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

Celebrating 30 Years- Thank You Technology

Before I begin today’s topic, I must correct a glaring omission from the thank you letter I wrote to April and all of our dental assistants. There is a woman who was our second dental assistant after Liz back in the mid 80’s and describing this person provides a perfect segue into today’s subject. The person to whom I refer is Remi, a very attractive young woman, who would come to the office dressed in popular clothing of the time, which were stretch pants and high heels with the top of her choice. Naturally, Remi was very popular among my male patients as well as being a top-notch dental assistant.  I had the pleasure of working with her for a couple of years until her family moved to North Carolina  but Remi and I stayed in touch.  Then, during the 90’s, we became quite good friends socially. When April began her first maternity leave, Remi stepped in to help us and remained on a part-time basis until she left for a new full-time position.  Remi is owed a big thank you for both her friendship and her contributions to our dental practice.  Remi, please forgive me for not having included you in the first article!!

But what does Remi have to do with today’s topic?  Today, I will express thanks for the amazing progress that we have made in dentistry owing to the development of various technological advancements. At the same time, I’ll have an opportunity to describe how the practice of dentistry has changed in the last thirty years. So, if you can picture Remi wearing stretch pants and high heels, you will realize that what we wear today is far different from the “uniform” of thirty years ago.  Better yet, if you can picture what Remi was not wearing at the time, you will understand the first major change that occurred in dentistry in the last thirty years.

Thank you technologyWhat Remi was not wearing back then was gloves, a mask and all the other outer protective garments, which are mandatory today. What changed was the AIDS epidemic had begun and the use of all  protective clothing and shields became mandated.  After having practiced “wet fingered” dentistry for several years, wearing gloves was initially quite a challenge due to the loss of tactile sensation that resulted.  But we all adapted and have since incorporated a multitude of protocols and protective items to protect not only those who work in the dental office but also every patient.

Thank you technologyThe next major change for dental practices was the use of computers which began in the mid to late 1980’s. I remember buying my first computer, an IBM with a whopping 50 MB of memory! Bear in mind that is megabytes and I’m not referring to RAM. This computer took some getting used to, but relieved us of hours upon hours of paperwork every day as all appointments and transactions had been done by hand up to that time. As you can imagine, the computers kept getting bigger and doing more for us every year.  Now, the practice of dentistry and the use of computers are totally integrated and amazing.

Thank You technologyToday, the world of dentistry is becoming more and more digital. By now, most of my patients have seen the digital x-rays which we employ.  These x-rays are so large and easy to read that patients can easily see what we see with minimum coaching. These x-rays can be manipulated in terms of contrast, size and various other features.  Similarly, in the future, impressions will be taken digitally using a small intraoral camera rather than all of that impression gook which many patients are not fond of.

If you’ve been in our office for the last dozen years or so, you’ll note that we also use a digital camera to record photos of your teeth.  In addition, we have an intraoral camera which takes close-up images of the teeth.    The use of these photographs helps us to better diagnose what is going on in a given patient’s mouth as well as the ability to easily explain conditions and options to patients.

Thank you technologyOne of my favorite newer pieces of equipment is called the K7.  We have been using this system for the past five years or so to help us better diagnose and treat patients who have Temporomandibular Joint Disorders.   This piece of equipment allows us to evaluate the jaw muscles, jaw movement and joint sounds. Using this piece of equipment, we can determine in an objective way the best position for an individual patient’s jaw.  Since using the K7, we have been able to help many patients who were suffering with a variety of TMD symptoms.   If you have any interest in the subject, you may find additional information on the website  www.myotronics.com  .

Other technological advances which assist us in our day to day treatment of patients include the use of the diode laser, the Wave One root canal system, and the Diagnodent cavity detection device.

Thank you technologyThe diode laser has a multitude of uses including preparing teeth for impressions, cosmetic re-contouring of the gums, the treatment of periodontal or gum disease and the speed healing of canker sores and fever blisters just to name a few. This is a marvelous piece of equipment which is kind to patients for its healing properties, its gentleness not requiring the need for anesthesia in many cases, as well as its ability to work without creating bleeding.

The Wave One root canal system is an equally wonderful system which helps us to perform root canal therapy for patients in less time than in the past while being more thorough at the same time.

Thank you technologyThe Diagnodent cavity detection device uses a laser to detect the presence of decay in an extremely accurate manner. We had even seen that it finds decay which is not visible either on x-ray or in the mouth but serves to help patients avoid more extensive treatment due to lack of prompt care.

The descriptions provided above of the technological advances which we have seen the last 30 years is by no means a complete list. Suffice it to say, the practice of dentistry is far more enjoyable, accurate and just plain better than it was in the 80’s.

Thank you to all the pioneers who helped to develop the technology that we use today. It will be fascinating to watch dentistry continue to evolve in the next thirty years!

Smile Enhancements for Healthy Aging

Earlier this month, we discussed common dental problems which affect us as we grow older and how to address them.  In this installment, we will describe three popular methods to improve both the appearance and the function of your teeth. At the end of this article, we will reinforce what we believe to be the best ways to improve the health and beauty of your smile.

smile enhancementsYou may be surprised to hear about the first popular procedure which has increased in frequency over the past several years.  Once considered only appropriate for adolescents and teenagers, orthodontics has become an excellent means for adults (even those well into their 60s) to improve their smile, take years off their facial appearance, and improve their self-esteem.  This, in turn, improves their overall outlook on life. Alternatives to the metal braces commonly seen in the past have grown in popularity as they have become more comfortable, effective and invisible.  In our office, Invisalign™ orthodontics has proven to be a discrete and successful method for adults to address bite issues and crooked teeth.  Even patients who had braces as a teenager find the system an excellent way to realign teeth which have relapsed over the years.

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Invisalign™orthodontic treatment, combined with either tooth bleaching and/or bonding, can help you to achieve your dream smile, improve your appearance, help you look younger, and feel a renewed sense of self confidence.  In addition, a properly aligned bite serves to preserve your overall health and well-being.  Teeth which are not aligned and bites which are not properly balanced are much more at risk for a variety of dental issues.  These issues include tooth fractures, tooth wear, loosening teeth, gum recession, ineffective chewing ability as well as a variety of jaw, neck, and shoulder pain and headaches.

The second popular dental enhancement which has steadily gained in popularity over the last twenty-five plus years is implants. Titanium implants have evolved and become a staple in the replacement of missing teeth for those who wish for comfort, convenience, and excellent appearance. Implants can be used in a number of different ways to replace missing teeth. The simplest way, of course, is for replacing a single missing tooth. But implants can also be used to replace a series of missing teeth or even an entire arch of missing teeth. Contrary to popular opinion, the placement of implants does not involve significant discomfort and their success rate is very high.

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There are many patients who have struggled with dentures for years. Such patients have had as few as two implants placed to stabilize their existing dentures. The benefits of such procedures are astounding for those who have struggled to eat and speak with loose plates for years. We even see patients who are about to lose all their remaining teeth in one or both arches. Such patients can have their hopeless teeth removed, four implants placed, and a set of teeth mounted on those implants all in a single appointment. That procedure is called “All-On-Four” and requires collaboration between a prosthetic dentist, an implant surgeon and a laboratory technician.  The results in these cases are life changing.

The third popular smile enhancement involves bonding or porcelain to restore worn, broken, or otherwise damaged teeth. “Bonding” utilizes tooth-colored filling material which is placed on one or a group of teeth to restore natural appearance, shape, and color. Similarly, porcelain is used in more advanced cases for those patients who wish to have the most long-lasting and cosmetic solution to their dental problems. Porcelain can be used to cover the entire tooth or limited areas of the tooth as needed in any given situation. The porcelain is bonded to the teeth which results in a very strong, cosmetic, and natural result.

Bonding and porcelain can be used to enhance smiles in a number of different ways. Teeth which have mild misalignment can be made to look perfectly aligned instantly using these materials. Similarly, problems with symmetry, proportion, color and shape can all be addressed using these materials. The next time that you are in our office, make sure to look at some of the photographs on our walls which exhibit the results gained by using these materials.

Finally, let us reiterate the best ways to ensure healthy aging at least as far as oral health is concerned.  As we grow older, we are all more prone to have decay which can sometimes develop very quickly.  It is not uncommon for adult patients to have some gum recession which results in the exposure of root surfaces.  Such surfaces are very prone to decay and must be carefully monitored both at home and in the dental office.  In addition, as our gums recede, food is more likely to lodge between the teeth creating another cause for decay developing.  Increased use of medications and other medical issues may lead to a condition of dry mouth.  Without the buffering effects of saliva, the likelihood for increased dental decay as well as gum disease is highly likely.

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So what is one to do to prevent an increase in gum disease and dental decay? Here are our favorite as well as most effective recommendations:

  1. Use an electric toothbrush and brush where the teeth and gums meet.
  2. Clean between your teeth with an appropriate sized tool. Large spaces require a proxy brush and smaller spaces require fluffy floss.
  3. Brush before bed!
  4. Rinse with a fluoride mouthwash especially before bed.  During this month we have been handing out Listerine Zero which is a good product found in the grocery store but any similar product which includes no alcohol can be used.
  5. Have regular checkups! This is the best way to make sure that small problems do not become big ones! In the past few years, we have seen more and more patients who have returned after extended periods with more severe problems. Regular checkups will save you money and give you more peace of mind.

In closing, cosmetic dentistry may be key to a person’s health in later life.  Here is a quote from a cosmetic dentist in Texas:

“We often hear older patients just wanting things patched up as opposed to getting something aesthetic. They may have the idea that they are not worth it, or their families have the idea that they are too old for cosmetic dentistry. This may lead to an attitude that things are ending.

“Improving an older person’s mouth can bring them more happiness and joy, not only by improving chewing efficiency, but also bringing joy back. They will want to smile more.”

If you have any questions concerning this article or any other dental questions, please call our office at 908.359.6655 or contact us via our website at 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