Dental Health and Systemic Disease

 

Dental Health and Systemic Disease

Oral health connects intimately with overall health. Periodontal disease associates with cardiovascular disease, diabetes, respiratory infections, and possibly cognitive decline through chronic inflammation. Regular dental care—biannual cleanings and exams, daily brushing and flossing, prompt treatment of problems—maintains oral health while reducing systemic inflammation.

Immunizations: Protection Throughout Life

Vaccines remain among the most effective medical interventions, preventing serious infectious diseases that disproportionately affect older adults:

Influenza: Annual flu vaccination reduces influenza infection, hospitalization, and death in older adults. High-dose or adjuvanted vaccines provide superior protection for those over 65.

Pneumococcal: Pneumococcal vaccines (PCV15/20 and PPSV23) prevent pneumonia and invasive pneumococcal disease. Recommended for all adults over 65 and younger adults with certain conditions.

Shingles: Recombinant zoster vaccine (Shingrix) is highly effective at preventing shingles and postherpetic neuralgia, recommended for adults over 50.

COVID-19: COVID-19 vaccines significantly reduce severe disease, hospitalization, and death. Older adults should stay current with recommended doses.

Tdap/Td: Tetanus, diphtheria, and pertussis protection requires periodic boosting.

Others: Depending on travel, occupation, or health status, additional vaccines (hepatitis A/B, meningococcal, etc.) may be appropriate.

Laboratory Testing and Biomarkers

Beyond condition-specific screening, certain laboratory tests provide valuable health information:

Complete Blood Count (CBC): Detects anemia, infection, clotting disorders, and blood cancers. Should be performed periodically, particularly if symptoms present.

Comprehensive Metabolic Panel (CMP): Assesses kidney function, liver function, electrolytes, glucose, and protein levels. Provides broad health overview.

Thyroid Function: Thyroid disorders become increasingly common with age. TSH testing screens thyroid function, with additional testing if abnormal.

Vitamin D: Vitamin D deficiency affects up to 40% of adults, impairing bone health, immune function, and possibly increasing chronic disease risk. Testing and supplementation to achieve optimal levels (30-50 ng/mL) may benefit health.

Vitamin B12: B12 deficiency, common in older adults and those taking metformin or proton pump inhibitors, causes anemia and neurological problems. Testing guides supplementation needs.

Inflammatory Markers: High-sensitivity C-reactive protein (hs-CRP) measures systemic inflammation predicting cardiovascular risk and possibly overall health status. Elevated levels warrant investigation and intensified lifestyle interventions.

Functional Testing: Tests of functional capacity—gait speed, grip strength, balance tests—predict mortality and disability as powerfully as laboratory tests. Declining functional performance should prompt intervention.

The Art of Medical Partnership

Effective preventive care requires partnership between patients and healthcare providers. Be proactive: prepare for appointments with questions and updates, track your health metrics, follow through with recommended screenings and tests, ask about prevention strategies appropriate for your situation, and seek second opinions when facing major medical decisions.

Equally important: avoid overuse of medical care. Not every symptom requires urgent attention; many resolve spontaneously. Be skeptical of screening tests outside evidence-based guidelines unless specific risk factors apply. Question whether medications, especially multiple medications, remain necessary—deprescribing inappropriate medications improves health in older adults. The goal is appropriate care—neither neglecting preventive measures nor pursuing excessive testing and treatment.

---