Did you know that dental diseases like periodontitis and even cavities are the most common diseases – apart from the common cold? It may surprise you, but enough people neglect their oral hygiene enough to make this an extremely common ailment, even though it’s an easily-preventable situation! These numbers are so high because most people who have some form of gum or tooth disease have no knowledge of it – and with 75% of the population having some form of periodontal disease, you must take careful attention when cleaning your mouth.
An Iraqi girl learns how to brush her teeth for the first time.
Dental decay is not much of an issue in modern society (thanks to fluoridated water and toothpaste), but a proper hygiene routine is still necessary to prevent gum disease and/or cavities. Brushing and flossing is essential, as this both cleans the smooth surfaces of the teeth, and also helps break up food particles and plaque in between the teeth and gum line. Gum disease starts in between the teeth, and some toothbrushes can’t reach critical areas necessary to be cleaned to prevent bacteria from growing.
Although gingivitis – the bacterial infection that invades your gums – is reversible, periodontitis is gum and bone disease, and is not irreversible! Because periodontal disease is so serious, and can only be managed under the strict supervision of a dental professional, it is important to understand just how periodontal disease can affect you. This disease has been linked to heart disease, stroke, diabetes and other degenerative diseases that can be life threatening! I’ve blogged about periodontitis before, and I can’t stress enough how important and serious it can be to have regular cleanings and check-ups from a dental professional twice yearly. Periodontal disease can disfigure even the most beautiful of smiles. Your gums can be so swollen, receded and bloody that your teeth will look longer, will become loose and eventually will need removal. If you detect gum disease early, you will need a management program that includes regular treatment with your dentist and/or hygienist and solid home care to manage the disease.
Root planing and scaling is the common form of soft tissue management treatment, when a hygienist or dentist uses a precise tool to detoxify the tooth surfaces below the gum line and in between each tooth, and then rinses with antiseptic . With advanced technology, laser energy can also be utilized to remove diseased tissues and eliminate bacteria to allow healing to take place. Your dental professional will discuss the best treatment plan for you – a routine cleaning is not enough by itself to treat periodontal disease! You may need to visit your dental hygienist more often, up to four times per year in order to properly manage the disease. On a daily basis, a solid home care program (which should be designed by you and your dentist) will help you maintain your oral health. Besides brushing and flossing after every meal, other tools like prescription tooth brushes (like Rotadent) and water irrigators (like Hydrofloss) could be helpful for your hygiene routine. Antiseptic rinses like Tooth and Gum Tonic Herbal Rinse, a healthy diet and/or supplements and antioxidants like vitamin C and B can also help to fight and manage gum disease. Healthy gum supports a healthy smile, which supports a healthy body!
Healthy gum appears pink and firm. Brushing and flossing in the healthy stages of gum tissue will be a pleasant experience and there will be no bleeding. This is the phase that all gum tissue should be in if it is healthy and clean. Once gingivitis sets in (the beginning stages of gum disease), gums will take on a red and puffy look, and bleed easily upon brushing and flossing. Once gum disease progresses, the chances of returning to a healthy condition deceases drastically – once gum tissue has reached the advanced level, it is likely past of the point of no return and will result in tooth loss. Periodontal disease is the #1 reason of tooth loss.
Healthy gums and teeth
Gingivitis, which is the early stage of gum disease, if treated professionally (with an implemented solid home care program), gum can return to be healthy again without further consequences. So how do we categorize the stages of gum disease (besides the clinical characteristics)? A bleeding index and dental radiographs help, along with periodontal probing depths, which are universally used as guide to diagnose and monitor the progress of the treatment and condition of gum disease. The periodontal probing depths are obtained with a read-out, by lightly inserting a needle (thin and finely marked instrument) sliding between the space between the gum and tooth.
The stage of gingivitis.
Gingivitis, could have a normal pocket reading of 0 to 3 mm. Gum will be red, puffy, and tender, it will bleed easily and possibly exhibit bad breath and bad taste.
Early (mild) periodontitis will show a pocket reading range from 3 t o 5 mm. At this stage, gum gets more tender, bleeds more easily, and there is always looming bad breath and bad taste. At this stage of gum disease, immediate attention and treatment is required if there is any chance of reversing the condition to an easily-manageable and healthy state.
Moderate Periodontitis is characterized by a periodontal pocket depth of 5-7mm. Gum tissue may become even redder and puffier, it will bleed easily, and bad breath and bad mouth taste are constant.Often times teeth may begin to look longer as gum tissue recedes, and gum boils or abscesses may develop. Front teeth may begin to drift apart showing space or becoming loose.
Advanced Periodotitis gets a pocket measurement of more than 7 millimeters, and may progress to 11 or 12 mm, indicating that bone and connective tissues have been continuously destroyed. This is the terminal stage of gum disease. If a patient has just been diagnosed with advanced periodontitis and the teeth are still firm (pockets are less than 9mm, with longer roots, and more localized condition), then there is possibility that with gum surgery and graft, bone regeneration still is possible. Keep in mind however, that the prognosis is guarded. In most situations, advanced periodontitis will result in tooth loss. Replacement implant therapy or other restorative options will be advised.
Remember that prevention is the best treatment, especially for gum disease. You are the person who can best take care of yourself, be disciplined with your home care program (including hygiene) and schedule regular check-ups with both your dentist and dental hygienist who can help you stay away of big problems.
Aging? Not me! We do not get old, but our body parts increasingly need more upkeep to stay young! Baby boomers need special attention in particular – although we may feel like as young as a college graduate, an aged and/or discolored smile will reveal your years. As a cosmetic dentist, my mission is to help you maintain a happy and healthy smile that will compliment your well kept physique – and “looking good” is often related with having a beautiful smile. If you’re not happy with your smile, get a consultation from a cosmetic dentist to see what you can do to refresh your smile!
The most commonly challenging dental dilemma for baby boomers is combating those dull and severely worn teeth. Many people are unaware of the slow aging process of loosing tooth structures, mainly from night grinding, erosion and attrition. Bad habits and poor hygiene can also ruin teeth. The approach to rejuvenate can be as simple as having your teeth whitened, or it could be more complicated, requiring a multidisciplinary approach with extensive time and financial investment needed.
Often times, porcelain veneers might be suggested by your cosmetic dental professional to restore an aging smile, but make sure your dental health has been evaluated first. It is pertinent to check whether or not the gum and bone tissues are healthy, if there are any missing teeth that haven’t yet been replaced and if any shifting bite or teeth issues have been addressed. If you have had prior cosmetic work done, however, maintaining your investment is vital if you want your new smile to last. Follow up any cosmetic procedure with proper hygiene habits, which include brushing and flossing twice daily (and after meals), a healthy diet, no smoking and no excessive drinking (sodas or alcohol). A night guard might also be recommended.
Baby boomers have worked hard to establish their careers, family and personal well-being – now it’s time to enjoy more of your accomplishments. Get the smile you’ve always wanted, as it’s not only for vanity but also truly for your overall health. Visit your dental professional not only for a routine cleaning and check up, but ask for a comprehensive cosmetic evaluation, including a smile analysis, TMJ and occlusion check and a periodontal exam with an oral cancer screening. When you take care of your mouth, you are taking care of a vital bodily system which performs in delicate balance with the rest of your body. When your oral cavity ’s health is at risk, your overall health is being endangered.
We all know that brushing and flossing is not the only key to preventing dental disease (tooth decay and gum disease) – you probably also know that a healthy smile and fresh breath can actually reduce risk of a heart attack and stroke. What may surprise you, however, is this: researchers at West Virginia University have discovered that a clean mouth may also help preserve memory!
Thanks to a grant awarded by the National Institutes of Health, West Virginia University has found an obscure link between periodontitis (gum disease) and memory loss. A test sample (of over 270 seniors) was chosen to be part of the university study, during which School of Dentistry researchers checked the oral and cognitive health of patients every day over a period of roughly two years. Initial conclusions showed that 23% of the group who suffered from mild to moderate memory loss also had relatively poor oral hygiene habits.
Dr. Crout of the WVU School of Dentistry explains that although the specific genetic link between periodontitis and memory loss has not yet been defined, the team hopes to have more details soon. “If you have a gum infection, you’ll have an increased level of inflammatory byproducts,” Crout explained. “We’re looking for markers in the blood that show inflammation to see if there is a link to memory problems. We’d like to go full circle and do an intervention — to clean up some of the problems in the mouth and then see if the inflammatory markers go down.”
We’re not quite sure about whether bacteria or the body’s inflammatory response is the contributing factor of observed memory loss; it may be a combination of both, or a result of other environmental and physiological factors. What we do know, however, is that the rate of Alzheimer’s cases is skyrocketing. Imagine the benefits of knowing that keeping the mouth free of infection could cut down cases of dementia – it could be revolutionary!
Keep brushing and flossing to keep the mind sharp – or maybe we need a sharp mind to keep brushing and flossing? As a clinician, when I see a patient who can’t keep their oral hygiene in reasonable condition, I become concerned. The risk of heart attack and stroke are heightened in patients who suffer from poor oral hygiene. Knowing that memory loss is somewhat associated with inflammatory factors in the mouth, we should all improve our oral health in order to keep our mind sharp!
“Only floss the teeth you want to keep!” It’s a funny punch line, emphasizing the importance of flossing, but it’s true. Flossing your teeth after meals (and twice daily) is just as important as brushing to keep your mouth clean, healthy and fresh.
Flossing is very efficient in removing plaque and debris that accumulates between the teeth and underneath portions of the gum pocket. This should be an essential part of your daily oral cleaning process. When plaque (a sticky bacterial substance that accumulates on curved tooth surfaces and crevices) is removed, dental diseases can be prevented, along with gum problem and bad breath (which require both brushing and flossing to prevent). If one fails to keep up their oral hygiene, tooth decay and gum disease (gingivitis and periodontitis, respectively) will affect your oral health.
Proper flossing technique is also critical. Begin by taking a piece of floss (around 12-18 inches) and wrapping it around your two index fingers tightly, with plenty of slack on each side. Move the piece of floss between each tooth, wrapping the floss around the curved sides of each tooth in a C-shape, sliding up and down several times beneath the surface of the gum. Between each teeth site will be two curved sides for flossing except for the far back molars. Be sure to move the floss down as far as possible, beneath the gum line, as this loosens and breaks up food buildup and initial bacteria buildup.If you have dental bridges or braces, the flossing technique will need to be slightly altered. A dental threader will be carry the floss passing under the jointed teeth contact area, and then the individual can pump up and down in typical flossing strokes. If you notice some bleeding, it is a sign of inflammation of the gum tissue – this usually signals the early stages of gingivitis. Keep up your proper home care routine and the condition will improve. If the condition of bleeding upon brushing and flossing lasts more than two weeks, get some help from your dental professional.
There are several different types of floss (including waxed, unwaxed, and tape floss) – normally, easy gliding thin floss (like Glide) will be a good choice for average dental conditions. Gapped teeth or in areas under a dental bridge should require tape floss. Remember, you can get advice from your dental professional to find out which is the best choice for you.
For people who have arthritis, advanced periodontal conditions or other issues of dexterity, additional dental cleaning home equipment will be very helpful. Electric tooth brushes (like Rotadent and Sonicare) and dental irrigators (like Hydrofloss and Waterpik) are very efficient tools to maintain proper oral hygiene. Remember to brush and floss twice daily (and after meals)! These important habits and routines will keep your teeth healthy, happy and looking fabulous!