1. #ASDAnet @ASDAnet The Oral Systemic Link and the Future of Patient Care Jamie Toop, DDS

2. #ASDAnet @ASDAnet About Me…

3. #ASDAnet @ASDAnet “I would give all my possessions for a moment in time ” WHAT ARE THE 7 LEADING CAUSES OF DEATH IN AMERICA? (according to the CDC)

4. #ASDAnet @ASDAnet Leading Causes of Death 1. Heart Disease 2. Cancer 3. Chronic Lower Respiratory Diseases 4. Stroke 5. Accident 6. Alzheimer's 7. Diabetes

5. #ASDAnet @ASDAnet WHAT DO THESE CONDITIONS HAVE IN COMMON? Six of the top seven leading causes of death in America have been associated with conditions in the mouth.

6. #ASDAnet @ASDAnet https://www.youtube. com/watch?v=XLDL8Nh NxWAhttps://www.youtube. com/watch?v=XLDL8Nh NxWA “The View” on Oral Systemic Link

7. #ASDAnet @ASDAnet 1. Heart Disease Associations Research Has Shown: Brushing < 2x/day = ↑ risk Gum disease → 60% ↑ risk of heart disease Gum disease → heart disease death 2x as likely Gum disease and cholesterol levels predictors

8. #ASDAnet @ASDAnet #ASDAnet @ASDAnet Gum Disease— Heart Disease Mechanism Infection/inflammatory components in gums Enter blood stream Can be carried to heart/coronary arteries Limits blood flow

9. #ASDAnet @ASDAnet 2. Cancer Associations Research Has Shown: Gum disease → 62% ↑ risk (pancreatic/kidney) Pancreatic cancer 4th leading cause of cancer-related death Detection difficult 5 year survival rate 21.5% if detected early Pancreatic cancer ↑ bacteria levels in saliva

10. #ASDAnet @ASDAnet Other Cancer Associations Research Has Shown: Men with gum disease ↑ associations of gum disease and cancer 30% ↑ risk to develop cancers of the blood ↑ risk of prostate cancer ↑ level of prostate-specific antigen secretion Saliva test in development may detect sooner

11. #ASDAnet @ASDAnet 3. Chronic Lower Respiratory Associations Research Has Shown: Oral cavity may play central role Relationship between oral hygiene and COPD Gum disease bacteria can be aspirated in lungs Respiratory pathogens can colonize in teeth

12. #ASDAnet @ASDAnet 4. Stroke Association Research Has Shown: Gum disease →3x ↑ likelihood to die from stroke Severe gum disease 4.5x ↑ risk of stroke Correlation ↑ in men and in those under 60 Gum disease bacteria enters blood stream Plaques form, can dislodge and enter brain

13. #ASDAnet @ASDAnet 5. Alzheimer’s (AD) Association Research Has Shown: AD irreversible - prevention key Declines in oral hygiene shown in AD patients Loss of teeth from gum disease ↑ AD risk Gum disease bacteria enters blood stream Can cause neuroinflammation Limits neurotransmitter activity

14. #ASDAnet @ASDAnet 6. Diabetes Association Research Has Shown: Diabetics with gum disease 3.2x ↑ risk of death Diabetic control ↑ with improved oral hygiene Infection/inflammatory components move in blood More research to establish causal relationship

15. #ASDAnet @ASDAnet Causal vs. Correlative Relationship of Oral/Systemic Link Can we establish a causal relationship?

16. #ASDAnet @ASDAnet GINGIVITIS—MATH AND VERBAL RECALL ASSOCIATION According to webmd.com, using antimicrobial mouthwash or toothpaste can make you less bad at math. webmd.com

17. #ASDAnet @ASDAnet LET’S DO SOME “CALCULUS”

18. #ASDAnet @ASDAnet Pick a number between 1 and 10 (though this will work with any number) Double it Add 10 Divide by 2 Subtract your original number WHAT NUMBER DO YOU HAVE?

19. #ASDAnet @ASDAnet IF YOU DON’T HAVE…

20. #ASDAnet @ASDAnet WHAT TO WATCH OUT FOR… Credibility of the publication Parameters of the study Repeatability Be careful to throw out what you know is true

21. #ASDAnet @ASDAnet Erectile Dysfunction (ED) Research Has Shown: Men in 30s with gum disease 3x ↑ risk of ED Infection/inflammatory components in gums Travels in blood stream, forms plaques Limits blood flow Can cause impotence - blood vessel damage

22. #ASDAnet @ASDAnet Pre-term Birth Research Has Shown: Mothers with gum disease 85% chance pre-term/low birth weight Gingivitis 3x ↑ risk Moderate gum disease 8x ↑risk Oral bacteria in pre-term placentas

23. #ASDAnet @ASDAnet Oral Systemic Link and the Future of Patient Care More research to establish causal relationships Draw conclusions from existing data Detection/prevention of disease far from oral cavity Nothing to lose in treating gum disease Eliminating can ↑ life by 6.5 years!

24. #ASDAnet @ASDAnet So, tell your patients to:

25. #ASDAnet @ASDAnet Then, tell them to:

26. #ASDAnet @ASDAnet And finally, tell them: