for developingdiabetes goes up as well.
Speaker 1 (15:32):
Yeah, it's fascinating.
So talk a little bit aboutthose types of relationships in
cardiovascular area.
You know what are things thatpeople should look out for,
what's the relationship and whatcauses what?
Speaker 2 (15:46):
to your point, yeah, it's actually very similar to
you know, the discussion we hadin adverse pregnancy, in that
the bacteria, if you haveperiodontal disease, it gets in
the bloodstream and we talkabout plaque around teeth, but
when you're talking aboutcardiovascular disease you're
talking about atheroscleroticplaques, right, that develop in
(16:06):
the vessels.
And if you look in thoseatherosclerotic plaques you can
actually find oral bacteria inthose plaques, right, and so it
drives inflammation within theplaques.
And you know, one of thegreatest risk factors, other
than cholesterol, forcardiovascular disease is an
(16:30):
acute phase protein calledC-reactive protein.
And that C-reactive proteingoes up in people who have
chronic inflammation.
So if you have periodontaldisease, crp is elevated.
If you have atheroscleroticplaques, particularly if you
have bacteria in them, like fromthe oral cavity, you have
(16:50):
inflammation coming out of thoseplaques themselves and those
same enzymes I mentioned beforethat caused the breakdown of
bone and connective tissue thatcaused premature rupture of
membranes, they cause rupture ofatherosclerotic plaques and
that's how you know you have astroke, you have a major heart
(17:11):
attack.
You know the widow makers,right, that happens when you
have rupture of those plaques.
We know that people withperiodontal disease are twice as
likely to have a heart attackand three times as likely to
have a stroke, and so it'simportant that we address their
(17:31):
periodontal disease to reducetheir risk for cardiovascular
disease and stroke.
We always say, unfortunatelymost physicians, they depress
the tongue and look straightdown the throat, but they don't
look at the teeth.
You know what's happening.
So that's part of the education.
When we talk about oral healthliteracy, we were talking about
(17:52):
consumers in general, but wehave programs to educate nurses
and physicians.
We're working with Dr Hugh Silk, who's up at Harvard in the 100
Million Mouths program, wherehe is educating other healthcare
professionals to do those kindsof screens and to do exactly
what you're talking about, bob,because he feels, as a physician
(18:14):
, that this is something thatneeds to be addressed and it
makes it more difficult for thephysician to manage the patient
if they're not aware of thisinfection and inflammation
that's ongoing.
I mean, could you imagine ifyou have a person who is
diabetic and you're sittingthere and giving them all these
medications and they're doinginsulin injections and you can't
(18:36):
get and giving them, you know,all these medications and
they're doing insulin injectionsand you can't get their A1C
down and they have ragingperiodontal disease?
You know, and gee, doesn't thatmake life difficult for you and
the patient.
Speaker 1 (18:45):
Exactly.
Speaker 4 (18:47):
We hope you've enjoyed hearing from our
wonderful, engaging guests onthis third and final episode on
Oral Health and GOMO Health'spodcast series Human Resilience.
Special thanks to Dr Deb Fullerof Cigna Dental and Dr Marie
Ryan, of course, from theColgate-Palmolive Company.
For more information, pleasevisit gomohealthcom.
Human Resilience is nowavailable on all major podcast
(19:11):
engines, including Apple Music,spotify and iHeartRadio.
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.
Hosting this podcast seriesHuman Resilience, along with my
podcast partner, bob Gold, hasreally been a lot of fun.
(19:32):
We've covered everything fromsubstance use disorder to
teenage drug, alcohol andtobacco education to caregivers'
challenges in caring for lovedones and remembering to care for
themselves too.
Stay with us and visit us atgomohealthcom for more to come
in this podcast series HumanResilience Changing the Way
(19:52):
Healthcare is Delivered you, you, you.
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