The oral-systemic disease connection has long been established (recall older recommendations for prophylactic antibiotics before dental work in individuals with endocarditis or joint implants), but with the emerging data on the oral microbiome, new attention is being paid to oral health and the prevention of diseases ranging from cardiovascular to autoimmune and more. A transient bacteremia is the normal course after brushing, but when there is a breakdown in oral health and alterations to the oral microbiome, this transient bacteremia leads to chronic, systemic inflammation, contributing to the course of systemic disease. There is much we can do to support our patients in correcting this inflammation, not the least of which includes a healthy, sugar-free diet; regular cleanings and appropriate brushing techniques. Ideally, the dentist is a part of the functional medicine team.

Disordered sleep breathing is a wide-spread, underappreciated problem in children and adults. Once thought to be primarily stress or trauma related, bruxism is now understood to be evidence of disordered breathing (see reference link below). Additionally, a scalloped or fissured tongue (macroglossia) also contribute to disordered sleep breathing.