Our dental practice has more over 50 year olds than under 50. As aging adults, we need to be aware of certain things that can keep us from retaining our teeth our entire lives.
Judith Ann Jones, DDS, a spokesman on elder care for the American Dental Association and director of The Center for Clinical Research at the Boston University Goldman School of Dental Medicine spoke about 5 things that are especially important to the over 50 crowd.
Tooth Decay: Contrary to what many people believe, adults keep getting cavities! I’m always surprised when people are stunned to learn they have a cavity as an adult. Areas of the teeth that have never had a cavity can decay, but areas where we see more problems are where an old filling is leaking and at the base of an older crown. The best prevention is brushing well each day along the gumline. An electric toothbrush is very helpful in accomplishing this as well as the use of fluoride. An over the counter fluoride rinse nightly is great and in our office we have special prescription strength fluoride that is wonderful for cavity prevention as well as help with sensitivity.
Dry Mouth: Keeping Your Teeth For a Lifetime We see so many people with this problem. “Saliva protects our teeth. The calcium and phosphate present in saliva prevent demineralization of your teeth”, Jones says. Many drugs cause dry mouth as well as some diseases and as we get older, we are on more medications thus we see this commonly in older adults. This is a difficult one to deal with for those affected. The best thing is to drink lots of water, use saliva substitute and try xylitol products. Also, if you smoke, stop, it just makes your mouth drier.
Gum Disease: If your gums are swollen, red, or bleed easily, you have gum disease. If left untreated, gum disease (gingivitis) will become more serious and will cause deterioration of the bone that holds the teeth, we call this periodontitis. If this condition continues without treatment, it can cause the loss of the teeth. The best way to prevent gum disease is to clean your teeth well each day with brushing, flossing, and use of interdental cleaners like soft picks or go betweens. And of course, seeing your friendly dental hygienist as often as recommended. We can remove the mineralized bacteria from your teeth that you can’t remove with brushing.
Tooth Crowding: “As you age, your teeth shift”, according to Lee W. Graber, D.D.S., M.S, Ph.D., Past President of the American Association of Orthodontists. And “that can be problematic, not because you’ll look different, but because it can make your teeth more difficult to clean, leading to more decay. It’s also of concern because misaligned teeth can lead to teeth erosion and damage to the supporting tissue and bone”, Graber says. “Add to that the tendency of older adults to have periodontal disease, and you could end up losing your teeth even faster.” If your teeth have really shifted, and you find you are having a difficult time keeping your teeth clean and food keeps getting caught in certain areas, ask our doctors about orthodontics. We offer Invisalign to our patients and we’ve had patients in their later years choose to straighten their teeth. I just finished with my invisalign treatment. I had braces when I was a teenager but my teeth had shifted and I was experiencing these problems I just mentioned. I decided to do Invisalign. It’s easy to do and my teeth are so much straighter. They are now in the correct alignment and my teeth and gums will be healthier. If you choose not to do orthodontics, more frequently exams and cleanings may be necessary.
Oral Cancer: According to The Oral Cancer Foundation, more than 43,000 Americans will be diagnosed with oral cancers this year, and more than 8,000 will die from it. “Oral cancer incidence definitely increases as you get older”, Jones says, and “is very often linked to smoking and heavy alcohol use.” Jones also said, “Only about half of people who develop oral cancer survive the disease.” If discovered early, there is an 80 percent chance of surviving for five years. When we do your periodic exams when you come in for your cleaning, you will be checked for oral cancer. We also offer Velscope, Identafi, or Oral ID technologies to help in finding oral cancer earlier.
Keep brushing, flossing and smiling! We want to help you keep your teeth healthy your entire lives!
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.
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.
What do brushing and flossing have to do with diabetes? Plenty. If you have diabetes, here’s why dental care matters — and how to take care of your teeth and gums.
When you have diabetes, high blood sugar can take a toll on your entire body — including your teeth and gums. The good news? Prevention is in your hands. Learn what you’re up against, and then take charge of your dental health.
Cavities and gum disease
Whether you have type 1 diabetes or type 2 diabetes, managing your blood sugar level is key. The higher your blood sugar level, the higher your risk of:
Tooth decay (cavities). Your mouth naturally contains many types of bacteria. When starches and sugars in food and beverages interact with these bacteria, a sticky film known as plaque forms on your teeth. The acids in plaque attack the hard, outer surface of your teeth (enamel). This can lead to cavities. The higher your blood sugar level, the greater the supply of sugars and starches — and the more acid wearing away at your teeth.
Early gum disease (gingivitis). Diabetes reduces your ability to fight bacteria. If you don’t remove plaque with regular brushing and flossing, it’ll harden under your gumline into a substance called tartar (calculus). The longer plaque and tartar remain on your teeth, the more they irritate the gingiva — the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily. This is gingivitis
Advanced gum disease (periodontitis). Left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support your teeth. Eventually, periodontitis causes your gums to pull away from your teeth and your teeth to loosen and even fall out. Periodontitis tends to be more severe among people who have diabetes because diabetes lowers the ability to resist infection and slows healing. An infection such as periodontitis may also cause your blood sugar level to rise, which makes your diabetes more difficult to control. Preventing and treating periodontitis can help improve blood sugar control.
Proper dental care
To help prevent damage to your teeth and gums, take diabetes and dental care seriously:
Make a commitment to managing your diabetes. Monitor your blood sugar level, and follow your doctor’s instructions for keeping your blood sugar level within your target range. The better you control your blood sugar level, the less likely you are to develop gingivitis and other dental problems.
Brush your teeth at least twice a day. Brush in the morning, at night and, ideally, after meals and snacks. Use a soft-bristled toothbrush and toothpaste that contains fluoride. Avoid vigorous or harsh scrubbing, which can irritate your gums. Consider using an electric toothbrush, especially if you have arthritis or other problems that make it difficult to brush well.
Floss your teeth at least once a day. Flossing helps remove plaque between your teeth and under your gumline. If you have trouble getting floss through your teeth, use the waxed variety. If it’s hard to manipulate the floss, use a floss holder.
Schedule regular dental cleanings. Visit your dentist at least three times a year for professional cleanings.
Make sure your dentist knows you have diabetes. Every time you visit your dentist, remind him or her that you have diabetes. Make sure your dentist has contact information for your doctor who helps you manage your diabetes.
Look for early signs of gum disease. Report any signs of gum disease — including redness, swelling and bleeding gums — to your dentist. Also mention any other signs and symptoms, such as dry mouth, loose teeth or mouth pain.
Don’t smoke. Smoking increases the risk of serious diabetes complications, including gum disease. If you smoke, ask your doctor about options to help you quit.
Managing diabetes is a lifelong commitment, and that includes proper dental care. Your efforts will be rewarded with a lifetime of healthy teeth and gums.
John, the patient, is taken back to the dental operatory for his dental cleaning appointment. The dental hygienist reviews John’s chart, his medical history, and John addresses any concerns he has in his mouth. The hygienist lays John back in the chair. John cringes, as he sees the hygienist holding a pointy tool in her hand. She informs him, “John, I am going to take a few measurements around each tooth, to assess how healthy your gums, and bone levels are.” John opens his mouth, and thinks to himself “I wonder if this going to hurt?” “What is she even doing with that tool anyways?”
Prior to becoming a dental hygienist, I too was like John. I did not understand what that “pointy” tool was, or why it needed to be used. With this blog post, I would like to briefly educate my dental patients of what a periodontal probe is, and why it is utilized in the dental office.
That pointy tool the hygienist uses at the beginning of a dental appointment is called a periodontal probe. The periodontal probe is marked in millimeter increments, which is used to evaluate the health of the patient’s gum, and surrounding bone levels of the jaw, with little to NO discomfort!
Each of your teeth are sitting in jawbone. Additionally, each tooth is surrounded by gum tissue (gingiva). To simplify this concept, your gums surround each tooth like a turtleneck sweater.
There is a natural space of pocket between the gum and tooth. The periodontal probe is used to measure this pocket depth, at each dental appointment.
In health, the tooth is surrounded by a gum pocket depth of 1-3 mm (No bone loss of the jaw bone).
If gingivitis is present (Swollen gums-no bone loss of the jaw bone) the tooth is surrounded by a 4 mm. pocket depth.
A periodontal pocket (Mild-Advanced periodontitis) is present when the space between the tooth and gum has been deepened by disease and bone loss. A 5-12 mm pocket depth surround the tooth or teeth.
The next time you are in the dental chair, feel free to ask your dentist or dental hygienist your latest periodontal probing scores. If you have never had these measurements taken before, call our office today and schedule a new patient exam, to determine the health of your mouth!
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.
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.