Leaders of the Mouth-Body Connection®: Prioritizing dental-medical integration

Here Daniel Burke, Chief Enterprise Strategy Officer, Pacific Dental Services® discusses 8 pressing questions on prioritizing dental-medical integration, focusing on principles and strategies applied at the ground level.

Question: For those that do not know, please define the Mouth-Body Connection® and explain why Pacific Dental Services® (PDS) feels it is important to understand.

Daniel Burke: The Mouth-Body Connection® begins, as it should, with science that confirms the critical link between oral health and the health of the whole body. Periodontal disease, infections, and bacteria in the mouth can spread throughout the body and exacerbate or, in some cases, potentially cause systemic health issues such as cardiovascular disease, diabetes, Alzheimer’s disease, pre-term/low weight births, and more. The link is often bi-directional. Many systemic diseases, conditions and even medications can affect a patient’s oral health. Therefore, a dental visit is not simply about caring for a patient’s teeth and gums, it is also about improving the patient’s overall health. PDS’ Founder and CEO, Steven E. Thorne IV, coined the term, the Mouth-Body Connection®, in order to make a fairly complex idea easily comprehensible. 

Q: How is PDS educating clinicians and patients about the Mouth-Body Connection®? What are the challenges?

DB: Our supported clinicians are a remarkably collegial group who truly live out what we refer to as Clinicians Leading Clinicians in Clinical Excellence®. We work with them every day to further explore the link between oral and overall health. This is a top priority for the entire PDS community, which is why we have invested heavily in training, technology, and equipment to improve our supported clinicians’ ability to access more data and provide more holistic care to their patients. As you can likely tell, we have done a lot of work in this area, but, honestly, we are just getting started.

While clinician education about the Mouth-Body Connection® is the first step toward improving health outcomes, educating patients is equally important. In addition to chairside education, we’ve redesigned the look and feel of our newest supported practices for patients to provide for an immersive experience as soon as they enter the door. Furthermore, PDS-supported practices electronically distribute a quarterly educational magazine, Generations of Smiles, to millions of patients focused on the importance of understanding the connection between oral health and whole-body health. One of our most important initial learnings has been that patients quickly get it. Patients accept the Mouth Body Connectio as obvious; for them, it seems common sense. 

Further building on the idea of whole-body integration, PDS launched a unique dental-medical practice where general dentistry, pediatric dentistry and medical care all reside in one convenient location. This innovative concept increases access to comprehensive care and offers patients an integrated strategy for their health care by presenting a number of services – primary medical care, oral health care for adult and pediatric patients, salivary testing, preventative medicine, chronic disease management and more – all under the same roof.

As for challenges to operationalizing the benefits of the Mouth-Body Connection®, while we are happy to be a leader in this endeavor, we need the entire dental profession and industry, including medical and dental plans, to embrace the changes necessary for the entire patient population to take full advantage of the health benefits promised by the science behind the Mouth-Body Connection®. Yesterday should not be allowed to impede the promise of tomorrow.

Q: What clinical treatment tools are being implemented into PDS-supported offices to help clinicians provide more holistic care?

DB: PDS has long been a leading investor in advanced, proven technology that helps our supported dentists to continually raise the standard of care for their patients. Whether we do it ourselves through our internal PDS Innovations team or in partnership with industry leaders, we are constantly working to envision, develop and operationalize technology and tools that help dentists raise their game. We know that in order to provide comprehensive care for their patients, clinicians must have full access to their patients’ relevant health history. To this end, PDS is implementing Epic®, the most widely used comprehensive health records system, into our supported dental practices. Serving as Epic’s vanguard partner for dental has been a huge investment, but the dividends for our clinicians and their patients are proving to be remarkable. Through Epic, dental practices and medical providers have access to a shared data set to allow for better collaboration, more effective treatment plans, and improved health for patients. 

In addition to Epic, PDS-supported practices are also at the forefront of oral and whole-body health care with technology and tools including 3D imaging through cone beam computed tomography (CBCT), assisted intelligence and machine learning, blood and salivary diagnostics, CEREC® CAD/CAM same-day restorations, soft tissue diode lasers, and the VELscope® oral cancer screening system. 

Q: Talk to us about the link between periodontal disease and diabetes and why PDS is focused in this area.

DB: The relationship between periodontal disease (PD) and diabetes is widely seen as bi-directional, meaning that both diseases and their inflammatory factors, when not treated or controlled, directly affect the other negatively. People with diabetes are more likely to have PD than people without diabetes, and PD is often considered a complication of diabetes. The impact of PD on people with diabetes can be devastating. There are many respected studies showing the massive increase in hospitalization rates and other medical costs for patients with diabetes and PD. Fortunately, there are also numerous studies that prove the positive impact that PD treatment can quickly have on this vulnerable population. 

There is evidence that the treatment of PD results in improvement of glycemic control. Our supported practices will soon have the ability to conduct blood glucose screenings right in the dental office. With this approach, a dentist can assist in the early detection of diabetes and evaluate the potential for any hypoglycemic emergencies in the dental office. 

We are pleased that the link between PD and diabetes is gaining traction in the medical community. We recently executed a contract with an accountable care organization (ACO) to help them care for their members, with an emphasis on their diabetic population. The ACO knows that their members will be healthier and, therefore, greatly reduce their medical costs by regularly seeing a dentist.

Q: PDS recently announced a partnership with the American Diabetes Association®. How do you see this partnership improving health for patients with diabetes?

DB: PDS and the American Diabetes Association® partnered to increase awareness of the link between periodontal disease and diabetes with the mutual goal of helping patients prevent and manage this chronic health condition. As the first DSO to partner with the American Diabetes Association in this manner, we believe oral health care providers can truly make a difference as a critical access point for these vulnerable patients. Patients might arrive for a routine dental visit but will receive a more comprehensive understanding of how periodontal health impacts their diabetic condition and vice versa. Together with the American Diabetes Association, we believe that we will help drive awareness and ultimately action that improves oral and overall health.

Q: You currently serve on the Centers for Disease Control and Prevention (CDC) and National Association for Chronic Disease Directors (NACDD) Medical-Dental Integration Steering Committee. What role do you see this 10-person committee playing in the advancement of medical and dental integration? 

DB: This committee is charged with guiding and supporting a framework for the expansion of medical and dental integration programs throughout the United States. In partnership with the Centers for Disease Control and Prevention, NACDD is the only membership association of its kind to serve and represent every chronic disease division. By forming this committee, NACDD has raised awareness of the importance of oral health. We anticipate releasing initial findings in the first half of 2022.

Q: Pacific Dental Services recently announced its 850th supported practice and plans to open 100 more in 2022. To what do you attribute PDS’ accelerated growth?

DB: PDS’ unique owner-dentist model has been integral to our success since our inception. Indeed, since Steve Thorne first partnered with Carolyn Ghazal, DDS back in 1994, the owner dentist relationship has informed every significant decision PDS has made. Today, PDS supports almost 700 individual owner dentists who each own and lead their practices. The demand for our services is at the highest level we’ve ever experienced, with interest coming from recent dental school graduates as well as experienced dentists.

When we look at opening a new supported practice, PDS partners with dentists with whom we already have a trusted relationship, associates working for a PDS-supported owner dentist who are ready to own their own practice. We then look for the best real estate and evaluate markets based on patient growth and open new practices from scratch (what is referred to as the “de novo” model). This allows our supported dentists to grow their practice from the ground up.

Today, our 850+ supported practices span 26 states across the country and continue to grow. The PDS business model supports clinicians so they can do what they do best: provide excellent care to their patients.

Q: What does the future of Pacific Dental Services look like?

DB: The future is remarkably bright. One can feel that optimistic energy in our support centers and in each of the practices we are proud to support. It’s palpable. The COVID-19 pandemic provided the dental industry the opportunity to prove that oral health care is essential to public health; it was a challenging time but one that ultimately elevated the profession to its proper place within our health care system. The coming years will see Pacific Dental Services continuing to lead on educating others on the Mouth-Body Connection®, implementing proven technology that enhances clinical care, expanding our footprint in communities across the country, and advocating for dental-medical integration to improve the overall health of our patients. These efforts and more are supporting our vision of becoming The Greatest Dental Company in America. 

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