Why do some patients struggle with anesthesia, requiring multiple cartridges just to get numb?

Could your TMD patients have an underlying systemic condition that’s been missed?

Are you overlooking the signs of a connective tissue disorder?

”When you can’t connect the issue, think connective tissue!”

Dr. Audrey Kershaw joins Jaz for a fascinating deep dive into the world of connective tissue disorders and their hidden impact on dentistry. Together, they explore how hypermobility, unexplained joint issues, and even a history of spontaneous injuries could be key indicators of an underlying disorder.

They also break down why dentists play a crucial role in screening and identifying these conditions, ensuring better patient outcomes and a more holistic approach to care. Because sometimes, when things don’t seem connected… they actually are.

Protrusive Dental Pearl: Don’t just take a “relevant” medical history—take a comprehensive one! Encourage patients to share all health issues, even those they don’t think relate to dentistry. You might uncover important clues about conditions like connective tissue disorders or sleep-disordered breathing, leading to better care and stronger patient trust.

Key Take-aways

• Ehlers-Danlos Syndrome is often misunderstood and underdiagnosed.
• Patients with connective tissue disorders often face skepticism from healthcare providers.
• POTS is a common condition associated with EDS that affects blood pressure regulation.
• Many TMD patients may have undiagnosed connective tissue disorders.
• Awareness and education about EDS are crucial for better patient outcomes.
• The healthcare system can be challenging for patients seeking diagnoses.
• Research on local anesthetic effectiveness in EDS patients is lacking.
• Personal experiences can help in understanding and diagnosing connective tissue disorders.
• Collaboration between healthcare professionals is essential for patient care. Genetic testing is crucial for diagnosing rare types of Ehlers-Danlos.
• Dental professionals should be aware of the signs of connective tissue disorders.
• Diagnosis can empower patients to understand their health better.
• Holistic care is vital in managing symptoms associated with EDS and TMD.
• Medical histories should be seen as relevant in dental practice.

Highlights of this episode:

• 02:17 Protrusive Dental Pearl
• 04:21  Dr. Audrey Kershaw’s Journey and Insights
• 09:45 Personal Experiences and Professional Observations
• 11:55 Diagnosis and Management of Connective Tissue Disorders
• 13:31 POTS (Postural Orthostatic Tachycardia Syndrome)
• 15:30 Understanding Ehlers-Danlos Syndrome (EDS)
• 24:55 Hypermobile EDS and the Need for Awareness
• 27:53 International Consortium of EDS GP Checklist
• 28:34 Genetic Testing and Red Flags
• 31:44 The Role of Dentists in Identifying EDS
• 40:32 Journey to Diagnosis
• 43:47 The Value of a Diagnosis
• 48:43 Dental Implications of EDS
• 55:00 Final Thoughts and Resources

“If you know one case of EDS, you only know one. Every case is different. Many are severely debilitated, unable to work or carry out daily tasks, often denying their struggles after years of being dismissed.” – Dr. Audrey Kershaw

Promised Resources

Podcast Recommendation:

• Linda Blustein’s Podcast (about POTS and connective tissue disorders)

Specialists & Research:

• Dr. Alan Hakim – A specialist in Ehlers-Danlos Syndrome (EDS) research based in London.
• Norris Lab (U.S.) – Researching genetic markers for hEDS
• Local Anesthesia Information

Resources for Screening & Diagnosis: 

Educational Conferences & Talks:

• Scottish Dental Show – Audrey is involved in raising awareness at this event.
• Podcast with Periodontist Reena – Discussing HbA1c meters for diabetes screening in dental practice.
• “If you can’t connect the issues, think connective tissues”. An EDS talk for professionals.

Advocacy & Support:

• Learn more about EDS and Dr. Audrey Kershaw
• Ehlers-Danlos Support UK Scotland – Audrey collaborates with them for better patient care pathways.
• EDS PATIENT EMAIL Template April 2025
• GMP EDS EMAIL TEMPLATE  April 2025
• Connect with specialists like Dr. Audrey Kershaw

Pack to aid identification of possible HCTD/EDS cases in the dental setting 

1. Watch YouTube video made for Prof Tara Renton, by Drs Kershaw and Bluestein 

2. Read this – https://gptoolkit.ehlers-danlos.org/ 

3. Fill out Oral Surgery Scotland Advanced Medical History Form 

4. Fill out this – International Consortium of EDS GP Checklist 

OR use this link – https://apps.apple.com/app/id6642710534 

5. If appropriate, give patient EDS information email EDS PATIENT EMAIL Template April 2025

6. Send email to GMP GMP EDS EMAIL TEMPLATE  April 2025 

7. For any issues, or feedback, please contact Dr. Audrey Kershaw

If you loved this episode, make sure to watch Periodontal and Systemic Link – Correlation or Causation?

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. 

This episode meets GDC Outcomes B and C.

AGD Subject Code: 150 Health medicine and nutrition

Aim: To enhance dentists’ awareness and understanding of connective tissue disorders (CTDs), particularly Ehlers-Danlos Syndrome (EDS), and their impact on dental treatment, local anesthesia effectiveness, TMD, and overall patient care.

Dentists will be able to –

1. Identify key dental manifestations of EDS, including local anesthesia failure, TMD, and periodontal considerations.

2. Apply a multidisciplinary approach to managing complex TMD cases with suspected connective tissue involvement.

3. Appreciate the dentist’s role in identifying and supporting patients with suspected connective tissue disorders.

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