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Why your medical doctor should examine your teeth

Family physician Hugh Silk explains primary care’s essential role in oral health

By Bryan Goodchild and Sandra Gray

UMass Medical School Communications

March 31, 2015

Good oral health is essential for overall health, and primary care doctors have an important role to play. That’s according to the American Academy of Family Practitioners, the U.S. Department of Health and Human Services—and UMass Medical School family physician Hugh Silk, MD.

“It’s become really important for us to integrate oral health into primary care because, this year alone, 186 million people will not visit their dentists,” said Dr. Silk, clinical associate professor of family medicine & community health, and chair of the Massachusetts Medical Society’s Oral Health Committee. “Because we see patients from cradle to grave, we can and should address this.”

Silk practices what he preaches with his own patients. He is principal investigator for Massachusetts on the From the First Tooth—Engaging Medical Clinicians in Oral Health initiative to train primary care providers to conduct oral health screenings and referrals at community health centers. He also teaches the oral health elective he spearheaded for medical and nursing students at UMMS.

“What we’re seeing is that there’s a lot of interaction between the mouth and the body,” Silk explained. “For example, if someone has really bad gum disease, their diabetes gets worse, their heart disease gets worse.”

Of course, oral health begins in childhood. Young children visit pediatricians and family physicians earlier and more frequently than they visit dentists, and primary care providers can perform childhood oral health exams right in their offices, as well as refer parents to pediatric dental professionals. Physicians are now being trained to examine the mouth. Efforts like MassHealth’s Age One program encourage parents to bring their children to see a dentist within six months of the eruption of their first tooth and the Affordable Care Act requires coverage for dental fluoride varnishing performed on children up to six years of age in a physician’s office.

“First of all we prevent cavities . . . but it also sets a lifelong approach to taking care of the mouth and therefore avoiding that downstream diabetes worsening, heart disease worsening, all because of the mouth,” said Silk.

Learn more from him about how primary care providers are working to improve oral health across the life span in this Expert’s Corner video.

Related links on UMassMedNow:
Silk: ‘There’s hope’ for integrating dental and medical care
Silk’s oral health resolution adopted by MMS
Medicine from the heart . . . Hugh Silk: Climbing the Mountain

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