Dr. Pallasch has misinterpreted the primary message of our article. We argue that the body of literature relating oral infection to diseases and disorders at distant sites should cause us to think about the future of dental practice and the health care services we provide as dentists. Specifically, we argue that this research should lead the profession to consider delivery of a broad health promotion/disease prevention message that focuses on the importance of a healthy lifestyle.
The studies we cite in the beginning of the article are intended to provide background material for the reader, and our article certainly is not a critical review of the literature. There is no denying, however, that a robust body of literature has been published in this field and, while many of the studies are cross-sectional, that this literature has been published in peer-reviewed journals traditionally read by dentists (and others by physicians) and that dentists and physicians often have collaborated in these efforts.1–4 Unfortunately, Dr. Pallasch dismisses this entire body of literature as "supporting nothing." This is scientifically invalid and completely unwarranted.
Dr. Pallasch raises the issue of "disease mongering," an unfortunate expression that implies that this research has been used by unscrupulous practitioners to promote unnecessary dental services. Does Dr. Pallasch have any basis for making this claim? If so, that should be provided. His statement that "the oral-systemic connection is a classic example of ... charging money for treatment that has not been demonstrated to work" is simply his opinion.
Allow me to emphasize that the published report was a distillation and expansion of the discussion at the workshop, and the opinions and statements expressed in the article are those of the five authors.
We agree with Dr. Pallasch’s concluding comment that new research findings need to be vetted by other scientists to prove or disprove the discovery. The research indicating that oral infection is a risk factor for diseases and disorders at distant sites is not the work of one institution or one group of investigators. Rather, this research has been conducted and published by many investigators in the United States and across the globe. Many of those groups have found, and continue to find, that those associations exist.
Nevertheless, as stated in our article, specific associations have not been fully defined, nor have treatment recommendations been accepted. It is our hope that as this debate continues, associated questions also will be discussed, including the potential impact of this work on expansion of the scope of dental practice, and what implications that may have for dental education. This debate will strengthen the profession and ultimately result in the improved oral health and general health of our patients.
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