Oral Health and Diabetes: A Two Way Street Maria Emanuel Ryan D.D.S., Ph.D. Professor of Oral Biology and Pathology Associate Dean of Strategic Planning & External Affairs Director of Clinical Research School of Dental Medicine

Surgeon General “A person is not healthy without good oral hygiene” C. Everett Koop, M.D. Former U.S. Surgeon General

Surgeon General’s Report Oral Health in America David Satcher, M.D. U.S. Surgeon General 2000 “oral health and general health are inseparable” “oral health is integral to general health”

Divisions of Oral Health and Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Diabetes and Oral Health: Science & Practice Diabetes an Epidemic: The Role of the Dentist March 5 th, 2007 Centers for Disease Control, Atlanta

Report of the Independent Panel of Experts of The Scottsdale Project Grand Rounds Supplement, September 2007 April 10 th -13th, 2007 Scottsdale, Arizona

“Purulence anywhere in the body needs to be treated and the mouth is no different. Judgment-based practice would dictate that treating purulence in the mouths of diabetic patients is something good.” Periodontal Disease and Endocrinology/Diabetology Guest Editorial, Grand Rounds Supplement, September 2007 Shailesh B. Patel Professor and Chief, Division of Endocrinology, Metabolism and Clinical Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin

Judgment-based practice relies on Established basic and clinical scientific principles Experience (personal and collective) Using procedures or therapies –that have been shown to be effective –pose no untoward risk (do no harm) –may prove beneficial (a positive risk-benefit ratio)

Periodontal Disease and Diabetes: Exploring New Paradigms Dental Considerations for the Optimal Medical Management of People with Diabetes Institute for Oral Health November th, 2007 Seattle. Washington

American Diabetes Association June 6th, 2008 San Francisco. California American Dental Association October 17th, 2008 San Antonio. Texas Prevalence and Risk Factors for Periodontal Disease in People with Diabetes

Periodontal Diseases Most common dental condition –Afflicts more than 30% of the adult population High morbidity –Chronic and Progressive No cure –Treatable and Preventable Linked to systemic health –Not an option or elective

Periodontitis – The Reality Underdiagnosed Undertreated Referral to specialists for management has declined Major cause of dental litigation Potential source of medical litigation