Integrative Dental Medicine: Standing In The Health Care Gap

By DeWitt C. Wilkerson, DMD


The television public that watches medical programs such as “The Dr. Oz Show”, has been thoroughly informed about the relationship between lifestyle choices and chronic disease processes. One frequent guest on the show, Michael Roizen M.D., Medical Director of the renowned Cleveland Clinic Wellness Institute, teaches five basic keys to good health and wellness:

  1. Stress Reduction
  2. Proper Nutrition
  3. Physical Activity
  4. No Smoking
  5. Floss Everyday

He has quoted studies showing nearly 90% of type 2 diabetics, who properly address these five keys, can lower their blood sugar levels back to normal, without medications. This is reversing diabetes. Dr. Roisen’s colleague, Caldwell Esselstyn M.D., former Chief of Surgery at the Cleveland Clinic, has written a book entitled, “Prevent and Reverse Heart Disease, the revolutionary, scientifically proven nutrition based cure”. Newstands and bookstores are lined with scientific information about preventing and reversing chronic conditions and diseases through positive lifestyle choices.

It is now understood, that in most cases, lifestyle factors are more critical than genetic factors in controlling the expression of high blood pressure, high blood sugar and diabetes, obesity, atherosclerosis, heart attacks, strokes, Alzheimer’s, and inflammatory diseases. This is very exciting news!

Headlines also report more sobering news. Every year our nation is becoming increasingly more unhealthy. The incidence of type 2 diabetes, obesity, heart attacks, strokes, and Alzheimer’s is on the rise. The buzzword in preventative medicine is inflammation. Chronic sources of inflammation are driving most of the chronic conditions and diseases plaguing our nation. Though the answers are readily available, many in our nation are not implementing positive lifestyle habits. There are many reasons that may explain the steady health decline we observe. We live in a very demanding culture with cell phones, texts, tweets, e-mails, voicemails, instant messaging and blogs to keep up with hourly. The pace, time demands, expectations and pressures seem higher every year. How can we create more time in a day? One way is called “Take-out”. Many Americans live on pre-prepared snack foods, pizza, burgers, fries, colas, and occasional Chinese on a bed of white rice. For many, including children, their physical activity is restricted to eating these “foods” while watching an average of 5 hours of television each day. We’re too busy, with too little time, and too tired to cook healthy meals or exercise… but 20.5% of men and 15.3% of women in American do have time to smoke cigarettes. Meanwhile these factors all play into periodontal health. Recent statistics from the Center for Disease Control estimate 47.2% of adults aged 30 years and older have some form of periodontal disease and 70.1% of adults 65 years and older have periodontal disease. We are in the midst of a very real health care crisis.

Health care costs are so severely spiraling out of control that we face the probability of national bankruptcy within the next several years, unless we ration healthcare or get rational, and start addressing this problem head on, one person at a time.

Dentistry’s Golden Opportunity

In 2012, this author attended a conference of the American Academy for Oral Systemic Health(AAOSH), at the Cleveland Clinic. In his keynote address, Dr. Michael Roisen made a statement that was most profound: “I believe that Dentists should be on the frontlines fighting the health crisis that is destroying our nation.” Those words resonated an urgent calling, to make a difference, like William Wallace for his beloved Scotland in the thirteenth century- Braveheart!

This can be the golden era for Dentistry as we learn how to stand in the health care gap. The gap created by a failure to combine scientific information regarding good health and wellness with practical lifestyle applications. The gap created by health care professionals not counseling and guiding their patients to live healthier lives. The principles of good health and wellness are not complicated. There are several very practical services that every dental practice can implement for each patient.

  • Take a blood pressure reading at every appointment. A normal blood pressure for an adult is 115/75. This reflects an open vascular system. This number should hold steady for a lifetime. When the blood pressure is rising, the vascular system is shutting down. This implies atherosclerosis. This is a call to take proactive measures in the dental office.
  • Carefully review the medical history for signs of systemic inflammation. that may be influenced by lifestyle factors, such as chronic fatigue and fibromyalgia. Consider the medications listed for conditions such as high blood pressure, diabetes, muscle relaxers, poor sleep, high cholesterol, weight control, and arthritis. Most patients treated with meds for type 2 diabetes are unaware of the influence of lifestyle modifications on sugar levels.
  • Look for signs of inflammation. Bleeding on periodontal probing is a sign of local inflammation/infection, and may reflect a larger picture of systemic inflammation. This is true for teeth diagnosed with periapical abscesses as well.  Examine for sore temporomandibular joints, sore masticatory muscles, soft tissue obstruction in the back of the throat, erosive tooth wear that may be related to gastric reflux, and a careful oral cancer screening.      
  • Learn the principles of Integrative Dental Medicine.  Integrative Medicine is a growing discipline whereby the objective is to understand cause and effect relationships of health and disease. Patients are counseled on how to prevent accelerated aging and chronic degenerative conditions, such as atherosclerosis. At the same time, patients are coached on how they can engage in a lifestyle that can turn back the clock, increase energy, sharpen their minds, make them trimmer, fitter, sexier and help them live with much more vibrancy and joy. These very same principles can be applied through Dental Medicine, by addressing 4 B’s-
      Bite: TMJ, Masticatory Muscles, Dental Malocclusion, Occlusal Orthotics, Headaches
      Bacteria: Oral Pathogens, Salivary Testing, Probiotics, Periodontal Therapy, Xylitol
      Breathing: Sleep Apnea, Disordered Breathing, Nasal vs. Mouth Breathing
      Body: Systemic Inflammation, Nutrition, Physical Inactivity, Toxins, Stress

There are many lines of service associated with the Integrative Dental Medicine model.  These services can dramatically impact the lives of our patients as well as provide an ongoing business model that can dramatically affect practice profitability.

Dental colleagues, now is the time.

As a profession, it’s time to stand in the health care gap.



Dr. DeWitt Wilkerson is the Immediate Past-President of the American Academy for Oral Systemic Health (AAOSH), has studied extensively for years with the top Physicians, Nutritionists, and Health Coaches, specifically to develop an effective implementation model for complete health in Dentistry.


View Dr. Wilkerson’s full bio