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eighteenth. This

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0:44

I'm Doctor Brian Goldman. welcome to the

0:46

Dose. I recall two

0:48

decades ago when studies discovered a

0:51

link between the health of your

0:53

gums and your heart and that

0:55

led some dentist to say loss.

0:58

Or. Die. That may

1:00

an exaggeration, but trust me, your teeth

1:02

don't just help you chew rude. They're

1:04

surprisingly important. For. Your general health

1:07

and so is your oral health in

1:09

general. With all the talk about publicly

1:11

funded dental care. Maybe. The Federal

1:13

government know something you should know to. So

1:15

this week we are asking how does the

1:17

health of my. Mouth affect my overall

1:19

health. I other welcome to the dose.

1:22

I am so pleased to be with

1:24

you. So what's your first thought? When

1:26

you hear the phrase floss or die. Well,

1:29

it, you know it. It's a

1:32

most extreme circumstance. It may be

1:34

true, but I just think it

1:36

might be. Slightly exaggerated

1:38

however it it gets attention and

1:40

it just as an indicator that

1:42

your oral health is part. Of. Your

1:45

overall health which is why we have come

1:47

to you as an expert to help us

1:49

on this very important subject. But before we

1:51

begin can you give us a hi? My

1:53

name is tell us what you do. And.

1:55

Where you do. It. I'm. Doctor Heather

1:57

Care. I'm the current President of.

2:00

Canadian Dental Association and I'm

2:02

a practicing general dentist in

2:04

Halifax for almost thirty six

2:06

years. What? Are some of the

2:08

tangible benefits of taking care of your oral

2:10

health? Is interesting. I just

2:12

back a few weeks ago it

2:14

was World Oral Health Day and

2:16

the same was actually healthy most

2:19

healthy body. So a healthy most

2:21

became. Myleene blogs you the

2:23

smell and taste properly. You can to

2:25

with a pain. If you're both, it's

2:27

healthy, you can followed properly. It allows

2:30

you to convey emotion and improve your

2:32

self esteem. You're able to smile and

2:34

talk with open self conscious so it's

2:36

a very important and such an easy

2:39

prevention is so easy for a healthy

2:41

meal. And

2:43

water is some of these specific

2:45

health benefits that we know from

2:47

evidence. That. Come from taking

2:49

care of oral health. Wasn't. Most

2:52

common is diabetes. I

2:54

quite often. In my pace and

2:57

family will see diabetics and

2:59

they're They're on. Control they often

3:01

have a lot more problems with come. To

3:03

these and on rare occasions to I've

3:05

been able to recommend a go see

3:07

their medical doctor because I get somebody

3:09

who's been in relatively. Good oral health.

3:12

And all the sudden has a lot

3:14

of gum disease, a lot of swelling

3:16

in a bleeding and so that's a

3:18

very important link and a very similar

3:20

like we find sometimes with Hiv patients.

3:22

They have a lot of issues with

3:24

their. Guns and gum disease. So.

3:26

It's actually a marker for you, so if

3:28

you see somebody with a lot of gum

3:31

disease you know they got other risk factors.

3:33

You're thinking diabetes. I certainly want them to

3:35

rule it out. And as it's

3:37

for if you get something I usual. Or

3:40

somebody comes into me new and they

3:42

seem to have more gum disease and

3:44

I would anticipate for their age and

3:47

other issues in their health in others.

3:49

Other things we diagnose at times or

3:51

at least and to a specialist: oral

3:54

cancer. You know stores in your mouth the don't

3:56

heal. For a couple weeks. Quite often,

3:58

these individuals. Have other risk factors. For help

4:00

or just tobacco use or excess alcohol

4:02

and the other thing with cancer of

4:05

any sort is the impact of chemotherapy

4:07

and sometimes radiation on your own health.

4:09

Quite often we recommend if a patient

4:11

know they have to undergo chemo that

4:14

they come in and see the dentist

4:16

first because it's very limited treatment we

4:18

can do with their immune. System

4:20

is depressed. And in other cases

4:23

depending on where the radiation field as a can

4:25

impact their sell their glance and make their mouth

4:27

tried have other issues. Let's. Talk about

4:29

some of the problems that can occur

4:31

if people aren't taking good care of

4:33

their teeth. What problems, For instance, can

4:36

most bacteria cause. Well, the most common

4:38

ones in my chair and the dental

4:40

chairs. His tooth decay. It's a two

4:42

days. It's probably one of the most

4:45

common diseases that we have and it

4:47

is very preventable. We see, as I've

4:49

mentioned already, we see gum disease. We

4:51

see oral cancer. There's just so much

4:53

of it to the reason that is

4:55

so important to have a healthy diet.

4:58

Avoid the sugar. Make sure you're coming

5:00

into your check out have your plane

5:02

is done. So much of it can

5:04

be prevented if you're. Having regular care

5:06

for your teeth, And. Of course,

5:08

the bacteria inside the mouse can

5:11

cause dental abscesses and sometimes the

5:13

bacteria can get into the bloodstream

5:15

man to the heart valves on

5:17

the lungs. Kathy. Is. Interesting

5:19

because with the things that we know

5:22

that a dental disease impact in our

5:24

overall body is a mirror to what

5:26

may occur, but it's a two way

5:28

street to. There's so many factors involved,

5:31

but definitely we certainly and the most

5:33

serious cases effect did Terry Get to

5:35

the bloodstream? Individuals get bacterial and decried

5:37

as know it is rare thankfully. but

5:40

if you have certain Valdis isn't your

5:42

heard other conditions you be more prone

5:44

to that. and there's certainly indications that

5:46

it can increase the risk of pneumonia.

5:49

And with also seen some studies that

5:52

are showing low birth weight or preterm

5:54

babies with. Individuals with gum disease.

5:56

One. Or the dental procedures that are

5:59

most likely to. Hi bacteria in your

6:01

mouth, around your teeth to leak out

6:03

into the bloodstream. If your gums and

6:05

teeth are healthy you have very low

6:07

risk that if you're as somebody who

6:09

has a lot of gum disease or

6:11

we call a on or disease with

6:13

a lot of build up when you're

6:15

having those cleans if you haven't had

6:17

one after several years is certainly could

6:19

introduce as and occasionally if you're having

6:22

a difficult fillings and more often extraction

6:24

those are the times the people have

6:26

to be aware. Is certainly.

6:28

I recall dimly from my medical school

6:30

days that there are heart valves that

6:32

are particularly at risk. And they're the

6:35

ones for which you need to take

6:37

antibiotics before you have a dental procedure.

6:39

One of the heart valves the your

6:41

most concerned about as a dentist that

6:44

you want to make sure your patients

6:46

are are taking antibiotics. It does

6:48

get updated and there is a list

6:50

conditions that we use the antibiotics pre

6:53

medication for. One that might surprise people

6:55

outside the hard as we have some

6:57

patients coming into a joint replacements and

6:59

they anticipate they should have antibiotic before

7:02

they have dental procedures and in many

7:04

cases they don't need it if their.

7:07

Overall in good health so there's a

7:09

very very. Elastic St list and we

7:11

try to follow that as careful as we can and had.

7:14

Been. Updated not too long ago. What?

7:16

Role does saliva play in keeping

7:18

our mouths healthy? Oh, it's

7:21

critical medications as we get older

7:23

and certain autoimmune conditions can dry

7:25

individuals mouth. And we tend to

7:27

see more cavities because your saliva base

7:29

your teeth and it helped keep things.

7:32

In or moving cleaner. Soviet

7:34

dry most you're much more prone. To

7:37

having gum disease and cavities so if

7:39

you're automatic case and I always suggest.

7:41

People have you have dry mouth of. A medication you have

7:43

to take. It's just. The a water carrier

7:46

always have water in out to substitute

7:48

and there are salary substitute that you

7:50

can buy in local pharmacies as well

7:52

that are effective for some individuals. You.

7:55

Certainly I know that whenever I see

7:57

my dentist my dental professional I'm ask

7:59

each time. Medications are you on? Are

8:01

you on the same medications? One of the

8:03

medications that your most concerned about. That would

8:06

decrease the flow of saliva? I know. certainly

8:08

the technical term would be Eddie Call an

8:10

urgent medication. So certain kinds of anti depressants,

8:12

antihistamines for instance one of the medications are

8:15

concerned you the most. Probably a big one

8:17

that I see as fair as the My

8:19

Door and let people tall. I have a

8:21

fluid. Pills, water, pills Guy Erratic yeah. Saw

8:24

that that's a big one. The other

8:26

thing even five or medications is better.

8:28

Pause can quite often lead to a

8:30

dryer mode, so that's another a side

8:33

effect that individuals to have to deal

8:35

with sometimes and are. Very careful

8:37

of people are on certain world

8:39

chemotherapy. Agents or radiation that can also. Try

8:41

it, you're out. In. The Emergency Department I

8:43

see patients all the time who have to Takes

8:46

we have dental residents were bill which is a

8:48

really good thing to habits. Sometimes at night when

8:50

they're not around I've had patients are coming who

8:52

asked me to pull a tooth. Which.

8:54

I don't do. As. Why

8:58

is that a bad idea? In general

9:00

when people ask for t to be

9:02

removed, it's about I did actually remove

9:04

it other and month ago we are

9:06

talking. There's multiple risk factors for the

9:08

certainly a correlation or relationship. Between

9:10

loss of teeth and actually a.

9:13

Shorter life expectancy. There's

9:15

multiple factors just practically

9:17

speaking. If you lose

9:19

t it causes. Difficulties.

9:21

When you to your food an individual

9:23

to lose all their teeth and either

9:26

weird fold enters or of know dentures

9:28

can quite often have. Poor nutrition if

9:30

they have difficulty navigating them, especially in

9:32

later years in their life. So. When

9:34

it's possible, and when it's reasonable. It's

9:36

much better to maintain your teeth. You.

9:39

Know kind of reminds me that dental

9:41

implants or naughty you should not be a

9:43

luxury item. What role do you think?

9:45

Dental implants my play and helping stave off

9:47

some of these problems that come from

9:49

losing teeth. It's interesting because I mentioned

9:51

earlier I've been out for with thirty six

9:53

years and there's been a lot of

9:55

advances and I think dental implants or one

9:58

of the greatest. Advances. And

10:00

as you say, there is definitely

10:03

cost involved. But. If. You

10:05

can replace a tooth with an implant and you have

10:07

to be in good health. You know I will

10:09

be mentor the diabetics if you're an uncontrolled diabetic. You

10:11

may not be able to get an implant

10:13

are you have other health issues they've You

10:16

can possibly are in a position to replace

10:18

a message to the implant is a game

10:20

changer in the dental world and as well

10:22

as helping you to it also maintains the

10:24

position of your other teeth and helps protect

10:27

them all. That so it's it is. I

10:29

agree with you as a it is a

10:31

wonderful and positive addition in the dental world.

10:34

You've. Mentioned chemotherapy for cancer treatment

10:36

and that can have an impact

10:38

on oral health. Are. There other

10:40

conditions that you're particularly concerned about.

10:43

When. You're treating patients in your practice.

10:46

Absolutely Well, we did mention that. There's

10:48

auto immune disorders such as Rogan Syndrome

10:50

which causes dry mouth as well as

10:52

have another you know impacts. On your

10:54

overall health and if you think about something

10:56

like eating. Disorders, for example, Billy

10:59

Mia quite. Often if somebody has

11:01

to severe case. Even. If

11:03

they don't self disclose we will see it

11:05

their teeth A road they have. Significant.

11:07

Were on the inside to their teeth,

11:10

their guns or irritated. Bad. Breath

11:12

which is not pleasant. There's different.

11:14

Issues, but those are to the come to my

11:17

mind right off the top of my head. That's

11:19

interesting, like in of course everybody's wearing masks so

11:21

very hard to smell the odor of somebody his

11:23

breath. But if somebody does have halitosis as bad

11:25

breath are you using that A clue to figure

11:27

out what other diseases they might have. Well

11:29

it depends that I'm right, You're right.

11:31

I have. I'm asked to a fifth

11:33

of dealing with the patients that. I

11:36

go by their descriptors. But

11:38

there's certain if your mother's dry.

11:40

That definitely cause health. As as

11:42

I mentioned, menopause sometimes contributes to.

11:44

At any of the medications that contribute

11:46

to the dry mouth and not having

11:48

regular cleanings and not cleaning your teeth

11:50

properly yourself with us it's funny. It's

11:52

back to the basics. floss brush in

11:54

a get your teeth cleaned because if

11:56

you haven't had a cleaning and you

11:59

tend to get. Lot of build up in

12:01

your teeth that. Definitely can create. The.

12:03

Halitosis as well and sort of in a

12:05

more. Extreme. you would be more aware. This as

12:07

a physician, but certainly and diabetes

12:10

if there's like ketone breath. It

12:12

I would be that would be more extreme as up very

12:14

often have run into that in my career. Between.

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your podcast. You.

12:48

Mentioned Radiation I wanted to elaborate

12:50

on that. What does radiation due

12:52

to the mouse? That. Might

12:54

affect oral health. In. The case

12:57

of the radiation, the biggest side

12:59

effect will occur if the Philo

13:01

radiation involves the head neck because

13:03

if it impacts. Them you're solving glance of

13:05

we just talk to at how important to live

13:07

as. And drives, you're both. Oh,

13:09

and also, if you know it tires people

13:12

and so if you're tired and you're not

13:14

feeling well, then you're oral hygiene. Yoda. Things

13:16

that you do to keep healthy may be

13:18

set aside for a while, and it doesn't

13:21

mean. They go away. They just as though

13:23

they are as time passes. You've.

13:25

Got everybody's attention right now. What are the

13:27

best ways that we can protect our oral

13:29

health? We have risk factors which

13:31

overlap with overall health, which is why

13:33

we're talking about this today. You know

13:36

you have a healthy diet. minimizes sugar

13:38

intake. That's going to help. Tooth.

13:40

Decay if you avoid tobacco products

13:42

and access our to halt the

13:44

tobacco products are related oral cancer

13:46

and it also can be trying

13:48

to your mouth and certainly access

13:50

alcohol will draw your mouth and

13:52

is a risk factor for all.

13:54

Cancer is so much prevention. If.

13:57

You can get in. To.

13:59

Your dentist. Then I don't regularly

14:01

for cleaning and have the dentist

14:03

check your teeth so you can

14:05

catch things that early. And if

14:07

you're also able to, I still

14:09

recommend that people. Try to during fluoridated

14:11

water. Because it is a great public

14:13

health measure which at positive impact on

14:15

the rate of decay or cavities. Does

14:18

fluoridated water help older people are? or?

14:20

is that something That's that's mainly of

14:22

value when you're just starting out in

14:24

life. That's an interesting question and

14:26

I don't have the detailed study on hand

14:29

that would prove it one where the other.

14:31

I certainly think it's a positive. We do

14:33

find as individuals get older we tend to

14:35

use fluoride varnish because when we get older

14:37

our roots are exposed and those roots are

14:39

much more prone to cavities. So I use

14:42

that as a treatment and many of my

14:44

i'm older patients who have to deal with

14:46

that to decrease the amount of decay they

14:48

have of it's valuable and and sometimes a

14:50

different way. but I certainly to be no

14:53

harm in heavy fluoridated. Water all throughout your

14:55

life. It would be a positive Fear: Dental

14:57

Health. I. Read an article very recently

14:59

that suggested that there's little evidence the

15:01

twice yearly gentle appointments are necessary and

15:03

I want to get your thoughts on

15:05

that. How frequently to we need to

15:07

see a dentist in order to maintain

15:09

our oral health. I think

15:11

that is different for every single individual

15:14

Some people are find once a year,

15:16

other people I see every two to

15:18

three months. We were just talking about.

15:20

Elderly patients are older, patients were fruit

15:22

exposure and very young children with a

15:25

high rate of cavities. I'll see

15:27

them every two or three months to give

15:29

the fluoride burnish. There's other. Individuals who

15:31

with they have they diabetes. And

15:33

they have a lot of gum disease that

15:35

they did have Cleaning at least cleanings if

15:37

not assessments. every three to four months you

15:39

know you have to look at the individual

15:41

and what can happen is the sale. Have

15:43

somebody come in is a new patient. they'll

15:46

have a lot of Candid is a lot

15:48

of build up, they haven't had regular care

15:50

or bring them back and for a four

15:52

month and will reassess. maybe at that time

15:54

they can move up to six months checkup.

15:56

I think the six months is just a

15:58

reasonable average for most individuals. That I really

16:00

think you need to talk to your dentist about

16:02

what is right for do have are want to

16:05

spend a couple of. Moments Talking about

16:07

Geriatric dentistry. we have a course

16:09

in aging population. We have more

16:11

and more people who have dementia.

16:14

T talk about some of the

16:16

particular challenges of treating frail seniors

16:18

perhaps with or without dementia and

16:20

how that affects the work that

16:22

you do. I always say

16:24

that a patient with the special need is

16:26

just another patient as well. Have special needs

16:28

of some sort by you are right. There

16:31

is challenges in many cases. It depends on

16:33

how much help to get home care. If

16:37

you have a caregiver especially

16:39

in and say deserve. Some.

16:41

Of these diseases such as Parkinson's or dementia,

16:44

it makes it much better. You know if

16:46

there's somebody who can get you into the

16:48

dentist or provide care you need. Daily.

16:51

That's critical but if to be patient and

16:54

caring and if you fit into service relationship

16:56

I find it helps because I certainly over

16:58

my thirty six years my patients are aging

17:00

with me as some of the were or

17:02

the me to start and there's have a

17:05

my favorite pieces to see but. They

17:07

certainly struggle, as. They get older

17:09

and there's ways around manual dexterity

17:11

even if you're trying to care

17:14

for yourself. And it's sad that.

17:16

As individuals get older they may have had them

17:18

about of it's and lose them or their income

17:21

plummeted and then I don't get to see them

17:23

as often. The time in your life when you

17:25

need the most care and you need the most

17:27

help. Is. When I stopped

17:29

to see them as regularly and then then

17:32

we're dealing with something, it's very challenging. It

17:34

is a difficult situation and I know that

17:36

it takes a lot of special care, but

17:38

it's well worth it. You.

17:40

Mentioned having a companion. When people have

17:42

dementia, one of the things they may

17:44

stop doing is taking care of their

17:46

teeth. Yes, and when that happens. I

17:49

assume the trouble follows absolutely.

17:51

And and these are individuals

17:53

who under normal circumstances. For.

17:56

Years and years would be impeccable

17:58

about oral hygiene. And in

18:00

some cases physical limitations which prevented if

18:02

a person has a stroke or as

18:04

other issues like that. So when you

18:06

talked about how often do I need

18:08

to see patients those are the type

18:10

the patients I need to see more

18:12

often as an individual who is a

18:14

quadriplegic and in a motorized wheelchair and

18:16

you know I see her every two

18:19

to three months and verb. Basically.

18:21

Brushing her teeth your thumb brush. It

18:23

is getting done in between but you

18:25

know they need that frequent care so

18:27

that we can keep them from losing

18:29

teeth, are having pain. So.

18:31

What do you do for somebody like that? The very

18:33

best we can. Or. Something Could have lived

18:36

on their own in a group home. So they

18:38

have their mother for. Many years you probably

18:40

was. Very diligent but family ties

18:42

to the caregivers. You give them

18:44

instructions and really just try to

18:46

get the men as frequently as

18:48

possible. do a thorough cleaning the

18:50

first and also has a tendency

18:52

this that. Her most sought solace

18:54

is a success. It's all of these

18:57

days I died but you know we

18:59

just your very best and find strategies.

19:01

Each day is a success because if

19:03

we can get that. Plaque.

19:05

Offer Teeth and Keep Her teeth. Alfie

19:07

Allen put some varnish on them to

19:09

keep the back terrier bay and repeated

19:11

as often as possible. Finally,

19:14

You heather! We don't usually get political

19:16

on the show, but in this case

19:18

will make an exception. for people who

19:20

don't have access to a dentist. How

19:22

much are you hoping that the new

19:24

Federal Dental Care Plan can help people.

19:26

As part of they can a

19:28

Dental Association in A We've been

19:31

advocating for access to care for

19:33

these individuals for years and so

19:35

I'm very excited that the Cdc

19:37

p you will hopefully provide access.

19:39

There are some concerns because it

19:41

has to be downright. you know

19:43

we have to make sure that

19:45

the patients are treated well. Because

19:47

of this is really a once

19:49

in a lifetime opportunity disinvestment. There

19:51

are several elements in this plan

19:53

that have raised concerns among the

19:55

demo profession. And we're still waiting for

19:58

details. Believe it or not, even though it's. To

20:00

start. In May, so I'm cautiously

20:02

optimistic. The minister health has had

20:04

several conversations with us and we're

20:07

hoping that will bale to move

20:09

forward and get these pieces the

20:11

care they need. You know we're

20:13

lucky in Canada in that two

20:15

thirds of Canadians get good care.

20:18

Primarily. Through Dell insurance and self funding,

20:20

but we really need to healthiest one third

20:22

the don't. Have. Access to care to make

20:24

sure. That they they have the good or ill

20:26

health that they deserve. Let's hope the

20:28

government is listening to professionals like you.

20:31

Doctor Heather Car, thank you for speaking

20:33

to us on the dose. Always happy

20:35

to talk about newport topic like this.

20:37

Thank you for having the Doctor Heather

20:39

Car is the President of the Canadian

20:42

Dental Association and a general dentist has

20:44

been practicing in Halifax for thirty five

20:46

years. To pseudo smart device,

20:48

oral health has a direct bearing on your

20:50

overall health. The milk contains lots of bacteria

20:52

and other germs. Tooth decay and gum disease

20:55

can cause infections in the mouth which can

20:57

spread to other parts of on. Poor

21:00

oral health is linked to heart

21:02

disease, stroke and pneumonia in pregnant

21:04

women gum or ginger will, inflammation

21:06

and infection has been linked to

21:08

premature birth and low birth weight

21:10

is a strong connection between diabetes

21:12

and or gum disease is more

21:14

prevalent if people who have diabetes,

21:16

diabetes leave the body less able

21:18

to fight infection and for the

21:20

games at risk like white people

21:23

who have gum disease have a

21:25

harder time controlling their blood sugar

21:27

levels. Regular dental care can improve

21:29

diabetes control. Hiv

21:31

Aids can lower the body's ability

21:33

to fight infection and make oral health

21:35

problems worse. Germs who

21:38

federal Cabinet or a frequent cause

21:40

of into her Dies which is

21:42

an infection of the inner lining

21:44

of the heart valves. Gum disease

21:46

has also been linked to cancer,

21:48

so the mouth, gastrointestinal tract, lung,

21:51

breast, prostate and uterus saliva is

21:53

important for good oral and general

21:55

health Medications that lower the flow,

21:57

saliva and increase risk include Decongest

21:59

Harriet the Means, Pain relievers, Water

22:01

Pills or Direct and Eighty to

22:03

prove to protect your oral health.

22:06

Take care of your mouth everyday.

22:09

Brush your teeth at least twice a

22:11

day for two minutes each time as

22:13

your tongue as well replace you to

22:15

say every three to four months for

22:17

sooner if Russell's are warm or flair

22:19

out. Clean between your

22:21

teeth daily with lots of other products. Your dentist

22:23

can tell you. Eat

22:26

a healthy diet and limits sugary

22:28

foods and drinks. Don't use tobacco

22:30

and drink alcohol. Modern. See

22:33

your dentist at least once a year

22:35

for checkups and cleaning and for your

22:37

dentist knows the other diseases. You have

22:40

and the medications you take see

22:42

your dentist right away if you

22:44

get pain of leading inside the

22:46

mouth or if you have authors

22:48

and source of the don't heal

22:50

quickly. As dementia gets worse people

22:52

tend to neglect they're all house

22:54

those with parkinson's disease and other

22:56

conditions that of that mobility may

22:58

find it difficult to take care

23:00

of that he for them paying

23:02

special attention to sugar intake and

23:04

more frequent visits to their dental

23:06

practice. Nope the meanest your topic

23:08

like discuss. To questions answered our email

23:10

addresses without a Cdc.if you like this

23:12

episode, please give us a rating and

23:14

review wherever you listen. This edition of

23:17

The Dose was produced by Severe Chopra

23:19

and Isabel Go land or sea producers.

23:21

Calling off the Dose wanted to be

23:23

better import better health. If you're looking

23:25

for medical advice, see your healthcare provider

23:27

and after Branco month until your next

23:29

else. For.

23:34

More Cbc podcasts go

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To Cbc.see A/ Podcasts,