Breath is vital for life. So is digestion and your circulatory system. All of these important bodily functions are influenced by your mouth, which is why functional dentistry, the type practiced by Dr. Sam Guarnieri, DDS, at Pittsford Dental Excellence Center in Rochester, NY, can play an important role in your total body health.

Dr. Guarnieri practices the conventional dentist roles, such as general, cosmetic, reconstructive, and sedation, but it’s his comprehensive approach to systemic care that he feels is the most important aspect of dentistry. In this capacity, a functional dentist plays a critical role in a person’s health care team.

Functional Medicine and Dentistry

Functional medicine is the practice of using a system’s biology-based approach to identify and address the underlying cause of a disease. Functional dentistry is similar, except it focuses on what is happening in the mouth to decode inflammatory issues throughout the body.

“Dentistry is more than just teeth; rather it should take a systems approach to total body health,” explains Dr. Guarnieri. “You really can’t have a healthy body with a sick mouth. There are clues in your mouth to what is happening systemically in the body.”

The story of one of Dr. Guarnieri’s patients illustrates how important the role of dentistry is in comprehensive care. It shows how a knowledgeable dentist is a critical member of your health care team, alongside your primary care physician and other specialists.

Solving a Medical Mystery

Dr. Guarnieri’s patient, who was in his sixties, came to him as a referral from a functional medicine physician after experiencing a heart attack. It was puzzling because by all apparent measurements he was healthy. He followed a vegetarian diet, exercised regularly, and had nothing in his health history to indicate being at risk for a heart attack.

The patient’s medical team was monitoring various biomarkers, indicators of various blood measurements, to track his inflammation. Dr. Guarnieri administered a thorough oral exam consisting of a periodontal probe. Specifically, he was looking for pockets around his teeth that might harbor bacteria. Most of the patient’s teeth were in good shape but one tooth had four bleeding spots.

“Bleeding is a sign of inflammation caused by bacteria. There are many good bacteria but 11 types of pathogenic bacteria,” says Dr. Guarnieri.

Testing revealed the patient had five types of the pathogenic bacterial in levels at a high enough threshold that would trigger them to become active and enter the bloodstream. Medical studies have shown that oral bacteria can attach to fatty plaques in the arteries surrounding the heart, helping to form clots that could lead to a heart attack. For Dr. Guarnieri’s patient, it was an important discovery.

During the exam, Dr. Guarnieri also noticed significant wear on his patient’s front teeth, which could indicate a sign of sleep disruption. This clue led him to ask his patient some very specific sleep-related questions.

“Tooth wear of this sort is one of many indications of sleep disordered breathing. I think of it as a red flag,” says Dr. Guarnieri.

After being engaged in the conversation, the patient revealed that he snores and sometimes wakes up gasping. Dr. Guarnieri recommended a sleep study and the patient was diagnosed with moderate sleep apnea.

Both sleep apnea and pathogenic bacteria cause an inflammatory response in the body. These could be contributors to the body responding to inflammation, a heart attack, for example. For his part, Dr. Guarnieri cared for the patient’s gum tissue problem by creating a treatment protocol through personalized, integrated periodontal therapy. He also sent him back to his functional physician for follow up. Soon after treatment, all the patient’s biomarkers for inflammation went down.

Mouth Body Connection

Being a source of where bacteria can enter the bloodstream makes the mouth a critical connection point to many potential inflammatory diseases in the body. Periodontal disease may be an indicator of heart disease, stroke and diabetes. Enamel erosion may be a sign of acid reflux. Tooth grinding may be one of many signs of sleep disruption.

“You see so many ads for CPAP machines because people are not well. There are so many red flags that can indicate an issue that can be treated. I see these clues all the time,” says Dr. Guarnieri.

However, in order to pick up these clues, a dentist needs to spend time with a patient. That’s the other role of a functional dentist; recognizing that personal care means that no situation is the same. There may be similarities, but each patient brings a unique set of circumstances. Dr. Guarnieri spends a lot of time getting to know his patients and setting up an environment where they feel very comfortable.

“Patients even come early to their appointments, just to be able to relax a little bit!” exclaims Dr. Guarnieri.

He adds, “Dentistry is not just about a healthy smile. It’s so much more.”

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