Laser Gum Treatment (L.A.N.A.P.)

New LANAP Study Excites Periodontal Community

2011-11-30T12:28:00.001-08:00

Leading Periodontists Worldwide Excited about Research Data for the LANAP Protocol

11/30/2011

Leading Periodontists Worldwide Excited about Research Data for the LANAP® Protocol

More Human Histologic Research, This Time on 'Hopeless' Teeth! Research Sponsored in Part by Millennium Dental Technologies, Inc. and the Institute for Advanced Laser Dentistry.

CERRITOS, Calif. (November 30, 2011)-New research unveiled to a standing-room-only assembly of the leading periodontists across the globe shows regeneration of bone in teeth affected by periodontal disease when treated with the LANAP protocol. These results have not been previously documented in any dental research worldwide.
The preliminary report for the independent nine-month en-bloc human histological study of the LANAP® protocol was revealed by its principal investigator, Marc L. Nevins, DMD, MMSc at the 2011 American Academy of Periodontology Annual Session in Miami Beach, Florida.

The study researches the effect of the LANAP protocol on the most extreme cases of periodontitis. Preliminary results positively support the LANAP protocol as an effective treatment for periodontitis, also known as gum disease. Human histology slides indicate new connective tissue attachment (CTA) and regeneration of root surface (cementum), both positive signs of the reversal of bone loss, a hallmark effect of gum disease. All 12 treated teeth returned to health, and 50% of teeth analyzed showed evidence of bone regeneration. Full study results are expected to be published in early 2012"The periodontists in the AAP are world-class," said Robert Gregg II, DDS, Program Director for the Institute for Advanced Laser Dentistry (IALD). "Their excitement about the research results was palpable, and underscores how important this research is to the dental community. The LANAP protocol is consistently producing results previously thought to be impossible."

The current study contributes to the body of evidence supporting the LANAP protocol. Previous Human Histology on more moderately involved teeth was published in the International Journal of Periodontics and Restorative Dentistry by Raymond Yukna, DMD, MS.

"Human histology reports indicate bone regeneration can be an expected outcome, even in extreme periodontally challenged teeth. This supports the fact that the LANAP protocol is effective in obtaining regeneration," said Delwin McCarthy, DDS, Institute for Advanced Laser Dentistry Executive Director. "Ultimately, this means more patients can save their natural teeth and improve their oral health."

Gum disease is a chronic bacterial infection that, left untreated, can lead to tooth loss and has been closely linked to major health problems including heart disease, strokes, pre-term, and stillborn births, as well as certain cancers. It is often painless and can go undetected or ignored until severe gum and bone destruction catches the individual's attention. Even when detected, patients often choose not to undergo traditional surgery due to fear, poor esthetic outcomes and associated pain.

The LANAP protocol, a patient-friendly, laser gum disease surgery, was developed by clinicians for clinicians as a treatment patients would accept. The protocol's strict operating parameters ensure consistent, reproducible, positive results.

Dawn Bloore, DDS, Director of Training for the IALD states, "The most recent research findings support the successful treatments reported by LANAP-trained clinicians worldwide." The LANAP protocol continues to be adopted by specialists as the preferred laser gum surgery, on the basis of its clinical results and treatment acceptance rates.

Erectile Dysfunction and Periodontal Disease

2011-05-02T15:08:00.000-07:00

Erectile dysfunction and chronic periodontitis may be linked

By DrBicuspid Staff
April 21, 2011 -- Erectile dysfunction (ED) and chronic periodontitis (CP) share common risk factors, and an association may exist between the two conditions, according to a new study in the Journal of Periodontology (April 5, 2011).

Researchers from the department of periodontics at the Government Dental College and Research Institute in Bangalor, India, studied 70 male subjects with a mean age of 35.3 ± 3.64 years who were clinically diagnosed with erectile dysfunction.

The subjects were given the Sexual Health Inventory for Men questionnaire and underwent penile color Doppler ultrasound. Researchers recorded periodontal parameters such as probing pocket depth and clinical attachment level.
Prevalence for chronic periodontitis among all erectile dysfunction subjects was highest among those with severe ED, and while association of CP and ED was found to be correlated positively, it showed no statistical significance.
"It can be hypothesized that an association exists between vasculogenic ED in young men and CP," the authors concluded. "However, a large-scale study with confounder analysis and a longitudinal follow-up is warranted."

Copyright © 2011 DrBicuspid.com

Dr. James Miller is a Scottsdale Arizona family, cosmetic and laser dentist. His websites can be reached at www.drjamesmiller.com and www.scottsdalelanap.com

IALD & the LANAP® Protocol Featured in Ivanhoe Broadcast News Segment

2011-04-14T10:36:00.000-07:00

Dr. James Miller is a Scottsdale, Arizona family and cosmetic dentist. He has been utilizing the LANAP laser gum procedure since 2008. For more information on LANAP or Dr. Miller www.drjamesmiller.com or www.scottsdalelanap.com

Pregnant Moms OK for Periodontal Treatment

2011-04-14T10:16:00.000-07:00

Mom's gum disease treatment safe for baby

By Reuters Health

April 13, 2011 -- NEW YORK (Reuters Health) - Pregnant women can safely be treated for gum infections without having to worry about their baby's health, according to a new study.

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The concern among dentists had been that treating the problem could cause bacteria to get into the mothers' bloodstream, where they could harm babies' development.

Gum disease -- caused by a bacterial infection that breaks down gum tissue and can cause tooth loss and serious health problems -- is a particular problem during pregnancy.

Hormonal changes appear to make a pregnant woman more susceptible to developing it, yet the standard antibiotic-based therapy is not recommended because it stains the baby's teeth.

What's more, dentists have shied away from aggressive teeth cleaning, which is also effective, out of fears they'd help the bacteria get into the bloodstream. In principle, that could harm the brain development of the fetus.

But those fears are baseless, the new study shows.

"Women can be confident that it's not going to have clinically meaningful effects on their child's development," said Dr. Bryan Michalowicz, whose findings are published in the journal Pediatrics.

Michalowicz, a dentist at the University of Minnesota School of Dentistry in Minneapolis, and his colleagues tested more than 400 2-year-olds, who'd been born to mothers with gum disease.

Half the mothers had been treated with aggressive teeth cleaning -- called scaling and planing -- during pregnancy, while the rest had not.

The researchers found the kids did just as well on language, motor, and mental tests regardless of whether their mothers had been treated.

On the other hand, treatment didn't seem to benefit the kids either. That was the researchers' original hypothesis, because earlier studies have linked gum disease to developmental delays.

"We asked the question, does treatment of periodontal disease in pregnant women improve child development?" said Michalowicz. "We found it doesn't."

The researchers did find a slight increase in toddlers' test scores when the mothers' gum disease improved. But the effect was so small it doesn't have any practical consequences, they say.

Nonetheless, he said, "As a dentist I think that improving oral health is a goal in its own right."

Dr. Marjorie Jeffcoat, a dentist at the University of Pennsylvania in Philadelphia who wasn't involved in the study, said it couldn't rule out that treatment might benefit the baby in some cases.

"You need to have a higher risk population in order to draw a conclusion," she told Reuters Health. "I wouldn't jump to the conclusion that we should let periodontal disease run rampant in pregnant women."

But, she added, women should try to maintain good oral health in the first place.

"They need to use a soft toothbrush and floss the right way," wrapping the floss around the tooth, she said. "The first goal with almost all dental disease is prevention, prevention, prevention."

By Frederik Joelving

Source: http://bit.ly/e3YPjA

Pediatrics, April 11, 2011.

Last Updated: 2011-04-13 16:59:16 -0400 (Reuters Health)

Dr. James B. Miller is a Scottsdale, Arizona family, cosmetic, and laser dentist. His websites are www.drjamesmiller.com and www.scottsdalelanap.com

Lasers in Periodontal Treatments

2011-04-06T08:12:00.000-07:00

Lasers continue to make waves in periodontology

By Rochelle Sharpe, DrBicuspid.com contributing writer

October 12, 2009 -- As the first periodontist in the U.S. to practice laser-assisted new attachment procedure (LANAP) in his practice, Lloyd Tilt, D.D.S., M.S., has carefully tracked his patients' experiences over the past decade -- and been delighted with his findings.

"Lasers are a wonderful option for doctors and patients to consider in treating periodontal disease," Dr. Tilt said at the American Academy of Periodontology (AAP) annual meeting in Boston last month.

But just five days before Dr. Tilt delivered his lecture, complete with new statistics showing the advantages of laser treatments over traditional techniques, the AAP endorsed the ADA's cautionary policy on laser use. The ADA's Council on Scientific Affairs warned in its policy, released last April, that it was still too early to know "to what extent LANAP [laser-assisted new attachment procedure] is safe and effective across the spectrum of patients with chronic periodontitis."

The policy was another blow to Millennium Dental Technologies, which invented the LANAP procedure and began selling its PerioLase laser in 1999 for removing dental caries as well as diseased tissue in periodontal pockets. In its policy statement, the ADA dismissed the laser curettage procedure for periodontal pockets as having "no known clinical value."

But the criticism didn't deter Dr. Tilt, a Utah periodontist and instructor for Millennium's Institute for Advanced Laser Dentistry.

Speaking at the AAP meeting, he told a crowded room of periodontists that the ADA should "take another look" at the laser research. He presented data on 107 patients he'd followed over the past 10 years, comparing his results to three other periodontal studies. Only 46 of the 2,696 teeth he treated with lasers were lost to periodontitis, he said. That's just 1.7% teeth lost for patients followed for 6.2 years, on average.

By contrast, in the three studies examining patients treated with more traditional methods, 9.8% of teeth were lost in one study and approximately 5% of teeth were lost in the other two. The authors of these studies, however, followed patients much longer than Dr. Tilt did. The studies showing 5% tooth loss followed patients for 12.5 years and 13.6 years, while the one showing 9.8% tooth loss followed patients for 19 years.

Dr. Tilt also said that only 4.7% of his patients were going downhill after six years, compared to the longer studies where 14.3%, 15.8%, and 23% of patients were. Even though the other studies were longer, he said, their duration could not account for the poorer performance results.

Not only do patients get better results with LANAP, he said, but they are more likely to accept the laser treatment. With lasers, he said, there is no postoperative swelling or bleeding, no additional gingival recession, and no extra tooth sensitivity.

Dr. Tilt stressed the necessity of treating all his patients' teeth. "It's important to disinfect the entire mouth," he said, pointing out the laser's capacity to reduce infections. In the studies of more conventional methods, dentists did not treat each tooth.

Effectiveness questioned

In spite of such testimonials, though, few periodontists use lasers in their practices. Dr. Tilt estimates that fewer than 8% of his colleagues use them.

With LANAP, the laser fiber is inserted between the periodontal tissue and tooth to selectively remove diseased or infected pocket epithelium from the underlying connective tissue. Image courtesy of Millennium Dental.

The low numbers are partially due to the controversy over the lasers' effectiveness.

"There isn't a huge amount of research," said Meg Dempsey, an AAP spokeswoman. "There isn't anything conclusive."

Indeed, there are few studies on laser use for periodontal work, and they have generated vigorous debate. Even online forums are filled with heated discussions. A recent post about LANAP on a dentistry online forum generated 63 responses, with dentists analyzing the latest research studies and spinning conspiracy theories.

"The AAP is terrified of GP's with lasers," John G. McAllister, a California dentist, wrote on the OsseoNews forum. "And the AAP has every reason to be afraid of GP's having an effective tool for treating moderate to severe gum disease."

For its part, Millennium continues to cite the work of Raymond Yukna, D.M.D., M.S., director of advanced periodontal therapeutics at the University of Colorado, Denver School of Dental Medicine. In a 2007 study published in the International Journal of Periodontics and Restorative Dentistry (Vol. 27:6, pp. 577-587), Dr. Yukna reported his examination of a dozen teeth, half of which had been treated with the LANAP procedure. All six of the LANAP-treated teeth showed new cementum and new connective tissue attachment, whereas five of the six teeth in the control group showed no such attachments, he found.

The ADA position paper said the study "provides no more than pilot validation for this treatment concept." The small sample size and the condition of the diseased teeth make it difficult to extrapolate the results to the general population, it said.

Millennium vigorously opposed the ADA's analysis, calling it "inaccurate, misleading, and scientifically unsubstantiated."

"It is terribly unfortunate that ... the use of lasers for the purposes of treating periodontal disease, and the research that supports it, continues to be marginalized," wrote Delwin McCarthy, D.D.S., chief technology officer of Millennium, in a formal rebuttal to the ADA policy.

Millennium argues that Dr. Yukna's study was not small, given what it was examining. It is the fourth largest human histology study in the periodontal scientific literature, it said, pointing out that institutional review boards strictly limit the size of such studies.

History of skepticism

Using lasers for periodontal treatment has met with skepticism for years. Douglas Dederich, D.D.S., Ph.D., former vice-chair of the ADA's Council on Scientific Affairs and former chair of an ADA committee outlining laser standards, has repeatedly voiced uneasiness with laser procedures.

In 2000, he wrote the U.S. FDA that there was "significant concern" in the dental community that applying the laser in the gingival sulcus "represents a serious risk to the dental pulp." The damage may not be detectable by standard pulpal tests, he wrote, but research with animal tissue examined under a microscope had shown severe pulpal damage. If such damage were to occur in humans, it would require root canal therapy.

Later, in a 2004 article in the Journal of the American Dental Association titled "Lasers in dentistry: Separating science from hype" (Vol. 135:2, pp. 204-212), he and co-author Ronald Bushick, D.M.D., Ph.D., wrote that laser curettage "appears to be neither scientifically nor ethically justified." They did say, however, that early evidence shows "exciting potential" for lasers to produce superior attachment levels after root debridement compared to mechanical planing.

Dr. Dederich could not be reached for comment as to whether he thinks that potential is now any closer to reality. And the AAP declined to comment beyond its formal endorsement of the ADA policy.

So, for now, the controversy continues, with dentists relying on their own judgment, experience, and existing research to figure out what is best for their patients.
Copyright © 2009 DrBicuspid.com

Dr. James Miller is a Scottsdale, Arizona general dentist and has been using the Periolase and LANAP procedure since 2008. His websites are www.drjamesmiller.com and www.scottsdalelanap.com

Link Between Obesity and Periodontal Disease

2011-02-24T12:34:00.000-08:00

Obese patients at higher risk of perio disease

By Rabia Mughal, Associate Editor

February 24, 2011 -- A recent study conducted by researchers from the University of North Carolina found that dentists are interested in helping patients with serious weight issues but are afraid of offending them and appearing judgmental.

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A large number of dentists would be more willing to have such discussions if obesity were definitively linked to oral disease, the study authors noted.

Now researchers from the University of Pittsburgh have found a positive association between periodontal disease and obesity, according to data from a study to be presented next month at the International Association for Dental Research (IADR) conference in San Diego.

"The prevalence of obesity is the public health challenge of our time as it can damage quality of life, boost medical costs, and is recognized as a predisposing factor to major chronic diseases ranging from cardiovascular disease to cancer," the study authors noted.

They hypothesized that the prevalence of periodontal disease would be greater in obese individuals and used electronic health records from the University of Pittsburgh School of Dental Medicine to retrospectively identify 4,537 unique individuals (2,445 female, 2,092 male, average age 54). The patient records documented weight, height, age, sex, type 2 diabetes status, and periodontal evaluation.

Periodontal disease was classified as periodontal pocketing of 4 mm or greater. Body mass index (BMI) was calculated, and patients with a BMI of 30 or higher were classified as obese, while those with a BMI below 30 were classified as nonobese.

"Statistical analysis of the retrospective data collected established that periodontal disease is more prevalent in obese individuals," the authors noted.

Systemic condition?

Obesity might represent a systemic condition influencing onset and progression of periodontal disease through the gateway of metabolic syndrome, the proinflammatory state characterized by insulin resistance and oxidative stress, in a bidirectional relationship, the researchers added.

"Obesity is an obvious national problem and is increasingly a global problem as well, affecting societies that never before were necessarily affected by obesity," study author Pouran Famili, DMD, a professor and chair of the department of periodontics and preventive dentistry at the University of Pittsburgh School of Dental Medicine, told DrBicuspid.com. "Not much has been done about it and its relation to dental issues."

While not surprising, the findings do indicate that more research regarding the relationship between obesity and periodontal disease needs to be conducted, she added.

Positive associations are repeatedly demonstrated between prevalent periodontal disease and obesity, but establishing any physiological mechanism behind this relationship will require well-designed prospective research, Dr. Famili and her colleagues concluded.

Other studies have come to similar conclusions.

Dentists in clinical practice can expect a higher prevalence of periodontal disease among obese adults, although the evidence pointing to a direct link between obesity and periodontal disease is limited, according to a recent study in the Journal of Periodontology (December 2010, Vol. 81:12, pp. 1708-1724).

"This positive association was consistent and coherent with a biologically plausible role for obesity in the development of periodontal disease," the authors of that study concluded. "However, with few quality longitudinal studies, there is an inability to distinguish the temporal ordering of events, thus limiting the evidence that obesity is a risk factor for periodontal disease or that periodontitis might increase the risk of weight gain."

Robert Genco, DDS, PhD, a distinguished professor of oral biology and microbiology at the State University of New York at Buffalo School of Dental Medicine, has conducted similar research (Journal of Periodontology, November 2005, Vol. 76:11-s, pp. 2075-2084). He noted that while there is no new information in this new study, the findings are "confirmatory."

In addition, he said, it is possible that inflammatory cytokines produced by adipose tissue could increase the inflammatory response to periodontal bacteria.

"The dentist can better understand why obese individuals may be at greater risk for periodontal disease, let the patient know this, and encourage weight loss as part of management of periodontal disease," he concluded.

For more information about peridontal disease and its treatment www.scottsdalelanap.com or www.drjamesmiller.com/lanap.html

Study links acute myocardial infarction and perio disease

2011-02-22T13:54:00.000-08:00

Study links acute myocardial infarction and perio disease

By Rabia Mughal, Associate Editor

February 22, 2011 -- The relationship between periodontal disease and cardiovascular disease (CVD) is a complicated one. While many studies have suggested that the presence of periodontal disease may be associated with CVD, others have not confirmed this association.

Now a new study to be presented next month at the International Association for Dental Research (IADR) conference in San Diego has found that periodontal disease can contribute to occurrences of acute myocardial infarction (AMI).

Few studies have focused on the associations between periodontal disease and AMI, and in many of them there has been a series of methodological limitations, lead author Isaac Suzart Gomes-Filho, PhD, of Feira de Santana State University in Brazil told DrBicuspid.com. These limitations include selection bias among the cases and controls, low quality of CVD diagnosis, and insufficient control over potential confounding factors.

"The aim of our study was to estimate the possible association between periodontal disease and AMI, using robust methodology that would avoid the limitations of previous studies," he said.

In a case-control study conducted in Salvador, Brazil, Gomes-Filho and his colleagues looked at 621 subjects: 207 cases, 207 hospital controls, and 207 community controls. They matched cases with proven clinical and laboratory diagnoses of a first acute myocardial infarct event and controls without any history of acute myocardial infarct according to sex and age.

All the cases and controls underwent a complete periodontal examination; lipid and blood glucose profile tests; and weight, height, hip, and waist circumference measurements. They also filled out a questionnaire on sociodemographic and lifestyle habit conditions.

Individuals with periodontal disease had a greater chance of presenting with AMI than those without periodontal disease, for both the community controls and the hospital controls, the researchers found. After adjusting for age, sex, smoking habit, schooling level, and blood glucose level, they found this chance increased for both control groups.

Calculating the total risk attributable to periodontal disease and comparing the case group and community control group, the researchers found that about 10 of every 100 cases of AMI would be exposed to periodontal disease. Comparing the case group and hospital control group, they found that 15 of every 100 cases would be exposed to periodontal disease, Gomes-Filho explained.

"Thus periodontal disease would explain 17.8% and 24% of the risk of AMI in the population investigated," he said. "In other words, controlling periodontal disease might have an important impact on reducing AMI among these individuals or among others under similar conditions."

The methodological care defined in designing and implementing the study, and the fact that the results were similar in the two analyses using different control groups, strongly suggests that periodontal disease is associated with occurrences of AMI among this study population, Gomes-Filho added.

Conflicting opinions

These findings add weight to other research in this area, according to Linda Humphrey, MD, MPH, of the Veterans Affairs Medical Center in Portland, OR, who has done similar research (Journal of General Internal Medicine, December 2008, Vol. 23:12, pp. 2079-2086).

"I think the findings argue for the importance of good periodontal care for all people," Dr. Humphrey told DrBicuspid.com. "Often dental care is left out of insurance packages, and I believe that this may be shown to be an error that is relevant not just to oral health but to patients' overall health."

However, James D. Beck, PhD, of the University of North Carolina at Chapel Hill, who also has conducted similar research (Circulation, July 5, 2005, Vol. 112:1, pp. 19-24), said these findings are not particularly enlightening or surprising.

"There have been many case-control studies previously published on this topic," he told DrBicuspid.com. "The majority have reported a positive association, but quite a few have found no association."

Dr. Beck did comment on the physiological mechanism connection between AMI and periodontal disease. While there are many possibilities, including the idea that both conditions are related to smoking, obesity, diabetes, and age, two underlying mechanisms may be at work, he said:

Inflammation: One of the causes of heart disease is inflammation, and periodontal disease is a source of inflammation; thus individuals who tend to respond to infection or injury in a hyperinflammatory manner may be at risk for both conditions.

The periodontal organisms themselves: These pathogens do get into the systemic circulation and are found in the arteries at sites where cardiovascular lesions occur.

Gomes-Filho also explained the possible connection between the two conditions.

"Periodontal disease occurs as a result of bacterial accumulations on the external surfaces of teeth," he said. "Through inflammatory mediators such as cytokines and collagenolytic enzymes, such accumulations may stimulate aggressive action at sites distant from the mouth, thereby causing the emergence of health hazards like CVD."

In addition, periodontal microorganisms may invade endothelial cells and modify their function and/or start an inflammatory response, which may induce, boost, or accelerate the development of atherosclerotic platelets, induce destabilization of pre-existing platelets, or increase the expression of inflammatory markers, he noted.

"Periodontal disease may also induce elevation of plasma fibrinogen levels and leukocyte counts, and may affect blood coagulation and platelet function, thereby favoring the formation of atherosclerotic lesions and thromboembolic events," Gomes-Filho said.

"Furthermore, it may induce a hyperinflammatory profile, with excessive inflammatory and immunological responses, and induce changes in blood glucose and lipid levels," he said. "All these mechanisms may facilitate occurrences of AMI."

His group's findings strengthen the evidence that has already been accumulated in the literature and place greater emphasis on the importance of this association, given the high frequency of periodontal disease in both developed and developing countries, Gomes-Filho concluded.

For more information of periodontal disease and its treatment www.scottsdalelanap.com or www.drjamesmiller.com

What Your Mouth is Telling You

2011-01-18T09:43:00.000-08:00

What Is Your Mouth Telling You?

By Jonathan B. Levine, DMD

The mouth is a window to your overall health. Problems inside your mouth, such as with your gums, teeth and/or tongue, can all be indicators that serious health troubles are lurking beneath the surface. It’s critical to pay attention to any and all signs or symptoms of oral problems. If your mouth is causing even the slightest discomfort, or you’re having trouble cleaning your teeth and gums, it’s time to book an appointment today to see your oral care health practitioner.

One common, yet frequently overlooked, oral issue is bleeding gums. Many people ignore inflamed or bleeding gums or brush it aside as a normal reaction to flossing, but the truth of the matter is that it’s one of the body’s clearest signs that something is awry. Think about gum tissue being similar to the skin on your body. If you developed an open sore every time you washed your hands, you would likely be very concerned and take immediate action to address the issue. The gums should be tended to with an equal amount of attention and care.

There are several, even some surprising, reasons for bleeding gums besides plaque build-up. These include pregnancy and hormonal changes, excessive stress, smoking, challenged immune system functioning, disease and illnesses, such as cancer, HIV and diabetes, and more.

And it’s not just about the bleeding gums alone. When you allow your gums to bleed chronically, your entire circulatory system is more vulnerable to the harmful bacteria in your mouth. If these bacteria gain entry into your bloodstream, it can cause a number of problems. These bacteria can bond to platelets in the blood and cause clots, which can lead to heart attacks, stroke, even dementia. As bleeding gums go untreated, inflammation in the mouth can result in the inflammatory process, setting up in other areas of your body and vital organs.

The bottom line is that good oral health is essential to good overall health. Pay attention to clues that your mouth is giving you and follow these tips to be the healthiest you in the new year.

Brush and floss at least twice a day.

Avoid fatty and sugary foods, as these can lead to plaque build-up.

Create a smile-friendly diet by eating foods high in fiber such as fruits and vegetables, which strengthen the hard and soft tissues of the mouth, and take calcium and vitamin C supplements to promote healthy gums. Additionally, fruits and vegetables raise the pH in the mouth which creates a healthier environment for the good bacteria to thrive and the bad bacteria to disappear.

Resolve to manage your stress levels for 2011. Too much stress can overload the mouth and affect the gums.

Care for your teeth, gums and tongue like any other body part, brushing and flossing regularly. Have a professional cleaning at least twice a year – and more if your gums are sensitive or inflamed, or you have had a good deal of dental work.

Small oral care steps you make today can bring a healthier you tomorrow.

For more information about gum disease and it treatment www.drjamesmiller.com/lanap.html

Breast Cancer and Periodontal Disease

2011-01-17T12:05:00.000-08:00

Breast Cancer May Be Linked to Periodontal Disease -- with a Strange Twist

Sunday December 5, 2010

Shocking. One word that sums up the latest study conducted by the Karolinska Institutet in Sweden. According to their research, chronic periodontal disease indicated, strangely, by missing molars, appears to be associated statistically with breast cancer.

The study involved 3273 randomly selected subjects aged 30-40 years. Of those selected, 1676 (group A) received an oral examination. Group B, consisting of the remaining 1597 did not receive an examination. 26 subjects in group A and 15 subjects in group B had breast cancer. The incidence of breast cancer was 1.75% in subjects who had periodontal disease and/or any missing molars, and 0 in subjects who had periodontal disease but had no missing molars. For periodontally healthy subjects with no missing teeth the breast cancer incidence was 1%. For group B the respective incidence was 0.94%. Female gender (odds ratio (OR) 13.08) and missing any molar in the mandible (OR 2.36) were explanatory variables for breast cancer. Of the subjects with periodontal disease and any missing molars in the mandible 5.5% had breast cancer in comparison to 0.5% of the subjects who had periodontal disease but no missing molars in the mandible (P < 0.02).

Periodontal disease begins innocently enough as gingivitis, but unfortunately, the disease progresses very quickly if it's not treated properly, and promptly. Once periodontal disease becomes irreversible, your risk for losing teeth increases substantially. Taking the above information into consideration, missing teeth, especially molars, appears to be the somewhat strange connection between periodontal disease and breast cancer.

I really strongly advise everyone to take any signs of "pink in the sink" very seriously. The first sign of gum disease is red, bleeding gums. Believe it or not, bleeding gums is not a normal occurrence when you are brushing your teeth. If you are consistently finding your gums bleed while you are brushing your teeth, speak with your dentist about how to halt the progression of gum disease; before it's too late

For more information on treating periodontal disease www.drjamesmiller.com/lanap.html

Gum Disease

2011-01-13T08:18:00.000-08:00

Periodontal DiseaseJanet M. Torpy, MD, Writer; Alison E. Burke, MA, Illustrator; Richard M. Glass, MD, Editor

KEYWORDS: PERIODONTAL DISEASES.

Periodontal disease (unhealthy gums and teeth) often reflects serious health risks. Mild inflammation of the gums (gingivitis) can be prevented by regularly brushing and flossing teeth to remove plaque (buildup of a film on the teeth). This stops the development of tartar (hardened accumulation of plaque at the gum line), which can only be removed by dental cleaning. More serious infection, called periodontitis, can cause not only disease of the gums, but loss of teeth and the bone structures that support the teeth. Periodontitis may be associated with heart disease, stroke, and systemic (whole body) infections. There is also evidence that premature births happen more often to women who have gum disease before or during their pregnancies. The February 6, 2008, issue of JAMA includes an article about an association between periodontal disease and smoking marijuana.

Next SectionCAUSES•Poor dental hygiene—not brushing your teeth or using dental floss regularly—allows the buildup of plaque and tartar, making the gum tissue unhealthy.
•Smoking causes decreased oxygen delivery to the gum tissue and makes it easier for bacteria to invade the gums.
•Some medications may cause gingival hyperplasia (overgrowth of gum tissue) or receding gums.
•Viral or fungal infection
•Poor nutrition, especially vitamin and mineral deficiencies, may cause gum disease or loss of teeth.
•Chronic medical conditions, including diabetes, may lead to greater risk of infections or poor healing in the gums as well as in other body tissues.
Previous SectionNext SectionSIGNS AND SYMPTOMS
•Receding or puffy, swollen gums
•Painful gums
•Bleeding when you brush your teeth
•Tooth loss or loose teeth in adults
•Pus draining from the gums
•Bad breath that is not related to food and does not go away
Previous SectionNext Section
PREVENTION AND TREATMENT•Brush your teeth at least twice a day.
•Use dental floss daily.
•Periodontitis does not cause symptoms initially, so it is important to have regular dental checkups.
•Maintain good nutrition by eating fruits, vegetables, and whole grains and making sure your diet contains plenty of calcium.
•Do not smoke
•Control chronic medical problems, especially diabetes (maintaining normal blood sugar levels decreases your risk of infection).
•In severe cases of periodontitis, advanced dental treatments may be offered, including gum surgery, bone grafts, or placement of antibiotics into the gum tissue itself.
Previous SectionNext SectionFOR MORE INFORMATION•American Dental Association
http://www.ada.org/
•National Institute of Dental and Craniofacial Research
http://www.nidcr.nih.gov/
•American Heart Association

http://www.americanheart.org/

Previous Section INFORM YOURSELFTo find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.

Sources: National Institute of Dental and Craniofacial Research, American Dental Association, American Heart Association

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.

Dr. James Miller is a Scottsdale, Arizona general dentist who uses the LANAP procedure utilizing the Periolase MVP-7 laser to treat gum disease. For more information www.drjamesmiller.com/lanap.html

2010-12-30T10:36:00.000-08:00

The Mouth-Body Connection: 6 Ways Oral Hygiene Helps Keep You Well

Taking good care of your mouth -- teeth and gums -- does more than help ensure you have a bright, white smile.
A healthy mouth and healthy body go hand in hand. Good oral hygiene and oral health can improve your overall health, reducing the risk of serious disease and perhaps even preserving your memory in your golden years. The phrase "healthy mouth, healthy you" really is true -- and backed by growing scientific evidence.
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Posttransplantation Dental Treatment
Caution should be given relative to oral treatment for transplant patients for at least the first year posttransplant. Even though hematologic parameters including complete blood count and differential may be documented as within normal limits, functional abnormalities may still be present. Patients should not resume routine dental treatment, including dental scaling and polishing, until adequate immunologic reconstitution has occurred; this includes recovery from graft-versus-host disease. The...

It's never too early to start teaching your children to take care of teeth and gums -- healthy habits learned in childhood can pay off in adulthood. And, if you're tempted to shrug off your good oral hygiene habits -- brushing, flossing, and seeing your dentist regularly -- remember that you're a role model for your kids. Keep in mind these six ways having healthy teeth and gums helps boost overall health.

Boosts Your Self-esteem and Confidence

Decayed teeth and gum disease are often associated not only with an unsightly mouth but very bad breath -- so bad it can affect your confidence, self-image, and self-esteem. With a healthy mouth that's free of gum disease and cavities, your quality of life is also bound to be better -- you can eat properly, sleep better, and concentrate with no aching teeth or mouth infections to distract you.

May Lower Risk of Heart Disease

Chronic inflammation from gum disease has been associated with the development of cardiovascular problems such as heart disease, blockages of blood vessels, and strokes.

Experts stop short of saying there is a cause-and-effect between gum disease and these other serious health problems, but the link has shown up in numerous studies. The findings of these studies may suggest that maintaining oral health can help protect overall health.

Preserves Your Memory

Adults with gingivitis (swollen, bleeding gums) performed worse on tests of memory and other cognitive skills than did those with healthier gums and mouths, according to a report in the Journal of Neurology, Neurosurgery & Psychiatry.

Those with gingivitis were more likely to perform poorly on two tests: delayed verbal recall and subtraction -- both skills used in everyday life.

Reduces Risks of Infection and Inflammation in Your Body

Poor oral health has been linked with the development of infection in other parts of the body. In one study, poor oral hygiene and periodontal disease was associated with the development of pneumonia in older people. Bacteria in the mouth can travel into the lungs, causing infection or worsening of lung conditions.

Other research has found an association between gum disease and rheumatoid arthritis, an autoimmune disease that causes inflammation of the joints. Experts say the mechanism of destruction of connective tissues in both gum disease and RA is similar. Eating a balanced diet, seeing your dentist regularly, and good oral hygiene helps reduce your risks of tooth decay and gum disease. Make sure you brush twice a day and floss once a day. Using an antibacterial mouthwash or toothpaste can help reduce bacteria in the mouth that can cause gingivitis.

Helps Keep Blood Sugar Stable if You Have Diabetes

People with uncontrolled diabetes often have gum disease. Having diabetes can make you less able to fight off infection, including gum infections that can lead to serious gum disease.
And some experts have found that if you have diabetes, you are more likely to develop more severe gum problems than someone without diabetes.
That, in turn, may make it more difficult to control blood sugar levels.
Reducing your risk of gingivitis by protecting your oral health may help with blood sugar control if you have been diagnosed with diabetes.
Helps Pregnant Women Carry a Baby to Term

Women may experience increased gingivitis during pregnancy. Some research suggests a relationship between gum disease and preterm, low-birth-weight infants.
Not all studies have found a solid link, but maintaining good oral health is still the best goal. If you're pregnant, visit your dentist or periodontist as part of your prenatal care. Consider it good practice for the role modeling that lies ahead for all new parents.

Dr. James Miller is a Scottsdale AZ Family dentist http://www.drjamesmiller.com/lanap.html

Sex Hormones May Explain Higher Incidence of Periodontal Disease in Men

2010-12-29T15:14:00.000-08:00

Science News Share Blog Cite Print Bookmark Email

Sex Hormones May Explain Higher Risk of Gum Disease in Men

ScienceDaily (Nov. 1, 2010) — Sex hormones may be the biological reason why men are at greater risk than women for destructive periodontitis, an infection of the gums, according to researchers at the University of Maryland Dental School.

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See Also:

Health & Medicine

•Dentistry

•Chronic Illness

•Diseases and Conditions

•Parkinson's Research

•Alzheimer's Research

•Joint Pain

Reference

•Periodontal disease

•Hormone replacement therapy

•Human skeleton

•Hysterectomy

To establish better management and risk assessment models for periodontal disease, Harlan Shiau, DDS, DMedSc, assistant professor, and Mark Reynolds, DDS, PhD, MA, professor at the Dental School, have published the first comprehensive review of gender differences in the development and progression of the destructive periodontal disease.

In a review paper in the Journal of Periodontology, the authors examine evidence for a biologic basis for a sexual dimorphism, or the differences in susceptibility, to periodontal disease between men and women. They conclude that sex steroids exert effects on multiple ways on the immune system regulation of inflammation. They also conclude that the root of the difference may be genetic.

"Differential gene regulation, particularly in sex steroid-responsive genes, could likely play a part in the observed sexual dimorphism of destructive periodontal disease," said Shiau.

"We think it is a plausible explanation," he added. The observation of men "having worse gum disease than women" was generally accepted by dental clinicians previously, says Shiau, "but we wondered if the traditional explanations were adequate. This study provides health care professionals with important comparative data for estimating gender-related differences in risk for destructive periodontal disease."

Prior to the current review paper, the researchers conducted a systematic review of published population studies on the prevalence of periodontal disease. In their analysis they established that men, indeed, have a greater prevalence of periodontal disease than women globally.

Shiau and Reynolds explored potential biologic explanations by drawing from the extensive body of literature in autoimmune disease research, where there also exists sexual dimorphism in disease prevalence.

"Also, we considered the competing hypothesis that the environment explains the dimorphism, such as the observation that men have worse oral hygiene and compliance than women. However, there exist population studies, which control for potential co-variants, like these, and have still yielded significant gender effects." Shiau explains.

"The innate immune response plays a considerable role in the pathogenesis of periodontal disease. The literature seems to indicate that a heightened innate immune response in men compared to women, as well as potential differences in regulation of amplification and termination of inflammation, provide a sound biologic basis for sex differences in periodontal disease progression," says Shiau.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Maryland Baltimore.

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Journal Reference:

1.Harlan J. Shiau, Mark A. Reynolds. Sex Differences in Destructive Periodontal Disease: Exploring the Biological Basis. Journal of Periodontology, 2010; : 100701094910009 DOI: 10.1902/jop.2010.100045

For more information on gum disease and it treatment www.drjamesmiller.com/lanap.html

Gum Disease and Heart Health

2010-12-27T09:59:00.001-08:00

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Periodontal Disease and Heart Health

Heart Disease (Coronary Artery Disease) Slideshow Pictures

Dental Dangers: Plaque and Your Heart

Heart-Healthy Foods Slideshow Pictures

Brushing and flossing may actually save your life.

WebMD Feature

Reviewed By Charlotte Grayson

If you're worried about heart disease, you can easily spend thousands of dollars each year trying to prevent it, paying hand over fist for prescription medicines, shelves of healthy cookbooks, fitness machines for your home, and a gym membership.

Or maybe not. A number of recent studies suggest that you may already have a cheap and powerful weapon against heart attacks, strokes, and other heart disease conditions. It costs less than $2 and is sitting on your bathroom counter. It is none other than the humble toothbrush.

"There are a lot of studies that suggest that oral health, and gum disease in particular, are related to serious conditions like heart disease," says periodontist Sally Cram, DDS, a spokeswoman for the American Dental Association.

So can preventing periodontal disease, a disease of the gums and bone that support the teeth, with brushing and flossing prevent heart disease?

The evidence isn't clear yet, experts say, but it's intriguing. According to the American Academy of Periodontology, people with periodontal disease are almost twice as likely to have coronary artery disease (also called heart disease). And one study found that the presence of common problems in the mouth, including gum disease (gingivitis), cavities, and missing teeth, were as good at predicting heart disease as cholesterol levels.

Evidence Links Periodontal Disease and Heart Health

When it comes to the connection between periodontal disease and heart disease, epidemiologist Moise Desvarieux, MD, PhD, is used to dealing with skeptics.

"One of the talks I give is called, 'Investigating the Links Between Periodontal Infection and Vascular Disease: Are We Nuts?'" says Desvarieux, from Columbia University's Mailman School of Public Health. "It's not a connection that people naturally think of."

Desvarieux was the lead author of a recent study published in Circulation: Journal of the American Heart Association that studied 657 people without known heart disease. He and his co-authors found that people who had higher blood levels of certain disease-causing bacteria in the mouth were more likely to have atherosclerosis in the carotid artery in the neck. Clogging of the carotid arteries can lead to stroke.

Atherosclerosis, also called "hardening of the arteries," develops when deposits of fats and other substances in your blood begin to stick to the sides of your arteries. These deposits, called plaques, can build up and narrow your arteries, clogging them like a plugged-up drain. If these plaques ever block the blood flow completely, you could have a heart attack or stroke, depending on the location of the blockage.

(Note: Not all plaque is alike. The plaques in your arteries have nothing to do with dental plaque your dental hygienist scrapes off your teeth. Dental plaque is a sticky residue of bacteria, acid, and food particles that can irritate your gums and eat away at tooth enamel.)

So what might hardening of the arteries have to do with gingivitis, that minor villain of toothpaste and mouthwash commercials?

No one is sure yet. Experts know that bacteria from the mouth can enter the bloodstream through the gums. These same bacteria have been found clumped in artery plaques. So one theory is that these bacteria stick to the fatty plaques in the bloodstream, directly contributing to blockages.

Other possibilities lie in the body's own defense mechanisms against bacteria. One of the body's natural responses to infection is inflammation (swelling). It's possible that as these oral bacteria travel through your body, they trigger a similar response, causing the blood cells to swell. This swelling could then narrow an artery and increase the risk of clots.

For more information please go to www.drjamesmiller.com/lanap.html

Vitamin D and Periodontal Health

2010-12-27T09:45:00.000-08:00

Does vitamin D enhance periodontal health?

December 1, 2010 -- Vitamin D supplements can play a positive role in supporting and improving periodontal health in older adults and pregnant women, according to two new studies in the Journal of Periodontology (JOP, September 1, 2010).

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In 2009, researchers from Saint Louis University, Southern Illinois University, and Washington University found that patients in periodontal maintenance programs taking vitamin D and calcium supplementation trended toward better periodontal health compared with patients not taking supplementation (JOP, September 2009, Vol. 80:9, pp. 1433-1439).

And this is just one of many cross-sectional studies and secondary data analyses in the last few years that reached similar conclusions, according to Charles Hildebolt, DDS, PhD, study co-author and director of radiology at the Mallinckrodt Institute of Radiology at Washington University.

Vitamin D stimulates the production of natural antibiotics -- antimicrobial peptides -- and bacteria and viruses have a hard time developing a resistance to them, he told DrBicuspid.com.

“It is very difficult to get too much vitamin D.”

— Charles Hildebolt, DDS, PhD,

Mallinckrodt Institute of Radiology "Periodontal disease is largely an immune response to bacteria in the biofilm, so if vitamin D stimulates production of natural antibiotics, this might be good in preventing periodontal disease," he said.

Dr. Hildebolt and his colleagues acknowledge, however, that the effects of vitamin D and calcium supplementation on periodontal disease have not been completely clarified in the scientific literature.

"Although a number of early studies suggested that vitamin D and calcium supplementation reduced tooth loss and alveolar ridge resorption, most of these studies included heterogeneous populations or did not directly measure periodontal diseases status," they wrote. More recently, however, analyses of the Third National Health and Nutrition Examination Survey, which included 12,000 adults, revealed significant associations between periodontal health and and calcium intake, they noted (JOP, July 2000, Vol. 71:7, pp. 1057-1066).

Even so, the National Institute of Dental and Craniofacial Research (NIDCR) wants more evidence on the effects of vitamin D on periodontitis before it will fund randomized clinical trials on this topic, according to Dr. Hildebolt. And on November 30, the Institute of Medicine (IOM) released a report that, while increasing the recommended daily intake of vitamin D and calcium, said that the current body of research does not offer the evidence needed to confirm that vitamin D has the larger positive health effects its proponents claim it does.

The IOM's report is a move in the right direction, Dr. Hildbebolt said. But he also believes there is enough evidence to support research into the effects that higher levels of vitamin D may have on periodontal disease.

"There have been many, many randomized clinical trials that have shown the benefits of vitamin D and calcium in preventing bone loss below the head, and everyone agrees that you need an adequate intake of vitamin D to promote calcium absorption," he told DrBicuspid.com. "So it seems reasonable that bone in the head is not too much different from bone in the rest of the body. If it is beneficial to those bones, it is probably also beneficial to the alveolar bone."

One-year findings

In an effort to convince the NIDCR of this, Dr. Hildebolt and colleagues went back to the same patient group from the 2009 JOP study to see if the trends they had initially found in the relationship between periodontal health and vitamin D and calcium supplements persisted after one year.

Their latest JOP study followed the original 51 patients (men and women age 50-80), who had moderate to severe chronic periodontal disease (at least two interproximal sites with at least 3 mm of clinical attachment loss) and were enrolled in maintenance programs at two dental clinics.

The patients were divided into two groups: 23 had been taking vitamin D (at least 400 international units [IU] per day) and calcium (at least 1,000 mg per day) supplements for more than 18 months at the time of their baseline visits, while the other group (28) had been taking no supplements and had daily dietary intakes of calcium and vitamin D below 1,000 mg and 400 IU, respectively.

All patients were clinically assessed using probing and CEJ-GM (cemento-enamel junction - gingival margin) measurements at baseline, six months, and one year. Clinical measurements were taken at six sites (buccal, lingual, me = 0.049), siolingual, mesiobuccal, distolingual, and distobuccal) for each mandibular posterior tooth. In addition, bitewing radiographs of the mandibular posterior teeth were taken at baseline, six months, and one year.

All subjects from both groups received periodontal maintenance therapy at three-month intervals. Treatment consisted of scaling and root planing, polishing, reinforcement of oral hygiene procedures, and a general dental exam.

For subjects who did not take oral supplements, the mean daily calcium intake was 642 mg and the mean daily vitamin D intake was 156 IU. For subjects who did take oral supplements, the mean daily calcium intake was 1,769 mg and the mean daily vitamin D intake was 1,049 IU.

Clinical parameters of periodontal health improved with time in both groups (p < 0.001). When clinical measures were considered collectively, the differences between supplement takers and nontakers had the following p values: baseline (p = 0.061), six months (p = 0.049), and 12 months (p = 0.114).

"This study suggests that periodontal health improves in patients attending regular periodontal care programs, regardless of their dietary calcium or vitamin D supplements," the authors wrote. "However, taking calcium and vitamin D supplementation is associated with better periodontal health relative to taking no such supplements."

The researchers observed less bleeding on probing and less inflammation in supplement takers, a difference that was evident at baseline and remained significant for one year while subjects underwent periodontal maintenance therapy.

"Our findings do not deny the possibility that vitamin D supplements may reduce the severity of periodontal disease if used at doses higher than 800-1,000 IU daily, thus supporting the rationale for testing the potential beneficial role of vitamin D on periodontal disease in more powerful, randomized clinical trials," they concluded.

Good for pregnant women too

Lack of vitamin D is also associated with maternal periodontal disease during pregnancy, according to researchers from the University of North Carolina at Chapel Hill and Harvard Medical School (JOP, September 1, 2010). In fact, maternal periodontal disease is found in up to 40% of pregnant women and is associated with adverse pregnancy outcomes, including preterm birth, preeclampsia, and late miscarriage, the authors noted.

In their case-control study, 117 cases of pregnant women with moderate to severe periodontal disease (15 or more tooth sites with 4 mm or more of gingival pocket depth) were compared with 118 pregnant women who were periodontally healthy. All the women had been prescribed a prenatal vitamin containing 400 IU of vitamin D.

Their serum 25-hydroxyvitamin D (25[OH]D) levels were measured and compared between the case and control groups to determine the prevalence of vitamin D insufficiency (defined as < 75 nanomoles per liter [nmol/L]). A serum concentration of 75 nmol/L or greater appears to support bone mineral density and dental health, the authors noted, and 90-100 nmol/L has been suggested as the optimal vitamin D level (American Journal of Clinical Nutrition, July 2006, Vol. 84:1, pp. 18-28).

The researchers found that the case group had lower median 25(OH)D levels than the control group (59 versus 100 nmol/L, p < 0.001) and were more likely to have vitamin D insufficiency (65% versus 29%, p < 0.001).

"The relationship between maternal vitamin D status, periodontal disease, and adverse pregnancy outcomes requires more study before definitive conclusions can be made," they wrote. "However, our data provide evidence that improvement of vitamin D status is a potential intervention to improve oral health among a vulnerable group of pregnant women."

Given the role of vitamin D in inflammatory responses and integrity of the innate immune response, vitamin D supplementation could improve maternal oral health, the researchers concluded.

Dr. Hildebolt believes that the best way to determine if patients are getting enough vitamin D from sunshine and diet is to test their blood for serum 25(OH)D levels. If less than 75 nmol/L of serum 25(OH)D is present, then a supplement may be warranted.

"There is a lot of hype about vitamin D right now," Dr. Hildebolt said. "It's not the magic bullet that will cure all forms of cancer, but it is much better to have too much than not enough. And it is very difficult to get too much vitamin D, and to get enough just from diet alone."

Copyright © 2010 DrBicuspid.com

By: Kathy Kincade, Editor in Chief

For more information on Gum Disease and it treatment options please go to www.drjamesmiller.com/lanap.html

Breast Cancer and Gum Disease Link

2010-11-22T09:18:00.000-08:00

Breast cancer linked to perio disease and tooth loss

November 18, 2010 -- As the body of research linking periodontitis with a host of other disease states -- including diabetes, cardiovascular disease, rheumatoid arthritis, surgical complications, and risk of fetal death -- a new study has added yet another to the list: breast cancer (Breast Cancer Research and Treatment, October 19, 2010).

"To our knowledge, this is the first study on the association between periodontitis and breast cancer," Birgitta Söder, DrMedSc, PhD, Lic Odont Sc, RDH, a professor emeritus at Karolinska Institute, told DrBicuspid.com
The American Cancer Society estimates 209,060 cases of invasive breast cancer in 2010, with more than 40,000 deaths. Breast cancer is rarer in men than women, accounting for less than 1% of breast cancer diagnoses, but both men and women should report any changes in breast tissue to their doctors.
“This is the first study on the association between periodontitis and breast cancer.”

— Birgitta Söder, DrMedSc, PhD,

Karolinska Institute Periodontal disease affects 15% to 35% of adults in industrialized countries. Most often caused by poor hygiene and bacterial infection, disease-active periodontitis also seems to be closely associated with human cytomegalovirus and Epstein-Barr virus co-infection. It is believed that these viruses act together to suppress immune response to bacterial challenges. Herpes viruses may also contribute to chronic periodontitis, leading the authors to conclude that these viruses and bacteria act together to lead to low-degree chronic inflammation and carcinogenesis.
"In severe periodontitis, probably there will be co-infection closely associated with a virus," Dr. Söder said.
The prospective study by Dr. Söder and colleagues followed 3,273 randomly selected subjects from 1985 to 2001 who were 30-40 years of age at baseline. At baseline, 1,676 individuals underwent a clinical oral examination (group A); 1,597 subjects were not clinically examined but were registered (group B).
In total, 26 subjects in group A and 15 subjects in group B had breast cancer. The incidence of breast cancer was 1.75% in subjects who had periodontal disease and/or any missing molars, and 0 in subjects who had periodontal disease but had no missing molars. For periodontally healthy subjects with no missing teeth, the breast cancer incidence was 1%. For group B, the incidence was 0.94%.
Of the subjects with periodontal disease and any missing molars in the mandible, 5.5% had breast cancer, compared with 0.5% of the subjects who had periodontal disease but no missing molars in the mandible (p < 0.02). Chronic periodontal disease indicated by missing molars seemed to associate statistically with breast cancer, the researchers concluded.
Smoking a risk factor?
The link between smoking and cancer has not been fully accounted for in many studies relating periodontal disease to cancer, according to Suellan Go Yao, DMD, and James Burke Fine, DMD, of Columbia University (Compendium of Continuing Education in Dentistry, July/August 2010, Vol. 31:6, pp. 436-444).

"Smoking is a known risk factor for many cancers as well as for periodontal disease and tooth loss," they wrote.
In the Karolinska study, the researchers controlled for smoking as a confounding variable by using multiple logistic regression and dichotomizing smokers into ever smokers (current and former smokers) and never smokers, and found no statistical difference between the two groups. Of the subjects with breast cancer, 42.8% were smokers, 17.9% were former smokers, and 39.3% had never smoked. These numbers were similar to the group with no breast cancer.
Similarly, a study by the American Association for Cancer Research also showed smoking to be a less significant variable than periodontal disease with head and neck squamous cell carcinomas (Cancer Epidemiology, Biomarkers, and Prevention, September 2009, Vol. 18:9, pp. 2406-2412).
And in 2007, researchers from the Harvard School of Public Health found periodontal disease to be independently associated with an increased risk of pancreatic cancer overall, including in people who had never smoked (Journal of the National Cancer Institute, January 17, 2007, Vol. 99:2, pp. 171-175).

"Periodontitis in its advanced form can be viewed as a hyperinflammatory response to bacteria," Dr. Fine told DrBicuspid.com. "The byproducts of this oral inflammation enter the bloodstream and can create problems at distant sites. Inflammation may enhance cellular proliferation and mutagenesis, allowing for the development and spread of cancer."

Copyright © 2010 DrBicuspid.com
By: Erin Archer, R.N., DrBicuspid.com contributing writer

For more information on gum disease and its treatment please go to www.drjamesmiller.com/lanap.html

Periodontal Disease and Sex Hormones

2010-11-15T11:26:00.000-08:00

'Landmark' Study Points to Role of Sex Hormones in Higher Risk of Gum Disease in Men

TEXT SIZE By: University of Maryland Baltimore

--------------------------------------------------------------------------------

Newswise - Sex hormones may be the biological reason why men are at greater risk than women for destructive periodontitis, an infection of the gums, according to researchers at the University of Maryland Dental School.

To establish better management and risk assessment models for periodontal disease, Harlan Shiau, DDS, DMedSc, assistant professor, and Mark Reynolds, DDS, PhD, MA, professor at the Dental School, have published the first comprehensive review of gender differences in the development and progression of the destructive periodontal disease.

In a review paper in the Journal of Periodontology, the authors examine evidence for a biologic basis for a sexual dimorphism, or the differences in susceptibility, to periodontal disease between men and women. They conclude that sex steroids exert effects on multiple ways on the immune system regulation of inflammation. They also conclude that the root of the difference may be genetic.

"Differential gene regulation, particularly in sex steroid-responsive genes, could likely play a part in the observed sexual dimorphism of destructive periodontal disease," said Shiau.

"We think it is a plausible explanation," he added. The observation of men "having worse gum disease than women" was generally accepted by dental clinicians previously, says Shiau, "but we wondered if the traditional explanations were adequate. This study provides health care professionals with important comparative data for estimating gender-related differences in risk for destructive periodontal disease."

Prior to the current review paper, the researchers conducted a systematic review of published population studies on the prevalence of periodontal disease. In their analysis they established that men, indeed, have a greater prevalence of periodontal disease than women globally.

Shiau and Reynolds explored potential biologic explanations by drawing from the extensive body of literature in autoimmune disease research, where there also exists sexual dimorphism in disease prevalence.

"Also, we considered the competing hypothesis that the environment explains the dimorphism, such as the observation that men have worse oral hygiene and compliance than women. However, there exist population studies, which control for potential co-variants, like these, and have still yielded significant gender effects." Shiau explains.

"The innate immune response plays a considerable role in the pathogenesis of periodontal disease. The literature seems to indicate that a heightened innate immune response in men compared to women, as well as potential differences in regulation of amplification and termination of inflammation, provide a sound biologic basis for sex differences in periodontal disease progression," says Shiau.

Mark Reynolds is chair of the Dental School's Department of Periodontics.

For more information contact

www.drjamesmiller.com/lanap.html

Gum Disease and Prostitis Link

2010-11-15T07:59:00.000-08:00

News in Brief

Prostatitis Linked to Periodontitis

Delicia Honen YardJune 10, 2010 Print Email Reprint Permissions

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Men with the most severe form of prostatitis also showed signs of periodontitis, raising the possibility that the inflammation characterizing the two conditions may be related. In an online report publish in the Journal of Periodontology, Nabil F. Bassada, DDS, MSD, of Case Western Reserve University School of Dental Medicine in Cleveland, and colleagues noted that in their small study of 35 men, those with moderate or severe prostatitis and poor periodontal health had significantly higher mean PSA levels than those with neither or only one condition.

For more information concerning periodontal disease and the LANAP procedure to treat the disease go to www.drjamesmiller.com/lanap.html

Possible Link Between Gum Disease and Alzheimer's

2010-11-10T07:59:00.000-08:00

Gum disease may increase Alzheimer’s risk

New research finds that periodontal disease may contribute to Alzheimer’s disease, brain inflammation, and neurodegeneration. (Credit: iStockphoto)

NYU (US)—Periodontal (gum) disease may increase the risk of cognitive dysfunction associated with Alzheimer’s disease in healthy individuals as well as in those who already are cognitively impaired.

Researchers examined 20 years of data and found fresh evidence that links gum disease to brain inflammation, neurodegeneration, and Alzheimer’s disease.
“The research suggests that cognitively normal subjects with periodontal inflammation are at an increased risk of lower cognitive function compared to cognitively normal subjects with little or no periodontal inflammation,” says Angela. Kamer, assistant professor of periodontology and implant dentistry at New York University.
The study builds on earlier research that found that subjects with Alzheimer’s disease had a significantly higher level of antibodies and inflammatory molecules associated with periodontal disease in their plasma compared to healthy people.
The latest findings are based on an analysis of data on periodontal inflammation and cognitive function in 152 subjects in the Glostrop Aging Study, which has been gathering medical, psychological, oral health, and social data on Danish men and women.
Kamer’s team compared cognitive function at ages 50 and 70, using the Digit Symbol Test, or DST, a part of the standard measurement of adult IQ. The DST assesses how quickly subjects can link a series of digits.
Periodontal inflammation at age 70 was found to be strongly associated with lower DST scores at age 70. Subjects with periodontal inflammation were nine times more likely to test in the lower range of the DST compared to subjects with little or no periodontal inflammation.
This strong association held true—even in those subjects who had other risk factors linked to lower DST scores, including obesity, cigarette smoking, and tooth loss unrelated to gum inflammation—and also for those who had a low DST score at age 50.
Kamer plans to conduct a follow-up study involving a larger, more ethnically diverse group of subjects, to further examine the connection between periodontal disease and low cognition.
Researchers from Copenhagen University contributed to the study.

For more information concerning gum disease and the latest treatment go to www.drjamesmiller.com/lanap.html

LANAP: What is it?

2010-10-27T13:00:00.000-07:00

What is L.A.N.A.P.?

Laser Assisted New Attachment Procedure ( L.A.N.A.P. ) is an amazing breakthrough in gum ( periodontal ) treatment. If you have been told you need periodontal surgery, involving a scalpel and sutures, L.A.N.A.P. is a laser alternative you need to learn about. Did you know that 50% of Americans has periodontal disease.

Periodontal disease starts off as plaque, an opaque film that is constantly forming in our mouths. The plaque eventually hardens, forming tartar or calculus. These calculus deposits harbor bacteria which infects the gums. In early stages, this is called Gingivitis, characterized by red, swollen gums that bleed when you brush your teeth. Many people experience bad breath and an unpleasant taste in their mouths as well. Without treatment, Gingivitis progresses to Periodontitis, a much more serious form of gum disease where periodontal pockets are formed, separating teeth from the gums and supporting bone structure. Without treatement, the infection becomes severe and the pockets deepen, eventually, resulting in tooth loss.

To repair the damage caused by gum disease is to get rid of the infection and close the periodontal pockets. Until now, this meant surgery and sutures. But today, LASER PERIODONTAL THERAPY OR LANAP, a patient friendly, minimally invasive procedure that is a great improvement over traditional gum surgery.

Dr. James Miller will schedule you a complimentary consultation to explain how the laser works and give you a demonstration. If you a candidate ( you have gum disease) for LANAP the first treatment involves a local anesthetic to eliminate any possible discomfort. A general anesthetic is not necessary as LASER PERIODONTAL THERAPY OR LANAP is much less traumatic. A tiny laser (about the thickness of three hairs) is inserted between the tooth and gum, and the infection is cleared away. The procedure is fast, it takes just two 2-hour sessions. One half of the mouth is treated at a time...most patients feel good enough to back to work afterwards.

Dr. James B. Miller is a Licensed Arizona General Dentist praciticing in Scottsdale Arizona. He can be reached at james@drjamesmiller.com or at www.drjamesmiller.com/lanap.html

Fatty Fish and Nuts May Prevent Gum Disease

2010-10-27T12:57:00.000-07:00

Fatty Fish, Nuts May Prevent Gum Disease

Study Shows Diet High in Polyunsaturated Fatty Acids May Reduce Risk for Periodontitis

By Jennifer Warner

WebMD Health NewsReviewed by Laura J. Martin, MDOct. 26, 2010 -- A new study suggests eating foods rich in polyunsaturated fatty acids (PUFAs), such as salmon and nuts, may help prevent gum disease or periodontitis.

Periodontitis is a common type of gum disease in which the gum tissue separates from the teeth and allows bacteria to build up. If untreated, the condition can lead to bone and tooth loss.

Researchers found that people whose diets were rich in PUFAs were as much as 30% less likely to have gum disease than those who ate little or none of this type of fat.

“We found that n-3 fatty acid intake, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are inversely associated with periodontitis in the U.S. population,” says researcher Asghar Z. Naqvi, MPH, MNS, of Beth Israel Deaconess Medical Center in Boston, in a news release.

"A dietary therapy, if effective, might be a less expensive and safer method for the prevention and treatment of periodontitis," says Naqvi. “To date, the treatment of periodontitis has primarily involved mechanical cleaning and local antibiotic application."

Researchers say polyunsaturated fats have already been shown to have beneficial effects on other types of inflammatory conditions, such as heart disease, and they may also play a role in fighting the inflammation that causes gum disease.
"Given the evidence indicating a role for n-3 fatty acids in other chronic inflammatory conditions, it is possible that treating periodontitis with n-3 fatty acids could have the added benefit of preventing other chronic diseases associated with inflammation, including stroke as well,” says Naqvi.
Slideshow: Top Problems in Your Mouth
PUFAs and Your Gums
In the study, published in the Journal of the American Dietetic Association, researchers compared fatty acid intake and risk of gum disease in 9,182 adults who participated in the National Health and Nutrition Examination Survey from 1999 to 2004.
The results showed those who ate moderate to high amounts of the fatty acid DHA through diet or fish oil supplements were up to 30% less likely to have gum disease than those who ate lower amounts. Those whose diets were rich in the EPA had up to a 23% lower risk of periodontitis.
Researchers found that even modest levels of these PUFAs (equivalent to less than 40 milligrams per day for DHA and 10 milligrams per day for EPA) were enough to significantly reduce the risk of gum disease.
Foods that are naturally high in polyunsaturated fatty acids like DHA and EPA include fatty fish, nuts, margarine, and peanut butter.

For more information on gum disease and it treatment please visit www.drjamesmiller.com/lanap.html

Want To Be Sexier....Improve your Oral Hygiene

2010-10-26T12:57:00.000-07:00

If you're thinking about being romantic tonight, you might want to make sure your oral hygiene is in check. Based on a new survey, oral hygiene is significantly preferred over the traditional romantic overtures to set the mood, such as dimming the lights, lighting candles, wearing perfume or playing romantic music.

"The results of this study reinforced some of what we already knew - that most consumers simply don't like to floss with string - but we were surprised at how important oral hygiene was in order to be attractive to your significant other"

The national survey, which was fielded by Kelton Research, examined Americans' views on oral healthcare and revealed that a clean mouth was most important in maintaining a healthy relationship. Close to six in ten, or 59 percent, would be most disturbed by their partner not brushing or flossing his or her teeth for a week, as compared to only 24 percent who would be most perturbed if their significant other passed on wearing deodorant. Far fewer were bothered by their partner skipping shaving, hair combing or trimming toe nails for a week, at nine percent, six percent and two percent, respectively.

The Waterpik® Sexy Smile Survey also found that while they are quick to judge the flossing habits of their significant others, the majority of Americans actually have a lot of ups and downs in their own relationship with floss. Key findings on flossing and oral healthcare include:

- Only When I'm Desperate. Americans are most likely to floss just before visiting the dentist (51 percent), and when they have food stuck in between their teeth or have bad breath (64 percent), which could mean their mouths are not as fresh as they should be most other times!

- Below Grade. Nearly six in ten (58 percent) Americans say they deserve a C or lower for the efforts they make to floss their teeth on a daily basis. In fact, about one in five (18 percent) give themselves a failing grade.

- Unpleasant Act. Among people who floss their teeth, close to six in ten (57 percent) say that floss makes their gums bleed, it gets stuck between their teeth, (52 percent), and it caused little bits of food to fly onto the mirror (42 percent). Yuck!

- We Want an Alternative. In fact, Americans would pay an average of $53 for an alternative to regular string floss (which you can usually get for free from your dentist) if it meant that the process was faster, easier and more effective.

"The results of this study reinforced some of what we already knew - that most consumers simply don't like to floss with string - but we were surprised at how important oral hygiene was in order to be attractive to your significant other," said Jay McCulloch, Vice President of Marketing for Water Pik Oral Health Products. "The Waterpik® Water Flosser is a great option for those who are struggling with traditional floss. It's easy to use, it's clinically proven to be significantly more effective than string floss, and it takes only one minute per day."

The Waterpik® Water Flosser utilizes pulsating water to clean deep between teeth and below the gumline to remove plaque and debris where traditional brushing and flossing can't reach.

About The Water Survey

The Waterpik® Sexy Smile Survey was conducted by Kelton Research between September 10 and September 16, 2010 among 1,001 U.S. adults using an email invitation and an online survey. Quotas are set to ensure reliable and accurate representation of the total U.S. population ages 18 and over. Results of any sample are subject to sampling variation. The magnitude of the variation is measurable and is affected by the number of interviews and the level of the percentages expressing the results. In this particular study, the chances are 95 in 100 that a survey result does not vary, plus or minus, by more than 3.1 percentage points from the result that would be obtained if interviews had been conducted with all persons in the universe represented by the sample.

Source:

Kelton Research

Water Pik, Inc.

For more information about periodontal disease please visit www.drjamesmiller.com/lanap.html

Six Signs of Periodontal Disease

2010-10-20T10:50:00.000-07:00

Six Signs of Periodontal Disease

July 28th, 2010, By Dental Health Magazine Staff
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Many people are completely unaware that they even have periodontal disease. Prior to the occurrence of a pain and a major symptom, this problem may have already begun.

For people who don’t get a dental checkup every six months, they may be well on their way to losing their teeth and to contributing to other significant health problems.

Prior to this problem becoming severe, there are six easy ways to tell if it is a problem for you.
The Six Signs of Periodontal Disease:
1. Halitosis that refuses to go away.

2. Swollen or red gums.

3. Bleeding or tender.

4. Chewing that is painful

5. Loose teeth

6. Sensitive teeth

The first sign of periodontal disease is bad breath that won’t go away. If you have chronic bad breath, make sure to rule out a systemic disease, like diabetes.

There are other causes of bad breath that not be the result of periodontal disease such as medication and diet. There are also some sources of bad breath that can come from the stomach, sinus, and lungs.

These factors should also be considered. But, because the majority of the population suffers from periodontal disease, that is the most likely that bad breath.

Red or purple gums that are swollen are another sign of periodontal disease, especially the gums around the teeth. The surface of healthy gums show stippling and are pink.

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Gums that bleed easily and are tender to the touch is another sign of periodontal disease. The gums shouldn’t bleed when flossing or brushing. Gums that bleed are an indication that infection is setting in.

Another sign of periodontal disease is chewing that is painful. A sharp pain that is located in only one tooth may be the need for a root canal, a cracked tooth, or a cavity. Non localized or overall pain is usually the result of periodontal disease.

Loose teeth in the mouth from periodontal disease are the result of deposits of plaque under and along the gum line around the bone of the teeth.

The bone will begin to deteriorate and the tooth loses its support in the jaw. The, pockets will form around the tooth and collect further bacteria and thus exacerbate the problem.

Teeth that are sensitive to cold air, sour, sweet, cold, and hot can also be a sign of periodontal disease. Gums that recede as a result of the disease expose the surfaces of the root which are covered with tiny tubes that lead into the nerve in the tooth.

When the external stimulus is introduced to the exposed portion of the tooth, the nerves feel the pain.

While the late stages of periodontal disease have these signs, the early stages don’t. You should make an appointment with your dentist before these signs appear.

For more information concerning periodontal disease and its treatment www.drjamesmiller.com/lanap.html

Gum Disease = Poor Health

2010-10-13T09:16:00.000-07:00

Periodontal disease and poor health outcomes

Peter N Galgut, clinical periodontist

Clinicians must recognise the risks and refer patients for periodontal care
Periodontal diseases are localised gingival infections that affect most adults at some time in their lives. They are broadly divided into two groups. Gingivitis is related to dental plaque and manifests as superficial redness, swelling, and bleeding of the gums. Periodontitis occurs when the infection spreads into the deeper tissues surrounding the roots of the teeth, and it causes breakdown of the gingival tissues and alveolar bone resorption.
Evidence shows that periodontal diseases can have systemic effects.1 2 3 Oral infection can result in the formation of sites that favour colonisation by blood borne microbes—a locus minoris resistentiae. A well known example of this phenomenon is heart valves that are damaged by rheumatic fever, which are more susceptible to bacterial infection from blood borne bacteria.

Dr. James Miller is a Scottsdale dentist utilizing LANAP laser gum therapy using Periolase MVP-7 laser. For more information on gum disease visit www.drjamesmiller.com/lanap.html

Gum Disease More Prevalent Than Previously Thought

2010-09-30T13:30:00.001-07:00

THURSDAY, Sept. 30 (HealthDay News) -- Officials have underestimated the prevalence of gum disease in the United States by as much as 50 percent, new research suggests.

"This study shows that periodontal disease is a bigger problem than we all thought. It is a call to action for anyone who cares about his or her oral health," Dr. Samuel Low, professor of periodontology at the University of Florida College of Dentistry and president of the American Academy of Periodontology, said in a news release from the organization.
But the chronic inflammatory condition known as periodontal disease can do more than harm the gums and the structures that support the teeth. Without treatment, serious diseases that affect the entire body can develop, including diabetes, heart disease and rheumatoid arthritis, the authors of the news release explained.
"Given what we know about the relationship between gum disease and other diseases, taking care of your oral health isn't just about a pretty smile. It has bigger implications for overall health, and is therefore a more significant public health problem," Low added.
In the study by Paul Eke of the U.S. Centers for Disease Control and Prevention and colleagues, periodontists examined the mouths of more than 450 people older than 35 years of age. They found more cases of gum disease overall than previous research indicated people had, suggesting that the older studies had high levels of misclassification of periodontitis cases and thus have low validity for surveillance and research.
Low said the findings highlight the importance of gum health. "Not only should you take good care of your periodontal health with daily tooth brushing and flossing, you should expect to get a comprehensive periodontal evaluation every year," he said.
The study, by researchers at the CDC and the American Academy of Periodontology, was published in the Sept. 21 online edition of the Journal of Dental Research.

More information
For more information on gum disease and treatment options click on www.drjamesmiller.com/lanap.html

Smoking and Sleep Affect Oral Health

2010-09-28T12:36:00.000-07:00

Smoking and Sleep Affect Oral Health

Study: Smoking and Lack of Sleep Are Among Factors in Periodontal Disease

By Jennifer Warner

WebMD Health NewsReviewed by Brunilda Nazario, MD May 18, 2007 -- Smoking may be public enemy No. 1 when it comes to the health of your teeth and gums.
A new study shows smoking was the leading lifestyle factor affecting the progression of periodontal disease. Second to smoking in terms of worsening periodontal disease was not getting enough sleep.
"This study points out to patients that there are lifestyle factors other than brushing and flossing that may affect their oral health. Simple lifestyle changes, such as getting more sleep, may help patients improve or protect their oral health," says Preston D. Miller Jr., DDS, president of the American Academy of Periodontology, in a news release. "It is also important to keep these in mind as the body of evidence linking oral disease with systemic diseases continues to grow because ultimately these lifestyle factors might impact a patient's overall health."
Smoking Affects Periodontal Disease

Periodontal disease, which affects the teeth and gums and can ultimately lead to loss of teeth, is thought to be caused by an imbalance of bacteria in the mouth. But recent research has suggested that other factors may also play an important role.
In the study, Muneo Tanaka, DDS, and colleagues at Osaka University Graduate School of Dentistry, followed a group of 219 factory workers from 1999 to 2003 to examine the relationship between periodontal disease and different lifestyle factors.
Researchers analyzed the impact of a variety of lifestyle factors on the progression of periodontal disease among the workers, including physical exercise, alcohol use, tobacco use, hours of sleep, nutritional balance of the diet, mental stress, hours worked, and eating breakfast.

Out of all the lifestyle factors examined, researchers found the No. 1 one factor affecting the progression of periodontal disease was smoking.
The results, published in the Journal of Periodontology, also showed that more than 41% of those who experienced a worsening of their periodontal disease were current smokers.
Lack of sleep was the second most important lifestyle factor affecting periodontal disease with those who received seven to eight hours of sleep per night showing less periodontal disease progression than those who received six or fewer hours of sleep per night. High stress levels and daily alcohol consumption also had an impact on periodontal disease progression.

For more information on the treatment of gum disease visit www.drjamesmiller.com/lanap.html

WebMD LANAP Laser Video

2010-09-27T10:15:00.000-07:00

Check out this Web MD video concerning LANAP laser treatment.
http://www.webmd.com/video/new-treatment-gum-disease

For more information on LANAP go to www.drjamesmiller.com/lanap.html

Smoking and Gum Disease

2010-09-27T09:04:00.000-07:00

Smoking and Sleep Affect Oral Health

Study: Smoking and Lack of Sleep Are Among Factors in Periodontal Disease

By Jennifer Warner

WebMD Health NewsReviewed by Brunilda Nazario, MD May 18, 2007 -- Smoking may be public enemy No. 1 when it comes to the health of your teeth and gums.
A new study shows smoking was the leading lifestyle factor affecting the progression of periodontal disease. Second to smoking in terms of worsening periodontal disease was not getting enough sleep.

"This study points out to patients that there are lifestyle factors other than brushing and flossing that may affect their oral health. Simple lifestyle changes, such as getting more sleep, may help patients improve or protect their oral health," says Preston D. Miller Jr., DDS, president of the American Academy of Periodontology, in a news release. "It is also important to keep these in mind as the body of evidence linking oral disease with systemic diseases continues to grow because ultimately these lifestyle factors might impact a patient's overall health."

Smoking Affects Periodontal Disease

Periodontal disease, which affects the teeth and gums and can ultimately lead to loss of teeth, is thought to be caused by an imbalance of bacteria in the mouth. But recent research has suggested that other factors may also play an important role.

In the study, Muneo Tanaka, DDS, and colleagues at Osaka University Graduate School of Dentistry, followed a group of 219 factory workers from 1999 to 2003 to examine the relationship between periodontal disease and different lifestyle factors.

Researchers analyzed the impact of a variety of lifestyle factors on the progression of periodontal disease among the workers, including physical exercise, alcohol use, tobacco use, hours of sleep, nutritional balance of the diet, mental stress, hours worked, and eating breakfast.

Out of all the lifestyle factors examined, researchers found the No. 1 one factor affecting the progression of periodontal disease was smoking.

The results, published in the Journal of Periodontology, also showed that more than 41% of those who experienced a worsening of their periodontal disease were current smokers.

Lack of sleep was the second most important lifestyle factor affecting periodontal disease with those who received seven to eight hours of sleep per night showing less periodontal disease progression than those who received six or fewer hours of sleep per night. High stress levels and daily alcohol consumption also had an impact on periodontal disease progression.

To find out more about gum disease and its treatments go to www.drjamesmiller.com/lanap.html

Gum Disease Major Health Concern

2010-09-23T12:47:00.000-07:00

The prevalence of periodontal disease in the United States may be significantly higher than originally estimated. Research published in the Journal of Dental Research from the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) suggests that the prevalence of periodontal disease may have been underestimated by as much as 50 percent. The implication is that more American adults may suffer from moderate to severe gum disease than previously thought.

In a National Health and Nutrition Examination Survey (NHANES) pilot study, funded by the CDC's Division of Oral Health, a full-mouth, comprehensive periodontal examination was conducted on over 450 adults over the age of 35. Periodontal disease was classified according to definitions determined by the CDC in collaboration with the AAP. The prevalence rates were then compared against the results of previous NHANES studies which used a partial-mouth periodontal examination. Historically, NHANES has served as the main source for determining prevalence of periodontal disease in US adults. The pilot study finds that the original partial-mouth study methodology may have underestimated true disease prevalence by up to 50 percent.
Periodontal disease is a chronic inflammatory disease that affects the gum tissue and other structures supporting the teeth. If left untreated, it can lead to tooth loss, and may also interfere with other systems of the body. Several research studies have associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis.
"This study shows that periodontal disease is a bigger problem than we all thought. It is a call to action for anyone who cares about his or her oral health." said Samuel Low, DDS, MS, associate dean and professor of periodontology at the University of Florida College of Dentistry, and president of the American Academy of Periodontology. "Given what we know about the relationship between gum disease and other diseases, taking care of your oral health isn't just about a pretty smile. It has bigger implications for overall health, and is therefore a more significant public health problem."
Dr. Low explained that the increased prevalence of periodontal disease makes it essential to maintain healthy teeth and gums. "Not only should you take good care of your periodontal health with daily tooth brushing and flossing, you should expect to get a comprehensive periodontal evaluation every year," he advised. A dental professional, such as a periodontist, a specialist in the diagnosis, treatment and prevention of gum disease, will conduct the comprehensive exam to assess your periodontal disease status.

According to Paul Eke, MPH, PhD, epidemiologist at the CDC and lead author of the study, the findings have significant public health implications. "The study suggests we have likely underestimated the prevalence of periodontal disease in the adult US population," he said. "We are currently utilizing a full-mouth periodontal examination in the 2009/10 NHANES to better understand the full extent and characteristics of periodontal disease in our adult population." Dr. Eke added, "Research suggests a connection between periodontal health and systemic health. In light of these findings, understanding the relationships between periodontal disease and other systemic diseases in the adult U.S population is more crucial than ever."

Source:

American Academy of Periodontology
Find out more about gum disease and treatment at www.drjamesmiller.com/lanap.html

Healthy Gums May Help Prevent Pancreatic Cancer

2010-09-23T11:56:00.000-07:00

Healthy Gums May Prevent Pancreatic Cancerfrom FitSugar by FitSugar

All cancer is bad news, but what makes pancreatic cancer so awful is that only 5% of people diagnosed with it will live another 5 years.
There are no recommended screening tests, early warning signs or symptoms to alert a person or their doctor that they have pancreatic cancer.
Some risk factors that could make you more susceptible to pancreatic cancer include cigarette smoking and possibly diabetes and obesity.
Oddly enough, periodontal disease (gum inflammation) and tooth loss may also be associated in some way with an increased risk of pancreatic cancer.
The connection it seems is that over time, the bacterial infection that causes gum disease can also cause loss of the bone that anchors the teeth. The inflammation from the infection may set the stage for other serious diseases, like pancreatic cancer.
There has also been recent interest in a possible link between gum disease and coronary artery disease, based on the theory that gum disease may lead to increased levels of inflammation throughout our bodies.

Fit's Tips: So take care of your teeth and gums people. Get regular dental cleanings twice a year, and whatever you do - don't forget to floss.

If you would like to learn more about gum disease and gum disease treatment go to www.drjamesmiller.com/lanap.html

LANAP Laser Gum Therapy vs. Conventional Gum Surgery

2010-09-20T09:09:00.000-07:00

It can be a difficult decision for people who have diagnosed with gum or periodontal disease. Firstly, patients are often surprised at their diagnosis. Periodontal disease is a very common, yet, sadly, is widely underdiagnosed ( another topic altogether). It is estimated that over 100 million people in the U.S. have some form of periodontal disease. When it comes to treating gum disease there are essentially two options - traditional gum surgery or LANAP laser gum therapy. Unfortunately, LANAP laser gum therapy option is often not presented to patient because of lack of knowledge of the LANAP procedure. My goal is to compare LANAP with traditional gum surgery so people can make an informed decision of the treatment choices.

Comparison of Procedures

With traditonal gum surgery, a scalpel is used to "flap" the gums back in order to expose the roots of the teeth and the jawbone. This allows the dentist to clean all the tartar from the roots and view the bone that supports the teeth. If there are any bony defects, the bone is reshaped or bone graft material is placed. The gums are then sutured back in place. The gums may also be excised (cut) in order to achieve a periodontal pocket that is 3mm deep to allow the patient to clean effectively. For example, if you had a 6mm pocket reading, then 3mm of gum tissue would have to be removed to create a 3mm pocket.

In LANAP laser gum therapy, there are no scalpels or sutures. The gums are not "flapped" back of the teeth and the bone. Instead, the laser fiber is placed between the teeth and gums into the periodontal pocket. The LANAP laser then selectively ablates (removes) the scar tissue lining the gums in the pocket and kills the bacteria as well. The roots are then cleaned using an ultrasonic devise. Then the LANAP laser is used again to seal around the cuff of the tooth. This creates an environment that allows your own body to heal and actually regenerate the attachment of the gum to the tooth.

Essentially, the difference is LANAP laser gum therapy promotes regeneration to reduce the periodontal pocket depths while Traditional gum surgery amputates the gums to attain a healthy periodontal pocket depth.

Post Operative Differences

Since LANAP laser gum therapy is less invasive than traditional gum surgery the downtime is dramatically reduced. It is typical for a LANAP patient to have downtime in the 24 -48 hr range. Compared to 2-4 weeks with traditional surgery. With LANAP there is less pain and less chance of infection.

Treatment Outcome Differences

While both LANAP and Traditional gum treatments will produce healthier gums, there are some major differences. Since Traditonal surgery removes gum tissue to produce shallower periodontal pockets, this exposes the roots of the teeth to the oral environment. Aesthetically, the teeth look longer as more of the teeth are exposed. By exposing the roots of the teeth, this often produces teeth that are sensitive to cold and hot temperatures. Also, the roots of the teeth are not as strong as the enamel of teeth. By exposing the roots it increases the risk of getting cavities on these root surfaces.

LANAP laser gum therapy does not remove gum tissue, it promotes regeneration of the gums attachment to the tooth. With LANAP we see very little gum recession. This means the roots do not get exposed, so the sensitivity and cavity risks are minimized, and aesthetics are maintained because we see very little gum recession with LANAP.

Time and Cost Differences

The time frame for LANAP consists of 2 two hour appointments scheduled one week apart. Traditional gum surgery usually take longer, with a longer time frame between surgeries. The cost is for each procedure is typically about the same.

If you would like to read more on LANAP laser gum therapy please click on the following link www.drjamesmiller.com/lanap.html .

LANAP Laser Gum Therapy One Year Results

2010-08-30T13:18:00.000-07:00

December 2008- Note the amount of bone loss
between the teeth. Approximately only 2mm of

bone supporting the tooth.

January 2010. Patient presents with significant
reduction in pocket depths and evidentce of
approximately 3-4 mm new bone formation.

This particular patient came to our office originally in December 2007. This was before I had been providing the LANAP laser gum therapy. The patient's periodontal condition, particularly the bottom front teeth, were in poor to hopeless condition. My original plan was to extract the four bottom incisors and replace them with a bridge. The depth of the periodontal pockets ranged from 8-12mm deep (normal is 3mm)! The teeth were mobile. Fortunately I began performing the LANAP procedure in September of 2008. This patient jumped at the opportunity to treat his periodontal condition using the Periolase MVP-7 laser and the LANAP laser gum therapy procedure. The LANAP procedure was performed in December of 2008. Since we do not want to damage the new gum attachment, we do not measure the gums for at least nine months. In January 2010, we measured the bottom front teeth, we were ecstatic with the results. Where there was a 12mm periodontal pocket now measured a 4mm, where there was an 8mm pocket now there was a 3mm. We also took an X-ray of the area to compare. This blew me away! We see evidence of new bone formation (approximately 3-4mm new bone) growing. Using the LANAP laser gum therapy is the only way I know about that can produce these types of results.

Dr. James Miller is a Arizona licensed general
dentist. His practice is located in Scottsdale Arizona.
For more information concerning LANAP
click on the following link http://www.drjamesmiller.com/lanap.html

There is a difference in the Laser that is used

2009-03-16T12:13:00.000-07:00

L.A.N.A.P. ( laser assisted new attachment procedure ) is used ONLY with one specific laser, the Periolase MVP-7. Most people think a laser is a laser. This is not the case. The difference between lasers is the certain wavelength it emits, this is why LASIK is not done with a hair removal laser. Lasers at different wavelengths are absorbed by different tissues/materials. The Periolase MVP-7 used in L.A.N.A.P. is a Nd:YAG laser which emits at 1064 nm. Other lasers used in the Medical/Dental field are CO2, YAG, Argon, Er:YAG, Ho:YAG, Diode, ErCr:YSSG, Nd:YAP, HeNe. All of these lasers are absorbed by different tissues and have different effects and treatment modalities.

The Periolase MVP-7 used in LANAP was developed specifically for the use in periodontal or gum disease. The laser is absorbed by darker pigmented tissues, which includes the bacteria that cause periodontal disease, and also the lining of the periodontal pocket, called epithelium. By removing these tissues from the periodontal pockets it leaves behing healthy connective tissue which can reattach to the tooth. Other lasers used in the dental field do not selectively remove these tissues without altering the connective tissue (which is required for regeneration). For example, the Biolase Waterlase, which is ErCr:YSSG laser, is absorbed highly by water, so any tissue that contains water would be detroyed. Diode lasers, which emit at 980nm, are essentially just a "hot tip" which removes tissue by heating. The diode would kill the bacteria but also destroy the healthy connective tissue we want when doing LANAP.

My point of this post is that if considering Laser Gum Therapy (LANAP) be sure that laser that is being used is the Periolase MVP-7. It is the only laser used in LANAP, which is an FDA cleared procedure.

LANAP Animation

2008-10-21T18:07:00.000-07:00

What is L.A.N.A.P.?

2008-09-12T12:08:00.000-07:00

Laser Assisted New Attachment Procedure ( L.A.N.A.P. ) is an amazing breakthrough in gum ( periodontal ) treatment. If you have been told you need periodontal surgery, involving a scalpel and sutures, L.A.N.A.P. is a laser alternative you need to learn about. Did you know that 50% of Americans has periodontal disease.

Periodontal disease starts off as plaque, an opaque film that is constantly forming in our mouths. The plaque eventually hardens, forming tartar or calculus. These calculus deposits harbor bacteria which infects the gums. In early stages, this is called Gingivitis, characterized by red, swollen gums that bleed when you brush your teeth. Many people experience bad breath and an unpleasant taste in their mouths as well. Without treatment, Gingivitis progresses to Periodontitis, a much more serious form of gum disease where periodontal pockets are formed, separating teeth from the gums and supporting bone structure. Without treatement, the infection becomes severe and the pockets deepen, eventually, resulting in tooth loss.

To repair the damage caused by gum disease is to get rid of the infection and close the periodontal pockets. Until now, this meant surgery and sutures. But today, LASER PERIODONTAL THERAPY OR LANAP, a patient friendly, minimally invasive procedure that is a great improvement over traditional gum surgery.

Dr. James Miller will schedule you a complimentary consultation to explain how the laser works and give you a demonstration. If you a candidate ( you have gum disease) for LANAP the first treatment involves a local anesthetic to eliminate any possible discomfort. A general anesthetic is not necessary as LASER PERIODONTAL THERAPY OR LANAP is much less traumatic. A tiny laser (about the thickness of three hairs) is inserted between the tooth and gum, and the infection is cleared away. The procedure is fast, it takes just two 2-hour sessions. One half of the mouth is treated at a time...most patients feel good enough to back to work afterwards.

Dr. James B. Miller is a Licensed Arizona General Dentist praciticing in Scottsdale Arizona. He can be reached at james@drjamesmiller.com or at www.drjamesmiller.com/lanap.html

Periodontal Pockets

2008-09-12T10:09:00.000-07:00

Periodontal pockets are a key determination of gum health. In normal health, pockets are 3mm or less. When these periodontal measurements exceed 3mm it can be determined that periodontal disease may be present.

Symptoms of Gum Disease

2008-09-11T12:23:00.000-07:00

The signs and symptoms of gum disease are quite often silent. What does this mean? You will not know about the disease until it has reached an advanced stage of the disease. Warning sign of gum ( periodontal ) disease include the following:

Red, swollen gums that may be tender/painful
Bleeding when brushing or flossing.
Gums that are receding. This results in teeth that look longer than before.
Loose teeth
Drifting/moving teeth
Pus
Sores
Bad breath

http://www.drjamesmiller.com

2008-09-11T12:14:00.000-07:00

What is Gum Disease?

2008-09-11T11:14:00.003-07:00

Gum disease, or Periodontitis, is a common disease affecting 80% of Americans. We have all heard the term gingivitis from the toothpaste manufacturers in their marketing. Simply stated, gingivitis is inflammation of the gums. The gums are red and swollen, and usually bleed when flossing. Gingivitis is reversible, simply by brushing and flossing, the inflammation subsides. The cause of gingivits is plaque. Plaque is the accumulation of bacteria that adheres to the teeth and gums. If it is not removed (brushing and flossing) it will cause the gums to become red and swollen. Gingivitis is the first stage of gum disease.

Periodontitis is much more serious form of gum disease. Periodontitis not only affects the gums, similar to gingivitis, but also causes adverse changes in the bone that supports our teeth. Periodontitis is classified by the severity of the disease, mild, moderate, advanced. This type of gum disease is caused by a multitude of different factors, including bacteria, genetics, immune system, systemic disease (ie. diabetes). Gum disease usually advances slowly and often asymptomatically, often taking several years before the patient is aware of any changes. Periodontal disease causes bone loss, reducing the support for the teeth. As the bone is lost, it produces a space between the tooth and gum called a "periodontal pocket". In normal health, the measurement between the tooth and gum is 3mm or less. With gum disease, pocket depths range from 4mm to 12mm or more. These "pockets" make it virtually impossible for people to properly remove the bacteria. This allows the bacteria to have virtual party as they can live and thrive in this environment, which in turns hastens the progression of the gum disease. If untreated, more and more bone loss occurs and eventually the teeth can get loose and possibly fall out.