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Periodontal disease, comes in two forms gingivitis (reversible) and periodontitis (treatable but non reversible), is an infection of the gums caused by bacteria found in plaque. Recent studies have shown between 50-75% of people have some form of periodontal disease. More statistics show that approximately 30% of Americans are at an increased risk of developing periodontal disease due to genetic factors. These statistics show how much a health concern periodontal disease can be especially when you add in even more research showing periodontal disease links with systemic diseases.

Factors in Development of Periodontal Disease

-Poor Oral Hygiene.

-Tobacco Use.

-Medications.

-Teeth Grinding or Bruxism.

-Genetics.

-Poor Immune System

-Systemic disease.

The earliest and mildest stage of gum disease is gingivitis, where the gums redden and bleed easily. If not treated, inflammation of the tissue occurs, resulting in progression of  the disease to periodontitis. Gingivitis is characterized by receding gums, loose teeth, sores, sensitive gums, swollen gums, red or discolored gums, chronic bad breath, change in teeth alignment and teeth movement. The ultimate consequence of advanced periodontal disease is loss of teeth, which occurs when the tissue and bone supporting the tooth breaks down.

Periodontal disease was previously thought to affect only the teeth and gums, but researchers have discovered that periodontal disease influences the overall health and well-being of an individual. Research has shown that gum disease is a risk factor for many health conditions throughout the body. The gum disease causing bacteria that normally resides around the teeth can enter the blood stream and reach other organs and tissues in the body. Once there, the bacteria  release disease-causing agents that can lead to chronic inflammatory conditions that can include:

Diabetes Mellitus (or simply Diabetes)

Periodontal disease impairs the body’s ability to maintain blood sugar levels making you more prone to diabetes or making diabetic symptoms worse. On the other hand, diabetic patients are more likely to suffer from periodontal disease due to a weakened immune system, making it easier for them to catch infections, viruses, and exhibit delayed wound healing.

Stroke

According to scientific studies, gum disease increases the risk of stroke and coronary artery disease. A chronic infection of the gums can be directly related to an increased risk of reduced blood flow to the brain. Stroke and gum disease have similar risk factors and severe inflammation from periodontal disease increases the risks of having a stroke.

Heart Disease

Having periodontal disease puts you at higher risks of heart disease. Just like periodontal disease, heart disease is a chronic inflammatory disease which can be greatly impacted by periodontal disease. The more severe the periodontal infection, the higher the risk of developing heart conditions such as high blood pressure, high cholesterol and acute coronary syndrome.

Respiratory Infections

When the bacteria in the plaque that causes gum disease goes to the lungs, it can cause respiratory diseases such as pneumonia. This explains the increased cases of pneumonia and other respiratory conditions in people with periodontal disease. This also is in conjunction with patients with lowered immune systems which makes it easier for them to be susceptible to these bacterial attacks.

Cancer

After considering risk factors for cancer including age, diabetes, smoking, BMI and more, experts found periodontal disease as a risk factor for lung, kidney, pancreatic, head, neck and hematologic cancers. Inflammation caused by periodontal disease is a major contributing factor to these cancers.

Bad Breath (Halitosis)

Periodontal disease can result in chronic bad breath which is more of a social issue than a medical one. Bacteria deposits on the tongue can also cause bad breath. This is one of the few conditions caused by periodontal disease that can be treated at home by practicing proper dental care to control halitosis (brushing, flossing, mouthrinses, tongue scraping).

Complications with Birth and Pregnancy

Periodontal disease in pregnant mothers has been shown to increase the risk of premature delivery and low birth weight. The  periodontal bacteria involved cause inflammation of the uterus and cervix. Periodontal disease also increases the risk of developing preeclampsia, a condition characterized by high blood pressure and excess protein.

Rheumatoid Arthritis

Rheumatoid arthritis is a painful chronic inflammatory disease that affects the joints. The relationship between rheumatoid arthritis and periodontal disease goes both ways as each increases inflammation in the other. Patients with rheumatoid arthritis are faced with increased risks and severity of periodontal disease and treating periodontal disease can relieve some of the symptoms of rheumatoid arthritis.

Conclusion

The best and easiest way to prevent and control periodontal disease is by maintaining a good oral hygiene program which includes regular dental visits as well as diligent at home care. This includes brushing, flossing, use of mouth rinse, and tongue scraping. Your health is important, taking care of your dental health is a great way to start taking care of your overall health.

 

Recent research has begun to mount linking the oral health to the rest of the body. Did you know that more than 90% of all systemic diseases produce oral signs and symptoms?  Oral health means more than just an attractive smile. Poor oral health and untreated oral diseases and conditions can have a significant impact on quality of life. In many cases, the condition of the mouth is a direct sign of the condition of the body as a whole. This means that it is even more important to seek regular dental care as your dentist might the one to notice oral signs of systemic disease developing.

Systemic Disease With Associated Oral Symptoms

-Heart Disease/Stroke – Recent research has proven a link between periodontal disease and heart disease. The research results find that the bacteria present in periodontal disease does not just stay in the mouth but can move and travel throughout the body. It is believed that the bacteria moves from brushing, flossing, or eating and causes inflammation. The process of inflammation that affects the tissues in the mouth are what causes the heart disease issues. In periodontal disease, the body goes into an inflammatory state to rid the offending bacteria but in the process they are destroying good tissues and bone. When bacteria goes mobile and travels throughout the body, this bacteria can irritate the arteries which in turn will respond by creating arterial plaques. These plaques lead to decreased or blocked blood flow which in turn can cause a heart attack.

-Diabetes – Diabetic patients are unique in that their disease reduces the body’s ability to fight infection. This reduced ability can lead to an increased occurence of periodontal disease. Diabetic patients need to increase their at home dental hygiene as well as see their dentist more often to ensure they do not succumb to their disease. Diabetics may experience burning mouth syndrome and fungal infections, such as thrush and oral candidiasis. Dry mouth may also develop, causing an increased incidence of tooth decay. To prevent problems with bacterial infections in the mouth, your dentist may prescribe antibiotics, prescription mouth rinses, and more frequent dental cleanings.

-Gastrointestinal Diseases – These diseases include Crohn’s disease, Ulcerative Colitis, and Gastroesophageal Reflux (GERD). The oral cavity is the portal of entry to the GI tract. In the case of GERD it is not uncommon to see tooth enamel erosion from the acids in the stomach entering the mouth and for the other diseases, the presence of regular ulcers can be a sign of colitis or Crohn’s disease. Obviously these ulcers alone would not be a diagnosis for them in absence of other symptoms.

-Hematologic (Blood) Disorders - Mucosal conditions, such as glossitis, recurrent aphthae, candidal infections, and angular stomatitis may be more common in patients with anemia. Glossitis can be the first sign of a folate or vitamin B-12 deficiency. The tongue appears red, and the papillae produce a smooth appearance. Angular stomatitis is commonly caused by a candidal infection, and it has been linked to a deficiency in iron. If the anemia persists, a person may have decreased resistance to infection.

-Sjogren Syndrome – This disease predominantly affects women (9 women to 1 man) and primarily affects those over age 50. Oral changes can include difficulty in swallowing and eating, changes in taste and speech, increased tooth decay, and an increased chance of infection, all due to a decrease in saliva.

-HIV/AIDS – The oral symptoms include candidiasis (oral infection), Karposi’s sarcoma, increased herpes outbreaks, as well as human papilloma virus (HPV) infections.

Conclusion

The above list is by no means comprehensive, but it goes to show you how various diseases affecting different parts of the body can appear and affect the mouth. Scientific research continually furthers the evidence that the mouth is a window to your health. While your dentist may not be able to definitively diagnose any of the above diseases they can be an early communicator of the symptoms developing to give you a better chance of recovering from the effects of these diseases. Some believe that increased dental health and oral hygiene have led to an increased chance of autoimmunity to certain diseases and conditions.

Osteoporosis is a disease of bones that leads to a decreased density of bone and subsequent increase in risk of fracture. Osteoporosis causes bones to become weak and brittle. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

Osteoporosis affects millions of people all over the world. It affects men and women of all races. Women are 4x more likely to develop osteoporosis. Research has shown that post-menopausal white and Asian women are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss and strengthen already weak bones. There is recent research showing that women who drink wine in moderation tend to have higher bone density than those who abstain from alcohol.

How Do I Know If Dental Implants Are An Option?

The first step is to get your osteoporosis under control and limit the further effects of the disease. This includes seeing a physician to prescribe the proper medications, diet, and exercise routine. The next step is to see your implant dentist for a full evaluation. This evaluation will include your overall health, your oral health, as well as the degree of your osteoporosis.

Some considerations before having dental implants placed include:

-State Of Oral Health. A major factor in the failure of dental implants is the presence of periodontal disease. With a patient already being compromised with osteoporosis this becomes doubly important that the patient be periodontal disease free.
-Strength, Density, And Volume Of Bone Tissue. You need to have some good quality bone left to have an implant last, healing will be prolonged, so volume of bone is extremely important.
-Medications. This includes medications you are taking for osteoporosis as well as other medications which could counteract those medications. Bisphosphanates have been long known to keep the body from reabsorbing bone tissue, but they also appear to affect your ability to heal after a dental implant procedure. Biphosphonates can increase the risk of biphosphonate-induced osteonecrosis of the jaw (also called BONJ). When BONJ occurs, the bone tissue actually begins to die due to inadequate blood supply.

-Is The Patient A Smoker? Smoking has long been a failure factor in dental implants as well as bone loss. Nicotine is a vaso constrictor so blood supply to the bones in the jaw can be compromised.
-Presence Of Systemic Disease. This can include a decreased immune system or diabetes. Good health is important for good healing.

If you have been diagnosed with osteoporosis, dental implants may still be an option. If osteoporosis has affected other parts of your body, it might not necessarily have caused decrease in jawbone mass or breakdown of these tissues. Recent research (International Journal of Oral and Maxillofacial Implants, Vol 21: 349) has shown a lowered success rate in patients with osteoporosis but the difference was less than 2%. The general success rate for dental implants is about 97% whereas the success rate in this limited study was 95%. The study also showed that bone grafting was successful as well.

Conclusion

Dental implants have long been the treatment of choice for tooth loss. For those who have been told it is not an option the effects can be devastating. The recent research gives hope to those who previously were told that it was not an option. Each individual needs to be evaluated on a case by case basis taking all factors into account before delving into placement of dental implants. If you are missing teeth or about to lose them, contact your dentist for a dental implant evaluation.

Dental hygiene should be one of those automatic chores we do every day. However, for many it is not. Brushing at least 2x per day and flossing once a day is a simple process and should only take a few minutes out of your day. Below you will find the top reasons to maintain good dental hygiene.

Benefits Of Good Dental Hygiene

-More Attractive Smile. When a smile is free of disease (periodontal or tooth decay) it will be healthier and more attractive to others.

-Maintain A Whiter Smile. Eating and drinking will leave stains on our teeth and as time goes on our teeth will darken. With good dental hygiene you can limit the stains the foods and drinks cause to our teeth. Brushing and flossing regularly will give you a better chance to remove those stains before they become deeper stains.

-Improved Breath. With good dental hygiene comes fresher breath. This occurs because we are removing food debris and keeping oral bacteria levels lowered.

-Increased Self Confidence. Studies have shown a bright, healthy smile instills increased self confidence for all to see.

-Avoid Systemic Health Complications. With poor dental hygiene comes periodontal disease. Periodontal disease as it progresses has been linked to cardiovascular issues, strokes, diabetes, and even alzheimer’s disease.

-Save Time And Money. Maintaining a healthy oral cavity means no periodontal disease or tooth decay which means you will need less restorative or periodontal treatments.

-Keep Dental Anxiety At Bay. Many patients with dental anxiety fear going to the dentist. However, neglecting dental hygiene is just a ticking time bomb for patients with anxiety or phobias. So, for these patients, it is of utmost importance that they maintain good dental hygiene.

-Dental Appointments Will Be Easy. Doesn’t it feel good to go to your regular dental appointment and be told great job and have no cavities? With each successful appointment you will feel better about yourself and your at home care.

-Continue To Look Younger As You Age. A healthy smile makes you feel younger about yourself and to others.

-Longer Lasting Dental Restorations. All dental restorations have a lifespan. For example a dental crown “should” last about 10-15 years with proper care. Without proper care they can fail quite quickly in as little as 3-4 years.

Dental Hygiene Conclusion

Dental Hygiene care is essential to a healthy smile. This includes in office care as well as at home care. Being diligent can reap huge rewards over time.