Health Measurables That Matter: Comprehensive Notes Part1

Overview

  • Purpose of the Health Measurables That Matter (HMTM) concept: a campaign-style framework in advertising for dentistry to raise patient awareness about measurable health improvements linked to dental care.
  • Goal: help practices integrate broader health conversations into Wellness Dentistry Network (WDN) beyond periodontal disease, enabling discussions about various health areas with patients.
  • Core idea: each health measurable is a specific aspect of health that can be measured, tracked, repeated, and shown to change with action.
  • The program is designed to be teachable to team members (assistants, hygienists, other staff), not just the dentist.
  • Access path: health measurables that matter are located in the dashboard under Marketing → Your Wellness Practice → Health Measurables That Matter; includes a trifold and 22 placards (and 22 individual informational placards).
  • There are 23 modules in the dental library (COI/WDN framework): the first is the Clinical Wellness Exam; the second is Gum Disease; and 21 more modules follow, each with its own Health Measurables That Matter form.

What is a health measurable?

  • A health measurable is something significant to overall well-being that can be measured.
  • It must be repeatable, and there must be a way to demonstrate that it can change through management.
  • The aim is to have metrics that can show patients they are improving, creating momentum toward actionable goals.
  • The front matter of each trifold explains why the information matters and how it connects oral health to systemic health (mouth health and whole-body health).

Why this fits the Wellness Dentistry Network (WDN)

  • Many patients focus only on dental issues like periodontal disease; HMTM campaigns push broader health topics.
  • The idea is that dentistry has a unique position due to regular patient contact (face time) and a large, regular patient base.
  • Data and literature referenced include: inflammation as a driver of systemic disease, and research linking oral health with systemic conditions such as cardiovascular disease and diabetes.
  • A 2017 paper cited in the talk states that ~70\% of premature death is lifestyle related and preventable; lifestyle changes can eliminate more than half of common diseases (e.g., heart disease, cancer, diabetes).
  • The emphasis is to help patients live healthier lives, not just fix teeth, leveraging dental visits as opportunities for broader health guidance.
  • The campaign emphasizes collaboration with physicians and other health professionals, including telemedicine options via the Partners in Health library.

Library and access details

  • In Marketing Your Wellness Practice, you’ll see Health Measurables That Matter.
  • You can print the general trifold or each of the 22 individual placards.
  • The library also features a “clinical wellness exam” module (Box #1) and a “gum disease” module (Box #2), with 22 modules total in that section.
  • The 23rd item accounts for the clinical wellness exam, which covers medical and dental history and wellness exam structure; a recording of a virtual patient meeting is planned to be uploaded.
  • Another area called the “Office Forms and Tools Library” houses the dental library and six-to-seven key measure areas that become the basis for the HMTM content.

The six (and seven) key health areas in the practice framework

  • The six original key areas (as derived from the COI Center approach: periodontal, biomechanics, function, dental facial) were recast for patient-understandability as:
    • Gum disease (periodontal health)
    • Cavities (caries)
    • Biocorrosion (cervical notching, abrasion, and erosion)
    • Bite disease (premature wear and functional issues)
    • Oral cancer / oral abnormalities
    • Sleep apnea and airway health
  • A seventh area, appearance, was added to address cosmetic/dental-facial appearance alongside the functional/health goals.
  • Biocorrosion details:
    • Notching near the gumline can be due to abrasion (toothpaste/brush aggressiveness), erosion (dietary/chemical exposure), and occlusal forces; the term “bile corrosion” is used in this talk to describe environmental damage to the teeth and is linked to notching, sensitivity, and wear.
    • The concept emphasizes teaching patients to consider toothpaste abrasiveness (relative dentin abrasivity, RDA) and the pH of drinks and mouthwashes (low pH can worsen erosion; high pH supports healthy bacteria).
  • Sleep health and oral health are integrated as part of the seven areas to acknowledge airway and sleep-disordered breathing connections.

The health measurables display: categories and what they cover

  • Displayed categories (sections on placards and in PowerPoint materials):
    • Oral health (gum disease, cavities, biocorrosion, bite disease, oral cancer/abnormalities, sleep, appearance)
    • Metabolic health
    • Cardiovascular health
    • Sleep health (airway management)
    • Nutrition and hydration
    • Lifestyle health
  • Each placard/poster includes:
    • A brief paragraph on why the health area matters
    • What can be measured in that area
    • Key questions to ask patients (prompts like gum recession, bleeding on brushing, pockets around teeth, etc.)
    • References to available tests (saliva/bacteria tests and other biomarkers)
  • Examples of specific tests mentioned:
    • PhytoLab (caries pathogens, 29 pathogens)
    • OralDNA (13 pathogens)
    • OralVital (6–7 pathogens)
    • MicroLobeDX / MicroBlinkDX (various pathogens)
    • Hain Diagnostics (historical tests; mentioned as a reference)
    • Active MMP-8 measurables (relevant to inflammatory and periodontal status)
  • The second page of each health measurables report important details: it confirms that oral bacteria and biofilm are linked to systemic health (cancer, cardiovascular disease, joint health, brain/dementia, Alzheimer’s, maternal health).

How the health measures are used in practice (implementation tips)

  • How to present information to patients:
    • Don’t overwhelm patients with every detail at once; introduce information progressively.
    • Post one placard/information piece in the office each month to keep the concept fresh.
    • Laminate and place placards in hygiene rooms, operatories, or waiting areas; patients may notice and ask questions.
    • Provide health measurables to patients at the end of a hygiene visit to encourage further reading at home.
    • The office staff (hygienists, assistants) should be trained to mention these topics casually during treatment.
  • Team approach:
    • Wellness dentistry is a team sport; assistants and hygienists should be informed and empowered to discuss health measurables.
    • The in-office culture should reflect a broader health mission beyond fixing teeth.
  • Practical display approach:
    • Use a large laminated 16×20 poster for trade shows or in-office displays; the placards are designed to be timeless and adaptable to different sizes.
    • A PowerPoint presentation for the general public is available to explain these concepts in a broader context.

How to introduce the program to patients (Q&A and patient flow)

  • Jeremy’s question about timing of information delivery:
    • Best approach is not to overwhelm ahead of an appointment; print and post health measurables in the office and provide the informational trifold to patients as needed.
    • Laminate placards in hygiene rooms or display on digital monitors so patients can view them during care.
  • The importance of staff training:
    • Hygienists, assistants, and front desk staff should be aligned on the language and purpose of HMTM so patients hear a consistent message.
  • Documentation and patient consent:
    • If a patient declines an action (e.g., probing or radiographs), document the refusal clearly and acknowledge the patient’s autonomy; do not override patient decisions, but explain why the measure is valuable.
  • Real-world example of patient experience:
    • Guided biofilm therapy was used in a case; one partner found it very well received, the other less so. The doctor discussed the experience with the patient, acknowledging preferences and offering alternatives; the patient retained choice and dignity.

Why we believe this can affect population health

  • The mouth-heart connection is repeatedly discussed in the literature; inflammatory processes from periodontal disease can influence vascular health and other systemic conditions.
  • The idea that a “healthy mouth” is foundational to a healthy body is supported by research; a substantial portion of systemic disease risk is modifiable through lifestyle and oral health interventions.
  • The program emphasizes measuring and communicating about multiple health domains (oral, metabolic, cardiovascular, sleep, nutrition, hydration, lifestyle) to help patients achieve better overall health outcomes.

Caries and cavities (module highlights)

  • Why cavities matter:
    • Cavities are a dynamic disease that can respond to early intervention and lifestyle changes; past history of cavities is an indicator of risk.
    • Patients with multiple amalgams or recent cavities may indicate higher risk; activity can vary over time.
  • Key patient questions for cavity risk:
    • Have you had a cavity in the last 3 years? If yes, this is a signal of dysbiosis in the mouth.
  • Tools and workflows:
    • Cavity management planner (a structured approach to plan preventive and treatment steps)
    • Caries risk tests include Phytolab caries panel (assessing lactobacillus and Streptococcus mutans); other tests include OralDNA, OralVital, and caries-risk panels by various providers.
  • Practical considerations:
    • X-ray frequency should be driven by caries risk; discuss fluoride strategies, sealants, and xerostomia risk for older patients.
    • Root surface caries and aging-related risk factors require attention to xerostomia and dietary/behavioral factors.

Gum disease, bite disease, and biocorrosion (more details)

  • Gum disease (periodontal health) is a major focus; a comprehensive probe (periodontal charting) is essential, and the team should understand its relevance to systemic health.
  • Bite disease: assess premature wear, active vs. stable disease, and plan appropriate interventions.
  • Biocorrosion: education about abrasivity and acidity; emphasis on patient understanding of toothpaste abrasivity and pH of beverages and mouthwashes; select high-pH rinses and consider reducing low-pH products that disrupt healthy biofilm.
  • The role of mouthwashes and beverages:
    • Many mouthwashes and drinks have low pH, which can hinder the balance of oral microbiota; high-pH products support healthy bacteria.

Sleep, airway, and appearance (integrated topics)

  • Sleep apnea and airway management are treated as separate health areas to address their oral-systemic connections.
  • Appearance (dental facial health) is included to address cosmetic and functional outcomes alongside health implications.

Ethical and practical implications

  • Avoid overwhelming patients with all information at once; tailor conversations to the patient’s concerns and readiness.
  • Ensure patient autonomy and informed consent when discussing tests and treatments; document refusals with respect and clarity.
  • Use telemedicine and external experts for collaboration when local resources are limited; build a trusted network of specialists for patient care.
  • Maintain patient confidentiality and ensure transparent communication about the role of dentistry in overall health.

Upcoming sessions and opportunities

  • Next webinar: Monday, October 4, 2024, at 08:30 (local time). The session will continue exploring additional health areas (e.g., mold, pollutants, hydration, nutrition, diabetes/insulin resistance, stress management).
  • Questions and participation:
    • Email: contact@wellnessdentistry.com for staff changes, additions, or to nominate team members to join webinars.
    • The goal is to create a scalable, team-based approach so the doctor does not have to manage everything alone.
  • Three critical points for success (summarized):
    • It remains unique within dentistry and will likely stay unique for years to come.
    • It is highly relevant and grounded in truth about oral-systemic health connections.
    • It has tangible impact on patients’ health and practice vitality, leading to increased longevity and improved quality of life.

Quick storied references and anecdotes from the talk

  • A vitamin-like story: a coupon in 2006 inspired a shift to emphasize oral-systemic health; the coupon was for a veterinary dental cleaning for a cat, which highlighted the need for communicating oral health significance more effectively.
  • Hydration and nutrition are potential webinar topics due to their impact on oral-systemic health and measurable outcomes (planning to explore in future sessions).
  • The speaker emphasizes that many diseases of aging are not normal and can be influenced by lifestyle choices with long-term health benefits.

Summary of key numerical references (LaTeX-formatted)

  • Proportion of premature death that is lifestyle-related: 70\%
  • Dentist patient return rate versus physician annual exams: dentists 72\% regular visits; physicians 53\% annual exams
  • Time-related mortality reference (heart attack or stroke): every 40 seconds
  • Cross-referenced diseases mentioned: 57
  • Number of health measurables placards: 22 placards
  • Number of health modules in the library (total): 23 modules
  • Population impact reference (older adults and periodontitis): cited in 2017 literature; relationship: inflammatory link between periodontal health and systemic conditions
  • Relative abrasion threshold referenced for dentifrices: relative dentin abrasivity (RDA) scale with a suggested safe range below 70 (and higher values warrant reconsideration)

Next steps for learners

  • Review the Health Measurables That Matter trifold and the 22 placards to familiarize yourself with the key questions and suggested patient prompts.
  • Explore the Marketing Your Wellness Practice section to locate the dashboard, the 23-module library, and the 22 placards.
  • Consider how to train your team to communicate these concepts consistently during hygiene visits and how to display information in your office.
  • Prepare questions for the next session (Oct 4) and think about which health areas you’d like to explore further, such as hydration, nutrition, sleep, and pollutants.