Which Is Worse –Bad Gums Or Teeth?

This may sound like a trick question, but really it’s not. The “correct” answer, of course, is that both are equally important. But, I have a different view and will share it later in this article.

Both gums and teeth require good to excellent daily hygiene to remain healthy.   Prevention of both periodontal disease and dental decay is accomplished using the same techniques and products.  Both gum disease and dental decay are caused by the attack of bacteria which produce acid.  This acid causes damage to both hard and soft oral tissues including gums, enamel, dentin and bone. Both conditions if not properly and promptly addressed will result in the eventual loss of teeth as well as the inability to properly chew food.   And, both problems are a source of embarrassment and self consciousness due to missing teeth, bad breath, swollen and red gums, black holes, etc., etc.

Both teeth and gums are checked at every dental re-care appointment.   Commonly, both june3of these dental diseases go unnoticed by patients until more involved and expensive treatments are required. In the case of cavities, decay which has advanced to the point when a patient feels pain will generally require root canal therapy. And, in the case of gum disease, by the time a patient realizes that there is a problem, the solution often involves the services of a periodontist, possible gum surgery and / or loss of teeth.   Unrecognized and untreated periodontal disease will eventually lead to loose teeth as a result of the loss of bone and the attachment of the teeth.

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Finally, both gum disease and tooth decay result in the existence of chronic infection and inflammation which has detrimental affects on the overall health of the body. A chronic infection which becomes acute, can result in serious illness which may require hospitalization. The hidden impact of such diseases, however, is that these chronic inflammations increase the risk of other health issues including heart disease, cancer, complicated births, etc.

As promised, my view whenever planning the treatment for patients and explaining its need is that once acute infection and pain are under control, the health of the gums is the number one priority.  Consider the gums and bone to be the foundation which supports the teeth.   Without a solid foundation, even the healthiest teeth can be lost. Once the periodontal condition is stable and healthy, then the teeth can be addressed as needed.

If you have any questions about gum disease or dental decay, please feel free to contact us by telephone @ 908.359.6655 or via our website www.DesignsForDentalHealth.com

A Healthy Mouth and Healthy Aging

For over 20 years, September has been designated healthy aging month. This is an annual celebration of the positive side to growing older. During this month, a variety of sources provide Inspiration and ideas for baby boomers and adults aged 45 and above to help them to improve their physical, mental, social, as well as financial well-being.  It is our hope that we at Designs For Dental Health can provide some pertinent information to contribute to our fellow baby boomers.

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It is interesting to note that there are over 76 million baby boomers today over the age of fifty and the first of the 82 million Generation X-ers are about to reach that milestone in 2015.  Why not use September as a time to look back on where you’ve been and consider what you might truly like to do with the rest of your life.  If you’re happy and fulfilled with what you’re currently doing, keep on keeping on!  If not, this is definitely the time to make a change.  From my point of view, I’m happy to keep on doing what we, as your dental care providers, love to do most.  Help to keep you healthy! dreamstime_l_21764121

So, with that in mind, here’s our question for you today: How’s your smile? 

  

First of all, research supports the idea that those who smile more are just plain happier.  Secondly, those with a healthy mouth are much less likely to develop a myriad of diseases commonly suffered by those of us in the 60+ population. So ask yourself- when is the last time that you had a comprehensive dental examination to determine your overall oral health and the best methods used to maintain it?  I promise to provide such a comprehensive examination free of charge for anyone over age 55 who has been a patient in our practice for more than 5 years and who requests it.  That’s right!  All you have to do is ask! I’ll sit down with you for as long as it takes to discuss your concerns and desires.  Then, we’ll do a comprehensive examination including an oral cancer screening, evaluation of your teeth, gums, and bite. Together, we’ll discuss any options that might be available to you to improve your dental health and from that discussion we will arrive at the best treatment plan for you.

 

Consider this – a mere 60 years ago, it was assumed that we would lose all of our natural teeth as we aged.  Now we know that a healthy mouth and teeth will help you to not only look good, but to eat delicious and nutritious foods, to speak clearly and to be confident.  An excellent quality of life demands a vibrantly healthy mouth.  Just consider the fact that those whose oral health is subpar are at risk for various serious medical conditions including: heart disease, stroke, diabetes, pneumonia, cancer, and various other diseases which are common in older adults.

 

What are some common oral health problems?

 

  1. Dry mouth.   Reduced salivary flow is most commonly the result of cancer treatments, the use of certain medications, and certain diseases. Dry mouth is a significant cause of decay and gum disease in older patients because saliva serves to buffer acids that are produced as we eat.  Without the protection of these buffers, rapidly advancing problems occur. 

  2. Darkened teeth.   Our teeth tend to darken with time as the pulp in our teeth recedes and the outer layer of enamel becomes thinner, thus allowing the darker dentin to show through. There are various methods available to whiten the teeth for a more youthful appearance.  These techniques do not harm teeth and most patients are extremely happy with their whiter, more beautiful smiles. 

  3. Root decay. As the gums recede, exposure of the tooth roots result. Exposed root surfaces are less resistant to decay than enamel and decay here is quite common. Good brushing and plaque removing habits go a long way to protect these surfaces. In addition, the judicious use of fluoride rinses can be most helpful to protect these exposed surfaces. 

  4. Gum disease. Inflammation of the gums and resulting bone loss in more advanced cases is quite common in adults over the age of 50.  Gum disease is worsened by poorly fitting tooth restorations, less than ideal dietary choices, and certain diseases like anemia, cancer, and diabetes.  The best way to fight gum disease is to practice excellent oral hygiene and have regular dental exams and cleanings as recommended in your particular case. 

  5. Tooth loss. Gum disease is the number one cause of tooth loss; however, teeth which have broken due to old, large silver fillings or simple attrition require prompt attention to avoid unnecessary loss of teeth!  Restoring a broken tooth is always better and less expensive than losing a tooth and later trying to replace it. 

  6. Uneven jawbone. This common problem is a result of premature tooth loss.  Once a tooth is lost, the bone previously around that root vanishes and teeth adjacent to and opposing the missing tooth will shift.  This causes an uneven bite and places for food and bacteria to become trapped. 

  7. Oral cancer. Routine examinations are essential to identify possible cancerous conditions in the mouth. Always report unusual lumps or bumps or discolorations to your dentist or hygienists promptly! 

So what is the best way to maintain your good oral health?  It’s the same regardless of your age!    

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  1. Brush at least twice a day with good quality toothpaste as recommended by your dentist or hygienist. The most important time to brush is just before bed!! 

  1. Floss or otherwise thoroughly clean between your teeth at least one time each day. 

  1. Visit your dentist or hygienist on a regular basis as recommended by them for regular cleanings and oral examinations.  

  1. Use appropriate rinses or fluorides or other such adjuncts as recommended by your dental professionals. 

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If you have any questions about healthy aging month or would like a complementary comprehensive examination please call us at 908.359.6655 or contact us via our website at www.DesignsForDentalHealth.com

Alzheimer’s Disease And The Oral-Systemic Connection

Infections in the mouth are now considered as potential risk factors for the progression of Alzheimer’s disease. Studies have shown that inflammation – like that which results from dental disease like periodontitis (gum disease) – has a role in the development of dementia and Alzheimer’s disease. Inflammation caused by specific bacteria in the mouth cause an inflammatory cascade throughout  the body which impacts our systemic health.

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A dental infection can cause severe illness requiring hospitalization.  Such infections are more common than most people might think. Some months ago, one of our patients postponed an appointment during which a tooth infection was to have been treated.   This infection was found on an x-ray, and this patient had no pain or other obvious symptoms of a problem.  Several days after the original appointment we received a call from the patient that she had developed severe swelling over her eye.  This infection ultimately resulted in this patient’s being hospitalized for four days and requiring IV (intravenous) antibiotics.

Just to be clear, oral diseases which are more chronic in nature than the example above may not only be direct causes of systemic disease. They indirectly cause an increase in severity especially in those diseases which are known to be inflammatory in nature.  It is clear that eliminating oral inflammation reduces the inflammatory impact on many systemic inflammatory diseases including cardiovascular disease, diabetes, and rheumatoid arthritis. Although Alzheimer’s disease is generally not considered to be inflammatory disease, inflammation does have a role in accelerating the progression of this disease.

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CBS News’ 60 Minutes produced a wonderful show about aging                                   which presents interesting information about Alzheimer’s Disease.

Here’s a link to view this show: 

www.CBSnews.com/news/living-to-90-and-beyond/

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Research has identified five specific pathways by which gum disease and oral infections seem to influence the progression of Alzheimer’s disease:

1. Bacteria from the mouth can directly enter the bloodstream.

2. These bacteria cause systemic (whole body) inflammation impacting Alzheimer’s disease.

3. The bacteria P. gingivalis plays a role in the formation of blood clots and thereby cardio vascular disease and strokes which are both risk factors for Alzheimer’s disease.

4. Germs from the mouth can travel directly to the brain.

5. Some people have a genetic predisposition which can increase the effects of oral inflammation

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To summarize, the ways by which oral infections and periodontal disease affect disease progression is not always direct. However, the link between diseases of the mouth and body is established, and the evidence is clear that maintaining a healthy oral environment is crucial to minimize the progression of various systemic diseases including Alzheimer’s disease.

If you have any questions about the oral-systemic connection or diseases of the mouth, feel free to call us at 908.359.6655 or contact us via our website at www.DesignsForDentalHealth.com

Gum Disease, Inflammation, and Your Health

All of our body’s organ systems are interconnected. What happens in one system can and often does affect other systems. One prominent and currently emphasized interrelationship is the one between periodontal (gum) disease and cardiovascular disease. And in particular, it is inflammation which is the common link between these two conditions.

Inflammation by itself is not a bad thing. Acute inflammation is the body’s normal response to injury and infection. This type of inflammation is experienced as redness, pain and swelling. Immediately after an injury, there is a biochemical reaction which improves blood flow to the affected area. Nerve and other cells send out signals to recruit white blood cells which help fight foreign bodies. This acute inflammation is absolutely necessary for normal good health.

There is another kind of inflammation which is our main concern in this article. That is chronic inflammation which is also known as low–grade or systemic inflammation. This inflammation is long–lasting and examples include autoimmune disorders like rheumatoid arthritis and lupus. In these cases the body mistakenly initiates an inflammatory response even though there is no actual infection or injury to be fought. Other examples of chronic inflammation include inflammatory bowel diseases like ulcerative colitis and Crohn’s disease.

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Chronic “hidden” inflammation occurs throughout the body when something engages the immune system. This engagement varies from person to person but may include repeated or prolonged infection, smoking and gum disease. Obesity also makes one prone to inflammation as fat cells turn out inflammatory proteins called cytokines. Most people don’t know that they are inflamed. There is a test which measures the inflammatory marker called the C–reactive protein but it is not used routinely to determine increased risk of associated diseases. The important point is that inflammation is the primary cause for most of our serious chronic diseases including cardiovascular disease, diabetes, cerebrovascular disease, rheumatoid arthritis, and Alzheimer’s disease to name but a few.

As far as the connection between gum disease and cardiovascular disease, research indicates that heart disease, clogged arteries, stroke and bacterial endocarditis may all be linked to oral health. Researchers believe that gum–disease–producing bacteria enter the bloodstream and make their way to the heart. And just as these bacteria create chronic inflammation and damage of the gums and bone around the teeth, the same bacteria can cause a similar response in the blood vessels. Inflammation can begin and accelerate the build-up of plaques with in blood vessels – called atherosclerosis or hardening of the arteries. These plaques decrease the flow of blood to both the heart and the brain, and if such a plaque breaks free can result in a heart attack or stroke.

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What can you do? Roughly 75% of adults have some form of gum disease and 30 % have moderate to advanced periodontitis. Those with more advanced gum disease are much more likely to develop associated inflammation-related heart disease or stroke or the other inflammation-related illnesses. Having a thorough periodontal examination and following up with necessary gum disease periodontal therapy is the best first step. Avoid the obvious creators of inflammation which have been proven to be unhealthy. Prime examples are smoking and heavy drinking of alcohol.

There are many who advocate an “anti-inflammatory” diet. Many of the recommended foods would be typical of Mediterranean cuisine and certainly represent good nutrition. Such a diet would include:

• Generous amounts of fruits and vegetables

• Using healthy fats like olive oil

• Eating small portions of nuts

• Drinking red wine in moderation

• Eating fish regularly

• Limiting or eliminating red meat

If you would like more information about inflammation, gum disease and your health, please feel free to contact us by telephone at 908.359.6655 or via our website at www.DesignsForDentalHealth.com