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
Thursday, February 24, 2011
Tuesday, February 22, 2011
Study links acute myocardial infarction and perio disease
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
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
Tuesday, January 18, 2011
What Your Mouth is Telling You
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
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
Monday, January 17, 2011
Breast Cancer and Periodontal Disease
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
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
Thursday, January 13, 2011
Gum Disease
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
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
Thursday, December 30, 2010
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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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
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.
Recommended Related to Oral Health
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
Wednesday, December 29, 2010
Sex Hormones May Explain Higher Incidence of Periodontal Disease in Men
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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.
--------------------------------------------------------------------------------
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.
Email or share this story:
More
--------------------------------------------------------------------------------
Story Source:
The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Maryland Baltimore.
--------------------------------------------------------------------------------
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
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.
--------------------------------------------------------------------------------
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.
Email or share this story:
More
--------------------------------------------------------------------------------
Story Source:
The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Maryland Baltimore.
--------------------------------------------------------------------------------
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
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