Is there a link between periodontal (gum) disease and cardiovascular disease? Medical researchers are endeavoring to answer this intriguing question, but early findings seem to say yes. If it bears true, the findings could advance treatment for both diseases.
There is one thing that can be said for certain: inflammation is a factor in both diseases’ progression. Gum disease begins as an infection caused by bacteria growing in plaque, which is made up of bacteria and a thin film of food remnant that adheres to tooth surfaces. The body responds to this infection through tissue inflammation, an attempt to prevent the infection from spreading. Likewise, inflammation appears to be a similar response to changes in blood vessels afflicted by cardiovascular disease.
While inflammation is part of the body’s mechanism to heal traumatized tissue, if it becomes chronic it can actually have a damaging effect on the tissues intended to benefit. For patients with gum disease, chronic inflammation causes connective tissues to detach from teeth, leading eventually to tooth and bone loss. Similarly, inflammation damages the linings of blood vessels in cardiovascular disease patients.
Researchers want to know what role bacteria may also play in the progression of cardiovascular disease. Initial studies seem to indicate that proactively treating the gum disease by removing all plaque from oral surfaces in patients with both conditions does appear to improve the health of diseased blood vessel linings. Whether this could ultimately reduce the occurrence of heart attack or stroke still needs to be ascertained.
As we learn more about the possible connections between these two diseases, there’s hope it will lead to new advancements that could improve health outcomes for both. It may prove to be the case, then, that maintaining a healthy mouth promotes a healthy heart, and vice-versa.
If you would like more information on the connection between gum disease and heart disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Inflammation and Heart Disease.”
As permanent teeth gradually replace primary (“baby”) teeth, most will come in by early adolescence. But the back third molars—the wisdom teeth—are often the last to the party, usually erupting between ages 18 and 24, and the source of possible problems.
This is because the wisdom teeth often erupt on an already crowded jaw populated by other teeth. As a result, they can be impacted, meaning they may erupt partially or not at all and remain largely below the gum surface.
An impacted tooth can impinge on its neighboring teeth and damage their roots or disrupt their protective gum attachment, all of which makes them more susceptible to tooth decay or periodontal (gum) disease. Impacted teeth can also foster the formation of infected cysts that create areas of bone loss or painful infections in the gums of other teeth.
Even when symptoms like these aren’t present, many dentists recommend removing the wisdom teeth as a preemptive measure against future problems or disease. This often requires a surgical extraction: in fact, wisdom teeth removal is the most common oral surgical procedure.
But now there’s a growing consensus among dentists that removing or not removing wisdom teeth should depend on an individual’s unique circumstances. Patients who are having adverse oral health effects from impacted wisdom teeth should consider removing them, especially if they’ve already encountered dental disease. But the extraction decision isn’t as easy for patients with no current signs of either impaction or disease. That doesn’t mean their situation won’t change in the future.
One way to manage all these potentialities is a strategy called active surveillance. With this approach, patient and dentist keep a close eye on wisdom teeth development and possible signs of impaction or disease. Most dentists recommend carefully examining the wisdom teeth (including diagnostic x-rays and other imaging) every 24 months.
Following this strategy doesn’t mean the patient won’t eventually have their wisdom teeth removed, but not until there are clearer signs of trouble. But whatever the outcome might be, dealing properly with wisdom teeth is a high priority for preventing future oral health problems.
If you would like more information on wisdom teeth and their potential impact on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Wisdom Teeth: Coming of Age May Come with a Dilemma.”
A baby’s teeth begin coming in just a few months after birth—first one or two in the front, and then gradually the rest of them over the next couple of years. We often refer to these primary teeth as deciduous—just like trees of the same description that shed their leaves, a child’s primary teeth will all be gone by around puberty.
It’s easy to think of them as “minor league,” while permanent teeth are the real superstars. But although they don’t last long, primary teeth play a big role in a person’s dental health well into their adult years.
Primary teeth serve two needs for a child: enabling them to eat, speak and smile in the present; but more importantly, helping to guide the developing permanent teeth to erupt properly in the future. Without them, permanent teeth can come in misaligned, affecting dental function and appearance and increasing future treatment costs.
That’s why we consider protecting primary teeth from decay a necessity for the sake of future dental health. Decay poses a real threat for children, especially an aggressive form known as early childhood caries (ECC). ECC can quickly decimate primary teeth because of their thinner enamel.
There are ways you can help reduce the chances of ECC in your child’s teeth. Don’t allow them to drink throughout the day or to go to sleep at night with a bottle or “Sippy” cup filled with milk, formula, or even juice. These liquids can contain sugars and acids that erode enamel and accelerate decay. You should also avoid sharing eating utensils with a baby or even kissing them on the mouth to avoid the transfer of disease-causing bacteria.
And even before teeth appear, start cleaning their gums with a clean, wet cloth right after feeding. After teeth appear, begin brushing and flossing to reduce plaque, the main trigger for tooth decay. And you should also begin regular dental visits no later than their first birthday. Besides teeth cleanings and checkups for decay, your dentist has a number of measures like sealants or topical fluoride to protect at-risk teeth from disease.
Helping primary teeth survive to their full lifespan is an important goal in pediatric dentistry. It’s the best strategy for having healthy permanent teeth and a bright dental health future.
If you would like more information on tooth decay in children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Do Babies Get Tooth Decay?”
Ask people about the “Great American Smoke-Out,” and many could tell you about this annual promotion encouraging tobacco smokers to quit. Ask them about “The Great American Spit-Out,” though, and they may look puzzled. That’s because most of society’s attention is on quitting smoking; but the truth is smoking isn’t the only tobacco habit that needs to be kicked.
Whether chewing tobacco or the more finely ground snuff, smokeless tobacco is a popular habit especially among young athletes. It doesn’t receive the attention of smoking tobacco because it’s perceived as less dangerous. The truth is, though, it’s just as hazardous — especially to your oral health.
While any form of tobacco is considered a carcinogen, smokeless tobacco in particular has been linked to oral cancer. This is especially dangerous not only because oral cancer can lead to physical disfigurement and other negative outcomes, but it also has a dismal 58% survival rate five years from diagnosis.
And because it too contains highly addictive nicotine, smokeless tobacco can be just as difficult to quit as smoking. Fortunately, the same techniques for smoking cessation can work with chewing habits. Nicotine replacements like nicotine gum, lozenges and patches, as well as Zyban, a cessation medication, have all been shown helpful with quitting smokeless tobacco.
Often, however, it takes a change in perception — taking chewing tobacco down from its pedestal of “coolness” and seeing it for what it is: a dangerous habit that increases the risk of cancer, cardiovascular disease and even decreased sexual arousal and function. And although not life-threatening, it can also give you bad breath, dry mouth and an assortment of dental problems that incur financial and social costs. Teeth and gums in that environment aren’t so cool.
The first step is to consider the consequences of continuing the chewing or dipping habit and making the decision to quit. You may also benefit from the help of others: counselors experienced with tobacco cessation programs or a support group of others trying to quit. Following through aggressively will help ensure smokeless tobacco won’t lead to the loss of your teeth, health or life.
If you would like more information on quitting smokeless tobacco, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Quitting Chewing Tobacco.”
There are several reasons why dental implants are so popular. Perhaps the most important, though, is their longevity: if maintained properly implants can last for decades. However, they’re not indestructible—certain mouth conditions could put them at risk for early failure. But if you address emerging problems early, you may be able to prevent that unfortunate outcome.
Your implants may be in danger, for example, if you have a teeth grinding or clenching habit. This occurs when a person involuntarily and repeatedly bites down on their teeth when not chewing or speaking. Usually triggered in adults by high stress, teeth grinding can subject both natural teeth and implants to damaging levels of force. Over time this can cause bone loss around an implant and weaken their support. It could also cause a direct break in an implant.
But there are ways to stop or at least reduce the effects of teeth grinding. One effective way is a custom-made bite guard you wear while you sleep. Made of hard plastic, the guard prevents the teeth from making solid contact with each other, reducing the amount of force generated.
A more prominent problem is periodontal (gum) disease, a bacterial infection caused by built-up dental plaque on tooth surfaces. This can trigger inflammation, a normal defensive response that when it persists for an extended period of time can damage tissues and supporting bone. It can also cause a specific form of gum disease related to implants called peri-implantitis, in which the tissues that support an implant become infected and weaken, leading eventually to possible implant failure.
If you have implants, then, you should brush and floss daily to prevent gum disease, as well as see your dentist at least every six months for cleanings and checkups. And if you notice anything like reddened, swollen or bleeding gums, see your dentist immediately. The sooner you undergo treatment, the better the outcome for your implants as well as your overall health.
Dental implants can give you years of great service and can prove to be well worth the cost. But you’ll have to stay on your guard against gum disease and other mouth conditions that could endanger them down the road.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants: A Tooth-Replacement Method that Rarely Fails.”
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