A Modern Approach to Healthcare:Bridging Dentistry, Medicine, Pharmacy, and the Allied Health Professions in Health Care Delivery

Slide 1: A Modern Approach to Healthcare: Bridging Dentistry, Medicine, Pharmacy, and the Allied Health Professions in Health Care Delivery Pre-Medical Society of La Sierra University Brian H. Bergh, DDS, MS April 15, 2007

Slide 2: • B.S. Physical Education, Cal Poly State Univ, San Luis Obispo, 1985 • D.D.S., Loma Linda Univ School of Dentistry, 1990 • M.S., Craniofacial Biology and certificate in Orthodontics, USC 1992 • Clinical Assistant Professor, USC School of Dentistry • Full-time private practice in Orthodontics, Glendale, CA • Husband and father of 3

Slide 3: Healthcare: a Retrospective

Slide 4: Healthcare: a Retrospective • Middle Ages: illnesses were self-limiting; patients either got well or died.

Slide 5: Healthcare: a Retrospective • Middle Ages: illnesses were self-limiting; patients either got well or died. • Late 19th Century: the role of healthcare expanded due to the understanding of infection and development of safe anesthesia.

Slide 6: Healthcare: a Retrospective • Middle Ages: illnesses were self-limiting; patients either got well or died. • Late 19th Century: the role of healthcare expanded due to the understanding of infection and development of safe anesthesia. • Early 21st Century: delivery of care still heavily based upon models over 100 years old, but changing.

Slide 7: Aging Population

Slide 8: Aging Population • 100 years ago average lifespan was less than 50.

Slide 9: Aging Population • 100 years ago average lifespan was less than 50. • Today, life expectancy is about 80 and climbing.

Slide 10: Aging Population • 100 years ago average lifespan was less than 50. • Today, life expectancy is about 80 and climbing. • In 1900, 13% of population 50 or older.

Slide 11: Aging Population • 100 years ago average lifespan was less than 50. • Today, life expectancy is about 80 and climbing. • In 1900, 13% of population 50 or older. • In 2002, 27% of population 50 or older.

Slide 12: Aging Population • 100 years ago average lifespan was less than 50. • Today, life expectancy is about 80 and climbing. • In 1900, 13% of population 50 or older. • In 2002, 27% of population 50 or older. • In 2020, 35% of population 50 or older.

Slide 13: Aging Population • 100 years ago average lifespan was less than 50. • Today, life expectancy is about 80 and climbing. • In 1900, 13% of population 50 or older. • In 2002, 27% of population 50 or older. • In 2020, 35% of population 50 or older. • In 2002, the median age was 34.

Slide 14: Aging Population • 100 years ago average lifespan was less than 50. • Today, life expectancy is about 80 and climbing. • In 1900, 13% of population 50 or older. • In 2002, 27% of population 50 or older. • In 2020, 35% of population 50 or older. • In 2002, the median age was 34. • In 2020, the median expected to be 38.

Slide 15: Aging Population • Baby boom generation – 76 million.

Slide 16: Aging Population • Baby boom generation – 76 million. • More demanding.

Slide 17: Aging Population • Baby boom generation – 76 million. • More demanding. • More sophisticated.

Slide 18: Aging Population • Baby boom generation – 76 million. • More demanding. • More sophisticated. • More knowledgeable.

Slide 19: Aging Population • Baby boom generation – 76 million. • More demanding. • More sophisticated. • More knowledgeable. • Will need more comprehensive care.

Slide 20: Aging Population • Baby boom generation – 76 million. • More demanding. • More sophisticated. • More knowledgeable. • Will need more comprehensive care. • Geriatric care in all areas will increase in demand.

Slide 21: Obesity

Slide 22: Obesity • In 1991, 22% of Americans considered obese.

Slide 23: Obesity • In 1991, 22% of Americans considered obese. • In 2002, 30% of Americans considered obese.

Slide 24: Obesity • In 1991, 22% of Americans considered obese. • In 2002, 30% of Americans considered obese. • In 2025, 42% of Americans expected to obese.

Slide 25: Obesity • In 1991, 22% of Americans considered obese. • In 2002, 30% of Americans considered obese. • In 2025, 42% of Americans expected to obese. • Obesity threatens to undermine many health gains made over the past 20 years.

Slide 26: Obesity • Collaboration and cooperation between all health care providers will be needed to help treat and combat this problem.

Slide 27: Obesity • Collaboration and cooperation between all health care providers will be needed to help treat and combat this problem. • AARP has partnered with USA Triathlon – Tri-Umph Classic Triathlon for 50+ (has an optional 6-8 week training program.

Slide 28: Prevention, Wellness and Fitness

Slide 29: Prevention, Wellness and Fitness • Heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes cause 2/3 of deaths in the US.

Slide 30: Prevention, Wellness and Fitness • Heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes cause 2/3 of deaths in the US. • 1 out of 10 American lives affected on a daily basis from these diseases.

Slide 31: Prevention, Wellness and Fitness • Heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes cause 2/3 of deaths in the US. • 1 out of 10 American lives affected on a daily basis from these diseases. • All health professions are important in the treatment of these diseases.

Slide 32: Health Care Delivery

Slide 33: Health Care Delivery • In 1960, Health care spending was 5% of GDP.

Slide 34: Health Care Delivery • In 1960, Health care spending was 5% of GDP. • In 2004, Health care spending was 16% of GDP.

Slide 35: Health Care Delivery • In 1960, Health care spending was 5% of GDP. • In 2004, Health care spending was 16% of GDP. • In 2014, Health care spending is expected to be 18.7% of GDP.

Slide 36: Health Care Delivery • In 1960, Health care spending was 5% of GDP. • In 2004, Health care spending was 16% of GDP. • In 2014, Health care spending is expected to be 18.7% of GDP. • In the 21st century, costs have climbed several times faster than inflation or personal income.

Slide 37: Health Care Delivery • Out of pocket expenses for health care for people over the age of 65 averages approximately 19% of income.

Slide 38: Health Care Delivery • Out of pocket expenses for health care for people over the age of 65 averages approximately 19% of income. • For those without Medicaid, health care expenses are over 50% of income.

Slide 39: Health Care Delivery • Para-professional care providers will be needed to help control costs of health care.

Slide 40: Health Care Delivery • Para-professional care providers will be needed to help control costs of health care. • Continued emphasis on the prevention of diseases will be necessary.

Slide 41: Health Care Delivery • Para-professional care providers will be needed to help control costs of health care. • Continued emphasis on the prevention of diseases will be necessary. • A central data base will be needed to provide appropriate care and medication, including natural and OTC medications taken.

Slide 42: Coordination of Care

Slide 43: Coordination of Care • All healthcare professionals will need to have the increased capacity to know the treatments and medications each patient is using.

Slide 44: Coordination of Care • All healthcare professionals will need to have the increase capacity to know the treatments and medications each patient is using. • Relying on patients to provide an accurate history of treatments and medications will continue to cause problems.

Slide 45: Coordination of Care • All healthcare professionals will need to have the increase capacity to know the treatments and medications each patient is using. • Relying on patients to provide an accurate history of treatments and medications will continue to cause problems. • A centralized data base will become more necessary in the future.

Slide 46: Coordination of Care • From a dental perspective.

Slide 47: Coordination of Care • Sleep Apnea

Slide 48: Coordination of Care • Sleep Apnea • Requires the diagnosis by a sleep physician.

Slide 49: Coordination of Care • Sleep Apnea • Requires the diagnosis by a sleep physician. • Historical treatments have included surgery and CPAP units.

Slide 50: Coordination of Care • Sleep Apnea • Requires the diagnosis by a sleep physician. • Historical treatments have included surgery and CPAP units. • More and more apnea sufferers can be treated minimally and effectively with a special dental appliance.

Slide 51: Coordination of Care • Periodontal Disease

Slide 52: Coordination of Care • Periodontal Disease • Silent, generally non-painful.

Slide 53: Coordination of Care • Periodontal Disease • Silent, generally non-painful. • Recently linked definitively to increased chance of heart disease.

Slide 54: Coordination of Care • Periodontal Disease • Silent, generally non-painful. • Recently linked definitively to increase chance of heart disease. • Significantly increased chance with smokers.

Slide 55: Coordination of Care • Temporo-Mandibular Joint Disease (TMJ/TMD)

Slide 56: Coordination of Care • Temporo-Mandibular Joint Disease (TMJ/TMD) • Diagnosis – physician to rule out systemic/neurological problems prior to dentist treating.

Slide 57: Coordination of Care • Temporo-Mandibular Joint Disease (TMJ/TMD) • Diagnosis – physician to rule out systemic/neurological problems prior to dentist treating. • Dentist may treat with dental appliance only and/or refer to physical therapist, psychiatrist, etc. for additional care.

Slide 58: Coordination of Care • Medications/Therapy

Slide 59: Coordination of Care • Medications/Therapy • NSAID’s – inhibit tooth movement.

Slide 60: Coordination of Care • Medications/Therapy • NSAID’s – inhibit tooth movement. • Biophosphonates – inhibit tooth movement and cause osteo-necrosis.

Slide 61: Coordination of Care • Medications/Therapy • NSAID’s – inhibit tooth movement. • Biophosphonates – inhibit tooth movement and cause osteo-necrosis. • Radiation therapy – can cause osteo- necrosis and tooth loss.

Slide 62: Coordination of Care • Imaging

Slide 63: Coordination of Care • Imaging • CAT Scan.

Slide 64: Coordination of Care • Imaging • CAT Scan. • MRI.

Slide 65: Coordination of Care • Imaging • CAT Scan. • MRI. • Tomography.

Slide 66: Coordination of Care • Imaging • CAT Scan. • MRI. • Tomography. • 3-D imaging (cone beam technology).

Slide 67: The Future

Slide 68: The Future • Exciting!

Slide 69: The Future • Exciting! • Fun!!

Slide 70: The Future • Exciting! • Fun!! • Unbelievable!!!

Slide 71: “Somewhere, Something Incredible is Waiting to be Known.” Carl Sagan

Slide 72: Thank you!