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Collaborating to Reduce Oral-Systemic Inflammation

Inside Dentistry - December 2019

Eric Goulder, MD, FACC and Patti DeMatteis, ASDH, RDH


"This oral-systemic link has forever altered the medical and dental industry's understanding of these conditions and is spurring the creation of collaborative treatment models to reduce the burden of pathogens and inflammation, and ultimately, their associated morbidity and mortality."

To read more about the oral systemic connection, please click here to visit the Complete Health Dentistry of Columbus research page.
Cardiovascular Prevention: Migrating From a Binary to a Ternary Classification

Frontiers in Cardiovascular Medicine - May 2020

Amy Doneen, DNP, ARNP; Brad Bale, MD; David J. Vigerust, MS, PhD; and Pierre P. Leimgruber, MD


"Migrating from a binary approach to risk assessment to a ternary model of disease identification allows for individualized, optimal management. Using a disease/inflammatory approach has been proven to identify, stabilize, and regress atherosclerosis while adding understanding to the progression of vascular disease."

High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis

Postgraduate Medical Journal - 2017

Amy Doneen, DNP, ARNP; Brad Bale, MD; David J. Vigerust, MS., Ph.D


"Level A evidence supports that Periodontal Disease is independently associated with arterial disease."

Precision Healthcare of Type 2 Diabetic Patients Through Implementation of Haptoglobin Genotyping

Frontiers in Cardiovascular Medicine - October 2018

Amy Doneen, DNP, ARNP; Brad Bale, MD; David J. Vigerust, MS, PhD


"It has been proposed that a paradigm shift needs to occur in healthcare placing more emphasis on prevention management which will generate more value for patients and most likely substantial cost effectiveness. The high risk Hp2-2 DM population is a prime target for such preventive care."

The BaleDoneen Method (BDM): A disease-inflammation approach to achieve arterial wellness

The Journal of Craniomandibular & Sleep Practice - 2018

Amy Doneen, DNP, ARNP; Brad Bale, MD


"The BaleDoneen Method could not guarantee arterial wellness without excellent oral healthcare providers being involved. Snuffing arterial inflammation is the keystone of the BDM, and that requires excellent oral health."

Inculpatory evidence: periodontal disease assessment and treatment is an essential element in cardiovascular wellness programs.

Dental Economics - 2012

Thomas Nabors, DDS; Bradley Bale, MD; and Amy Doneen, ARNP


"Research indicates that inflammation appears to be causal for CVD, which intensifies the importance on the oral-systemic inflammatory link."

Carotid intima-media thickness testing as an asymptomatic cardiovascular disease identifier and method for making therapeutic decisions

Postgraduate Medicine - March 2015

Amy Doneen, DNP, ARNP; Brad Bale, MD


"Carotid intima-media thickness (CIMT) testing via B-mode ultrasound is a safe, simple, and inexpensive method for evaluating CV risk by measuring the combined thickness of the intimal and medial layers of the arterial wall. Use of CIMT testing can also detect marked thickening of the arterial wall, possibly indicating plaques or atheromas that are associated with accelerated atherosclerotic disease and increased risk for coronary artery disease, myocardial infarction, and stroke."

Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic

Archives of Medical Science - 2016

Cheng, H.G., B.S. Patel, S.S. Martin, M. Blaha, A. Doneen, B.Bale and S.R. Jones


"These results show the beneficial effect of comprehensive, evidence-based lipid management on subclinical atherosclerosis and vulnerable plaque."

Eight-year outcomes of a program for early prevention of cardiovascular events: a growth-curve analysis

Journal of Cardiovascular Nursing - August 2015

Du Feng, PhD; Christina M. Esperat, PhD, RN, FAAN; Amy L. Doneen, RN, BSN, MSN, ARNP; Bradley Bale, MD; Huaxin Song, PhD; and Alexia E. Green, PhD, RN, FAAN


"The current findings suggest that the Bale/Doneen Method is effective in generating a positive effect on the atherosclerotic disease process by achieving regression of disease in the carotid arteries."

Carotid intima-media thickness: knowledge and application to everyday practice

Postgraduate Medicine - January 2010

Brad Bale, MD; Michael E. Cobble, MD, FNLA


"Carotid intima-media thickness is associated with CVD and is an independent predictor of stroke and myocardial infarction. Therefore, CIMT is valuable for clarifying CVD risk, particularly for patients with intermediate risk by conventional risk assessment. Screening for subclinical disease even in low-risk patients may have benefit."

The identification of occult cardiovascular disease through the use of a novel biomarker: a case report

Journal of Clinical Lipidology - September 2009

Amy Doneen, DNP, ARNP; Brad Bale, MD; Michael Wegner, PhD


"Acknowledging the limitations of traditional risk factors to precisely assess cardiovascular risk among many persons, the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) recognizes the potential of bioinflammatory markers to more properly assess hidden cardiovascular risk as an adjunct to traditional risk factor assessment."

Cardiovascular wellness and optimal oral health: A symbiotic relationship.

Aperito - November 2014

Amy Doneen, DNP, ARNP; Alice Dupler, JD, ARNP-BC: and Neva L. Crogan, PhD, ARNP, FAAN


"The language spoken between the medical and dental community in regards to CVD must be one of mutual recognition."

Aggressive Risk-Factor Modification in Patients With Subclinical Atherosclerosis Reduces Plaque Burden and Regresses Carotid Artery Wall Thickness

Medscape Cardiology - July 2006

Bradley Bale, MD


"The study used measurements of carotid artery intima-media thickness (CIMT) obtained by ultrasound screening as a marker of atherosclerosis at the start of the study and 1 year after treatment to evaluate the effect of global risk-factor assessment and treatment on the process of atherosclerosis. Dr. Bale and colleagues found not only a significant improvement in CIMT but also in plaque burden. "

Associations among Periodontitis, Calcified Carotid Artery Atheromas, and Risk of Myocardial Infarction

Journal of Dental Research - 2020

N. Gustafsson, J. Ahlqvist, U. Näslund, K. Buhlin, A. Gustafsson, B. Kjellström, B. Klinge, L. Rydén, E. Levring Jäghagen


"Calcified carotid artery atheromas (CCAAs), detected in panoramic radiographs, and periodontitis have both been associated with increased risk of cardiovascular disease. "

The Significance of Periodontal Infection in Cardiology

Dentistry IQ - 2006

Stanley Shanies, MD, FACP


"Despite the fact that the formation of the atherosclerotic lesion and its impending threat to cardiovascular health has a very complex etiology, dental screening to identify patients at risk for CVD and those patients with diagnosed CVD who are at greater risk for recurrent cardiovascular events offers an undeniable intervention opportunity."

Why the RDH is a critical member of the health-care team: Dental hygienists are a vital link in the multi-disciplinary team addressing heart disease

RDH Magazine - February 2015

By Amy L. Doneen, DNP, ARNP; Alice E. Dupler, JD, APRN-BC, Eqs; and Neva L. Crogan, PhD, ARNP, FAAN


"The complexity of vascular disease (atherosclerosis) requires an inclusive approach to care, including the oral health-care specialist."

Evolving Relationship Between Sleep-Disordered Breathing and Stroke

American College of Cariology - June 2015

By Mary Ellen Wells, PhD


"Evidence has identified SDB is an independent risk factor for stroke. The risk of stroke or death increases for patients even with mildly elevated AHI's. For this reason, effective screening, diagnosis, and treatment of SDB are needed to decrease risk of cardiovascular disease, as well as improve outcomes post-stroke."


The HASPC of Central Ohio

BaleDoneen Method Research

Dr. Eric Goulder and the entire team at The Heart Attack and Stroke Prevention Center of Central Ohio are on the cutting edge of preventative health care and medical-dental collaboration. They follow methods that are scientifically based, while constantly staying up to date on the latest trends through research and advanced continuing education. Below is a variety of research studies and articles that lay the foundation of their practice methodologies.

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