Non-surgical Periodontal Therapy

KatieM

Katie Moynihan, BS RDH

Non-surgical Periodontal Therapy

If your hands bled when you washed them, you would be concerned. However, many people think it is normal if their gums bleed when they brush or floss. False! Inflammation and bleeding are early signs that your gums are infected with bacteria. If not treated quickly and properly, those early signs of gingivitis may lead to a more serious infection called periodontal disease.

Periodontal disease affects the supporting tissues around the teeth including the gums, the periodontal ligament, and the bone. As the plaque in your mouth spreads and accumulates below the gum line, the toxins within that plaque infect and break down the “foundation” that hold your teeth in place. If not treated with periodontal therapy, the disease will only get worse and tooth loss may occur.

In the presence of periodontal disease, a “regular” prophylaxis cleaning can NOT be completed. The definition of prophylaxis is the prevention of disease. Once periodontal disease is diagnosed, your dentist and dental hygienist will recommend non-surgical periodontal therapy. Non-surgical periodontal therapy is also referred to as scaling and root planing, or a deep cleaning. Scaling and root planing involves thoroughly removing the plaque and calculus (tartar) that resides above and below the compromised gums. Smoothing the tooth roots allows a clean surface for tissue re-attachment and pocket reduction. Local anesthetic is recommended to make this procedure comfortable and painless for the patient. The goal for non-surgical periodontal therapy is to treat and eliminate the active infection, reduce periodontal pocketing around teeth, prevent further bone loss. The shallower the pockets are around your teeth, the easier they are to keep clean and healthy! When periodontal health is achieved, your oral health care provider will recommended more frequent periodontal maintenance cleanings every 3-4 months to keep tissues healthy and stabilized. In few circumstances where periodontal health cannot be achieved, a referral to a Periodontist may be recommended for further treatment.

Signs & Symptoms of Gum Disease:

  • Swollen, red, tender or bleeding gums
  • Gums that recede or move away from the tooth
  • Persistent bad breath or bad taste in mouth
  • Pain/sensitivity when chewing
  • Loose teeth
  • Visible pus surrounding the teeth and gums

You can prevent periodontal disease by practicing good oral hygiene and visiting your dentist regularly for professional cleanings. In recent years, gum disease has been linked to overall health problems. You can read more about those on Andra’s recent blog post Oral Health: A Window to your Overall Health! Remember, taking care of your oral health is an investment in your overall health.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

www.perio.org

www.colgate.com

What is Calculus?

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Lora Cook, RDH

What is calculus and what dangers does it cause to the health of your mouth.

Calculus or tartar, same thing is calcified plaque.  Plaque is the soft sticky film that will start to form twenty minutes after you brush your teeth.  Another name for the soft sticky plaque is biofilm.  This is basically a bacteria that grows in your mouth, a “slime layer”.  Plaque is white or pale yellow soft, sticky, slimy stuff.  This is what makes your teeth feel “fuzzy” when you first wake up and at the end of a long day.  So do all these pleasant descriptions make you want to go brush your teeth yet?

So where does calculus come from?  Calculus is calcified plaque.  When plaque is allowed to stay hiding in your mouth for twenty-four hours or more is has the opportunity to harden and turn into tartar. Calculus/Tartar, same thing, this is calcified plaque. Once this soft sticky substance (biofilm) becomes hard it will attach itself to the tooth surface, then you will not be able to remove it yourself with your tooth brush or your floss. Calculus will form above and below your gum tissue.

The calculus will be a physical irritant to your gum tissue, causing inflammation.  The calculus also becomes a source that harbors bacteria that causes harm to the tissue and bone around the teeth.  This aggressive bacteria may lead to periodontal disease. What is periodontal disease?  In short, it is bone loss around the teeth.  This bone loss may range from slight to moderate, to severe.  Some people will build up tartar more quickly than others, and some people are more prone to the bacteria that causes periodontal disease (bone loss).

So this brings the questions; What can I do to prevent calculus build up?

USE AN ELECTRIC TOOTHBRUSH: electric tooth brushes have been proven to be more effective at cleaning than manual brushes. Use the rechargeable electric brushes, not the battery spin brushes.

CHANGE YOUR TOOTHBRUSH EVERY THREE MONTHS: Do not go longer than three months with the same tooth brush or tooth brush head.  Once the bristles start to wear out they cannot do a good job for you.

TIME YOUR BRUSHING ROUTINE: Brush for at least two minutes, preferably two to three minutes.  Sometimes just adding more time to your routine can make a big difference, most people will brush for only forty to sixty seconds. So try timing yourself, you will be surprised.  Two minutes feels like forever when you are brushing.

FLOSS DAILY: You don’t have to floss two times daily, once a day is sufficient. Make flossing part of your nightly routine.  Flossing techniques are important, because some techniques are more effective than others. It is important to floss under the gum tissue where everything likes to hide, not just in between the teeth.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.colgate.com/en/us/oc/oral-health/conditions/plaque-and-tartar

https://www.quora.com/Does-tartar-cause-gum-disease-purely-through-MECHANICAL-means/

Oral Health: A Window to your Overall Health

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Andra Mahoney, BS RDH

Oral Health: A Window to your Overall Health

Many people are realizing that there is a direct connection between oral health and total body health.  It is finally being generally accepted that oral health and general health are to be interpreted as one entity, not separate as has been the view in the past.  Dentists has been saying this for years, and finally science is proving them right! You cannot be healthy without good oral health.

“The mouth can act as a portal of entry for infection, ” says Salomon Amar, DMD, PhD, Professor and Director at the Center for Anti-Inflammatory Therapeutics at Boston University School of Dental Medicine.  “Ongoing inflammation in your mouth can allow bacteria to enter the bloodstream, which may lead to more inflammation in other parts of your body, such as the heart.”

What conditions may be linked to oral health?

Your oral health might affect, be affected by, or contribute to various diseases and conditions, including:

Endocarditis. Endocarditis is an infection of the inner lining of your heart (endocardium). Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart.

Cardiovascular disease. Some research suggests that heart disease, clogged arteries, and stroke might be linked to the inflammation and infections that oral bacteria can cause.

In 2005, the NIH funded a study on this topic. They randomly selected 1,056 participants with no prior heart attacks or strokes.  All were evaluated for levels of periodontal bacteria.  After removing the effects of the other risk factors of age, gender, and smoking, Moise Desvarieux, MD, PhD, Associate Professor of Epidemiology at the Mailman School and lead author of the study stated, “It was found that there was an independent relationship between gum disease and heart disease.” One theory about why this may occur is that small amounts of bacteria enter your bloodstream while you’re chewing. “Bad” bacteria from an infected mouth may lodge itself inside blood vessels, ultimately causing dangerous blockages. Strengthening his theory is the fact that when scientists have looked at atherosclerotic blood vessels, they have sometimes found fragments of periodontal bacteria. Meanwhile, a study published in the New England Journal of Medicine in 2007, established that aggressive treatment of gum disease reduces the incidence of atherosclerosis within six months.

It has been found that up to 91% of patients with heart disease have periodontitis. “The theory is that inflammation in the mouth causes inflammation in the blood vessels,” says Sally Cram, DDS, PC, Consumer Adviser for the American Dental Association. “This can increase the risk for heart attack in a number of ways. Inflamed blood vessels allow less blood to travel between the heart and the rest of the body, raising blood pressure. There’s also a greater risk that fatty plaque will break off the wall of a blood vessel and travel to the heart or the brain, causing a heart attack or stroke.”

Pregnancy and birth. Periodontitis has been linked to premature birth and low birth weight.

Scientists believe that gum disease or inflammation in the mouth possibly triggers an increase in a chemical compound called prostaglandin, which induces early labor. While this theory has not yet been confirmed, a 2001 study found that pregnant women who develop gum disease between weeks 21 and 24 of their pregnancy are four to seven times more likely to give birth before week 37. There is evidence that poor gum health in the extreme can lead to low birth weight as well.

Babies born too early or at a low birth weight often have significant health problems, including lung conditions, heart conditions, and learning disorders. While many factors can contribute to premature or low birth weight deliveries, infection and inflammation in general seem to interfere with a fetus’ development in the womb.

Though men have periodontitis more often than women do, hormonal changes during pregnancy can increase a woman’s risk. For the best chance of a healthy pregnancy, Pamela McClain, DDS, President of the American Academy of Periodontology, recommends a comprehensive periodontal exam, “If you’re pregnant or before you become pregnant, identify whether or not you’re at risk.”

Diabetes. Diabetes reduces the body’s resistance to infection which puts the gums at risk.

Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels.  Researchers at Columbia University’s Mailman School of Public Health followed 9,296 non-diabetic participants, measuring their level of periodontic bacteria over the course of 20 years. “We found that people who had higher levels of periodontal disease had a two-fold risk of developing type 2 diabetes over that time period compared to people with low levels or no gum disease,” explains Ryan Demmer, PhD, Associate Researcher at the Department of Epidemiology at the Mailman School and the lead author. There are a few theories about why this might be the case.  One proposes that when infections in your mouth get bad enough, it can lead to low-grade inflammation throughout your body, which in turn wreaks havoc on your sugar-processing abilities. “There are all kinds of inflammatory molecules,” says Dr. Demmer, “and it’s believed that maybe some attach to insulin receptors and prevent the body’s cells from using the insulin to get glucose into the cell.”

It has also been noted that inflammation that starts in the mouth seems to weaken the body’s ability to control blood sugar. People with diabetes have trouble processing sugar because of a lack of insulin, the hormone that converts sugar into energy.  “Periodontal disease further complicates diabetes because the inflammation impairs the body’s ability to utilize insulin,” says Dr McClain. Diabetes and periodontitis have a two-way relationship. High blood sugar provides ideal conditions for infection to grow, including gum infections. Diabetes can also slow the healing process and lower resistance to infections, including oral infections.  Fortunately you can use the gum disease-diabetes relationship to your favor: managing one can help bring the other under control.

HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.  Studies suggest that oral bacteria and the inflammation associated with periodontitis, a severe form of gum disease, might play a role in some diseases. Certain diseases, such HIV/AIDS, can lower the body’s resistance to infection, making oral health problems more severe.

Osteoporosis. Osteoporosis, which causes bones to become weak and brittle, might be linked with periodontal bone loss and tooth loss.  Osteoporosis and periodontitis have an important thing in common, bone loss. Researchers are testing the theory that inflammation triggered by periodontitis could weaken bone in other parts of the body.

Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease.
Dementia: The bacteria from gingivitis may enter the brain through either nerve channels in the head or through the bloodstream, that might even lead to the development of Alzheimer’s disease.

Pneumonia. A 2008 study of elderly participants found that the number who developed pneumonia was 3.9 times higher in patients with periodontal infection than in those free from it. “The lungs are very close to the mouth,” says Marsha Rubin, DDS, practicing Diplomat of Special-care Dentistry at New York-Presbyterian/Weill Cornell. “Even in a healthy mouth there is lot of bacteria, but bacteria in a not-healthy mouth can get aspirated into the lungs, causing pneumonia or aggravating COPD, chronic obstructive pulmonary disorder.” Several intervention studies cited by the CDC show that an improvement in oral health can lead to a reduction in respiratory infection.  Periodontal disease may make pneumonia and chronic obstructive pulmonary disorder worse, possibly by increasing the amount of bacteria in the lungs.

Pancreatic Cancer. A study published in 2007 in the Journal of the National Cancer Institute surveyed 51,529 American men about their health every two years between 1986 and 2002. Of the 216 participants who developed pancreatic cancer, 67 of them also had periodontal disease. Independent of the participants’ smoking status, the study found that having a history of periodontal disease was associated with an increased risk of pancreatic cancer. This, according to the study, could be because of systemic inflammation or increased levels of carcinogenic compounds produced in the infected mouth. Interestingly, another viable theory about why gum disease may cause type 2 diabetes points to damage to the pancreas as well. “With the pancreatic cancer study, we thought it was very interesting that you have this localized infection that has an impact on a systemic organ that is very intimately tied to the pathophysiology of diabetes,” says Dr. Desvarieux.

Cancer.  Your dentist and hygienist should screen for oral cancer and other cancers of the head and neck, including skin cancer, cancer of the jaw bone, and thyroid cancer, during routine checkups. He or she feels for lumps or irregular tissue changes in your neck, head, cheeks and oral cavity, and thoroughly examines the soft tissues in your mouth, specifically looking for any sores or discolored tissues. Survival rates greatly increase the earlier oral cancer is discovered and treated. During your next dental visit, ask your dentist to do an oral cancer screening. See your dentist immediately if you observe:

Any sore that persists longer than two weeks

A swelling, growth, or lump anywhere in around the mouth or neck

White or red patches in the mouth or on the lips

Repeated bleeding from the mouth or throat

Difficulty swallowing or persistent hoarseness

Scientists aren’t sure of the exact cause of oral cancer. However, the carcinogens in tobacco products, alcohol and certain foods, HPV infections, as well as excessive exposure to the sun, have been found to increase the risk of developing oral cancer. Risk factors for oral cancer may also be genetically inherited. You can help prevent oral cancer by:

Not smoking or using spit tobacco

Limiting your alcohol intake

Eating plenty of fruits and vegetables

Also, periodic self-examinations can increase your chances of detecting oral cancer, so be sure to examine your face, cheeks, jaw and neck regularly for any changes or lumps.

Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome, an immune system disorder that causes dry mouth, and eating disorders.

Because of these potential links, be sure to tell your dentist if you’re taking any medications or have had any changes in your overall health, especially if you’ve had any recent illnesses or you have a chronic condition, such as diabetes.

How can I protect my oral health?

To protect your oral health, practice good oral hygiene every day. For example:

Brush your teeth at least twice a day.

Floss daily.

Eat a healthy diet and limit between-meal snacks.

Replace your toothbrush every three to four months or sooner if bristles are frayed.

Schedule regular dental checkups.

Also, contact your dentist as soon as an oral health problem arises. It is important to let your dentist know your full family medical history. If you have periodontal disease, make sure you see your dentist frequently and get it treated promptly, before it progresses to the point where you begin losing teeth or it starts to affect your overall health.  Remember, taking care of your oral health is an investment in your overall health.

One thing is clear: the body and mouth are not separate. Your body can affect your mouth and likewise, your mouth can affect your body.  Taking good care of your teeth and gums can really help you live well longer.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/sgr/part1.htm

http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475

https://www.deltadentalins.com/oral_health/connection-oral-health.pdf

http://www.colgate.com/en/us/oc/oral-health/conditions/gum-disease/article/sw-281474979066921

http://www.everydayhealth.com/dental-health/101.aspx

http://www.webmd.com/oral-health/features/oral-health-the-mouth-body-connection

http://www.webmd.com/oral-health/features/oral-health-affects-wellness

 Periodontal Disease and Diabetes 

PeggyS

Peggy Stoor, RDH

 Periodontal Disease and Diabetes

Recently much has come to light regarding oral health and its impact on systemic health and disease. While I’ve always been borderline fanatic about oral health and have been aware of some of these relationships, the recent research connecting oral health to systemic health has helped to make my daily work much more relevant and interesting.

Presently there are 18 million diabetic patients in the U.S. and 171 million diabetic patients worldwide. Diabetes is characterized by increased susceptibility to infection, poor wound healing, and a number of complications that can affect quality of life and length of life.  Diabetes is also a risk factor for severe periodontal disease (the destruction of tissues and bone that support the teeth). It’s critically important to realize that diabetics who have periodontal or gum disease have two chronic conditions, each of which affect the other.

periodontitis-300x195

While we have long known that diabetes can predispose one to periodontal disease, research now suggests that treatment of periodontal disease can have a positive impact on the diabetic condition.  Patients with periodontal disease have more difficulty controlling their blood sugar. Patients who have treatment and gain control of their gum disease have been shown to require less insulin and have a decreased hemoglobin A1c level. (A1c denotes a patients average blood sugar level over the past 3 months). In other words, periodontal disease and diabetes is a two-way street with each disease having a potential impact on the other, either positively or negatively.

Management of gum disease in patients with diabetes involves removal of plaque and calculus both at home and professionally, and maintenance of glycemic control. Nearly all diabetics respond to treatment and maintenance, therefore treatment of periodontal disease should be done as soon as possible. Both conditions require frequent professional evaluations, patient-self monitoring, daily brushing and flossing, approved antibacterial mouth rinses, and good blood glucose control.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

Southerland, J.H. (2005.) Diabetes and periodontal infection: Making the connection. Retrieved from http://clincial.diabetesjournals.org/content/23/4/171

Diabetes and Periodontal Disease: Retrieved from http://www.perio.org,  American Academy of Periodontology, Diabetes and periodontal Disease

Diabetes and Oral Health: Retrieved from http://www.nidcr.nih.gov/OralHealth/Topics/Diabetes.National Institute of Dental and Craniofacial Research by National Institutes of Health-(2007)

Mealey, B.L. ,(2006).Periodontal disease and diabetes: A two-way street. Journal of American Dental Association. Oct.137 suppl:26S-31S. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed

Mirza,B.A., Syed A., Izhar F., Ali Khan. (2001). Bidirectional relationship between diabetes and periodontal disease: Review of evidence. J  Pak Med Assoc. Retrieved from http: http://www.ncbi.nlm.nih.gov/pubmed/21381588

Dental Care and Diabetes. http://www.webmed.com/diabetes/dental-health-dental-care-diabetes

Image Credit: http://www.intelligentdental.com/2012/03/31/effect-of-systemic-factors-on-the-periodontium-part1

What is a Periodontal Maintenance?

AriannaM

Arianna Ritchey RDH

What is a Periodontal Maintenance?

One of the terms that is commonly used by dental professionals, and also commonly misunderstood by patients, is ‘Periodontal Maintenance.’  A periodontal maintenance procedure is similar to a prophy, or general adult cleaning, but is a more involved procedure meant for patients who have periodontal disease.

Periodontal disease, or gum disease, is characterized by deep periodontal pockets, inflammation, and bone loss.  Periodontal disease is an irreversible condition which, if left untreated, may lead to further bone loss and eventually tooth loss.  In order to treat periodontal disease, a dental hygienist or dentist will likely recommend a procedure called a “deep cleaning,” also known as SRP, or scaling and root planing.  Once a deep cleaning is completed, inflammation will reduce and periodontal pockets may decrease in depth.  When the patient’s periodontal status has stabilized, the next step in the care of the teeth and gums is periodontal maintenance, or more colloquially, “perio maintenance.”

Perio_Health

Periodontal maintenance is a teeth cleaning procedure which is done at either 3, 4, or 6 month intervals, depending on the patient’s needs.  The purpose of the periodontal maintenance procedure is to maintain the level of the periodontal disease present, and to prevent it from getting any worse.  Unfortunately, bone that has been lost as a result of periodontal disease does not grow back, and as such, periodontal pockets may remain at a deeper-than-optimal level despite the initial deep cleaning therapy.  These deep periodontal pockets collect plaque and tartar, and are impossible to clean properly with a toothbrush, floss, and other dental hygiene aids.  In order to keep these periodontal pockets clean and prevent further bone loss, it is necessary to have a dental hygienist regularly perform professional cleanings.

perio probe

Periodontal maintenance involves a dental hygienist scaling and root planing some areas in order to remove irritating tartar buildup.  When a dental hygienist performs root planing, instrumentation is completed below the gumline all the way to the bottom of the periodontal pocket.  This cleaning of the root surface below the gumline is what makes a periodontal maintenance different, more involved, and potentially more costly  than a prophy, or regular cleaning.

scaling-root-planing

In patients who have deep periodontal pockets, a prophy, or general cleaning, is not beneficial, because the irritating plaque and tartar below the gumline that is causing the most irritation and loss of bone is not removed during a prophy or general cleaning.  Performing a general cleaning on a patient with periodontal disease would be similar to sweeping dirt under the rug instead of properly cleaning a floor.  The offending dirt in the case of the floor,  or the bacteria-infused-tartar in the case of the mouth, is still present and causing harm.


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As dental hygienists, our primary goal and concern is to assist patients in maintaining the healthiest oral cavity possible.  Providing periodontal maintenance treatments for our patients who have periodontal disease at 3, 4, or 6 month intervals, along with the patient’s good oral hygiene care at home, is the best way to work towards a stable periodontal health status and to help our patients from experiencing bone and tooth loss.

perfect-smile

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources

http://jdh.adha.org/content/82/suppl_2/16.refs

http://www.rdhmag.com/articles/print/volume-0/issue-9/columns/staff-rx/prophy-vs-perio-maintenance.html

https://www.deltadental.com/Public/Study/StudyPerio.jsp

What Is Calculus Exactly?

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Wendy Parker RDH

 

Ever heard your hygienist use the words, “build up” or “calculus” while they were cleaning your teeth? Ever wondered what that was, exactly, or what they were talking about?

Growing up, most of us heard about plaque and the importance of removing it daily, but nowadays we hear about bioflim and calculus.  What is this all about? Well, my friends, read on and you’ll find out.

In the dental world, dental plaque has been changed to the term “Biofilm.”It is a more accurate term than plaque. It is more than just the soft fuzzy stuff on your teeth.  Biofilm is everywhere in our surroundings and can form on just about anything. Ranging from clogged drains, to slippery coated rocks, and in your mouth. Biofilm is bacteria’s home. Millions of bacteria stick together in biofilm which adheres to surfaces in moist environments. Biofilms excrete a slimy glue-like substance that sticks to all kinds of materials, including your teeth! Dental plaque IS the yellowish biofilm that builds up on teeth and is composed of a complex baterial community that causes gingivitis, in the mild form, cavities, and periodontal disease, in the more advanced cases.

 staphylococcus_aureus_biofilm_01_cmyk

Typically, you can remove this biofilm, a.k.a. plaque, with your fingernail in the early stages where it still feels like the soft fuzz-like feeling on your teeth.

However, within 48 hours, if undisturbed, it begins to harden and causes gingivitis (inflammation of the gum tissues).

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     If still undisturbed, about 10 days later, it becomes calculus (a.k.a. tartar), which is difficult to remove.  But don’t worry, we know a few good hygienists that can take care of that for you!

If, by some chance, the calculus stays there for a long period of time, the bacteria that is making it’s home in your mouth, then begins to affect the surrounding tissues, causing periodontal disease (bone and gum disease).

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     So now that we KNOW what and how we get biofilm and calculus, how do we get rid of it?  The solution is something that we already know and that we have been hearing from the beginning of time.  There is no new shocking treatment, but it’s simple…you have to disrupt the bacteria from forming in your mouth and the best way to do this is to brush twice a day, floss once a day, and see your dentist/hygienist regularly.  If you wear some kind of appliance at night, like a nightguard or retainer, be sure you are brushing it and soaking it regularly.  Be sure to let us help you with any issues or needs you have to keep your smile working for you!

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.colgateprofessional.com/patient-education/articles/what-is-biofilm

http://en.wikipedia.org/wiki/Dental_plaque

http://www.dujs.dartmouth.edu

http://www.meadfamilydental.com

www.johngoodmandds.net

www.clipartbest.com

Hydrogen Peroxide

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Lora Cook RDH

 Is Using Hydrogen Peroxide as a Mouth Rinse Safe?

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Many commercial mouth washes and whitening strips have hydrogen peroxide as one of the key active ingredients. However many are using straight hydrogen peroxide as a mouth wash to kill germs. Is this a safe and effect practice?

Hydrogen peroxide is compose of water and oxygen that works to kills germs and bacteria, and helps to whiten teeth.  It comes in either 1% or 3% concentrations. You can even see it in action!  When it foams in your mouth you know that it is working at killing bacteria.  It also can be used to clean your night guard, retainers, or even soak your tooth brush in.  Best of all it is inexpensive. 

 However this is not the magic cure all, there are some strong precautions that I would like to share with you.  While there are many benefits it can be harmful on gum tissue if used in too strong a solution or too long.  It is very drying to the tissues. This will also work to kill good bacteria in the mouth.  This will leave opportunity for yeast infections of the mouth to flourish, also called thrush.  Candidiasis is a fungal or yeast infection of the mouth or throat. Candida yeast that normally live in the mucosa membrane will flourish causing a over growth of candida, commonly called yeast infections. 

This can be a relatively safe practice by following a few guidelines; dilute peroxide with 50% water, and do use every day.  If you are one of the many people who suffer from dry mouth stick with a over the counter rinse formulated for dry mouth sufferers. 

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.using-hydrogen-peroxide.com/hydrogen-peroxide-as-mouthwash.html

http://copublications.greenfacts.org/en/tooth-whiteners/l-3/6-tooth-whitening-side-effects.htm

http://www.healthline.com/health/thrush#Symptoms4

The Link Between Mouth and Body-Exploring Possible Links

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Lindsay Whitlock RDH

 

oral-perio-systemic

The oral cavity is recognized as a portal of entry for many infections that affect overall health; including both physical health and emotional health. Among these infections are two leading widespread dental diseases: caries (decay) and periodontal disease (gum disease). The consequences of decay in the oral cavity and periodontal diseases are profound and often times underestimated in context of their negative impact on one’s physical health. More studies are needed but some researchers suspect that bacteria and inflammation linked to periodontal disease play a role in some systemic diseases and or conditions. Research suggests that although periodontal disease starts as a local infection in the mouth, it is generally accepted that associated bacteria and toxins gain access to the body’s blood supply and travel throughout the body. This creates a systemic inflammatory response, which may increase the risk for: heart disease, pneumonia, and complications of diabetes and pregnancy. Although periodontal disease may contribute to these health conditions, it is critical to understand that just because two conditions occur at the same time does not necessarily mean one condition is the cause for another. Researchers are continuing to work hard to examine the affects of when periodontal disease is treated within individuals suffering with these various health problems.

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Periodontal Disease – What You Should Know

Periodontal disease is a chronic infection within the oral cavity caused by bacteria. It begins when specific bacteria in dental plaque produce harmful toxins and enzymes that irritate the gums. An inflammatory response occurs if dental plaque is not removed on a daily basis. Plaque that remains on teeth over a short period of time can irritate the gums making them red and likely to become tender and bleed. This condition is called gingivitis, which can lead to more serious types of periodontal diseases. Gingivitis can be reversed and gums kept healthy by removing dental plaque daily with oral hygiene routine as well as having your teeth professionally cleaned.

If gingivitis is allowed to persist, it can progress to periodontitis (periodontal disease), a chronic disease in the pockets around the teeth. Inflammation that results may be painless however, it can damage the attachment method of gum tissue and bone to the teeth. Consequently advanced periodontitis is linked with other health problems such as cardiovascular disease, stoke and bacterial pneumonia. Left untreated, teeth may eventually become mobile, fall out, or require removal by a dentist.

Given the link between periodontal disease and the systemic health problems, prevention is a critical step in maintaining overall health.

1. Brush your teeth twice a day for two minutes.

2. Clean between teeth with floss or another type of interdental cleaner once a day.

3. Eat a balanced diet and limit snacks.

4. Schedule regular dental checkups as recommended by your dental hygienist or dentist.

5. Tell your dentist about changes in your overall health.

Click this link that is presented by Listerine and Reach to watch a video further explaining the link between periodontal disease and our bodies.

https://www.youtube.com/watch?v=m-BGfwCoJJA

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Images:

http://www.richmondinstitute.com/significance-behind-the-oral-systemic-connection

http://www.cvlsmiles.com/images/figure_2.jpg

http://smilesbygoh.com/wp-content/uploads/2013/11/human.jpg

Health and Nutrition

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Julie West BS RDH 

Statistics from the World Health Organization show that up to 93% of diabetes, 81% of heart disease, 50% of strokes, and 36% of all cancers could be prevented by a healthy diet and lifestyle.  We have all heard of fad diets and medications that claim to slim you down in weeks, but have you looked at the asterisk on the bottom of your television screen during their commercials?  You will see that the testimonials you are seeing are from “results not typical” and have occurred in less and 5% of the people who took that particular diet plan or pill.  The best weight loss experts will tell you that there is no shortcut to being healthy.  Diet and exercise are essential in establishing and maintaining health.

Obesity is increasing in prevalence and is a major contributor to worldwide morbidity.  As obesity in this country rises, are we surprised that the prevalence of heart disease, diabetes, cancer, and other diseases rises too?  One of the dangers in obesity is due to a prolonged state of inflammation in the body.  Inflammation is the first response of the body to injury, cell damage, infection, or irritants.  Inflammation that is chronic and unresolved can lead to:

  • Rheumatoid Arthritis
  • Periodontal Disease
  • Diabetes
  • Cardiovascular Disease
  • Asthma
  • Cancer

Fat cells produce hormones and proteins that cause inflammation and insulin resistance, which promote cell growth.  Overweight people have high levels of substances circulating in their blood that stimulate cell division. The more often cells divide, the more opportunity there is for cancer to develop.  To help lower your risk for cancer, it is important to know how much inflammation is present inside your body.

At your next visit to your doctor, ask for a blood workup with a screening of your C-reactive protein, a protein made by the liver when there is inflammation in the body.

Inflammation also often manifests in the mouth.  If you have one or more of the above diseases, inflammation may be the underlying factor.  At your next dental visit, ask your dental hygienist if there is inflammation in your mouth.  Your dental hygienist can provide great information about the inflammation process and its effects on the body.

 

Source:

Brand-Miller J, et al. Cur Opin Lipidol 2012, 23(1): 62-7

Low Dog, MD. (February 2014). Cancer and Nutrition in the 21st Century. Western Regional Dental                    

Convention.  GC America, Phoenix, Arizona.

 

Tooth Brushes!!

Karen

Karen Kelly RDH

As a dental hygienist, one of my most frequently asked questions is, ‘There are so many toothbrushes, which one should I use or should I just switch to an electric toothbrush?’.  My response is, first, always use a SOFT name brand toothbrush (I know stores sell medium and even hard toothbrushes but don’t buy them!!) and second to make sure you are brushing correctly at least 2 times daily and brushing for at least 2 minutes.  When I say correctly, I mean to aim the toothbrush up into the gums at a 45 degree angle.

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 Properly angled brushing

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Unhealthy vs. healthy gum tissue

I see lots of people who do brush their teeth, but since they don’t actually brush along the gumline, their gums are red and puffy.  So, brush the gums like you are giving them a massage; use little back and forth or circular motions.  Don’t use long scrubbing strokes, it is abrasive!  Then floss and/or use an interdental cleaner of some kind each and every day.  No matter how good a toothbrush is and how good someone brushes, it’s impossible to get in between the teeth clean with just a brush.  Also, change your brush often!  When the bristles begin to flare out or it’s been 3 months, change it, it makes a difference to use a new brush.

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                        If your brush looks like this, throw it out!                

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 A brand new SOFT toothbrush

If you brush really well with a manual toothbrush, you probably won’t see that much of a difference if you were to switch to an electric toothbrush.  The problem is, many people don’t clean their teeth that well with a manual toothbrush so that’s where the electric toothbrush can really help.  We recommend 2 brands of the electric brushes, the Sonicare and the Oral-B Braun.  These are not the battery powered toothbrushes, these brushes plug into the wall and have a rechargeable battery.  They just have so much more brushing action than a manual toothbrush that even if you aren’t that great of a brusher, you can do an excellent job if you use one of these brushes daily.  In a recent study conducted by the National Institute of Health, they stated, “The subject group using the powered toothbrush demonstrated clinical and statistical improvement in overall plaque scores. Powered toothbrushes offer an individual the ability to brush the teeth in a way that is optimal in terms of removing plaque and improving gingival health, conferring good brushing technique on all who use them, irrespective of manual dexterity or training.”(1)  In another study, “the Sonicare DiamondClean toothbrush was found to be safe and significantly superior to a manual toothbrush in reducing gingivitis, sites of gingival bleeding and plaque over time.  DiamondClean reduced gingivitis and gingival bleeding sites up to two times more and removed up to four times more plaque than a manual toothbrush after four weeks of use.”(2)   Sonicare also states that their ‘DiamondClean toothbrush effectively removed extrinsic tooth stain within one and two weeks of use, and it was significantly superior to a manual toothbrush at both one and two week checks.'(3)  On the Oral B website, they state that their Professional Precision 5000 toothbrush has produced these results:  34% less gingival bleeding at 6 months vs. a regular manual toothbrush and 29% lower gingival bleeding scores at 3 months vs. Sonicare® FlexCare (4)

It is still important to use the powered toothbrush 2 times daily for at least 2 minutes and allow the toothbrush to clean along the gumline.  If you have an electric toothbrush but it mostly sits on your counter, that doesn’t count when we ask if you use an electric toothbrush!

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Philips Sonicare DiamondClean

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                                                     Oral-B® Professional Precision 5000

Electric toothbrushes come in many different models and prices.  Take a look at a store like Target or Walgreens, they have lots of choices so you can find one that will fit your budget and taste.  We carry our favorite electric brushes and replacement brush heads in our office as well, and we are happy to answer any questions you might have about toothbrushes.  I like to answer questions about brushes so much that I go to Target and walk up and down the dental isle just so I can give advice to shoppers!!

So, remember what I tell my younger patients:  2 times a day for 2 minutes.  It’s easy to do and easy to remember!

Karen Kelley  R.D.H.

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 Just some fun photos to make you smile!

 

1.  http://222.ncbi.nlm.nih.gov/pubmed/23674927

2.  http://sonicare.com/professional/en_AU/pdf/Gingival_DC_2011_Milleman.pdf

3.  http://staging1.microsites.ce.philips.com/DP_AU_EN_3_3_Orc2/pdf/Stain_DC_2010_Colgan.pdf

4.   http://www.dentalcare.com/en-US/oral-b-crest-professional-products/category/electric-toothbrushes/oralb-5000-professional-trial.aspx

Image Sources

http://www1.macys.com/shop/product/sonicare-hx9332-diamondclean-rechargeable-electric-toothbrush?ID=827710

http://www.webmd.com/oral-health/proper-angle-for-brushing-your-teeth

http://www.impledent.com/patient-services/teeth-dental-cleanings/

http://blog.sciencemuseum.org.uk/talkscience/2011/10/27/wonderful-things-more-than-meets-the-eye/

http://www.oralb.com/products/pro-health-gentle-clean/

http://www.oralb.com/products/professional-care-smart-series-5000/?utm_source=google&utm_medium=cpc&utm_term=%2Boralb%20%2B5000&utm_campaign=Oral-B_Search_Desktop_Brand+Awareness_Power|ProfessionalCare+SmartSeries+5000&utm_content=sGVAVXD2P|dc_21461550775_b_%2Boralb%20%2B5000

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