Come in for an appointment in April to enter the drawing for our Spring Gardening Basket give-away.

o There are a number of questions which remain unanswered at this time, but it does appear that individuals with periodontal disease may have about a 20% increased risk for coronary heart disease and stroke.

o While we wait for the findings of further research, it is important to identify those individuals who may be at greater risk for heart disease or stroke because of undiagnosed and untreated gum infection.

o Today we know that infection from gum disease is not contained simply within the oral cavity. It is important that you understand how gum disease and increased risk for heart disease and stroke may be related.

o Bacteria from gum infection cause inflammation.

o As a result of inflammation, the blood supply to gum tissues increases.

o This allows the bacteria and their toxins to enter the blood stream from the gum pockets. Simply put, when your gums bleed, a path for bacteria and their toxins to enter your blood stream is created.

o This bacteria and toxins can move through blood vessels to distant sites in the body, including the heart.

o When this happens the artery becomes less elastic and the inside of the artery becomes smaller and smaller.

o What happens next is small blood clots may form and arteries get clogged which causes blood flow to be cut off. This results in a heart attack or stroke depending on the location of the blood clot.

o What we now know is that it is infection and inflammation that accumulates over a lifetime that increases the risk for heart disease and stroke.

o So, it is important that any potential source of infection and inflammation be treated.

o The American Academy of Periodontology has determined that patients should be told that “periodontal intervention may prevent the onset or progression of atherosclerosis-induced diseases.”

o This opinion was based on the strength and consistency of scientific evidence, negligible risk associated with periodontal therapy, and the overall benefits of oral health.

Copyright Casey Hein 2008

Come in for an appointment in March and enter to win 50 (real) gold coins! Or leave a comment on this blog post for an entry in the drawing.

o With the aging process often comes lowered resistance and decreased ability to fight infection. As a result many elderly individuals will be at greater risk for various infections. One of these infections is periodontal (gum) disease.

o Not only are many elderly persons more vulnerable to developing periodontal disease, but if they already have periodontal disease, the aging process could trigger increased disease activity resulting in more severe disease.

o About 90% of the elderly population has periodontal disease (gum disease) and the majority may be undiagnosed. As a result of untreated periodontal infection over many years, inflammation and destruction usually goes beyond just the gum tissue and into the bone.

o Typically, periodontal disease is not painful until the most advanced stages when abscesses and tooth loss, through natural means or extraction, are very common.

o Damage from periodontal disease is not limited to the oral cavity. Recent research suggests that there may be a relationship between periodontal disease and other serious chronic conditions, including coronary heart disease, stroke, and increased risk for complications of diabetes.

o Of particular importance to you, research also suggests that elderly people with periodontal disease may be at greater risk for pneumonia.

o Research indicates that dental plaque can serve as a reservoir for certain bacteria which are known to cause pneumonia. Secretions from the oral cavity often contain these types of bacteria which can by aspirated into the lungs.

o As is often the case in the aging process, the immune system is impaired and as a result, the body’s defenses may fail to clear the bacteria.

o Cytokines are a type of chemical which are normally produced by the body to defend itself against inflammation. Cytokines which are produced in gum tissue as a result of periodontal infection may promote inflammation of the lower respiratory airway following aspiration of bacteria known to pneumonia. This causes the lining of the airways to become more vulnerable to these invading bacteria.

o Therefore, it is important to identify elderly individuals who may be at greater risk for respiratory problems because of undiagnosed and untreated gum infection.

o It has become increasingly clear that prevention, diagnosis, and treatment of periodontal disease are very important in maintaining overall health during the aging process.

o Make sure that you come to each dental appointment with an up-to-date list of the prescribed and over-the-counter medications you are taking so your dentist or dental hygienist will be aware of any medication that may affect the oral cavity or be a contraindication for certain types of dental treatment.

o Make sure you provide updated information regarding the status of your overall physical health to your dental care provider.

o Make sure you provided the status of your oral health, especially when periodontal disease has been diagnosed, to your medical care provider.

Copyright Casey Hein 2008

o We know that diabetes increases the risk of infection from any source. Periodontal (gum) disease is an infection and complication of diabetes which is often unrecognized.

o People with poorly controlled diabetes are much more susceptible to periodontal disease; with a 2 to 4 time’s greater risk of developing periodontal infection than people without diabetes.

o Once periodontal disease is established in a patient with diabetes, metabolic control (glycemic control or blood sugar levels) of diabetes is complicated from the constant reservoir of gram-negative anaerobic bacteria that sit at the bottom of the gum pockets producing infection and low grade inflammation throughout the body.

o That is why it is important for diabetic patients to achieve and sustain the same level of glycemic control as a healthy, non-diabetic individual.

o Good glycemic control, and HbA1c value of less than 6% for most patients, significantly reduces the risk for the serious complications of diabetes, including periodontal disease.

o The presence of periodontitis increases the risk of worsening glycemic control; (perhaps 6-fold increased risk of worsening glycemic control over time).

o Research also suggests chronic periodontal infection causes systemic inflammation that enhances insulin resistance and hyperglycemia. Insulin resistance makes it difficult for patients and their physicians to achieve and sustain optimal glycemic control, and increases the risk for coronary heart disease.

o Some studies show that diabetic patients with periodontitis require less insulin following treatment of periodontal disease.

o Although more research needs to be conducted, studies that have measured the difference in HbA1c after treatment of periodontal disease reported improvements in HbA1c ranging from 0-2 percentage points in HbA1c levels.

o Patients with poorer glycemic control may have more rapid recurrence of deep pockets and less favorable long-term response to treatment.

o When a periodontal infection goes untreated in diabetic patients, this puts them at greater risk for developing the long-term complications associated with diabetes and cardiovascular disease.

o Comply with your health care provider’s recommendations of HbA1c testing at least every 3 months, and request copies of the results are forwarded to your dentist. This allows your dental care provider to monitor your glycemic control against your periodontal status.

Copyright Casey Hein 2008

Proper oral hygiene is an important part of a healthy life. The mouth is the gateway to the body. Recent studies are proving oral health has more to do with over all health than was commonly thought. Your oral health can affect diseases such as Diabetes and Heart Disease. Making oral hygiene as efficient as possible promotes follow through. When something is too hard or takes too much time, we don’t want to do it. Here are the top 10 tips to make it easier and more productive:

1. Use a timer. It’s important to brush for a full 2 minutes. Using a timer allows you to brush for the exact amount of time and not worry about brushing for too little or too much time.

2. Use a floss aid. Regular floss is hard for some people to use, which means it is commonly not used. There are numerous floss aids on the market that make flossing quick, easy, and just as effective as regular floss. A popular flosser is the Reach Access Flosser.

3. Make it a habit. Pick a time to brush your teeth every day. A good example is right when you wake up and right before you go to bed. If you brush, floss, and rinse at the same time every day you are less likely to forget.

4. Start in the same spot every time. Choose one part of you mouth to start brushing in every time. For example, start with the upper right and work your way around your mouth. If you start in the same spot every time you’ll be less likely to forget to brush one area.

5. Avoid sports drinks. A new study published in RDH shows sports and energy drinks are just as bad for your teeth, or worse, than juice and soda. Try to limit these beverages to when needed (after strenuous physical activity), use a straw to limit exposure to tooth enamel, and rinse with water afterward.

6. Use mouth wash for 30 seconds. It is unnecessary to rinse for any longer than 30 seconds. That is all the time you need to kill the bacteria in your mouth.

7. Don’t brush too hard. Brushing harder won’t help remove more plaque. It may even abrade your enamel and cause damage to your gums. Using a soft bristled toothbrush will also help avoid abrasion.

8. Check for the ADA seal. We encourage patients to choose any toothpaste they prefer, as long as it has the ADA seal. By choosing an ADA approved product you can be sure it has been thoroughly tested to be safe and effective.

9. Chew sugar-free gum. Chewing sugar-free gum after eating can help reduce the amount of acid in the mouth and dislodge particles on and between the teeth. However, if you have TMJ, gum chewing is not recommended.

10. Ask for personalized suggestions. Don’t be afraid to ask your dentist or hygienist for personalized recommendations to make taking care of your oral health more productive.

Happy Holidays everyone! Stop in this month for our December Tooth Whitening Special – Save $100 on whitening! We also have gift certificates available.

During the month of October we are having a “Guess the Number of Candy Corn” contest. Stop in to take a guess and to pick up a reflective Trick-Or-Treat bag for your trick-or-treaters!

Come by the office to schedule an appointment this month and take an apple. Apples can be an important part of a healthy diet. They are fat free and an excellent source of antioxidants and fiber!

Our contest for the month of July is a basket with grilling supplies and sauces. Call us for an entry, or leave a comment on this post with your name.