February is the second month of the Gregorian calendar. February is the month that we highlight childrens' oral health. February 1st is our "Give Kids a Smile" Day. February is also Dental as well as Heart Awareness month! February at the USC School of Dentistry is also the month that we celebrate the research investigations of our faculty, staff, residents and students; this year on February 13th 2008 at the Galen Center with 140 different abstracts and posters. We also are thrilled to have two superb plenary speakers including Nancy Byl from UCSF School of Medicine who will highlight the seamless connections between translational and clinical research, and Steve Offenbacher from University of North Carolina who will address a new concept in promoting health based upon his pioneering studies of oral-systemic diseases.

The mouth, as the gateway to the body, is constantly barraged by invaders--viruses, bacteria, parasites and fungi. Transmissible infectious diseases, notably cavities (dental caries) and periodontal diseases, are predominant among the ills that can compromise oral health.

It is well-established that the mouth is connected to the body, that infections in the mouth rapidly enter the bloodstream and cause bacteremia or septicemia, that oral hygiene is a profoundly important dimension of maintaining health throughout the lifespan. During the 1990s a number of investigations have been published that either establish or confirm findings that people with oral infections, children and adults, are at a greater risk of other systemic diseases. We are painfully reminded of two deaths that received national attention with bacterial infections of teeth invoking bacterial meningitis and the preventable death of two young children. If only we could promote health promotion, risk assessment, disease prevention and early access to comprehensive health care for all Americans including mental, vision and oral health care.

Scientists found that diseased oral tissues released significantly higher levels of bacterial pro-inflammatory components, such as endotoxins, into the bloodstream in people with severe periodontal diseases as compared to people with healthy oral tissues. As a result, these harmful bacterial components in the blood can travel to other organs in the body, such as the heart, and there cause harm. Further, human genetics teaches us that we each possess genes can confer relative susceptibility or resistance to regulatory molecules that control the inflammatory responses to a variety of environmental insults such as virulent bacteria in the bloodstream.

What is less certain or less "specific" is how bacteria in the bloodstream induce changes in the linings of blood vessels, changes in the basement membranes interposed between endothelial cells and the underlying connective tissue stroma, and a number of other responses to host inflammatory processes. There is still much research to be done to understand the link between periodontal diseases and systemic diseases such as cardiovascular diseases. The connections or associations, however, between oral bacteria and host inflammatory responses and overall health continue to grow. For example, researchers say the presence of antibodies to certain oral bacteria identified in amniotic fluid and fetal cord blood suggests that mothers with periodontal diseases may be as much as six to seven times more likely to have a pre-term, low-birth-weight baby.

Other associations between oral and overall health include:

-- Heart disease and stroke. While no causal effect has been established between stroke, cardiovascular disease and oral soft tissue diseases such as periodontal diseases, some data support a close association. The available biomedical literature suggests the involvement of at least two bacterial strains: Chlamydia pneumonia and Helicobacter pylori.

-- Diabetes. People with diabetes are at significantly higher risk for severe periodontal diseases. Research indicates that good diabetes management will slow down or reduce the progression of disease and that blood sugar levels are more easily controlled if periodontal diseases are treated. Elimination of the "bacterial load" reduces the severity and progression of diabetes.

-- Pre-term, low-birth-weight babies. Numerous studies are currently being conducted to determine if treating the periodontitis in pregnant women will decrease the number of pre-term, low-birth-weight babies. If documented with rigorous scientific evidence, this relatively inexpensive oral hygiene therapy during the third trimester of pregnancy could reduce the burden of low birth weight, premature babies and would be enormously "cost effective."

In 2007, approximately 40 percent of adult Americans had one of several chronic diseases and disorders (e.g. periodontal diseases, diabetes, arthritis, osteoporosis, cardiovascular diseases, pulmonary diseases and disorders, dementia). Osteoarthritis, osteoporosis, oral and pharyngeal cancer, AIDS, Parkinson's disease, and periodontal disease each represent striking examples of the mouth-body connections.

Do national, state and private-industry health policies really reflect the fact that the mouth is part of the body? Why do we segregate dental, mental and vision health care from medical care? Is there more to oral health than brushing, flossing and tooth whitening? These questions herald new opportunities as many of us consider academic professional health education, patient care, and research and health policies. In 2008 as a nation we are considering who to elect as the leader of the so-called "free world." In 2008 as state and national elections take place we will also be considering our national health and well-being in terms of economic health, quality of life and wellness, the imperative for comprehensive and universal health coverage to provide access for all Americans, and our personal and national security.

The scientific and technological foundations of dentistry, medicine, nursing, and pharmacy, as well as the allied health professions, are expanding rapidly along with the changing demographics of industrial nations, expectations for enhanced quality of life, and changes in the management and financing of health care. Health professional schools are responding to these challenges and opportunities. Public and private sector funding for clinical research will continue to enhance multicenter, prospective and randomized clinical trials, as well as behavioral interventions to advance health promotion, risk assessment, and disease prevention. Students and practitioners alike will need to be prepared to adopt evidence-based health care.

Federal health and regulatory agencies and private industry are applying a new and evolving understanding of human genetics to research on the causes and treatment of disorders related to oral health. This research, and the development of new drugs and other treatments it could promote, will significantly enhance the capacity to improve the health and well-being of all Americans. However, science is the fuel for technology. Science and technology advance diagnostics and therapeutics. But it is health policies, both private and governmental, that open access and provide essential regulations to optimize both access and quality of care for all people. It has been one year since Deamonte Driver's death from bacterial meningitis invoked by infections of his maxillary teeth. As a nation we must re-learn that our future is directly connected with the health and education of our nations' children.