Tag Archives: periodontal disease

Healthy Mouth, Happy Heart!

Heart Disease and DentistryCardiovascular disease claims the lives of about 2,400 people every day.  New medical guidelines published in the American Journal of Cardiology encourage medical and dental professionals to cooperatively diagnose and manage patients who are at risk for heart disease and stroke. According to the American Academy of Periodontology, healthy gums can ward off heart disease and prevent you from becoming a statistic.

Periodontology meets cardiology.

Most people have experienced gingivitis, which is the mildest form of gum disease. If gingivitis is left untreated, it can progress and involve the deeper tissues surrounding the teeth.  Gum disease leads to inflammation and bleeding, which allows oral bacteria to access the bloodstream. Research has suggested that some of these bacteria can cause blood clots in the arteries, which may contribute to blockages that lead to stroke.

Research conducted at several major universities, including the State University of New York at Buffalo, has concluded that inflammation is a common factor underlying both cardiovascular and periodontal disease. What does this mean for people living with heart disease or those at risk? Ultimately, controlling both conditions simultaneously leads to improved overall health for patients.  Don’t be surprised if your dentist refers you to a cardiologist, or if your physician sends you to the dentist’s office for an evaluation.

Are you at risk for developing heart disease? There are a number of steps you can take to positively impact your health:

EKG stethoscope picture

  • If you take Statin – type medications for high cholesterol, take them consistently.
  • Keep up with your medical and dental checkups.
  • Eat a healthy diet. It’s good for your gums and your heart.
  • Tell your dentist if you are being treated by a physician.
  • Brush and floss regularly, and have regular dental cleanings.
  • If your dentist tells you that you have periodontal disease, follow through with the recommended treatment… it could save your life!

Aquafresh, toothbrush, toothpaste

Most people realize that their dental checkups are important, but people who have or are at high risk for periodontal conditionsshould be seen for more frequent exams and cleanings? Sometimes this additional service is covered by insurance and sometimes it isn’t – regardless, rest assured that your dentist is making recommendations that are in your best interests.  We look forward to seeing you at your next visit and would be happy to help answer any questions you may have about managing your risks for cardiovascular or periodontal disease, and improving your overall health.

Diabetes and Periodontal Disease

Diabetes and periodontal disease are two common chronic diseases that are reaching epidemic proportions in America; and in fact current research indicates that the two diseases actually directly influence each other. Periodontal disease effects more than half of all adults; and according to recent statistics released by the American Diabetes Association, 25.8 million children and adults in the United States are diabetic. Another 79 million people are pre-diabetic, meaning that they are at risk for developing this serious disease which can affect many major organs including the heart, blood vessels, nerves, eyes and kidneys. Scientists understand a great deal about both diseases and they are learning more all the time… considering the number of people at risk and the potentially life threatening consequences of developing either of these conditions, isn’t it a good idea to know your risks and to understand how the two diseases are linked?

What is Diabetes?

Diabetes is a complicated disease which involves the inability of the body to make the hormone insulin (Type I) or to use the insulin that it makes (Type II). Insulin is necessary to move glucose, also known as “blood sugar” from the blood stream into the cells, to be used for energy that sustains life. When cells do not receive adequate glucose, the body stops functioning…and if too much glucose accumulates in the blood, a variety of severe health complications can occur. Furthermore, people with diabetes are at higher risk for infections and they tend not to heal as well as people without the disease because their immune systems don’t function as effectively.

Type one diabetics are born with the disease, and are treated with replacement insulin. However, type II diabetes generally develops slowly over time as insulin receptors are damaged or destroyed, thought to result from chronic inflammation. Periodontal disease is jointly caused by the by-products of oral bacteria and the body’s inflammatory response to those bacteria. The common thread appears to be inflammation, but how does the diabetes-periodontal disease relationship work? Researchers have determined that there are several reasons for the association.

  • Chronic inflammation occurs in the body for a variety of reasons including untreated periodontal infections and even excessive body fat, and the long standing inflammation causes tissue damage. This process is how the gums and bone surrounding the teeth are destroyed in periodontitis. Similarly, inflammation damages the part of the cell that allows insulin to work (the insulin receptor) making cells “insulin resistant”. As the body’s cells become increasingly resistant to insulin, type II diabetes develops. Untreated, the process continues: damaged tissue itself causes more inflammation, so one disease provokes the other.
  • High blood sugar inhibits and slows circulation. The body heals itself of infections by using specialized cells and substances transported in the blood to the site of an infection. Sluggish circulation impairs this natural healing ability, which makes the gum tissues more susceptible to infections and much more difficult to treat.
  • High glucose levels in saliva promote growth of bacteria that cause periodontal disease.
    • Untreated periodontal disease can actually increase blood sugar and make it more difficult to control; and a study in the Journal of Periodontology found that if Type II diabetes is poorly controlled, patients are more likely to develop periodontal disease.

    Many of the risk factors that are associated with Type II diabetes can be minimized through healthy lifestyle changes; and fortunately the same is true of periodontal disease. Good home care practices and regular dental checkups are the keys to good oral health, especially for people diagnosed with or at risk for diabetes. Eliminate tobacco use as well… research has shown that diabetic smokers may be 20 times more likely than diabetic non-smokers to develop periodontal disease! The major risk factors for developing Type II Diabetes include:

    • High blood pressure
    • High blood triglyceride (fat) levels
    • High-fat diet
    • High alcohol intake
    • Sedentary lifestyle
    • Obesity or being overweight

    Many people feel overwhelmed by everything they need to learn when they are first diagnosed with diabetes, but they quickly realize that they must take steps to manage their condition every day. Excellent oral care is an essential step in that process, and the good news is that your dental team understands its important role.

    Research at Columbia University has demonstrated that dentists can often identify patients with undiagnosed diabetes based on what they observe about the conditions in the mouth during a checkup. So, if you are at risk or suspect you might have the symptoms of either diabetes or periodontal disease, please take the risk seriously and speak to both your dentist and physician … it could save your life. If you have already been diagnosed with either condition then you should know that your dentist is committed to working with you and the rest of your medical team to maintain optimal health and quality of life.

    Tea Time!

    Do you have Green tea on your grocery list? If so, you are not alone… it is heavily marketed for its potential health benefits ranging from weight loss to cancer prevention, heart health and more. Recent scientific research supports what Asian medical practitioners have believed for nearly 5000 years: many of the reported general health benefits of tea are genuine, and regular consumption may even improve your oral health!

    According to an article that appeared in the Journal of Periodontology, green tea promotes healthy teeth and gums because it contains antioxidants called catechins that interfere with the body’s inflammatory response to the oral bacteria responsible for periodontal disease. Evidence suggests that green tea may have an anti-cavity benefit as well, but interestingly, researchers at the University Of Illinois School Of Dentistry have reported that drinking black tea may also lead to fewer cavities. Black tea seems to inhibit the formation of dental plaque by suppressing the ability of decay-causing bacteria to grow, stick to the teeth and produce the destructive acids that cause decay. This is great news, since about 80% of all the tea consumed in Western countries is the Black Oolong variety.

    A few important cautionary notes are in order before incorporating more tea into your diet:

    • When sugar is added to the tea, the anti-cavity effect may be lessened or negated – if you must use a sweetener, consider using Xylitol which is a sugar substitute that has its own anti-bacterial effect.



    • Tea stains! Like most pigmented liquids, tea can leave a brown stain behind on your teeth. Rinse with water after drinking tea to keep stain to a minimum, and consider using a whitening toothpaste. Remember that regular professional cleanings and perhaps a simple cosmetic whitening procedure available in the dental office can keep your smile looking its best!

    Alternative medicine fads come and go, and it can be a challenge to differentiate between the ones that have some real health benefit from those that have little value or may actually be dangerous. As a general rule, it is a good idea to verify claims about products and practices with reliable sources and research before incorporating any supplement or practice into your diet or self care routine. Your dental team is here to help, and a great resource for all of your oral health questions.

    Enjoy the many benefits of a perfectly brewed glass of ice tea (or a cup) this summer … with all of its many benefits, and we look forward to hearing from you!

    Vitamin D and Your Oral Health

    Medical researchers have long known that Vitamin D has many oral and overall health benefits, but there is growingconcern that deficiency of this critical nutrient is more common than once thought. Understanding the benefits of Vitamin D, where it comes from and who is at risk for deficiency could make an important difference in your general and oral health.

    Somewhere along the way you can probably remember being told to have plenty of calcium in your diet to build strong bones and teeth… mothers admonish their children, and doctors advise pregnant mothers about the importance of getting adequate calcium. Fortunately calcium is everywhere – readily available in many of the foods we all love like milk, cheese, ice cream and even commercially added to orange juice, breads and cereals. Perhaps you didn’t know that without Vitamin D, the body can’t absorb that calcium… no matter how much of it you swallow!

    According to a Canadian study, only about 10% of women in their second trimester of pregnancy had adequate Vitamin D levels, a phenomenon which was correlated the frequency of milk and prenatal vitamin consumption. Babies born to women with low levels of vitamin D during pregnancy may be at increased risk for tooth enamel defects and therefore, early childhood tooth decay. A diet lacking or low in vitamin D will contribute to a phenomena known as “ burning mouth syndrome”, symptoms of which can include dry mouth, a burning sensation of the tongue and oral tissues and a metallic or bitter taste. The condition is most common in older adults who, coincidentally, are frequently found to have a Vitamin D deficiency! Oral Health scientists have found that in addition to many general health benefits, Vitamin D helps to reduce inflammation in the body, which is widely known to have a direct impact on the development and severity of periodontal (gum and bone) disease. As a matter of fact, according to a study published in the Journal of Dentistry1 among 6700 research participants, those who had the highest blood levels of Vitamin D were about 20% less likely to have gum disease. Since more than half the people in the country have some form of gum disease, which may be a very good reason to drink your milk!

    Vitamin D is produced naturally by the human body when skin is exposed to sunlight, but more often than not people choose to protect themselves from the harmful effects of ultraviolet rays. Sunscreen and protective clothing may prevent getting enough vitamin D from the sun; and deficiency is common among people who live in northern latitudes or otherareas that receive limited sunlight. Up to 50% of older adults have inadequate Vitamin D levels, perhaps partly due to decreased outdoor activity and sun exposure; and African Americans of all ages produce less Vitamin D, probably due to the darker color of their skin.

    Although it is a rule of thumb that the best source of nutrients is a natural one, Vitamin D supplements are readily available over the counter and routinely recommended to individuals at risk for deficiency. The American Academy of Pediatrics recommends that Vitamin D drops be given to breast-fed infants, because breast milk usually has low levels of vitamin D. Do you have unexplained body or mouth symptoms? Could you be at risk … or have you been recently diagnosed with low Vitamin D levels? Your doctor and dental professional can advise you about the benefits of a supplement, and a recent discovery of Vitamin D deficiency is a good reason to schedule your regular dental checkup.

    1. Journal of Dentistry (2005), 33:703–10.

    Osteoporosis and Periodontal Disease

    Osteoporosis is a disorder characterized by bones that become thinner, more porous and more fragile over time. The condition affects about 6 million women and 2 million men Nationwide and has few if any symptoms in the early stages. As a matter of fact, for many people a fractured bone is sometimes the first indication that a problem exists. The good news is identifying the early signs of bone loss in the mouth may be reliable predictors of your risk for osteoporosis.
    Scientists have studied the relationship between periodontal disease and osteoporosis for over a decade, recognizing that the bone that supports the teeth in the mouth becomes significantly more porous after about age 50 and is affected by conditions in the rest of the body. Periodontal disease is caused by inflammation and bacterial infection – it is not caused by osteoporosis; but osteoporosis can make bone loss from periodontal disease more severe. Risk of developing the disorder increases with age… over 40% of women over age 65 have signs of low bone density, primarily caused by a decrease in the amount of the hormone estrogen produced by the body after menopause. However, inadequate intake of Vitamin D and calcium, physical inactivity, smoking and certain medications and family history are also known risk factors.
    Identifying the signs of bone loss in the mouth can help identify osteoporosis – and the sooner it is treated, the less likely it is to cause debilitating fractures, tooth loss from periodontal disease and a diminished quality of life. Even when teeth are already missing, loss of the bony ridges that holds dentures or partials in place will cause a poor fit. Studies have shown that patients with osteoporosis usually require new dentures more often than patients who do not have osteoporosis.
    Not surprisingly treating periodontal disease and osteoporosis simultaneously can be very beneficial. A study published in the Journal of the American Dental Association in March 2011* by Stony Brook University researchers has generated some strong evidence for making sure that dental visits are an integral part of your personal health care plan. The two-year double-blind study involved Sub-antimicrobial-dose doxycycline (SDD), the only drug approved by the FDA for treating the most common type of periodontal disease. Researchers tested the drug in postmenopausal women with both periodontal disease and low bone density – and produced some encouraging results. According to the researchers, SDD not only reduced periodontal disease over a time, it but also reduced the risk of bone loss around the hips and spine.
    A dental exam is not a replacement for a bone density evaluation when recommended by the doctor, but current research suggests that the dentist can help identify people at risk for developing osteoporosis by analyzing bone thickness and patterns on dental x-rays during routine dental checkup appointments. Of course, this is part of the comprehensive oral examination you receive at every check-up visit. Did you know how useful dental x-rays could be? Are you at risk?

    Journal of the American Dental Association (March 2011, Vol. 142:3, pp. 262-273).

    Nutrition and Oral Health: You Really Are What You Eat!

    It’s true! Do you have gingivitis, periodontal disease, mouth sores or frequent cavities? Most people know that good nutrition is an important part of an overall healthy lifestyle, but did you also know that what you eat actually has a direct impact on the health of your teeth and gums?

    Here is something to smile about: a well balanced diet that is high in fiber can improve your oral health, and may reduce the risk of other diseases as well. Poor nutrition impacts the entire immune system, making it less efficient at fighting disease – including oral disease. As a result, people whose diet is lacking in key nutrients are more susceptible to a variety of systemic disorders including diabetes and cardiovascular disease. As a matter of fact, a study that appeared in the Journal of Periodontology reported that periodontal (gum and bone) disease progresses faster and is more severe in patients whose diet is deficient in certain nutrients. The key nutrients for a healthy mouth include:

    Calcium: Teeth and the bones that support them are strengthened by the calcium they contain; and when there is not enough in your diet, the risk of developing gum disease and tooth decay is greater. Researchers have studied the relationship between calcium intake and gum disease, and have found that the participants with the healthiest teeth and gums consumed more than 800 mg of calcium daily, whereas those who consumed fewer than 500 mg were 54% more likely to develop gum disease. The best sources of calcium are dairy products, such as milk, cheese, and yogurt, however, beans, oysters and certain green, leafy vegetables are also rich in calcium. Calcium is also commercially added (fortified) to some juices and breakfast cereals. Supplements are available in various dosages for the lactose-intolerant and those who are calcium deficient in their diet.

    Iron: Iron deficiency can cause tongue inflammation and mouth sores. Iron is found in many foods, particularly liver and red meat, but other iron-rich foods include bran cereals, some nuts, and spices.

    Vitamin B3 (niacin): A lack of vitamin B3 can cause bad breath and canker sores in the mouth. To boost your B3 levels, eat chicken and fish.

    Vitamins B12 and B2 (riboflavin) and folic Acid: When you do not consume enough of the vitamins B12 and B2 in your diet, you can develop mouth sores and a condition called pernicious anemia in which the body does not have enough red blood cells or hemoglobin. Pernicious anemia is often diagnosed in the dental office because patients with the condition will have a swollen red, shiny tongue. All three of these nutrients are essential for healthy gums .Red meat, chicken, liver, pork, fish, and dairy products like milk, yogurt, and cheese, are good sources of vitamin B12. Vitamin B2 is found in foods like pasta, bagels, spinach, and almonds. Spinach and broccoli are good sources of folic acid.

    Vitamin C. Too little vitamin C may lead to bleeding gums and loose teeth. Not only does this vitamin support a healthy immune system for fighting disease, vitamin C is necessary to help the body produce collagen, a substance that gives support and structure to the gums and other body tissues. Sweet potatoes, raw red peppers, strawberries and citrus fruit like oranges are great sources of vitamin C.

    Vitamin D. Vitamin D is necessary for the body absorb calcium. A diet low in vitamin D may cause a burning sensation in the mouth, with a metallic or bitter taste and dry mouth. Drink milk, and eat egg yolks and fish to increase your vitamin D intake.

    Fiber: Foods with fiber stimulate saliva flow, which is the body’s natural defense against cavities. About 20 minutes after you eat something containing sugars or starches, saliva begins to neutralize the acids that destroy tooth enamel. As an added benefit, the fruits and vegetables that are fiber-rich are also good sources of other important nutrients!

    Bacteria feed on leftover foods in the mouth and they produce acid which causes tooth decay. Carbohydrates like breads and pasta, or sticky foods that contain sugar – even natural sugar can be as harmful as a candy bar because they cling to the teeth and are not easily washed away by saliva. Soda that is high in sugar presents an obvious cavity risk, but all soda contains acids and phosphorous that erodes the tooth enamel. Even the fruits and vegetables that are so important nutritionally contain sugars that are damaging if left in contact with the teeth. You have heard it before: good homecare, including brushing and flossing are essential to a healthy mouth, and don’t forget about regular checkups and cleaning!

    How sure are you that your diet is well balanced? Could you be at risk? Older adults or people with health issues that make eating certain foods difficult are at particular risk for oral health problems, but vegetarians who avoid meat and animal products may also be at higher risk for gum disease if they lack the nutrients these foods provide. Ensure that you’re getting the nutrients, vitamins and minerals your body needs… speak to your physician and dentist, and check out the U.S. Department of Agriculture’s website.

    Senior Oral Health: Smiles For A Lifetime

    Like the rest of the body, our mouth and likewise our oral health needs change as we get older; and just a few generations ago, oral disease and eventual tooth loss were expected parts of the aging process. Thanks to advancements in medicine over the past fifty years, adults expect to live longer healthier lives… and when seniors and the people who care for them are aware of their unique oral health needs, it is not unrealistic to expect to keep teeth in great shape for a lifetime of smiles!

    Normal or not?

    Changes in the skin, bones, circulation and immune system that affect the body also affect the mouth; and even the teeth undergo normal changes with age. Do you know what to expect?

    A decline in the function of the immune system is a natural part of aging, but it is significant because it makes the body less capable of fighting infection. Everyone has both good and harmful bacteria in their mouth but as a result of the aging immune system, there is a gradual shift toward a greater number of the harmful bacteria which are responsible for gum disease, tooth decay and fungal infections such as yeast or thrush.

    • The Enamel: the outer shell of the tooth is the hardest substance in the body, and it is not replenished over time. Normal wear and tear over the life span causes it to be gradually worn away, which can expose the softer dentin underneath, making teeth more vulnerable to decay. Professional fluoride treatments may be recommended to strengthen the enamel. White fillings protect exposed dentin and cosmetically enhance your appearance… a stronger and more youthful smile is possible!
    • The Dentin: is the yellower, softer layer that underlies the enamel and covers the nerve of the tooth. Dentin is continually produced over the life of the tooth, and over time the tooth will naturally become darker and less sensitive to temperature. Older adults can and do have their teeth whitened with outstanding results. Usually, a cosmetic whitening procedure performed in the dental office is preferable to an over the counter product when the teeth have darkened significantly.
    • The Pulp: is the core of the tooth where the nerve and blood supply are found. The pulp shrinks as we age, making teeth less sensitive overall. Cavities may be much deeper and larger before they are felt. Many people mistakenly believe that dental checkups are less important as we get older but in reality, they are more important than ever!
    • The Bone: that supports the teeth should not change just because we get older. However, a person’s oral hygiene over their life span will directly impact the health of the bone over time. Periodontal (bone and gum) examinations are an important part of a routine dental checkup appointment for everyone. People who have had gum disease should have their bone level monitored more frequently, especially if they have difficulty fighting infections.
    • The Gums: lose collagen and connective tissue with age. Just like the skin of the rest of the body, the gums become thinner, more fragile, more susceptible to injury and infection, and may take longer to heal.

    Common problems

    Normal physiological changes may leave older adults vulnerable to oral complications… declining eyesight, failing memory and even arthritis may make self-care more challenging and those professional checkups much more critical. Chronic conditions such as diabetes, osteoporosis, and circulatory problems are often associated with aging and these can these have a major impact the health of the mouth as well. Regular checkups can alert your dentist to the possibility of underlying medical conditions that you may not be aware of; and just in case you still need to be convinced, here are some surprising facts about oral health problems commonly experienced by seniors:

    • Among those over 75 years of age, about 50% of have cavities on the roots of their teeth (root caries) and may not be aware of it. Untreated decay can progress into the pulp of the tooth causing pain and serious blood infections, such as septicemia.
    • About 25% of seniors ages 65 to 74 have severe periodontal disease. Research has linked this condition with other serious health problems such as diabetes, heart disease, stroke, respiratory illness and pneumonia in institutionalized patients.
    • Oral cancer is diagnosed most frequently in people over age 65. Each year 30,000 new cases of oral and throat cancers are diagnosed and about 8,000 individuals die from these diseases. Early cancers are treatable, but since they are usually painless they often remain undetected until they have reached the later stages. Do you know about your risk factors for oral cancer? There are many… including tobacco and alcohol use, but some oral cancers develop in people with no known risk factors at all. When was the last time you were examined by a dental professional?
    • Dry mouth is a major side effect of over 400 medications, many of which are taken by older adults. Blood pressure medications, cholesterol-lowering drugs, medicines for Alzheimer’s disease and antidepressants are just a few examples. Don’t underestimate the importance of this treatable condition… it contributes to tooth decay, gum disease, denture discomfort and it makes eating and speaking difficult or painful.

    No matter what your age, a healthy mouth is important for general health and quality of life… and many older adults are choosing to cosmetically enhance their teeth for a real self esteem boost! Your personal oral health needs might include preventive checkups, fixing or replacing teeth or a brighter and younger looking smile. Whatever the case may be, your dental team has the expertise and the products that will allow you to look your best and love your smile for a lifetime! What types of services would you be most interested in learning more about?