The most important part of making treatment recommendations is to conduct a thorough “assessment” of the patient. In order to capture both oral and systemic components of the assessment, a thorough understanding of the inter-relationship between oral and systemic inflammation as previously discussed is imperative. Assessment of the presence/absence of both oral and systemic inflammation must be done before proceeding further. The presence of oral inflammation is assessed by conducting an oral periodontal examination using bleeding on probing as the gold standard for assessing periodontal inflammation. Systemic inflammation may be determined through a thorough medical history. A model for the assessment and treatment of inflammation follows. The boxes highlighted in red show the True Risk factors for periodontitis as well as the link between periodontitis and CRP. The boxes in deep blue represent Risk Indicators of periodontitis that have not yet been shown to be true risk factors for periodontitis but do have an impact on elevating levels of CRP. The resulting treatment algorithm provides a suggested pathway of intervention for the treatment and control of both oral and systemic inflammation.
Some future directions we can take to help Baby Boomers maintain their oral health are to increase our role in health advocacy, collaborate more with other health professionals and take on a more holistic approach to patient care. This future holistic approach could include the conduction of chair side screenings for inflammatory markers such as CRP and IL-6 as well as diabetes screenings for HbA1c levels. All oral health professional students are taught to take and monitor blood pressure, yet how many actually perform this function on a routine basis once they are out in practice? These screenings should become integral to patient care as we assume a more inter professional and holistic role.
Oral health professionals and in particular, dental hygienists, spend a large part of their educational preparation in learning to be health promoters, yet this very important role is often forgotten in practice. Dental hygienists can play a significant role in helping the emerging Baby Boomers to improve not only their oral health but their overall health by increasing their focus on health promotion activities such as: