The eyes might be the windows into the soul, but science is learning that the mouth is an important portal into your health.
Two East Amherst dental partners have taken that science to heart. They have become among the first in the region to start testing for – and destroying – mouth bacteria that can wreak havoc on other parts of the body.
“Once it’s gotten into your tissue and into your bloodstream, where it goes is anybody’s guess. Researchers have already made the links to heart disease, stroke. They’ll also tell you that kidneys and lungs and dementia can be related,” said Dr. Mark S. Wendling, who, along with Dr. David R. Rice, owns East Amherst Dental Center.
The process of identifying and treating particular bacteria that can cause periodontal disease costs roughly $300 – which brings Wendling and Rice to another professional subject they feel passionate about: dental insurance.
The practice, established by the two University at Buffalo Dental School graduates in 2000, requires patients to handle the insurance claims for the work conducted in the office. Not that it matters to as many patients as when they started, the partners said. Reimbursements for most Americans barely make an imprint on their bottom lines.
“Over the course of time, insurance companies have not kept up with cost of living or changes in the industry,” Wendling said, “so generally speaking when you deal with them, you’re still dealing with the same numbers that you may have seen in the ’70s and the ’80s, and it’s just not that way anymore.”
Q: Why dentistry?
Wendling: I have a cousin who’s a dentist, and his practice always seemed a good fit for a family. You can make your own destiny in terms of where you want to practice and the hours you want to practice. I have a couple of brother-in-laws who are in medicine. It’s very different. We control more of how we want to practice and what we want to do in the building in dentistry. In an insurance-driven market the way medicine is – where you’re unfortunately doing what insurance companies will allow you to do – Dave and I decided years ago we would practice the way we want to, versus the way insurance companies want us to.
Q: What are some of the more common things you do in your office, and some of the more challenging?
Wendling: Fillings are the most common. It’s the same stuff we used to deal with as kids. Decay is prevalent. The CAD-CAM and aesthetic work is probably more life-changing.
Rice: The philosophy of dentistry hasn’t changed much in 100 years, but the technology has evolved tremendously, and CAD-CAM is a major piece of that pie. It’s a piece of technology that only about 8 percent of dentists worldwide own. It allows us to treat teeth. You hear of some people getting crowns or bridges or dental implants the same day? This allows you to build that dentistry for a patient in a day.
Q: Talk about tooth decay and gum disease.
Wendling: It’s an old statistic that 80 percent of adults have periodontal issues or disease, but it’s a painless, slow, progressive disease, so there is very little motivation for someone to act on that. What we see doesn’t always have that importance in a patient’s mind.
Rice: It’s like cholesterol. Oftentimes, people figure out their cholesterol’s bad when they’ve had a stroke or a heart attack.
Q: What about testing for mouth decay that can be related to heart disease?
Wendling: Periodontists and dentists have known for years that it’s a bacteria-driven disease.
Rice: “Remember in recent years where medicine said, ‘We’ve been throwing antibiotics at people for decades and that’s a bad thing?’ That’s because we blanketed everything. If it was a cough or a cold, ‘Let’s just give them this.’ These tests, this technology, allows you to give somebody just what they need.”
Wendling: Doctors and dentists have used antibiotics for decades. There has just been no testing done to identify what you’re targeting. Dave might need metronidazole and you might need amoxicillin and I might need clindamycin. Each bacteria responds to something different, so instead of just throwing a dart in the dark hoping you can cover it, now you can identify the bacteria or bacterias present in high quantities … and what’s best to treat you. Some of our patients have taken the test results to their physicians. Certainly, cardiologists would be very interested because of connections to heart attack and stroke. The bleeding and the inflammation that you see in your mouth and your gum tissue is what the cardiologists are generally concerned about. Any inflammation in the body ultimately leads to the breakdown of the body. So the bacteria causing this inflammation is really part of the big picture. You want to try to minimize this in the body…
When your hygienists asks you, ‘Do your gums bleed?’ they want to know because that’s the port of entry for the bacteria into your system. It also means that your body is going to respond to that inflammation, and the way it responds is essentially to break itself down.
Q: Is there any other part to the course of treatment?
Rice: There’s a process with which we treat people inside the four walls of our office. There’s education and a system we want people to learn so they can take care of themselves at home. The antibiotic is one piece of the puzzle. Nutrition is really important. … Smoking is a major factor, so we counsel patients on that.
Wendling: We even have a conversation where we tell patients the bacteria is communicable. We have some cases in which we only see one of the two spouses. We can pass this on to our children. So we tell patients, ‘We see you, but we don’t see your husband. Spouses share everything, so he’s going to keep giving it back to you.’