Research has proven there is a strong link between oral health and overall health. Though
medicine and dentistry have operated in separate but parallel spheres for many years,
today’s doctors and dentists know there is a strong link between the two and research
offers proof. Pregnant women are prone to delivering premature babies if their teeth and
gums are neglected or infected. Young children with many cavities can experience fever
and infection elsewhere in their bodies. Older adults with poor health can lose teeth
sooner; those with osteoporosis will have bone loss that affects the teeth and jaws.

Dr. Sreenivas Koka, Chair of Dental Specialties at the Mayo Clinic, was in Alberta
recently to speak at the Alberta Dental Association and College annual congress. A
researcher who explores oral-systemic links, Dr. Koka has most recently been
investigating the use of saliva to measure bone turnover, the prequel to osteoporosis.
“Right now, we use blood and urine to test for many medical conditions,” said Dr. Koka.
“Why not saliva? It may be easier to draw a sample from this body fluid than others,
particularly for the elderly, and may well reveal as much.”

As a dentist, much of Dr. Koka’s work centers around bone loss and how to prevent it.
“I like working with the elderly and finding ways to improve their health and quality of
life,” he said. “My recent work is in osteoporosis, a common disease of old age, and it
can lead to all sorts of complications. One study showed that 25% of people with a hip
fracture die within four months of experiencing the break; 50% can’t walk across a room
unaided a year later. Dentists and physicians ideally work together to educate patients on
ways to prevent this disease and also observe signs of bone loss so they can start the
patient on medications.”

Osteoporosis and bone loss are slowed by the ingestion of bisphosphonate medication,
but some people are reluctant to take it because of rumors that it may cause disfigurement
to the jaw and face, a condition called osteonecrosis of the jaw (ONJ).

“This is an issue of risk versus benefit,” said Dr. Koka. “It is extremely rare that
bisphosphonates would cause damage, and the significant majority of documented ONJ
cases were found in people who received large doses of bisphosphonate medication as an
adjunct to cancer therapy or who took less potent forms for an extended period of time. If
you have osteopenia or osteoporosis, and your physician advises you take these drugs, it
is probably good advice. The alternative, fracture of the bone, is far worse.”

Talking with a patient about the various treatment options in dentistry is a foundation of
the profession. Both practitioners and researchers explain what each option can or cannot
do, the supportive evidence available, and the associated maintenance and cost of
treatment.

“Many of today’s patients want information before they make a decision, and dentists are
well prepared, and indeed obligated, to give them information and statistics about the
latest technology or technique, and the evidence that supports it,” said Dr. Koka. “Many
will also want advice and they ask their dentist ‘what would you do if you were me?’
Presented the wrong way, it can be presumptive on the part of the dentist to assume that
their own beliefs and preferences should supersede those of the patient. To that end,
although the dentist’s expert opinion is valuable, ultimately, the decision belongs to the
patient.”

Dr. Koka cited tooth loss as an example. Some people may not feel uncomfortable about
losing their teeth, so may not agree to treatment such as root canals or crowns that help
preserve them. People who have lost teeth are faced with a range of options including
bridges, implants, a combination of bridges and implants, or dentures. “Some care about
function, some about aesthetics, some about cost. Culture, personality and values play a
large role in each person’s decision making, and we need to respect that.”
To find out more about oral health care and treatment, talk to your dentist or go to the
Alberta Dental Association and College website www.abda.ab.ca.-

Media contact:
Kimberly McDonald, Director
Marketing, Communications & Member Services
Alberta Dental Association and College
Phone: (780) 432-1012 or toll free 1-800-843-3848