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Birth control is an integral part of many women’s lives. The newer method of receiving a birth control shot (DMPA) every Three (3) months versus taking a pill every day has become a convenient way of  birth control  for many women.

Depo-Provera is the most well known and used DPMA. This contraceptive is injected into a woman’s muscle every three months.

DMPA works to prevent pregnancy in three different ways:

1) Prevents ovaries from releasing eggs.

2) Thickens cervical mucus to act as a barrier preventing sperm from reaching the egg.

3) Changes the lining of the uterus to prevent implantation.

Birth Control Research Study Findings

New studies have shown, that there are some dental health risks involved with the DMPA shot. The study has found a possible link between injectable progesterone contraceptives (Depotmedrooxyprogesterone acetate-DMPA) and periodontal disease.

The researchers examined about 4,500 participants ranging in age from 15 to 44. These patients were confirmed to not be pregnant and all reported receiving DMPA shots in the past or never having received the contraceptive shot.

About 4% of the  research participants were currently using the  Depo Provera shot, and about 12% had used it in the past. All the participants were thoroughly examined by a dentist. The dentist recorded gum tissue health indicators, such as  presence of bleeding gums,  any gingival recession, as well as  periodontal probing to measure bone levels surrounding the teeth.

Bone loss, periodontal pockets, and gingival recession are hallmark signs of periodontal disease.

Birth Control Marielaina Perrone DDSResearchers found that those currently taking DMPA injections were about 73% more likely to have gingivitis,( Gum inflammation and bleeding, without periodontal bone loss). Those women who had previously used DMPA also had a slightly higher incidence of gingivitis but the level of risk was not significant enough to prove an association.The researchers also found that Hispanic and Black women were 30-50% more likely to have some form of periodontal disease. Women of lower economic levels or who had not visited the dentist within the past two years also had a higher rate of periodontal disease.

The researchers believe that the hormones played a major role in the presence of periodontal disease. Women receiving any hormone based contraceptive (like DMPA) injections need to pay extra  attention to their teeth and gums to help prevent periodontal disease. This should include regular dental visits along with professional cleanings every 3-6 months.

Periodontal Disease Impacts your Whole Body

This research has once again shown, a definite link between periodontal disease and your overall health. When your mouth becomes diseased it does not remain contained there. When periodontal disease advances, toxins are released into your bloodstream. These toxins promote inflammation and can have a negative impact on your heart and other organs. This combination of bacteria and inflammation has been linked to a number of chronic diseases. These include:

Heart Disease. People with periodontal disease are actually almost twice as likely to have heart disease.

Diabetes. Periodontal disease is considered a definite complication of diabetes. Patients with diabetes are more likely to have periodontal disease than those without. According to the Journal of Periodontology, not only does having diabetes increase the risk of periodontal disease but it also increases blood sugar which will lead to  diabetic complications including problems with healing.

Rheumatoid Arthritis. Rheumatoid arthritis and periodontal disease are both chronic inflammatory processes. It has been found that treating periodontal disease has reduced the effects of rheumatoid arthritis.

Cancer. Periodontal disease has been linked to several different cancers including pancreatic, kidney, and blood cancers.

Other disease links include Alzheimer’s Disease, Kidney Disease, Respiratory Disease, Pregnancy complications (premature birth and low birth weight), and Osteoporosis.

What to Do If You Take a Progesterone Contraceptive?

See your dentist more often, ( every 3-4 months) and amp up your home care. More frequent cleanings, and flossing after meals will help prevent complications and the advancement of periodontal disease. The sooner the problem is detected, the better your chances are at reversing the disease process through professional cleanings and proper oral hygiene. If periodontal disease progresses it can be treated. Most often,  a deeper cleaning called scaling and root planing will start the healing process. In more severe cases,  periodontal disease surgery may be required. Remember to ask your dentist and hygienist for better brushing and flossing techniques, and ask them how often you should be seen for cleanings.

 


Periodontal Disease– is a group of diseases that affect the tissues that support and anchor the teeth. If untreated, periodontal disease results in the destruction of the gums, alveolar bone (the part of the jaws where the teeth arise), and the outer layer of the tooth root. The earliest form of periodontal disease is called gingivitis. Gingivitis is reversible with proper treatment.

Once a patient is diagnosed with advanced periodontal disease (also called periodontitis), their dentist will recommend procedures above and beyond that of a normal professional cleaning to properly treat and manage the periodontal disease. In the initial stages, most treatment revolves around non surgical intervention but as the periodontal disease progresses surgical treatment is often recommended and required.

Periodontal Disease Treatment

Non Surgical Procedures

Scaling and root planing. This procedure is a special type of cleaning that removes plaque and tartar from under the gum line and makes the root surfaces smooth. The smoother root surface is thought to promote reattachment of the gum tissue and promote healing. This type of cleaning is the only way to remove tartar from below the gum line. This is usually completed in multiple visits utilizing a numbing anesthetic to make the procedure more comfortable..

-Drug Therapy. In some cases, antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early periodontal disease, scaling and root planing in addition to continued daily cleaning at home (flossing, brushing , and rinsing) will achieve a satisfactory result of reversing periodontal disease.  A wide array of antibacterial rinses such as Peridex, antibiotics taken in pill form such as  Periostat, or localized placement directly into the affected pockets with an antibiotic such as Arestin, can aide in, and promote healing of the affected gum tissue.

-Periodontal maintenance or supportive periodontal therapy: Following a scaling and root planing, routine specialized  cleanings (every 3-4 months)  to target your periodontal problem area, can minimize the recurrence or progression of periodontal disease.

Surgical Procedures

-Pocket depth reduction procedures: Your dentist or periodontist will open up the affected gum tissue so that periodontal disease causing bacteria and calculus build up can be easily seen and removed. Some cases may require contouring and smoothing of the damaged bone and root surfaces to allow the gum tissue to reattach to healthy bone during the healing phase. The procedure also repositions the gum tissue so that it is easier to keep clean going forward.

Perioscope cleaning: A deep cleaning requiring a microscope to be placed below the gum line to remove tartar, cement, or other debris.

-Regeneration. Your dentist will treat the affected gum tissue in the same way as in pocket depth reduction procedures, with the additional procedure of using membranes, bone grafts or tissue-stimulating proteins to stimulate the body’s natural ability to regenerate healthy bone and gum tissue. A good example of this is a bone and tissue growth factor called Emdogain.

-Soft tissue grafts. Your dentist will take synthetic tissue such as Alloderm, or healthy gum tissue from the roof of the mouth (palate) or other areas of the mouth and use it to repair receding gums and cover exposed root surfaces.

-Hard Tissue Bone Grafts.  This procedure is needed when periodontal disease has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone. The dentist can use your bone, cadaver bone, cow bone, or a lab created calcium based bone matrix material.

Conclusion

If you have been diagnosed with periodontal disease please take the news very seriously. Periodontal disease is a progressive disease that will continue to get worse without treatment. Periodontal disease  leads to tooth loss and oral infections. Your dentist can help you with diagnosis, prevention, better oral hygiene methods and instruction, and proper treatment for your particular needs.  Studies have shown time and again that there is a link between oral health and your general health. Keeping your mouth healthy will lead to better overall health. As always visit your dentist regularly for dental examinations and regular professional cleanings to stave off the onset of periodontal disease.

National Flossing Day!!

November 23rd, 2012

Daily flossing is a requirement for healthy teeth and gums. Thorough flossing removes the plaque and food debris between your teeth that your toothbrush may not. It also

Flossing Marielaina Perrone DDS

Happy National Flossing Day!!

increases blood circulation in your gum tissue to help prevent periodontal disease.

Flossing is a critical technique for a healthy smile, but it has a fair share of interesting facts, as well.

Fun Facts about Flossing:

Flossing has been credited to Levi Spear Parmly, a New Orleans Dentist, in 1815. He advised his patients to use a thin silk thread to clean between their teeth.

Floss was manufactured commercially for the first time in 1882. Codman and Shurtleft Company began marketing unwaxed silk dental floss. Johnson & Johnson released their first silk floss product in 1896 and patented dental floss in 1898.

During the 1940’s, the physician Dr. Charles Bass found that nylon material is better for flossing than silk. The silk often shredded when going between teeth. Nylon has a consistent texture and better resistance. This led to the development of waxed floss and dental tape. In response to environmental concerns, dental floss made from biodegradable materials is now available on the market.

Proper flossing requires the average person to use approximately 120 yards of floss per year. Manufacturers data shows that only an average of 18 yards is sold per person each year.

Dentists and dental hygienists recommend the daily oral hygiene regimen of tooth brushing and flossing. Almost all Americans brush their teeth daily. However, the ADA indicates that only about 12% of Americans floss daily, 39% floss less than daily, and almost 50% do not floss at all.

Occasional flossing or flossing improperly can typically lead to bleeding gums. The main cause of the bleeding is inflammation of the gingival tissue due to gingivitis (the earliest form of periodontal disease).

It comes in many forms – waxed, unwaxed, flavored, unflavored, wide, and regular. All floss works the same, but only if you use it properly.



Flossing is one of those tasks in life that we know we should do, we know the benefits of it, and we know how little time it takes but most of us, just do not do it regularly.

Flossing your teeth every night can be a hard habit to develop and maintain, but it’s one that comes with great benefits.  Simply having a cleaner feeling mouth, avoiding bad breath , preventing tooth cavities or even avoiding loss of teeth can be accomplished with flossing. Regular tooth brushing cannot reach all the areas of our mouth. Brushing supposedly is only able to clean about 60% of the mouth whereas flossing is able to get to the other 40%. Flossing is able to reach those areas if done properly. Flossing is able to remove plaque, bacteria, and food debris between teeth.

It is recommended by the American Dental Association that we floss at least once a day. Proper oral hygiene maintenance is important to stave off periodontal disease and also to keep our entire body healthy. Studies have shown less than half of Americans admit to flossing daily. In reality, that number is probably much lower.

What if there was an easier way to floss daily to maintain our teeth and gums?

 

Alternatives to Flossing

These alternatives will never be as good old fashioned flossing but they will make an improvement to your oral health versus not using them.

Flossing with Waterpik Flosser Marielaina Perrone DDS

Flossing with Waterpik

Waterpik Oral Irrigator. As the name suggests the waterpik is able to do its job by using a stream of pulsating water to remove plaque, bacteria,  and food debris between teeth and above and below the gum line, to stimulate blood flow, and to improve overall oral health. Studies have shown when used correctly that the waterpik is actually superior  in reducing bleeding of gum tissue and is as effective in reducing plaque buildup. The beauty of the waterpik is its ability to mix antibacterial rinses or a rinse like Periogen into the irrigating chamber. This adds the benefit of being an antibacterial or anti tartar rinse as well, making it doubly effective.

Oral-B Hummingbird Electric Flosser. The hummingbird flosser is an electric flossing tool that is able to gently vibrate to massage your gums while it is cleaning between your teeth. This is an excellent flossing tool for those lacking dexterity since it can be used with one hand vs two with traditional flossing.

Tooth Pick, stimudents, soft piks. Yes, a good old fashioned tooth pick can be useful for cleaning in between your teeth. While it doesn’t do the best job, it is definitely  easy to use, can remove large food particles, and stimulate blood flow. Just be careful not to poke your gums and injure yourself.

Sonicare AirFloss. This product makes it easier to keep our teeth clean between dental visits. The Sonicare AirFloss was specially

Flossing with Sonicare AirFloss Marielaina Perrone DDS

Flossing with Sonicare AirFloss

designed to give you an easy and simple, effective way to clean in between your teeth. The Sonicare AirFloss works using patented micro burst technology. This technology delivers micro droplets of air and water to remove plaque, bacteria, and food debris between teeth. Studies have proven the Sonicare Airfloss to be safe and effective as well as gentle on teeth and gum tissue.The Sonicare Airfloss is very easy to use. It features a single button and a guidance tip that allows the user to target cleaning in between teeth. Patients can complete their flossing in as little as 60 seconds. And with the narrow tip, patients are able to reach the back of their mouth very easily. This allows all the teeth in the mouth to be cleaned. The reservoir holds two teaspoons of water, mouthwash, or other oral rinse. This is enough for two uses and makes the Sonicare AirFloss doubly effective as it has an anti bacterial component as well.

Alternative Flossing Conclusion

As you can see above there are a few alternatives to flossing. Bottom line is nothing beats using a simple piece of floss and flossing like many have been for decades. But if you are unable to or unwilling, the products listed above will help improve your oral hygiene.  Use what works best for you and use it as often as you can. Keeping your teeth clean between dentist visits is very important in having your teeth last a lifetime and preventing the development and advancement of periodontal disease. So, maintain a regular schedule of complete dental examinations as well as professional cleanings along with continued at home care and you will see great results in your smile and your health.