Associates of Dental Arts
Dr. Gregory Kivett

To HEENT or to HEENOT, That Is the Questions

Dentist have known for a long time that oral health is inexorably linked to overall health and wellness but other medical health professionals have been slow to include oral health into their regular exams. According to an article on, The Interprofessional Oral Health Grant Team is stepping into this gap in oral care and is looking to put “‘the mouth back in the head’” through the New York University College of Nursing's (NYUCN) Teaching Oral-Systemic Health (TOSH) program.

The traditional examination at a doctor’s office consists of the head, ears, eyes, nose, and throat (HEENT). The TOSH program wants to add the teeth, gums, mucosa, tongue, and palate to the examination by promoting a head, ears, eyes, nose, oral cavity and throat (HEENOT) exam. By teaching the HEENOT vs the traditional HEENT program, medical practitioners will be better able to identify oral health problems and refer their patients to a dentist as needed.

Some of the major reasons TOSH highlights in the article for why doctors should practice HEENOT includes:

  • Early childhood caries (cavities) are the most common chronic disease of childhood in 5-17 year olds, 5 times more common than asthma
  • Application of fluoride varnish can reduce the incidence of caries in children by up to 50%
  • Oral cancer morbidity and mortality rates have not declined over the past 10 years, at least, in part, related to absent or inadequate oral exams
  • Human papillomavirus (HPV) is associated with the recent rise in the incidence of oropharyngeal cancer
  • Linkages between diabetes and periodontal disease are established
  • Older adults taking multiple medications for chronic health problems often have xerostomia (dry mouth) increasing their risk for tooth decay and poor nutrition

According to the article, the TOSH program is showing great results in increasing communication between various healthcare providers about oral health and is increasing patient referrals to dentists to take care of their oral health. By acknowledging the mouth body connection and working with dentists, medical doctors and dentists will be able to better protect the health of their patients and save patients time and money. Hopefully more and more healthcare providers will include oral cavity as part of their exam to improve the overall health of their patients.

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