Patient pointing at the screen of the tablet that the nurse is holding

What Is Whole Mouth Health?

Date: Nov 08, 2018

Author: Lisa Knowles, D.D.S

Thanks to our hard work as dental professionals, many patients understand the need for preventive care. They are accustomed to getting their teeth cleaned and checked for dental caries or periodontal problems. However, dental practitioners shouldn't stop there. Instead, think about how you can help your patients better understand how they can best protect their mouths and how the mouth and the rest of the body affect one another. Preventive oral care means thinking from a Whole Mouth Health perspective.

Complete oral health involves much more than patients brushing their teeth and flossing. It means controlling bacteria on both hard and soft tissues in the mouth and being able to overcome the daily challenges of a modern lifestyle. Maintaining the health of your patients' whole mouths, including teeth, tongue, cheeks and gums, also includes monitoring the balance of biofilm. The soft tissues, which actually harbor 80 percent of the total bacteria in the mouth, are a reservoir from which bacteria can repopulate teeth immediately after brushing, therefore increasing the risk of common oral health issues.

The oral microbiome contains bacteria, viruses and fungi. If this delicate system gets into a dysbiotic, or unbalanced, state, it allows harmful bacteria to take over and cause cavities, periodontal disease or halitosis. For your patients, you can compare the balance of good and bad bacteria in biofilm to the balance of plants and animals in nature. When one species in an ecosystem changes, the whole equilibrium is disrupted.

Whole Mouth Health is relevant to your patients due to the well-documented mouth-body connection. Remind your patients that seemingly minor oral conditions like gingival inflammation may have a significant impact on their overall health. Periodontal disease has been shown to be connected to diabetes and heart disease, while dry mouth may be an indicator of HIV/AIDS or Sjögren's syndrome, as well as other diseases and conditions.

How Can I Teach My Patients About Whole Mouth Health?

Patients may be aware of how important it is to brush their teeth, or that there is a connection between their oral health and their overall health, but they might miss the relevance of soft tissues in the mouth, or might not understand how the relationship works. They may prioritize whiter teeth over preventing inflammation or infection. It's our jobs, as coaches and health advocates, to explain the reality. Teach patients using an analogy. As an eco-friendly dentist, I often remind them about symbiotic relationships in nature, like a clownfish living in a sea anemone or a bird eating bugs off a rhino's back. Both sides are interdependent.

Let patients know that the balance in their mouths can shift without proper control measures, like brushing, flossing and controlling bacteria on all mouth surfaces. Some patients are very open to hearing about how to proactively take care of their oral health, and others are not willing to engage. Guilt may work for a week or two, but then patients may resume their former inadequate routine. (Not to mention, guilting and scolding could scare them away from ever visiting you again!)

Despite dental professionals' valiant efforts to get people to change their habits, it is often a dental crisis, such as a toothache, that ultimately motivates a patient to change. Take the opportunity to remind all your patients that they can act at any time to prevent issues from occurring, for the benefit of both the mouth and the overall body. The more we partner with our patients and learn about their specific barriers to better health, the better we can help them toward a positive outcome.

How Will Whole Mouth Health Change My Recommendations to My Patients?

With a Whole Mouth Health approach to patient care in mind, your recommendations should reflect a personalized review of each person's situation. One patient may disrupt the balance of their oral microbiome by smoking cigarettes. Another may eat and drink sugary products that affect bacteria in a different way. All patients need individualized product and care recommendations that help them proactively care for their oral health.

Realizing the harmful effects that can occur throughout the entire body when there is a lack of oral harmony should change the way you approach patient care and oral care recommendations. It's not enough to simply remind patients to brush, floss and limit their sugar intake. We have to explain the consequences and risks of inaction to our patients, not only for the health of their teeth and gums but also for the health of their entire bodies.