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Conditions

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Periodontal Disease

Periodontal (gum) disease is a leading cause of tooth loss and may be associated with other chronic diseases, including diabetes and heart disease.  Until recently it was thought that bacteria was the common link between periodontal disease and systemic diseases in the body.  Current research demonstrates that inflammation may actually be responsible for the association. Therefore, treating inflammation in the mouth may not only help manage periodontal disease, but may also help with the management of other chronic inflammatory conditions.


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Diabetes

It is no secret that diabetes is exploding the in the United States.  If the current trends continue, it is projected that the number of Americans with diabetes will double, possibly triple by the year 2050.  Currently, 25.8 million Americans have been diagnosed with diabetes and it is estimated that there are an additional 7 million undiagnosed Americans.  Diabetes has been identified as a major cause of heart attack and stroke.

There is an urgent need to increase opportunities for diabetes screening and early diabetes detection.  Current research reveals oral blood samples drawn from deep inflamed periodontal pockets can be used to measure the hemoglobin A1c.  It is likely that in the future, dental visits will be a useful resource in initial diabetes screening, allowing for identification of patients needing additional testing to determine their diabetes status.

You may be asking yourself ‘how does this pertain to my teeth?’ Current research tells us that oral health and diabetes is a two way street, and are directly correlated.  Meaning if your gums and teeth are healthy, your blood sugar is more likely to be controlled.  On the opposite side, if your blood sugar is uncontrolled, your gums and teeth are likely not healthy.

Research shows that one-third of all diabetics have severe periodontal disease.  The link between gum disease and diabetes is so strongly documented that dental insurances are beginning to cover additional cleanings throughout the calendar year to better maintain gum health and to minimize future dental expenses.

Both gum disease and diabetes increase the risk of heart disease and stroke. Considering these conditions commonly coincide one another, it is substantially important for diabetics to work with multiple health care providers to maintain their oral health as well as their systemic health.


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Heart Disease

According to the American Heart Association, heart disease is the number one killer in the United States.  Knowing the risk factors and possible systemic links to coronary artery disease is the first step in prevention.

It is important for people to talk to their dentist about the health status of their teeth and gums because current research shows cardiovascular disease and periodontal disease have many common risk factors.  Bacteria most commonly associated with severe chronic periodontitis (gum disease) has also been identified in atherosclerotic plaque of coronary vessels.  Eliminating dental plaque could potentially be an important step in preventing periodontitis and coronary artery disease.

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CIMT

Coming Soon!

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Smoking

By now almost everyone knows that smoking has been linked with lung disease, cancer and heart disease.  But most people are not aware that smokers are three to six times more likely to have periodontal disease, and two times more likely to lose teeth.


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Pregnancy

Bleeding gums and pregnancy is something we have come to expect, and in some regard “accept” as a society. However, new research tells us that in doing so, we could be risking the lives of our babies. Dr. Yiping Han discovered how bacteria associated with mild gingivitis in a expecting mother’s mouth caused pre-term birth at 39 weeks and sudden fetus death.

We all know that it is critical to keep our bodies healthy and infection free during pregnancy. So, why then do we tolerate bleeding gums during pregnancy? Is bleeding not a sign of inflammation and infection?

Often times hormonal changes can cause the gums to be swollen and bleed more easily. And, yes the immune system is certainly compromised during pregnancy increasing the odds of gingivitis. But, the question is how do we actually know what is causing the bleeding and swelling?

Advances in dentistry using saliva testing allow us to check the bacteria types and quantities present in the mouth to determine if you and your unborn child are at risk. Dr. Han states that it is important to not only establish oral health prior to pregnancy but to maintain health throughout the entire pregnancy. Some women may even need to see their dentist more frequently while they are expecting.


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Oral Cancer

For years, medical and dental professionals have warned the general public that tobacco use and alcohol consumption are the leading risk factors for oral cancer.  However, the latest research suggests that the human papillomavirus (HPV) is actually the fastest growing causative factor for oral cancer, and is predicted to soon be the #1 cause of oral cancer.

Over 100 varieties of the human papillomavirus exist.  HPV-16 has been discovered to cause both cervical and oral cancers.  The most recent research states that HPV-positive oral cancers increased by 225 percent during 1988-2004, while HPV-negative oral cancers actually decreased by 50 percent during the same period.

You should be aware that most HPV oral cancers occur at the base of the tongue or in the tonsillar area.  And, although increasingly more common, HPV related oral cancers have a much higher survival rate than non-HPV related oral cancers.  Your dentist and/or dental hygienist should be performing a thorough head and neck exam to detect oral cancer at your check up appointments.  In addition, there is new technology that allows for the detection of this virus by simply rinsing with a saline solution.


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Rheumatoid Arthritis

Over 1.3 million Americans suffer from rheumatoid arthritis (RA), a chronic, inflammatory disease of the joints.  Current research suggests that patients with RA are nearly eight times more likely to have periodontal disease compared to patients without RA.  Both periodontal disease and RA are systemic inflammatory disorders, which may explain the connection between the two.  Inflammation is already thought to link periodontal disease with other conditions such as cardiovascular disease and diabetes.

In an effort to best maintain oral health, RA patients are encouraged to brush and floss on a regular basis and see a dental professional at least twice a year. RA can be a disabling condition, and can lead to long-term joint damage resulting in persistent pain and loss of function in affected areas.  For some patients, brushing and flossing can become impossible tasks.  If gum disease develops, treatment is critical to both the oral and systemic health of the patient.  Management of RA should be a collaborative effort on behalf of the patient’s dentist and medical doctor.  It is equally important to keep your dentist advised on the status of your RA as it is to keep your medical doctor informed on your oral health.


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Respiratory

Coming Soon!


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Other Conditions

Organ Transplant

Organ transplant patients need specialized dental care.  Prior to surgery a transplant recipient should have a thorough, non-invasive oral evaluation completed by their dentist.  It is recommended that all active periodontal infections be treated prior to transplant surgery whenever possible, since post-operative immunosuppression impairs the patient’s ability to fight systemic infection.  Decisions regarding need for antibiotics prior to dental treatment, techniques to control bleeding during dental procedures and timing of dental treatment should be a collaborative effort between your dentist and medical doctor.

With the exception of emergency dental treatment, transplant recipients should wait at least three months after surgery before having any dental treatment completed.  Again, it may be necessary for the patient to take an antibiotic prior to receiving dental treatment.  This is a decision that should be made by the surgeon and the dentist.  Many oral manifestations can develop after an organ transplant.  Apthus ulcers, simplex/herpes zoster, oral candidiasis and other uncommon viral and fungal infections may develop.  Progressive periodontal disease, excessive bleeding and delayed wound healing may also become problems for transplant patients.  Effective dental treatment plays an important role in the prevention of infection for transplant patients.  It is very important that the dentist and medical doctor keep an open line of communication in order to meet the specific needs of patients with organ transplants.

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD), or acid reflux, is a condition in which the esophagus becomes irritated or inflamed because of hydrochloric acid backing up from the stomach.  Individuals who have this disease are at risk for serious damage to the esophagus, including developing esophageal cancer. But they may not also realize that they are at an increased risk for tooth erosion and oral health problems.

The stomach’s gastric acids are refluxed up through the esophagus and into the oral cavity, and constant exposure to these acids can erode the outer surface of the tooth (enamel).  This can lead to permanent weakening of the teeth that leave them prone to chipping, increased wear and decay.  The teeth may become overly sensitive and can develop color changes over time.

Here are a few tips for avoiding enamel erosion associated with GERD
  • Brush twice a day using a low abrasive fluoridated toothpaste and a soft brush (toothpastes containing baking soda are low in abrasion and will help in neutralizing the acids)
  • DO NOT brush after being exposed to acid.  Using a fluoridated rinse to neutralize the saliva and freshen breath is recommended within the first 60 minutes of exposure
  • Avoid mint flavored products as they relax the valve that can release the backflow of stomach acid.

It is critical to both your oral health and your overall health that you manage your acid reflux properly.  You should see a physician for proper diagnosis, and to have the appropriate medications prescribed.  See your dentist regularly for evaluation and management of tooth erosion.  Your dentist can prescribe the appropriate toothpastes and mouth rinses to help you manage enamel erosion.

Bisphosphonate Therapy

Bisphosphonate medications help to strengthen the bones and are typically used to prevent and treat diseases like osteoporosis and Paget’s disease, and are even being used as part of cancer treatment.  If you use a bisphosphonate medication you should be sure that your dentist is aware. Here’s why: In rare instances, some people being treated with intravenous bisphosphonates for cancer have developed osteonecrosis of the jaw.  Osteonecrosis is a rare but serious condition that involves severe loss, or destruction, of the jawbone.

Symptoms include, but are not limited to, the following:
  • pain, swelling or infection of the gums or jaw
  • gums that are not healing
  • loose teeth
  • numbness or a heavy feeling in the jaw
  • drainage
  • exposed bone

If you receive intravenous bisphosphonate therapy (or have received it in the past year) and experience any of these or other dental symptoms, tell your oncologist and dentist immediately.

More rarely, osteonecrosis of the jawbone has developed in patients taking oral bisphosphonates to prevent or treat osteoporosis or Paget’s disease.  Most cases of osteonecrosis of the jaw associated with bisphosphonates are diagnosed after procedures such as tooth extraction. However, the condition can develop spontaneously. Also, invasive dental procedures such as extractions or other surgery that affects the bone can worsen this condition.

Patients receiving intravenous bisphosphonate therapy should avoid invasive dental procedures if possible.  The risk of developing osteonecrosis of the jaw after dental surgery in patients using oral bisphosphonates appears to be low.

It is important to inform your dentist if you are currently taking, or have any history of taking bisphosphonates to decrease the risk of complications with dental treatment.