What does gum disease have to do with your heart—and what should your dentist and cardiologist know about each other’s care?
In this episode of Not Just a Dentist, Dr. Rob Raimondi and Dr. Marc Sclafani are joined by Columbia cardiologist Dr. Jennifer Haythe for a conversation about oral health, inflammation, cardiovascular risk, and the value of healthcare professionals working together.
They begin with an important distinction: gum disease and cardiovascular disease are associated, but that does not mean gum disease has been proven to cause heart attacks. Dr. Haythe explains why shared risk factors and inflammation matter, how bacteria entering the bloodstream can pose a separate concern for certain patients with heart-valve conditions, and what she would like to hear from a patient’s dentist.
The conversation expands into women’s heart health and why pregnancy complications can remain relevant long after delivery. They discuss preeclampsia, gestational hypertension, and gestational diabetes, along with the importance of appropriate medical follow-up and dental care during pregnancy.
Dr. Raimondi, Dr. Sclafani, and Dr. Haythe also unpack some of the cardiovascular terms patients encounter online: LDL, HDL, triglycerides, lipoprotein(a), ApoB, calcium scoring, and VO2 max. They explain how testing fits into an individual’s history and risk, why a wearable estimate differs from a formal exercise test, and how strength and balance affect day-to-day function as people age.
Throughout the episode, the focus comes back to practical ways to participate in your care: bring an accurate medication list, share existing test results, understand the questions your doctors are trying to answer, and seek a second opinion when you need one.
In this episode, they cover:
About the guest:
Jennifer H. Haythe, MD, is a cardiologist at Columbia University Irving Medical Center. She is the Irene and Sidney B. Silverman Associate Professor of Cardiology, director of the Adult Pulmonary Hypertension Program and the Cardio-Obstetric Program, and co-director of the Columbia Women’s Heart Center. Her clinical interests include heart failure, pulmonary hypertension, cardio-obstetrics, and cardiovascular disease in women.
Guest profile: https://doctors.columbia.edu/us/ny/new-york/jennifer-h-haythe-md-173-fort-washington-avenue
Connect with the show:
Educational disclaimer: This transcript and episode are provided for general educational purposes. They do not establish a doctor-patient relationship and should not be used as a substitute for individualized medical, dental, endodontic, or sleep evaluation.
Dr. Marc Sclafani: So Rob, we’re very lucky to be here today sitting with Dr. Jennifer Haythe. Thank you for giving us your time this morning to come with us. Dr. Jennifer Haythe is the Irene and Sidney B. Silverman Associate Professor of Cardiology at Columbia University Irving Medical Center. She is Director of the Adult Pulmonary Hypertension Program, Director of the Cardio Obstetric Program, and Co-Director of the Columbia Women’s Heart Center. She is a board-certified in cardiovascular disease and advanced heart failure and transplant cardiology, with clinical expertise spanning heart failure, pulmonary hypertension, cardiovascular disease in women and heart disease during pregnancy. That’s quite the resume. Harvard graduate and then Columbia Medical School.
Dr. Jennifer Haythe: Yep, I haven’t been at Columbia since then. Thank you. Thanks for having me guys.
Dr. Marc Sclafani: So Rob, so people wonder why are we as dentists sitting here with a cardiologist and how does that work with our practice?
Dr. Rob Raimondi: Well, we had introduced to Jen by being lucky enough to take care of her and see her social media and all the things you’re doing. And we wanted to collaborate with you because this is a really important topic. I know patients are talking with you all the time about it. The past couple of years, especially since COVID, it’s one of the most common conversations us dentists are having with our patients about their health, their non-dental health and how it contributes to their dental health. It’s been really fun for us to expand our practice to take care of people like that. What is your experience?
Dr. Jennifer Haythe: Yeah, I mean, I think that any time that we can have contact with a patient and share information and help them in their screening process and in their basic healthcare needs is so important because many people don’t have that much contact with doctors and practitioners. So being at the dentist, if your dentist can tell you that, talk to you about gum disease and heart disease and your cholesterol and your blood pressure and these topics come up, then to me, that’s amazing because I talk about taking care of a lot of pregnant women and often the only doctors they see for many, many years is their OB-GYN. And so I just feel like the more contact people can have that can help them understand what their risk factors are and how to control them is better.
Host: Yeah, so it’s the communication to tie the healthcare providers together, which really benefits everyone. You know, we speak with that of how our patients ask us better questions, they get better results and it puts us in communication with their doctors and so forth and really a benefit for their health. I guess before we dive into our topic with inflammation, heart disease and uneral disease, I guess it’s a good moment where what you let in with is what do you want patients to do to advocate for themselves when they’re your patient? What do you hope that they do when they’re your patient so you can take better care of them or they can get more from you or just to open the conversations? Maybe the ones, there are some patients that are doing that and some that aren’t doing that.
Dr. Jennifer Haythe: Yeah, I mean, for sure, I have all different kinds of patients and how they treat their healthcare. I think basic things are patients with medical problems, if they can bring someone to an appointment is always great because for me, if there’s another person who’s following along and understanding, sometimes the patients don’t always understand. If like if it’s your mother or father, someone and you can go along with them, that’s great for me because then I can have a communication. Another thing is that patients often don’t know their medicines or bring their medicines. So I’m always asking them, you know, take pictures on your cell phone of your pill bottles or, you know, just take a picture of a list or make a list, put it in your phone. Everyone has a phone for the most part now. And so that’s really helpful. A lot of patients are getting savvy. They show up with their lab results from other places they’ve done. So we don’t have to repeat. There’s so much redundancy in the medical system and waste of money. So that’s been really helpful. Also, if you have a lot of testing that’s been done, bring it to me so I can see it.
Host: A lot of times now with my chart and a lot of the hospitals, it’s linked together. It must make it easier for you.
Dr. Jennifer Haythe: Yeah, I mean, if they’re in the care everywhere system, it makes it easier. But if not, sometimes patients will just open their my chart for their hospital system they were part of in South Carolina or Texas or California, and then I can just read their results.
Host: You know, it would be nice if eventually you can loop every medical profession into that loop. What if the dental information was there? What if you knew a patient had periodontal disease? It would probably help all of us.
Host: So I guess what you’re saying is be prepared for your appointment.
Dr. Jennifer Haythe: Yeah.
Host: Don’t just show up.
Dr. Jennifer Haythe: Right.
Host: And I guess if you can’t bring someone, record the appointment.
Dr. Jennifer Haythe: Right. You can just ask the doctor if that’s okay.
Host: Right. Ask if it’s okay and upload to chat and just keep keep track of it maybe. If you can’t bring someone, which everyone can’t. Right. Everyone can’t bring someone.
Host: So, you know, the benefit is having everybody in the loop together. We’ll see patients three, four times a year. We’ll see inflammation, gum disease and so forth, where as a cardiologist, maybe only see them once a year. So sharing that information, I think, is really important, which, Rob, brings us into the first topic, which is the main part of this is gum disease and heart attack. Can gum disease increase your risk of having a heart attack?
Dr. Jennifer Haythe: Well, that’s a great question. And what we know is that people who have a lot of inflammation, gum disease, periodontal disease, have an increased risk of heart disease and heart attack. But that doesn’t mean that the gum disease is causing the heart attack. We just are able to acknowledge that those two things can coexist and seem to be maybe related to one another, which raises this question of, well, how is gum disease causing heart disease? And there’s some really straightforward ways we may get to, like, people get bacteria through their gums into their bloodstream that causes an infection on the heart valve, or there’s this correlation with higher incidence of heart attack and heart disease. So is the inflammation in the mouth leading to inflammation in the plaque in your coronary arteries or helping somehow develop plaque in the coronary arteries, which then ruptures and causes a heart attack?
Host: So is it more this just inflammatory state? So it’s not necessarily causal, but contributing factor. And it’s probably a different degree of intensity or effect on different people, depending on susceptibility.
Dr. Jennifer Haythe: Exactly. Which is part of your genetics, part of the rest of your risk factors, how well you’re taking care of them.
Host: So what would you like to see from every patient’s dentist?
Dr. Jennifer Haythe: Oh, that would be nice. It would be great if I got a note or an email or some, if we were connected in the MyChart somehow that says, you know, this patient has very little gum disease, comes three times a year, does a great job with their dental care, or this patient has terrible gum disease, just wanted to make you aware of it. And that helps us know maybe we should intensify our risk factor management. You know, if their blood pressure is just 120 over 80, maybe we want to be more like 110 over 70. If their LDL is 90, maybe we want to bring it a little bit closer to 70. So that’s sort of the type of things that we could do.
Host: You mentioned bacteria and such. Do you think, you know, we do salivary testing to culture someone’s saliva, see what bacteria is in that? Do you think there’s a good place in that and share information with you?
Dr. Jennifer Haythe: Yes. Right. That would be really interesting, especially if someone has a prosthetic card valve, right? People who, I mean, as we see so much more common for people to have TAVR, aortic valve replacement, mitral valve, even mitral clips. There’s a lot of devices out there now for valves, and those are all potential places for bacteria to stick if it gets in the bloodstream during dental work.
Dr. Rob Raimondi: Yeah, that’s a great note, Mark. You know, patients have prosthetic things. They think about doing bacterial testing on their saliva just to see even if it’s joints, too.
Dr. Jennifer Haythe: I think it’s great. I mean, you could write a paper on it.
Host: Yeah, really interesting. I know it’s really good.
Host: The first time I see inflammation in a patient, I’m thinking heart disease. I’ll ask a patient, do you see a cardiologist? Are you taking statins? And the answer is usually yes. Like you’ve had a stent. You’ve had, or you have high cholesterol. Yeah. Yes. And again, it’s not proven that it’s related, but I do see a lot of people with inflammation in the mouth, you know,
Dr. Jennifer Haythe: because it’s the same risk factors that they share, right?
Host: So the same inflammation in the mouth, does that translate into inflammation around the heart?
Dr. Jennifer Haythe: Right.
Dr. Jennifer Haythe: And inflammation is really this vague, broad term, but it is encompassing this idea of what is happening to the blood vessels in different parts of the body. So we know COVID was a virus that was really pro-inflammatory and it affected literally every organ, right? Like people’s hearing their hearts, their kidneys, their skin. And so the same goes with other kinds of inflammation. And we know people with autoimmune disease have higher rates of heart disease and different kinds of heart disease. So what is that pro-inflammatory state doing and how is it irritating the walls of our blood vessels? And is it making you more prone to plaque formation and plaque rupture?
Host: Another thing that we see that affects the gums and obviously the heart is smoking. So what do you see for patients that smoke?
Host: Dry your mouth, which we’ll get into hydration and dry mouths. We see a lot of dry mouths.
Host: It’s the quality of the tissue and the ability of saliva, right? It’s the tissues dryer, more inflamed, less resilient.
Host: So increases inflammation.
Host: Increases inflammation and increases bacteria, which increases bacteria through the bloodstream, which then had to bring the heart everywhere.
Dr. Marc Sclafani: Rob, same thing with the nicotine patches and people, things that put them on the gum.
Dr. Rob Raimondi: Yeah, that’s the dehydrating thing. It’s less cancerous, but yes, dehydrated.
Dr. Jennifer Haythe: I’d rather they do zins than smoke cigarettes.
Host: I’ve seen the zins do damage to the gum tissue. People place it.
Dr. Jennifer Haythe: Oh yeah.
Host: Particular patient.
Dr. Rob Raimondi: My buddy, yeah. Good friend.
Host: And you’ll see blanching of the tissue around that area if they put it in the same spot.
Host: Or hyperkeratosis on the tissue and like, yeah.
Dr. Jennifer Haythe: I mean, that’s not that surprising because again, it’s inflaming the gum.
Host: You’re causing inflammation.
Dr. Jennifer Haythe: Oh yeah.
Dr. Jennifer Haythe: Changing the blood vessels.
Dr. Rob Raimondi: Yeah. So we love to focus on people’s inflammation in their mouth because we’re dentists. What are some of the other main risk factors you wish people knew? Because I find patients aren’t aware, right? We’ll get patients who cardiologists send them to us to manage their gum tissue and to do salivary testing. What are a few things that you wish people knew that were some of the main risk factors that they could easily fix to help to lower the chance of heart disease?
Dr. Jennifer Haythe: There’s like the basic ones we know, which are, you know, cholesterol, obesity, like sedentary lifestyle, smoking, diabetes, huge, also major inflammation with high sugar in the bloodstream. And then there’s this whole other group of risk factors that has to do with women specifically, which is, you know, my area of interest in particular is, you know, what I don’t think a lot of women know is that having had one of the hypertensive disorders of pregnancy, like preeclampsia, gestational hypertension, gestational diabetes, this all increases your risk factors later in life. So if you had severe preeclampsia, you have like two to four times the risk of heart disease later in life than someone who didn’t. Preterm labor, similar. And then gestational diabetes, everyone’s like, oh, you had the baby and you’re not diabetic anymore. You have a much higher risk of having diabetes later in life. Also, and the same with high blood pressure. And women are, you know, as I said before, they often have a baby and then they don’t really get a lot of health care between then and the next like 15 years, right? They see their GYN once a year. Maybe they go to the dentist. So these are great touch points to sort of focus on that. Like how do we treat, how do we like recognize that this woman still has high blood pressure? And by the way, high blood pressure now is like, we don’t, we want you to be below 120 over below 70, below 80. Like we don’t, we want your blood pressure low. So there’s a lot of things we can do. Awareness is a big one so that we can screen and treat risk factors aggressively.
Host: We try to make sure we see pregnant women every three to four months. If we can, we do notice inflammation, pregnancy gingivitis is the term. We notice gingivitis in the gums and bleeding in the gums. How do you feel that relates to the health of the patient versus the baby?
Dr. Jennifer Haythe: I tell my pregnant patients, you should get your teeth cleaned like as frequently as possible while you’re pregnant. I mean, you know, again, you have when you’re pregnant, all your blood vessels are dilated, you’re bleeding more, your gums are bleeding more. I mean, your women who are pregnant often have, you know, their fingers get swollen, they have ruddy cheeks. So this is all part of how your body accommodates the volume that happens with pregnancy. And so your gum health is crucial. We don’t want women to get and have infections in their mouth or get bacteria in their bloodstream while they’re pregnant related to that because endocarditis, when you get an infected heart valve is terrible and pregnant.
Host: But to be clear, it’s affecting the pregnant woman. It’s not affected the health of the baby.
Dr. Jennifer Haythe: Yeah.
Host: And I think that it’s important what you said is that it doesn’t just end after you have the child.
Dr. Jennifer Haythe: No.
Host: Is there anything else pregnant women can do is exercising diet?
Dr. Jennifer Haythe: Yeah, I mean, we want pregnant women to be as healthy and fit as possible. What we’re seeing now is a lot of women having children later in life. And so the outcomes and the heart disease risk factors are more likely to be present. Right. So if you’re having a baby when you’re 22, you probably don’t have high blood pressure, diabetes or high cholesterol. If you’re having a baby when you’re 40, you probably have high risk. You already have existing risk factors. So the more that we can get you in shape before pregnancy, the better.
Host: I’m assuming normal 20, 25 year old woman who’s pregnant is not seeing a cardiologist.
Dr. Jennifer Haythe: Probably not.
Host: Probably not. Right. Is that a good idea to
Dr. Jennifer Haythe: not necessarily? I mean, I think it depends on your family history and your risk. But I think if you are a woman who’s 25 and pregnant and your mother or aunt or older sister developed a pretty significant heart problem in pregnancy, then you should see someone for sure.
Host: Someone gets pregnant and they have high blood pressure or we note that they have their inflammatory pregnancy, bad gums during pregnancy. What do you hope they do at that moment once they figure that out?
Dr. Jennifer Haythe: While they’re pregnant?
Host: While they’re pregnant, there are several months into pregnancy and their blood pressure spikes up.
Dr. Jennifer Haythe: First, they need to go to their OB-GYN for sure to rule out preeclampsia, which is a sort of systemic disorder of like protein and fluid management in the body, which can be lethal if left untreated, like truly. So a sudden change in blood pressure should alert your OB-GYN. Obviously, I want them to have the best dental care they can during their pregnancy because that makes them, you know, the healthiest going in. And what else can they do? They shouldn’t be trying to treat their blood pressure themselves like, oh, that’s weird. I’m pregnant and my blood pressure suddenly won’t don’t press it off. Right. Don’t be like, I’m going to eat less salt today. You need to see someone relatively urgently for that.
Host: And that would be a cardiologist?
Dr. Jennifer Haythe: Not necessarily. I mean, OBS around the country should really be are trained in preeclampsia management. When we get called in is when there’s really hard to control blood pressure. Like it’s not responding to the normal libetalol or, you know, nifedipine or the drugs that they typically use. Or they do an echo of the heart because there’s some symptoms and the heart’s looking like it’s a little bit weakened from that. Those are the kinds of cases that they involve us with.
Host: Is there anything else we could do on our part if we see more unnecessary inflammation in the mouth?
Dr. Jennifer Haythe: For the pregnant woman, probably the easiest person to let know would be the OB-GYN because they often don’t have a cardiologist.
Host: No reason to be in the connection. We wouldn’t have everybody connected.
Host: If someone finds out they’re pregnant, is it something like they can maybe should think and they’re not working out a ton and maybe their diet’s not great? Is it something they should really invest some effort and energy into maybe considering cardiovascular or weight training?
Dr. Jennifer Haythe: Right. If you find out that you’re pregnant and you haven’t been doing any exercise, I wouldn’t recommend like getting on the treadmill and jogging. But what I would say is we know that preeclampsia responds to diet and a healthy sort of Mediterranean diet. So changing your diet to that kind of diet is really important. I would say a walking program is like the greatest thing you can do.
Host: How long would someone walk for?
Dr. Jennifer Haythe: I tell people to start with whatever they’re comfortable with. If they’ve been really sedentary and they can only do 10 minutes, then start with 10 minutes.
Host: What are they trying to build up to?
Dr. Jennifer Haythe: I would say if you can do 45 minutes or 30 to 45 minutes four to five times a week of walking when you’re pregnant, that’s great.
Host: Makes you the cardiologist happy.
Dr. Jennifer Haythe: Yes. And then women who are very fit going into pregnancy, they need they’re in a little bit of a different group. We kind of have to decide what is OK. A lot of women will continue to jog through their pregnancy as long as they’re OK with that and the baby’s OK. That’s also a conversation with your OB. You know, like as long as there’s no placental issues where they’re telling them to have bedrest or something.
Host: So would it be a bigger risk for a woman who said who’s never worked out and is a little bit obese and now is pregnant to start a regimen of working out?
Dr. Jennifer Haythe: I would not probably recommend a regimen where they’re really pushing themselves. I would say like walking.
Host: Increase their activity.
Dr. Jennifer Haythe: Yeah. And light weights. Like light weights are great.
Host: We don’t have to get 30 minute workout.
Dr. Jennifer Haythe: Right. Light weights. Totally.
Host: I guess we all know pregnant or not, we should all be working out.
Dr. Jennifer Haythe: Sure.
Host: In shape or life.
Host: And not wait for an episode. We all should be.
Dr. Jennifer Haythe: It’s so hard.
Host: Not wait. You have a heart attack before you start working out. Not wait till you’re pregnant before you start working.
Host: Tried to get you to meet me in the park this morning.
Host: Yeah, you wouldn’t do it now. I would be working out at any point.
Host: Supposed to meet me in the park for a run this morning.
Dr. Jennifer Haythe: So this was my last sub stack. I talked about like, why is it so hard when you once you work out, you feel so great. And then you’re like, I’m going to do this every day. Like, I’m going to be like, you know, like, Telvester Stallone and then like, you know, in Rocky. And then the next morning your alarm goes off and you’re like, no, thanks. Yeah, I don’t get it.
Host: I think it’s setting it into your calendar and putting it in your day. And it’s some kind of.
Host: Yeah. I think it’s forcing your brain to do uncomfortable things. You need to get good at walking into the discomfort.
Dr. Jennifer Haythe: Well, I think that that must be something you guys see a lot. Like, I have a lot of people who are afraid. You know, patients are afraid of the doctor because they don’t want to find out something’s wrong with them. And I think patients are afraid of the dentist for a different reason.
Host: What do you think it is?
Dr. Jennifer Haythe: I think that they think it is like associated with a lot of physical discomfort.
Host: Yeah, it can be, I think.
Dr. Jennifer Haythe: And it’s so interesting because the most physical discomfort I’ve ever had is having like the right before the root canal. Like the tooth that’s like dying is the pain is the pain that like you want to rip your head off, whereas the dental cleaning has never bothered me.
Host: Well, I think that stems from some bad experiences to a childhood and things like that and so forth.
Dr. Jennifer Haythe: Although, again, having your kids have great teeth is so crucial.
Host: Or neglect and wait until there’s many problems. I mean, same with your business when there’s a lot of neglect. It’s more complicated.
Dr. Rob Raimondi: I think this is a bigger issue that no one’s addressing. What it comes down to, in my opinion, when people are experiencing more discomfort at the dentist or not having great experience with their health care professionals, I think they’re not finding the right person. Right. If you’re in a room with someone you trust and feel cared for, the hormonal level in your body is going to be lower. You’re going to feel pain less. Opposed to if your fight or flight is activated, you’re not in an office that you’re comfortable. They’re running late. The phones are ringing. The staff isn’t great. The office isn’t wonderful. You don’t feel great to be there. The person’s not looking you in the eye.
Host: Or the dentist may be rough with you or whatever.
Dr. Rob Raimondi: The dentist isn’t like Mark and I.
Dr. Rob Raimondi: No, and then like you but your your fight or flight is raised. And so you’re in survival mode. So therefore a flick may feel like a punch or someone cleaning your teeth gently may feel very intrusive. And so I think the root of it is having to find the right health care professionals. And like we started come to your doctors prepared, but also find the right people that you trust. If you know, you might have to drive a little further. You might have to work out your schedule and take off a work to go let doctor because it’s not convenient, but it’s going to make an impact in your health. I think that’s a big part of any any relationship with your doctor and your own relationship with yourself and your health is to find the right teammates and partners that you feel empowered and trusted with.
Dr. Jennifer Haythe: Totally.
Dr. Rob Raimondi: And I think that’s the foundation of why people then have bad experiences in health care and at the dentist.
Dr. Jennifer Haythe: I mean, I have a very strong feeling. Sometimes patients will say, you know, well, I feel bad. I use I’ve been seeing that person for so long. And I’m like, it doesn’t have to be a fight. You just can just get a second opinion.
Host: It’s not a breakup.
Dr. Jennifer Haythe: It’s not a breakup. And, you know, when I have patients that are very complicated, I encourage them to get a second opinion. I’m like, please do. That makes me feel better. And if you have a doctor who’s offended by that, like get in your doctor. That’s not OK. Yeah.
Host: It seems like if if the patient’s seeking that second opinion, maybe the communication with the doctor is not there.
Dr. Jennifer Haythe: Well, even if it is like I feel like if I was coming for some reason and I needed something big and I was a little nervous, I don’t think either of you would say to me, like, don’t get a second opinion. You would be like, do whatever you want.
Dr. Marc Sclafani: Like, yeah, I’ll send you to Rob for the second.
Host: Yeah. We have multiple opinions right here in the office. Generally, one of the smartest patients that she she she like has this relationship with all of us in a great in a great way.
Dr. Jennifer Haythe: Yeah. I’m like, who’s available? I have something in my mouth.
Dr. Rob Raimondi: You get the best care of our way because you get like, we don’t have to squeeze you in and literally like it’s like, whatever it is, it’s so smart. It’s so smart. And that’s the trust issue and the comfort zone. Like, yeah, like just to lean into that. So the way that Mark and I are so close with Jen is that we both take care of you in a way. And like, it’s so smart of her. Like, think how brilliant that is, because it’s like I have the two owners of this practice that are working really hard. They’re paying attention to everything. And like, that’s the opposite of what we’re talking about. Right. We all are connected as people with your family. Like, we have this really strong relationship that it’s the opposite of what we’re talking about. You feel empowered and you know that like you need us. We’re there. Whatever you need on your terms in a way. Right. In a good way. We represent your needs. We understand you enough. That’s the other part is you need your health care professionals to understand what they’re doing and to be focused. And then also merge that with your philosophical wants of how you want to be taken care of.
Host: Like you said, some people are afraid of getting tests and finding things out. Well, you could tell your doctor, listen, take the test and only share with me actionable items that I need to do. Don’t give me artifacts.
Host: Right. Which are a lot of tests when you get a radiologist report. There’s a ton of stuff that’s around.
Dr. Jennifer Haythe: Oh, yeah. Like, you know, I mean, if people freak out.
Host: [Scan name unclear.]
Host: Right. It’s 20 pages of irrelevance.
Host: It really was like it was. I just want to know if I had cancer and I had to worry. Right. That’s what I really cared about. I don’t care about my back and this of the joint. My disk is to grab. I don’t care.
Host: Now you can take that report and put it into Claude, put it into AI and get abbreviated version of it and find what’s really important.
Host: That’s one of the most important points of our conversation is to encourage people to find the right health care professionals that represent them properly and that are working hard to take great care of them.
Dr. Jennifer Haythe: Yes. And that when you were mentioning about that, just your purineuvo test, like, I think sometimes people, you know, I see people who have zero testing done. And then I have people who come with like reams and reams of labs that I am like, I don’t know what to do with this. But. But one thing that is becoming talked about a little bit more is this lipoprotein little a.
Host: Yeah, let’s talk about that. It’s all over social media.
Dr. Jennifer Haythe: Yeah, it is all over social media. And I’m like, and the irony of LP little a is that you basically can’t do anything to lower it. It is your in your genetics and it’s like 95 percent genetic. And it is a level you only need to really check one time in your life. It is either normal or it’s not normal. It doesn’t vary. It doesn’t vary. It’s not treated by statins. And it is a it is like a cholesterol particle that’s attached to LDL that has a higher risk of inflammation and heart attack associated with it. So it is more likely to cause the dangerous kind of unstable plaque. And what why it was most recently, I was literally like moving my kid into college last weekend. And there was a notification on the news that this drug that had been designed to treat LP little a failed in the initial studies. And so people were disappointed by that because they’re trying to fix because like we said, none of the drugs we have can treat it. It’s like either you have it or you don’t have it. And what we do know, though, is if your LP little a is elevated and you are at increased risk, especially if you have a family history, then the one thing you can do is then more aggressively treat your other risk factors, which is sort of what we’ve been talking about with dental care, like you have terrible, gingable problems or, you know, periodontal problems, then what can I do with that? Besides you guys taking care of their teeth, I can treat their other risk factors more aggressively. And that is what kind of it comes down to with LP little a be more aggressive with cholesterol, be more aggressive with blood pressure.
Host: How does that compare the LP little a with cholesterol? I mean, someone can have a high LP little a and low LDLs.
Dr. Jennifer Haythe: Yeah, you could, I guess, in theory, your I mean, depending on if you’re on a statin or not, but your LP little a is not going to change.
Host: It’s not going to change. Yeah.
Host: But all those patients aren’t on statins necessarily.
Dr. Jennifer Haythe: Not necessarily.
Host: And so how do you feel the relationship with APO B is that’s completely different now?
Dr. Jennifer Haythe: Well, so APO B is.
Host: Something else on social media. Post also.
Dr. Jennifer Haythe: It’s a cholesterol particle that are carrying protein. And again, like if it’s elevated, it may be a better marker of the total cholesterol particles in your blood than just LDL. But again, it’s just more information about being more aggressive with maybe your statin or Repatha or with a [unclear medication name] or whatever you’re taking that lowers your cholesterol. But we don’t have anything specifically to fix that.
Host: Well, the APO B is found in the gingival crevice, but you can’t measure that in the tissue, you can only measure it in a blood test throughout the body.
Dr. Jennifer Haythe: Do you find that people who have high APO B have worse gum disease?
Host: More inflammation.
Host: I think hardly any of my patients give me that number. And I would say, what, if one percent of my patients know that number, I’m surprised.
Dr. Jennifer Haythe: Right. Most people don’t. I mean, cholesterol is really confusing. It’s like confusing for everyone. I feel like the recommend, you know, the recommendations change. What are you focusing on? What are you not focusing on? What’s good cholesterol? What’s bad cholesterol? And then there’s a lot of fear of statins and there’s, you know, so there’s a lot of information out there.
Host: Right. So what markers should somebody know? So I want my patients to know they’re in phlegm of their CRP or their homocyst, whatever the doctor said, I want them to know that number and I want them to know what it means. What numbers do you think a patient coming to your appointment should know a history of what they’ve had? What top numbers should they know?
Dr. Jennifer Haythe: Right. I would like to know what their LDL and HDL and triglycerides are. So they’re bad cholesterol, they’re good cholesterol and they’re triglycerides. I want to know if they’ve done an LP literally once in their life. I would like to know what that level is because that just tells me, do we put the statin at this dose or maybe we think we should have a statin at this dose, because even though the statin doesn’t touch LP little a, it helps stabilize other plaque. Right. And a lot of people don’t know this. They think statins just lower their cholesterol levels, but statins actually stabilize the plaque that’s already in your wall and makes it less likely to rupture because a heart attack, you know, while your artery can narrow over time as the plaque grows, that’s not really the typical heart attack. A heart attack is when there’s an unstable plaque that may not even be blocking blood flow, but it ruptures. And then all these little blood particles come to stop the bleeding from that plaque rupture called platelets. And it’s that response to the plaque rupture that blocks the artery.
Host: So is it fair to say the statins aren’t removing the LDLs?
Dr. Jennifer Haythe: They are lowering the amount of LDL in your blood.
Host: OK.
Dr. Jennifer Haythe: And they are stabilizing the plaque already formed.
Host: Preventing them from separating from the wall.
Dr. Jennifer Haythe: But they’re not going to change that some of your LDL has LP little a on it and is more likely to cause inflammation.
Host: Right.
Host: Do you wish patients knew their APOB?
Dr. Jennifer Haythe: Some people do. I’m more like LDL, HDL, triglycerides, LP little a. I don’t mind a CRP or homocysteine because it’s another marker of inflammation. I like their basic labs like their liver function panel, their thyroid, their CBC, you know, LFTs.
Host: There’s a really good HDL negate LDL limit the LDL and want to put patient on a statin.
Dr. Jennifer Haythe: It might not necessarily change whether you put someone on a statin if their LDL is high, but in high HDL is protective.
Host: Yeah.
Dr. Jennifer Haythe: And again, some people have a high HDL and some people have a low HDL.
Host: Do you think people should test their blood pressure at home?
Dr. Jennifer Haythe: Yes.
Host: How often?
Dr. Jennifer Haythe: I think that there are people who whenever they have contact with medical professionals enough that they don’t maybe need and have normal blood pressure that they don’t. So like if I go to my OB and I go to my primary care and I go some other doctor and every time my blood pressure is checked, it’s totally normal. Then I’m not I don’t need to be obsessing. Right. But if you go and you’re like 130 over 85 and you’re like and I hate what I hate is like, oh, it’s probably just because you’re nervous. Well, check it in six months. Like, no, that is not OK. Maybe you are nervous. But like then I would be like, you know what? I’m not going to immediately start you on a blood pressure medicine because people don’t always like that. But I want you to get a cuff and I want you to measure your blood pressure at home.
Host: Send me the results. Yeah.
Dr. Jennifer Haythe: Send me the results. And I don’t you need to be obsessed about it. But check it, you know, twice a day for a little while, once a day, three times in a row.
Host: When and how should they do that?
Dr. Jennifer Haythe: You should always like be calm. Not after you just drank like, you know, whatever.
Host: The Red Bull or a big thing of coffee.
Dr. Jennifer Haythe: Right. You should be like, you know, normal part of your day, sitting down for 10 minutes, legs uncrossed, empty bladder. But your arm on the table should be the same level as your heart. You know, and then check with the automatic cuff three times and write those three numbers down. You always should do it two or three times. And also, if the numbers seem wacky, make sure that the battery is fresh. A lot of people are like, you know, in their closet. I’ve been there where you’re like, where’s that blood pressure cuff? And it’s like been there for 10 years. And it’s like beeping and like it needs fresh batteries.
Host: Do you think that’s something that a dentist should part of the armamentarium? So we do blood pressure cuffs on every patient that comes in.
Dr. Jennifer Haythe: It’s so interesting because someone reached out to me about this from your office. And like, of course, I would want any again, this gets back to like, why do you know? This is actually so fascinating. My husband always says this, like the reason why we want to vaccinate children is because they’re it’s like a captive audience. You know, people are bringing their kids to the pediatrician. And like at a certain point, we may start to lose contact. Right. So when you have contact with a health care professional is when you want to be able to intervene. And so if they have contact with you and you can check their blood pressure, that’s great, except if someone has a blood pressure that’s really high. What do we do with what do you do? You know, like, do you arrange for that person to go to the emergency room because they have hypertensive emergency? Do you cancel the procedure and just send them home? Or do you then your responsibility is to call their doctor? So it does open a lot of potential.
Host: What to do, what to do. Yeah. But it seems like it’s a benefit for the patient.
Dr. Jennifer Haythe: It is a benefit for the patient. But again, you have to know what if there is someone who has terrible white coat hypertension and they really don’t have high blood pressure, but every time they come to the dentist, they’re so freaked out that there are a lot of pressure goes to one nine. And that’s possible. Yeah. So again, it may not be the right setting to check blood pressure.
Host: And so we have what blood people should know. Yeah. People should be testing their blood pressure at home once in a while. Are there any other things that people should have done in their lifetime? Like you said, L.P. little a or any other test, they should have like a CPA, CTA or things to help to figure out their risk factors.
Dr. Jennifer Haythe: If you go by the guidelines, right.
Host: In your opinion, you know, your clinical experience.
Dr. Jennifer Haythe: I think that what I do is, for instance, if you had really high cholesterol, you have no symptoms, right? But your cholesterol is really high. Maybe a familial hypercholesterole, maybe something. I would probably screen you with a calcium score, which is a very low dose CAT scan of the chest that looks for calcifications in the coronary arteries that often form with plaque. Now, you can have plaque in your coronary arteries that don’t has calcium. We call that soft plaque. But so it won’t find that. But again, that is a good screening test for someone who has no real symptoms but risk factors and you want to stay on top of it. You know, every 12 lead EKG like you’re just an a pink piece of paper with the like that everyone should have done at some point. And then stress testing depending on what your symptoms are and what your risk is. So there are clear guidelines about who gets stress testing. What kind of stress testing are you having? Chest pressure when you exert yourself. Are you feeling suddenly more short of breath? Like you said, we were going to meet in the park this morning. What if you went running today and you were like, I don’t know. Like, that was so much harder than normal. And not just because you’re tired, but like.
Host: And what age would you like people to start doing this at?
Dr. Jennifer Haythe: Oh, I am like, I want to know their blood pressure when they’re like 18.
Host: OK. And what about like the bloods we spoke about?
Dr. Jennifer Haythe: Like my kids got their blood drawn at the pediatrician this year. And they I mean, they still see the pediatrician, but like he goes up to age 22, but like she’s 19 and he’s 22 and they check their cholesterol, their basic labs.
Host: What would be the youngest you would have someone have a CTA or calcium score?
Dr. Jennifer Haythe: It range. It ranges on their risk, right?
Host: Sure. Like if you would say someone who’s at moderate risk, the average person like 40s,
Host: you’re basing that off of maybe that high cholesterol first.
Dr. Jennifer Haythe: Are you going to have a high cholesterol or they have a family history or they maybe they have two risk factors. Maybe they smoke and they have high cholesterol, but they otherwise feel OK in terms of like other kinds of screening tests. That’s very much guideline driven and dependent on like your risk. Like if you have like three people in your family had colon cancer, that dictates what time they start doing colonoscopies on you. If if you have a very strong history of pancreatic or lung cancer or an exposure, that also dictates, you know, when your screening starts. So if you had a first degree, like your mother or your father, have a heart attack for women under 55 and men under 65, you would be more likely to get screened more aggressively. That would be the recommendation.
Host: And a screening with someone who’s at high risk. You’re doing all these tests and you obviously do the blood.
Dr. Jennifer Haythe: So I would do like a 12 lead. I do the blood test. I might do a calcium score. I might do actually a stress test if they’re having symptoms. Stress tests are most valuable when people have some symptoms.
Host: How about nitroglycerin? Is that used also?
Dr. Jennifer Haythe: Well, nitroglycerin is used. Those are the little tablets that we know that you put under. People put under their tongue when they’re having chest pain. So that is for people with established coronary artery disease. They may have a lot of blockages in their heart arteries and. But it’s stable. There’s nothing to do. There’s no stenting to be done. And when they get their symptoms like going up a hill or walking upstairs and they start to feel that pain, they sometimes take a nitroglycerin, which dilates the blood vessels and helps relieve the pain. But again, our goal is for most people to not have pain. And if you’re having pain, is there something now we can do to fix it? You know, back long ago, there was nothing to do. So people were popping nitroglycerin all the time to try to help their pain. But now we have other drugs, stents, beta blockers, aspirin, lipid, you know, statins.
Host: Is there anything new that’s come out that’s helped you with your diagnosis? I mean, you’ve been doing the same blood test and so forth for years. You know, we take the same x-rays now. We use AI to help read the x-rays with us. Is there any armamentarium that helps you?
Dr. Jennifer Haythe: Yeah, we’re doing a lot of studies on what we can see from the EKG now and correlate trying to correlate it with the echo, which is an ultrasound of the heart with where that’s where they use the gel and they put the probe just and you can see your heart pumping. All the CAT scan related imaging like CT of your coronary arteries is all getting much more advanced AI. We do per people who have valve disease and need valve replacements or the new valves that they deploy through the legs. Those are all screened first with CT scans to like image and know exactly where.
Host: What is it doing? Explain to people what it’s exactly doing for you. What is AI doing in those images?
Dr. Jennifer Haythe: Well, I think it is helping identify the best size for those valves, the best like locations. And I think for diagnosis, it’s probably helping diagnose, like see things that we can’t see with our eye, like calcium that might be there that we can’t see the same probably for mammograms.
Host: Same for us. Yeah, and you’re right.
Dr. Jennifer Haythe: And we have other testing like PET scans to do stress tests. Things are coming MRI that can look at, is there any living tissue in the heart? Is it inflamed? Is there scar? Is it alive still? Like if we give it a little time, does it come back and have some blood cells still working? So that’s all helpful.
Host: So we talk a lot about what people should do, what people should know and test. There’s one more thing that I think that is all over social media. That’s important to talk about. How important do you think VO2 max is for people? Because you can’t not scroll for my algorithm and hear how important it is to longevity and how long you live as a single indicator. That strain all these things. So should people know their VO2 max?
Dr. Jennifer Haythe: If they can, they should. I mean, a real VO2 max is studied on a cardiopulmonary exercise test, which is a real procedure.
Host: As opposed to wearable.
Dr. Jennifer Haythe: Yeah, a wearable is kind of estimating your VO2 and it’s doing a pretty good job.
Host: Yeah, it’s based on age, right?
Dr. Jennifer Haythe: And your performance, and it changes with age. But a high VO2 max is a very good marker for longevity and health long term. It’s affected by a lot of different factors. It’s very important in my practice because we do heart transplants and VO2 max has been shown to be a predictor of survival over the course of the next year. So if someone’s VO2 max is less than 12, they’re much more likely to die in the next year if they don’t get a transplant. So we use it as a real marker for studying who should be listed and not listed for transplant.
Host: What’s the number you want to see for VO2 max?
Dr. Jennifer Haythe: 20s, 30s, depends on your age.
Host: Yours is 40 to 50.
Dr. Jennifer Haythe: That’s insane.
Dr. Jennifer Haythe: That’s amazing.
Dr. Jennifer Haythe: 40 to 50 is like, I mean, the higher the better.
Host: VO2 max is a measure of how much oxygen you can turn around. It’s that amount of time.
Host: Wait, so that’s not on the order.
Host: That is not on the order.
Host: That’s not on the order.
Host: Are you sure?
Host: No, that’s not on the order.
Host: I thought it was confusing.
Host: It’s a predictive age.
Host: Yeah, so VO2 max is a single thing that’s tested. Like a Garmin will test it. Your WHOOP will test it.
Dr. Jennifer Haythe: Yeah, the Ora doesn’t do it. Your Apple watch doesn’t do it.
Host: It doesn’t?
Dr. Jennifer Haythe: I don’t think so.
Host: I think it must.
Host: We got to look at that way. That doesn’t make sense.
Dr. Rob Raimondi: My Garmin does it after my runs to tell me what my VO2 max performance was. So it was really cool when I was training for the marathon. I tracked my VO2 max.
Host: Did it go up?
Dr. Rob Raimondi: Oh, yeah.
Host: What did it do?
Dr. Rob Raimondi: I got almost a 50.
Host: So the more you find the more you work out, the higher your VO2 max is.
Dr. Jennifer Haythe: Yes, definitely. It’s basically how your heart and lungs like process oxygen and carbon dioxide and how quickly.
Dr. Rob Raimondi: As Jen said, it’s a sum of all these physiological pathways outputted into this number. And because your body’s responding to all these things, yeah, it was great to see.
Host: What tests are you doing to get the most accurate VO2 max?
Dr. Jennifer Haythe: Oh, you have to do a cardiopulmonary exercise test in a lab. They do the Bruce protocol or a similar protocol where it gets faster and steeper. So even if you’re in the greatest shape of your life, you can only run straight uphill for so long before you get tired. And also, we don’t need you to go forever because we can tell where the crossover has.
Host: It’s not about increasing the speed. It’s the angle of the treadmill that gets it up there.
Host: All schedules on a Thursday will go do the do one.
Dr. Jennifer Haythe: You could pick on a bike or a treadmill. And they put a mask on you.
Host: I mean, it’s similar to a stress test.
Dr. Jennifer Haythe: Yeah, but it’s not looking for blockages.
Host: Yeah, it’s less than 12 minutes.
Host: We’ll do it.
Dr. Jennifer Haythe: It’s fun.
Host: Whoever loses has to pay for dinner.
Host: Then, so what age should people start testing their VO2 mass either on a wearable just just to have the number or going to a lab?
Dr. Jennifer Haythe: Of course, to me, like these are things that like if you’re privileged enough to have these devices, then if you get it, the sooner, the better. But I mean, certainly in your 20s and 30s, it would be nice to know before 40.
Host: You should know where you’re at. Is there any correlation with that with hot rate? Like a lower heart rate, would that be a lower VO2 max?
Dr. Jennifer Haythe: I’m sure there is some correlation. But what happens is we’re looking at like resting heart rate, right? So if your resting heart rate is low in the absence of some conduction problem in your heart, that means that you have to remember cardiac output is stroke volume and heart rate, right? So if your stroke volume is bigger with every pump, like your heart’s ability to pump the blood, then you only need to have a heart rate of 50. If your heart is not in shape, it’s a muscle and the stroke volume is smaller than in order to maintain your cardiac output, your heart rate goes up. It’s very basic. So people who have really strong hearts who exercise all the time are going to have a resting heart rate in the 50s, 40s even, because boom, boom, like every time it pumps, it like is able to get blood to your whole body in a way that someone who’s not in shape is like.
Host: That’s why it’s pumping less.
Host: Yeah, I mean, it’s my resting heart rate is like 40.
Dr. Jennifer Haythe: You’re just genetically different.
Dr. Jennifer Haythe: He’s like showing off at this point. It’s like VO2 is 40 to 50 is resting heart rates 40. Like we’re all like, okay, you’re amazing.
Host: But I noticed when I first start running, unlike you, my heart rate is going to spike a lot quicker with a low heart rate.
Host: I feel you don’t do cardio, not like you do cardio.
Dr. Jennifer Haythe: Well, this is a whole other conversation that I also just wrote about, which is like I have osteopenia, which is very much in my family history. And I was like, there’s nothing I can do. I have osteopenia. And everyone’s like, no, you need to do like lift heavy weights. And I’m like, come on. And I like did the research and it’s really real. Like you can really not only stop progression of bone loss, but you can also build bone back with with real weightlifting. Obviously supervised by someone, but it really is important. And also from my patients that I see forget about all of that is like balance and strength really correlates with longevity. So if you can get up from a chair without using your hands.
Host: We’re getting from the floor.
Dr. Jennifer Haythe: That’s even higher. But like, you know, if an 80 year old can get out of a chair themselves without.
Host: And stairs.
Host: That’s stepping down.
Dr. Jennifer Haythe: Yeah, that’s amazing.
Host: Stepping down.
Host: It drives me nuts when I’m on an airplane and that patient going to the bathroom has to touch every seat on the way up because they’re not stable.
Dr. Jennifer Haythe: Well, yeah, you feel bad for them.
Dr. Rob Raimondi: I think in our practice, an interesting thing is how many people we see fall. How many people as they get older, it breaks my heart a little bit. These people who I’ve been treating for years and they were healthy. And as they get older, now they fall. They fall. And it’s always, always walking down the stairs or down the curb, or they don’t lift your feet high enough and get caught on a carpet.
Dr. Jennifer Haythe: For sure. You got to take all the carpets out of the old people’s houses because it’s not.
Host: It’s dangerous. It’s dangerous.
Host: So that’s not a stability.
Dr. Jennifer Haythe: That’s everything. It’s a whole thing.
Host: It is.
Host: It’s strength. It’s everything.
Dr. Jennifer Haythe: Balance is a huge part.
Host: One thing you pointed out is if people fall and break their hip, break their knee, break their elbow, that begins a down cycle of health problems from what I’ve seen.
Dr. Jennifer Haythe: They break their hip, then they need surgery, then they might have infection complication or pneumonia, then they go to a rehab. And then it’s just like if you can just not have that happen. And I think there’s also a lot of pride. People don’t want to use walkers. They don’t want to use canes. But I’m telling you, it’s better than falling and breaking your hip.
Host: And in that year when they’re injured, they lose so much muscle mass.
Dr. Jennifer Haythe: So much muscle mass.
Host: And cardiovascular output.
Dr. Jennifer Haythe: Yeah. I say one day in a hospital bed is seven days recovery for muscle.
Dr. Rob Raimondi: Think about that, Mark. One day in the hospital is like seven days out of recovery.
Host: To get your muscles strength back.
Host: Just for a week.
Host: It’s a month.
Dr. Jennifer Haythe: Just think about like when’s the last time you had influenza or bad COVID where you were like in your bed and you don’t do much for four to five days. When you start walking around, you’re like.
Host: Pretty amazing.
Host: It magnifies even more with the person who’s never worked out during their life.
Dr. Jennifer Haythe: Well, I think people don’t realize too when they’re just like even us sitting here, you move your legs, you squeeze your calves, you’re doing stuff and your muscles are triggering. When you’re in a hospital bed and you’re just watching TV, you’re not doing that.
Host: Let’s talk about medications for a moment. Statins, PSK9 inhibitors, and GLPs. Just because they’re kind of a talk everywhere. And I guess what’s your thoughts on these medications?
Dr. Jennifer Haythe: Well, statins are like our bread and butter and work very well and have been studied in millions and millions of people. And I know that they definitely can have side effects. They can definitely be worse in women, especially thin women who have higher muscle cramping. I think that a lot of statin studies were done in mostly men. Like we have a lot of this, what’s the appropriate dosing for women? I’m very much about trying to accommodate people and not just start them at the highest dose seven days a week. So I’ll say, maybe we’ll start Crestor three days a week at low dose. And we’re suvastatin. And see if their cholesterol comes down. We don’t have to like blast you right from the beginning. My mentor used to always say, start low and go slow. And we know also, even though I know there’s a lot of internet chatter about dementia, the actual data, if you look at the data, shows that the risk of dementia and stroke is lower in people on statins. So that’s-
Host: That’s noise probably.
Dr. Jennifer Haythe: I know that there’s a lot of noise. In terms of PCSK9 inhibitors, they’re incredible drugs. They’re a shot once a week or once a month, dramatically lower your cholesterol and do not cause side effects. It’s a different mechanism of action and they are much more tolerated. But usually your insurance company requires you to fail a statin. And then GLP1s are like, I think still like in the study phase. I mean, at this point, besides the weight loss part, the overall mortality benefit from all cause death is like 20% lower on a GLIP. So any cause of death was lower. Not just cardiovascular death, which we know it is.
Dr. Rob Raimondi: Early this week, I’m training for a half marathon and I’m doing some [Unclear IV treatment] and things just to help with the whole, I know we could get a whole different story, but why not? Hydration, no matter what, right? I’m still getting hydration. It’s for that more than anything else. And we’re busy and working on patients all day wearing masks.
Dr. Jennifer Haythe: Just don’t get peptides injected.
Host: Obviously.
Host: No, no, no, no.
Dr. Jennifer Haythe: I could go off on that too. I mean, I’m not saying peptides don’t have a benefit. I’m just saying we haven’t studied it. Like, so you’re literally injecting into your body something that comes from God knows where.
Host: These are failed medications that pharmaceutical companies, that’s a whole other conversation. These are medications that pharmaceutical companies put through trials that failed the trials. And then the secondary market have picked them up and are using them because they’ve shown no real benefit and no real harm from what we know. So I can inject, it’s a supplement.
Dr. Jennifer Haythe: But there is harm in some cases.
Host: But there is harm in some cases.
Host: And because it’s not manufactured at the dosage of the way it was tested, it’s a whole other conversation.
Dr. Rob Raimondi: But I was at this, I real quick, I got this place getting in drip. And I’m fusion. And that’s another conversation. But on the wall, check this out. On the wall, there was membership plan for full GLPs or for microdosing GLPs. And so like my wife comes to me and she’s like, do you think I should microdose GLPs?
Dr. Jennifer Haythe: I can’t say yes or no. I don’t think we know the data.
Host: Would you do it yourself right now on the data?
Dr. Jennifer Haythe: Based on what? No.
Host: Agreed.
Dr. Jennifer Haythe: I wouldn’t. I mean, I don’t have a reason to.
Host: Based on, people think that it’s going to help with health.
Dr. Jennifer Haythe: It may.
Dr. Jennifer Haythe: It may because I think-
Host: It may.
Host: I’m saying based on any markers or just to take it as a health precaution.
Dr. Jennifer Haythe: I think because it’s so anti-inflammatory in some level, they think that there’s again this high anti-inflammatory component. I mean, we’ve seen reports of increased fertility on GLP ones. We’ve seen reports of people’s joint pain getting better.
Host: Do you think that’s because of the reduction in calories?
Dr. Jennifer Haythe: Maybe. I don’t know.
Host: Right. Not the GLP itself directly doing it. It’s less sugar, less calories and your body can now become healthier.
Dr. Jennifer Haythe: That’s why we need randomized double blinded cells.
Host: It’s like we need more testing. We need more time.
Host: So I would anyone listening, pump the brakes.
Host: Right. Pump the brakes.
Dr. Jennifer Haythe: I mean, look, I don’t want to say you can do whatever you want. I mean, I just think that it’s a lot of money and we don’t know for sure. And if you’re not using it for weight loss specifically or diabetes that or sleep apnea or one of the true indications like heart failure, whatever some of these indications are, just be careful.
Host: If you’re not obese, slow down. No need to take care.
Dr. Jennifer Haythe: Right. Because it’s not nothing. You’re injecting something in your body.
Dr. Marc Sclafani: Rob, we see a lot of patients that pre-medicate for so many different reasons, for heart problems, for hip replacements, for knee replacements, and the American Dental Association seems to change this every couple of years.
Dr. Jennifer Haythe: The American Heart Association.
Dr. Marc Sclafani: The American Heart Association through the American Dental Association.
Dr. Jennifer Haythe: Well, for guess it depends on which body part is being prophylaxed.
Host: And there’s a discrepancy with different doctors that pre-medicate. So us as dentists have a patient came in and they say, my doctor told me to do or the doctor didn’t say anything. And they just had a valve replacement. Now, another reason why we need to be in communication with the physician or the doctor. Where are we going with that?
Dr. Jennifer Haythe: We know that dental work releases bacteria into the bloodstream. And we know that in most people, that transient amount of bacteria that gets from your gums, and as you would know, into your blood, is attacked normally by your white blood cells and killed. And it’s like an end of story. But there are people who have things like hardware in their body or certain kinds of conditions where there is an increased risk of developing that bacteria sticking on it. And developing a real problem. And so what we do is give antibiotics, like people often will come and they have to take for a moxicillin or something 40 minutes before the procedure to try to prevent that bacteria from sticking. And we know people with prosthetic heart valves, people with certain congenital conditions. I actually don’t know, do you do it for people with hip replacements?
Host: Depends on doctor and depends on for how long. So sometimes for two years, sometimes for six months, sometimes for life. And then the patient doesn’t follow up and go back to their doctor. So now we’re at a point, no, it’s been two years, you’ve been taking antibiotics and we’re not going to pull them off without knowing from the doctor.
Host: And then they’re going for pedicures and manicures and not pre-medicating, which is probably similar.
Host: Same thing, right?
Dr. Jennifer Haythe: It’s interesting, is it? I don’t know.
Dr. Jennifer Haythe: I mean, if you don’t cut someone’s foot.
Host: But if they do.
Dr. Jennifer Haythe: There’s no blood draw.
Host: But if they do.
Host: But if they do.
Host: Which some of the places aren’t so careful.
Dr. Jennifer Haythe: But I guess with dental work, it’s like so much more likely to bleed.
Host: It could be.
Dr. Jennifer Haythe: Yeah, yeah.
Host: Years ago, every heart murmur was pre-medicated.
Dr. Jennifer Haythe: Which we don’t pre-medicate for anymore.
Host: Like they took away mitral valve prolapse.
Dr. Jennifer Haythe: Yes, yes.
Host: I don’t medicate for that.
Dr. Jennifer Haythe: I favor medication.
Host: I do too.
Dr. Jennifer Haythe: I’m like, who wants to get endocarditis?
Host: We do too.
Dr. Jennifer Haythe: Yeah, that’s sort of. So bacteria and the condition.
Dr. Jennifer Haythe: There are very strict guidelines you can look up that say, and it’s the same for women who are about to deliver a baby. Sometimes they need antibiotic prophylaxis if they have certain risk factors.
Host: Is that something that you would mention to every one of your patients?
Dr. Jennifer Haythe: Dental care?
Dr. Jennifer Haythe: Oh, I tell. Yes, one is the last time you got your teeth cleaned.
Host: No, but meaning for pre-medication.
Dr. Jennifer Haythe: Oh, yeah. That is my job. If they have a heart problem, I have to give them that.
Host: This is great.
Dr. Jennifer Haythe: Yes.
Dr. Rob Raimondi: On wrapping up, Mark, what is something somebody can do this week to improve their mouth or heart health?
Dr. Marc Sclafani: Get on a treadmill. Go running.
Dr. Marc Sclafani: Walking or running. Go to the park and go for that run in the morning. Don’t go back to sleep.
Dr. Jennifer Haythe: I mean, God, exercise is really the best medicine for all things. Mood, health. I would say, I’m going to say my usual line, which is make an appointment to see your primary care doctor and see someone. Please just go to the doctor once and for women, not your OB-GYN. I mean, do that too. Make an appointment to get your teeth cleaned if you haven’t done it.
Host: And go to a good doctor.
Dr. Jennifer Haythe: Yeah.
Host: And hopefully they don’t need to see you after everything properly.
Dr. Jennifer Haythe: And then, I agree.
Dr. Jennifer Haythe: Like, get outside and walk or do on a treadmill or whatever you can do. It’s the cheapest form of exercise. If you can buy a pair of sneakers or afford some kind of comfortable shoe, it’s just you and nature.
Host: After dinner, go for a walk.
Dr. Jennifer Haythe: Yeah. Walk it off.
Host: And look at your diet. Really look into your diet and what you’re reading every day.
Host: I would just say clean between your teeth. Floss, water pick, buy that new Dyson toothbrush, anything.
Host: Yeah, water pick.
Host: Did you see it?
Host: Into the water pit?
Host: Right?
Dr. Jennifer Haythe: I’m obsessed.
Host: So did you see the new Dyson?
Host: The Dyson.
Host: Dyson has a toothbrush.
Host: Toothbrush has a camera and a water floss built into it. It’s like a little mist between your teeth. The camera you could see on your phone.
Dr. Jennifer Haythe: Oh, God. I don’t want to see that.
Host: Do it.
Dr. Jennifer Haythe: I don’t know.
Host: But the water pick, you’re like, oh, there was that little dot comes out.
Host: A little things come out.
Host: Surprising.
Host: You have to you brush, you floss, you still removing some things.
Dr. Jennifer Haythe: Oh, it’s so gross.
Dr. Jennifer Haythe: But I love it.
Host: Yeah, we love it too.
Host: It’s the one thing that our patients who have the best health all do. They water pick.
Host: For sure.
Host: I’ll tell you why, is because you can floss wrong with the dexterity. You could brush wrong. The water pick between your mouth is going to flush everything out.
Dr. Jennifer Haythe: I struggle with the electric toothbrush because I like to brush my tongue.
Host: That’s fine. Then shut it off and brush it.
Host: No, you want to use a tongue scraper.
Dr. Jennifer Haythe: I like the real toothbrush.
Host: Well, I have to.
Dr. Jennifer Haythe: Okay.
Host: I know. I’ll get it. All right. I’ll get it in a light.
Host: I’m going to get your tongue scraper also.
Host: Jennifer, this has been great.
Host: This has been great.
Host: Thanks for spending time with us. We appreciate you in our life. Enjoy the rest of your day.
