Let me ask you something: Have you had problems writing checks, paying bills,
balancing a checkbook, recently? How about assembling tax records? That's always a
problem. Our business affairs or papers, how about a problem in shopping alone
for clothes household necessities or groceries? How about playing a game of
skill or working on a hobby? Heating water? Making a cup of coffee? Turning the
stove off, after use? Thats actually an issue that I've started having over the
past year. Doug Thompson, the Dentist founder of The Wellness Dentistry
Network and I, were having a conversation the other day and we started talking
about dentists and patient awareness. Dentists helping in patient awareness for
Alzheimer's. Is that crazy or what? Actually, it's not crazy at all.
Periodontitis has been linked many, many times to the development of Alzheimer's
disease and studies like this one, how gum disease could lead to the
development of Alzheimer's and in this one, they showed that patients who had 10
years or more of periodontitis were 70% more likely to develop Alzheimer's. Now
what could be a possible role for dentists? And what - what interests would they have?
I'll let Doug talk about that, then a little bit later in the video, I'll just
give you some reminders of what we've done in terms of MOCA. What the MOCA
looks like. When to do a MOKA, and the mini cog, as well. so a couple of
different ways at screening for dementia.
(Dough Thompson:) Thanks Ford. With our Wellness Dentistry Network and through our program,
we're trying to get dentists to control oral biofilm and, typically, the oral bio
film would cause gum disease. Gum disease is caused by bacteria, yeast, and viruses.
And you and I were talking about it and we teach dentists about -
We are - we give dentists methodologies to teach their patients in the easy way
about gum disease and what the big deal is. And, so, we use bleeding gums, we use
teeth flaring, people with bad breath, measuring the pockets around the teeth - I
mean it's really, really important to do and we know that what the root - the root
of this or the initiating factor, this disease - bacteria, different bacteria to
live in the mouth. So we have these tests that we can do to measure these bacteria.
And these are simple. Swish and spit tests that we can get for 30-40 seconds.
You can have someone swish and spit in a cup and you can get these bacteria and
and, usually, what signals us that we need that is bleeding gums. So if you see any
blood on your flossing or your toothbrush, that's probably even a
later stage disease. So we do this when we measure, we look at bleeding when we
measure our pocket depth and then we realize that these bacteria on these
reports, they give us information about the concentration and level of bacteria.
But these reports also remind us that these - these bacteria cause other
problems: Cancer, Colorectal cancer, Pancreatic cancer, Cardiovascular disease.
You and I have done other pieces on cardiovascular disease. Joint health - but
this is what got my attention today - is this dementia on brain health issue. So
one of the issues, when we do these tests for it is that we get up, we get a report
back and this report tells us what - what bacteria are really in the mouth and
what concentration is and not only does the company tell us about bacterial
presence but they remind us that these bacteria are also implicated. These other
diseases - you know - Cancer, Colorectal cancer, Pancreatic cancer, or other
cancers, cardiovascular health in the - you and I have done other pieces on
cardiovascular health and how oral bacteria affect that. But muscle and
joint health and then, of course, came dementia in brain health. And, when I saw
dementia and brain health, well, in addition, there's metabolic health and
pregnancy, as well. But when I was looking at dementia and brain health, I was
trying to think about - How could dentists help their patients become aware of what
their current level of cognitive, either decline or
cognitive - just cognitive condition is. And that's when you mentioned to me
about some of these different assessments. And I know you through
PrevMed and through - you know - I know people can learn a lot on them - on your
Ford Brewer or YouTube channel. You know about - about these kind of things in
a number of formats. But one of the services you provide is some kind of
testing, you told me it's got Montrealine and Amos. That's what I wanted - that's what I
wanted to call and have you - you know - tell me a little bit more about that. (Dr. Brewer:) So,
Thank you. I think what you're referring to is MOCA Montreal Cognitive
Assessment. It takes about half an hour to do that, at least in order to
administer it. It has some basic psycho monitor neurological testing components.
For example, the - the patient has to follow some dots and have to figure out
how to accomplish some things while following the dots. They have to do some
very basic things like be oriented. In fact, I did a video where I went through
one of those and I'll send you that video after, after this is done, where it goes
through the actual details of the test. I didn't flunk it. I did pretty well but
here's the one place I did miss: I can't take it - I got the wrong date. I'm always -
so that's a - that's a part of orientation for our time and place but it's a good
test. It's - you do have to get training in terms of standardization on how to get -
how to administer it, how to grade it, and how to counsel with the patient
regarding what it says and then how to interpret it as I was getting our grip
geared up to look a little bit more at dementia. We looked through several
different types of tests as you and I discussed Cambridge earlier. I know we
looked at that. At this point in time, I don't remember all of the pluses and
minuses. I do remember this though, that the MOCA appeared to be the - the most
rigorous, the widely used, and the best gauge for what
we were doing. It was reassuring when I went down for training with Dale
Bredesen. Just about every other word out of his mouth was MOCA this, MOCA that.
He's - he uses that heavily - heavily in his assessments, as well. so that helped us in
terms of fitting well with the Dale Bredesen activities. So those are the
basics. Yes, as you mentioned Janice does provide it. Dr. Derrickson is gone - works in
our group. She - she's had training in it. She got certified in it and she provides
that for our patients. That's on one of our options as well. (Doug:) Great and I know we
have that listed in your list of services and our Wellness Dentistry
Network partners in Health section, the WDN member dentists can go there and
look up that information and for any Docs out there that want to find a
dentist too that can refer - they can refer to, they can always go to
WellnessDentistryNetwork.com and look at the member directory and find these dentists.
But we would hope our dentists would be aware that there's a connection between
gum disease - you know - oral bacteria, yeast, and viruses and brain health. And thanks
Ford, for giving us an option to have our patients - you know - be able to have
somebody qualified to help them determine where they are and their
journey with dementia and heart disease or dementia and Alzheimer's. I know it's
a big, big problem for the future. (Dr. Brewer:) Absolutely, Thank you Doug for what you
do. I think - again - I think one of the biggest untapped potentials that we have
from a public health manpower perspective, in dealing with the number
one cause of death with heart attack, the number one cause of disability and with
stroke, right now - and rapidly becoming the number one cause of both, with
dementia, is the dental community and the dentists - you know - the dentists have
a unique opportunity to - to help in this area.
Again, for folks that score 4 or less on a mini cog, you want to go ahead and
do what's called a MOCA. Now, this is the SMOCA, meaning the Sequence MOCA and
if you remember the mini cog, it basically had two major components:
Remembering a list of three words and being able to claw - draw the hands of a
clock. Now, this has the same thing. It has those two. You start off with the three
words, then you go to what's called a sequence. Some attention span by
subtracting 7 from 100, and 7 from that and 7 from that. Then abstraction language,
orientation, naming, delayed recall, the clock face, and again, you get a score on
all that. I'll just run through these fairly quickly with you. One of them, they
do a different type of memory recall. This one is 5 words. I was reading
this earlier. I believe it is now and again, maybe I'm teaching you to cheat
here on the exam, maybe not. Here's the the sequence - basically, what you're
looking for on this next test is go from 1 to A. 2 to B. 3 to C. (Next Video)