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Posts for tag: oral health

By Joseph A. Revak, DMD
October 15, 2019
Category: Oral Health
Tags: oral health   gum disease  
HeresWhatYouCanDotoAvoidGumDisease

Here's an alarming statistic: Nearly half of adults over 30—and 70% over 65—are affected by periodontal (gum) disease. It's sobering because if not caught and treated early, gum disease can lead to not only tooth loss but also an increased risk of heart attack or stroke.

Gum disease most often begins with dental plaque, a thin film of bacteria and food particles that builds up on tooth surfaces mainly from poor oral hygiene. Undisturbed plaque can become a breeding ground for bacteria that cause gum infections.

Daily brushing and flossing can remove most of this plaque buildup, but you also need to get professional dental cleanings at least twice a year. This is because any plaque you missed brushing and flossing can interact with saliva and harden into calculus or tartar. This hardened plaque can't be dislodged through brushing and flossing alone, but requires special instruments used by dental professionals to remove it.

You should also be aware of other risk factors you may have that increase your chances of gum disease and take action to minimize them. For instance, you may have a higher genetic propensity toward gum disease. If so, you'll need to be extra-vigilant with personal hygiene and watch for any signs of disease.

Tobacco use, especially smoking, can double your chances of gum disease as well as make it difficult to notice any signs of disease because your gums will not bleed or swell. Quitting the habit can vastly improve your odds of avoiding an infection. Your disease risk could also be high if you have a diet heavy in sugar, which feeds bacteria. Avoiding sugary foods and eating a more dental-friendly diet can lower your disease risk.

Oral hygiene and managing any other risk factors can greatly reduce your risk for gum disease, but it won't eliminate it entirely. So, be sure you seek professional dental care at the first signs of swollen, reddened or bleeding gums. The sooner you undergo treatment for a possible gum infection, the better your chances of avoiding extensive damage to your teeth, gums and supporting bone.

The risk for gum disease goes up as we get older. But by following good hygiene and lifestyle practices, you can put yourself on the healthier side of the statistics.

If you would like more information on gum disease care and treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Gum Disease Gets Started.”

By Joseph A. Revak, DMD
October 05, 2019
Category: Oral Health
Tags: oral health  
ThereAreaLotofBacteriainYourMouthbutOnlyaFewMeanYouHarm

Say “bacteria,” especially in the same sentence with “disease” or “infection,” and you may trigger an immediate stampede for the hand sanitizer. The last thing most people want is to come in contact with these “menacing” microorganisms.

If that describes you, however, you’re too late. If you’re of adult age, there are already 100 trillion of these single-celled organisms in and on your body, outnumbering your own cells 10 to 1. But don’t panic: Of these 10,000-plus species only a handful can cause you harm—most are either harmless or beneficial, including in your mouth.

Thanks to recent research, we know quite a bit about the different kinds of bacteria in the mouth and what they’re doing. We’ve also learned that the mouth’s microbiome (the interactive environment of microscopic organisms in a particular location) develops over time, especially during our formative years. New mothers, for example, pass on hundreds of beneficial species of bacteria to their babies via their breast milk.

As our exposure to different bacteria grows, our immune system is also developing—not only fighting bacteria that pose a threat, but also learning to recognize benevolent species. All these factors over time result in a sophisticated, interrelated bacterial environment unique to every individual.

Of course, it isn’t all sweetness and light in this microscopic world. The few harmful oral bacteria, especially those that trigger tooth decay or periodontal (gum) disease, can cause enormous, irreparable damage to the teeth and gums. It’s our goal as dentists to treat these diseases and, when necessary, fight against harmful microorganisms with antibacterial agents and antibiotics.

But our growing knowledge of this “secret world” of bacteria is now influencing how we approach dental treatment. A generalized application of antibiotics, for example, could harm beneficial bacteria as well as harmful ones. In trying to do good we may run the risk of disrupting the mouth’s microbiome balance—with adverse results on a patient’s long-term oral health.

The treatment strategies of the future will take this into account. While stopping dental disease will remain the top priority, the treatments of the future will seek to do it without harming the delicate balance of the mouth’s microbiome.

If you would like more information on the role of bacteria in oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “New Research Show Bacteria Essential to Health.”

By Joseph A. Revak, DMD
July 27, 2019
Category: Oral Health
Tags: oral health  
SeeYourDentistifYouHaveoneoftheseTop3OralProblems

For years people tuned in to enjoy one of David Letterman's "Top 10 lists," a frequent gag performed on his show Late Night. Each countdown list poked fun at off-the-wall topics like "Top 10 New York City Science Projects" or "Top 10 Questions People Ask when Shopping for an Umbrella."

Recently, the American Dental Association presented their own kind of list—"America's Top 3 Oral Health Problems"—based on surveys of around 15,000 people across the U.S. But unlike the popular Late Night lists, this one is no laughing matter.

Coming in at #3, 29% of the respondents indicated they had experienced tooth pain at some time in their life. Tooth pain is the body's way of alerting to trouble in the mouth, anything from a decayed tooth to a gum abscess. The best thing to do if you have any persistent oral pain is to see your dentist as soon as possible for a thorough examination. And you should do this even if the pain goes away.

The second most prominent oral problem among people is difficulty biting or chewing, about 31% of those in the surveys. As with tooth pain, the reasons can vary greatly, including cracked, loose or deeply decayed teeth, dentures or jaw joint disorders (TMD). Because dental disease is usually the ultimate culprit, the best way to avoid this is to practice daily brushing and flossing and regular dental visits. And, as with tooth pain, you should see your dentist if you're having symptoms.

At 33% of respondents, the number one oral problem in America is chronic dry mouth. It's a constant inadequate flow of saliva often caused by medications or certain systemic conditions. Because saliva helps protect the mouth against infection, a restricted flow increases your risk of disease. If you notice your mouth is dry all the time, you should talk to your dentist about ways to boost your saliva. If you're taking medications, ask your doctor if they could be causing your symptoms and if you could change to something else.

While any of these Top 3 oral problems can be a stepping stone to more serious dental problems, it doesn't necessarily have to lead to that. You can improve your dental health through daily oral hygiene and regular dental treatment. And it might help you stay off this unpleasant list.

If you would like more information on treating dental disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Top 3 Oral Health Problems.”

PreservingthePulpisPriorityOnewithaNewlyEruptedPermanentTooth

The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.

While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.

To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.

That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.

If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.

These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.

If you would like more information on caring for your child's teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Saving New Permanent Teeth after Injury.”

By Joseph A. Revak, DMD
October 10, 2018
Category: Oral Health
Tags: oral health   gum disease  
InflammationtheLinkBetweenGumDiseaseandCardiovascularDisease

Cardiovascular disease and periodontal (gum) disease are two different conditions with their own set of symptoms and outcomes. But they do share one common element: inflammation. In fact, this otherwise normal defensive response of the body might actually create a link between them.

When tissues become damaged from disease or injury, the body triggers inflammation to isolate them from the rest of the body. This allows these tissues to heal without affecting other tissues. If inflammation becomes chronic, however, it can damage rather than protect the body.

This happens with both cardiovascular disease and gum disease. In the former, low-density lipoproteins (LDL or “bad cholesterol”) in animal fat leave behind remnants that can build up within arteries. This stimulates inflammation of the vessel’s inner linings, which accelerates hardening and increases the risk of heart attack or stroke.

With gum disease, bacteria living in a thin, built-up film of food particles on the teeth called plaque infect the gum tissues, which in turn trigger inflammation. A struggle ensures between the infection and inflammation, causing the gum tissues to weaken and detach from the teeth. Coupled with erosion of the supporting bone, the risk of tooth loss dramatically increases.

Recent research now seems to indicate the inflammatory responses from these two diseases may not occur in isolation. There is evidence that gum inflammation could aggravate inflammation in the cardiovascular system, and vice-versa. The research, though, points to some possible good news: treating inflammation in either disease could have a positive effect on the other.

Making heart-friendly lifestyle changes like losing extra weight (especially around the waist), improving nutrition, and exercising regularly can help reduce LDL and lower the risk of arterial inflammation. Likewise for your gums, daily oral hygiene and visiting the dentist at least twice a year reduces the risk for gum disease. And at the first sign of a gum infection—swollen, reddened or bleeding gums—seeking immediate treatment will stop it and reduce any occurring inflammation.

Taking steps to prevent or reduce inflammation brought on by both of these diseases could improve your health and save your life.

If you would like more information on how your oral health affects your whole body, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Link between Heart & Gum Disease.”