Periodontal disease and Rheumatoid arthritis

At the 93rd General Session and Exhibition of the International Association for Dental Research, researcher Sheila Arvikar, Massachusetts General Hospital, Boston, USA, will present a study titled "Inflammation in the Mouth and Joints in Rheumatoid Arthritis." The IADR General Session is being held in conjunction with the 44th Annual Meeting of the American Association for Dental Research and the 39th Annual Meeting of the Canadian Association for Dental Research.

---

Periodontitis shares pathogenic mechanisms with rheumatoid arthritis (RA) and may trigger its onset. In this study, researchers performed joint and dental examinations, determined Porphyromonas gingivalis (P. gingivalis) antibodies, and examined inflammatory microenvironments in early and chronic RA patients.

Twenty-three RA patients, (15 new-onset disease, eight chronic) and 20 age/gender-matched healthy subjects (HS) without periodontitis/RA were enrolled in this study. Serum P. gingivalis IgG antibodies were measured by ELISA. Twenty inflammatory mediators were measured in serum, saliva, gingival crevicular fluid (GCF), and joint fluid by Luminex.

The 23 patients (87% female) received routine dental care, except for one; none currently smoked. Of the 23 RA patients, 10 had gingivitis and nine had periodontitis. RA patients exhibited increased pocket depth, clinical attachment loss, bleeding on probing and GCF volume compared with HS. Six of 23 patients had P. gingivalis antibodies, and all six had periodontitis.

RA patients showed a marked inflammatory profile in all microenvironments, including oral, despite routine dental care. P. gingivalis antibodies can be considered as biomarkers for rheumatologists in identifying those who may benefit from periodontal treatment.

Smilesaver Office Tour

http://www.youtube.com/v/jJw6QDBB24U?autohide=1&version=3&attribution_tag=-M-TNTXNpy4N6mCyWVQ_3w&feature=share&autoplay=1&autohide=1&showinfo=1

American Dental Association News: Common oral bacteria breaks into bloodstream to infect organs.

Common oral bacteria breaks into bloodstream to infect organs. Dr. Han, professor of periodontics at Case Western School of Dental Medicine F. nucleatum for over ten years. This oral bacteria has been uncovered in brain abcesses and infections in the lungs, liver, spleen and joints. Dr Han also found direct evidence linking the bactereum to preterm labor and fetal death. When F. nucleatum invades the body through mucous membranes in the mouth, due to injuries or gum disease, it may trigger permeability allowing it and other bacteria to colonize at different sites throughout the body. The colony of bacteria induces an inflamatory reaction that can lead to tissue death.

www.thesmilesaver.com 

EATING RIGHT FOR A HEALTHY SMILE

WHAT IS A HEALTHY DIET?
A healthy diet includes a variety of foods from the six food groups. Different foods have different benefits for your body. Eating a variety of foods ensures that your body gets all the nutrients it needs to be healthy.
You can have a healthy diet by following these simple steps:
 *Choose your food wisely from each of the six food groups:
*grains,half of them whole grains, such as whole wheat bread, brown rice or oatmeal.
*vegetables, especially dark green or orange colored ones.
*fruits.
*milk products, such as low fat yogurt or low fat cheese.
*lean meats, poultry,fish,beans, eggs, nuts.
*oils, most of them from fish, nuts and vegetable oils.
*EAT FOODS THAT ARE LOW IN SATURATED FATS, TRANS FATS, CHOLESTEROL, AND SALT.
*AVOID A DIET HIGH IN ADDED SUGARS, this increases the risk of tooth decay.
*EAT A VARIETY OF FOODS FROM EACH OF THE SIX FOOD GROUPS. By eating a variety of foods, you get all the nutrients that different parts of your body needs.
*DRINK WATER BETWEEN MEALS, which helps your overall health.

WHY IS A HEALTHY DIET IMPORTANT?
A healthy diet:
*provides nutrients needed for your body to function properly.
*helps prevent diseases linked with being overweight, like diabetes and heart disease.
*helps you keep your teeth and gums healthy.
SNACKING SMART
It is important to make smart choices when you snack. More and more, we are learning it is not only what you eat, but how often you eat. Frequent snacking or grazing can lead to tooth decay. When you are choosing a snack, think about the following:
*LIMIT SNACKING THROUGHOUT THE DAY. Stick to meal times whenever possible.
*MAKE HEALTHY SNACK CHOICES, such as fruit, nuts or cheese.
*EAT SWEETS WITH MEALS INSTEAD OF WITH SNACKS. Saliva increases during meals and helps weaken acid and rinse food particles from the mouth.
*AVOID BEVERAGES WITH ADDED SUGARS such as soda, sports drinks or flavored water.
CHEW GUM THAT HAS THE ADA SEAL. Chewing sugarless gum for 20 minutes after meals has been shown to reduce tooth decay, because increased saliva flow helps wash out food and neutralize the acid produced by dental plaque bacteria.
A HEALTHY DIET HELPS KEEP YOUR MOUTH HEALTHY
If you often eat or drink sugary foods and liquids, especially between meals, and if you don't bother to clean your teeth, the result may be tooth decay and periodontal disease. These can lead to tooth loss.
Plaque is a thin, sticky film that constantly forms on teeth. When you eat or drink foods containing sugar, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with the teeth. After many acid attacks, the enamel breaks down and a cavity forms.
If the plaque is not removed with daily brushing and cleaning between teeth, it eventually hardens into calculus, or tarter. As calculus forms near the gumline, it becomes more difficult to keep teeth clean. Gums can become inflamed and may bleed. Sometimes the disease can get worse, and the gums can begin to pull away from the teeth and form pockets. If this condition, called periodontitis, is not treated in time, the bone supporting the teeth can be destroyed and healthy teeth may be lost.
HEALTHY SMILES FOR LIFE
A lifetime of good oral health depends on the choices you make today. Making smart choices about food and keeping good oral health habits can help you have both a healthy body and a healthy smile for years to come. For more tips on how to make healthy eating choices, visit the U.S. Department of Agriculture's website, http://www.mypyramid.gov/

Periodontal Disease and Respiratory Disease

Periodontal disease (also called periodontitis and gum disease) has been linked to respiratory disease through recent research studies.  Researchers have concluded that periodontal disease can worsen conditions such as chronic obstructive pulmonary disease (COPD) and may actually play a causal role in the contraction of pneumonia, bronchitis and emphysema.

Periodontal disease is a progressive condition which generally begins with a bacterial infection.  The bacteria found in plaque begin to colonize in gingival tissue, causing an inflammatory response in which the body destroys both gum and bone tissue.  The sufferer may notice the teeth “lengthening” as the gums recede while the disease progresses.  If left untreated, erosion of the bone tissue brings about a less stable base for the teeth, meaning loose, shifting or complete tooth loss.

There are a number of different respiratory diseases linked to periodontal disease.  Pneumonia, COPD, and bronchitis are among the most common.  Generally, bacterial respiratory infections occur due to the inhalation of fine droplets from the mouth into the lungs. COPD is a leading cause of death and should be taken very seriously.

Reasons for the Connection

The fact that respiratory disease and periodontal disease are linked may seem far-fetched, but there is plenty of evidence to support it.

Here are some of the reasons for the link between periodontal disease and respiratory disease:

• Bacterial spread – The specific type of oral bacterium that causes periodontal disease can easily be drawn into the lower respiratory tract.  Once the bacteria colonize in the lungs, it can cause pneumonia and exacerbate serious conditions such as COPD.
• Low immunity – It has been well-documented that most people who experience chronic or persistent respiratory problems suffer from low immunity.  This low immunity allows oral bacteria to embed itself above and below the gum line without being challenged by the body’s immune system.  Not only does this accelerate the progression of periodontal disease, it also puts the sufferer at increased risk of developing emphysema, pneumonia and COPD.
• Modifiable factors – Smoking is thought to be the leading cause of COPD and other chronic respiratory conditions.  Tobacco use also damages the gingiva and compromises the good health of the oral cavity in its entirety.  Tobacco use slows the healing process, causes gum pockets to grow deeper and also accelerates attachment loss.  Smoking is not the sole cause of periodontal disease, but it is certainly a cofactor to avoid.
• Inflammation – Periodontal disease causes the inflammation and irritation of oral tissue.  It is possible that the oral bacteria causing the irritation could contribute to inflammation of the lung lining, thus limiting the amount of air that can freely pass to and from the lungs.

Diagnosis and Treatment

When respiratory disease and periodontal disease are both diagnosed in one individual, it is important for the dentist and doctor to function as a team to control both conditions.  There are many non-surgical and surgical options available, depending on the specific condition of the teeth, gums and jaw.

The dentist is able to assess the extent of the inflammation and tissue loss and can treat the bacterial infection easily.  Scaling procedures cleanse the pockets of debris and root planing smoothes the tooth root to eliminate any remaining bacteria.  The dentist generally places antibiotics into the pockets after cleaning to promote good healing and reduce the risk of the infection returning.

Whichever treatment is deemed the most suitable, the benefits of controlling periodontal disease are two-fold.  Firstly, any discomfort in the oral region will be reduced and the gums will be much healthier.  Secondly, the frequent, unpleasant respiratory infections associated with COPD and other common respiratory problems will reduce in number.

If you have questions or concerns about respiratory disease or periodontal disease, please ask your dentist. Dr. Bill Rubiano 310-832-4916

http://www.thesmilesaver.com/

Dental Emergencies

http://www.thesmilesaver.com/

Dental emergencies are quite frightening and often painful.  Prompt treatment is almost always required to alleviate pain and to ensure the teeth have the best possible chance of survival.

Sometimes teeth become fractured by trauma, grinding or biting on hard objects.  In other cases, fillings, crowns and other restorative devices can be damaged or fall out of the mouth completely.  If there is severe pain, it is essential to make an appointment with the dentist as quickly as possible.  The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health.

Types of dental emergency and how to deal with them

Avulsed tooth (tooth knocked out)

If a tooth has been knocked clean out of the mouth, it is essential to see a dentist immediately.  When a tooth exits the mouth, tissues, nerves and blood vessels become damaged.  If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Here are some steps to take:

1. Call the dentist.
2. Pick up the tooth by the crown and rinse it under warm water.  DO NOT touch the root.
3. If possible, place it back into its socket – if not tuck it into the cheek pouch.
4. If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort.  It is important to keep the tooth from drying out.
5. Get to the dentist, quickly and safely.

The dentist will try to replace the tooth in its natural socket.  In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy may be necessary.

Lost filling or crown

Usually, a crown or filling comes loose while eating.  Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure.  Crowns generally become loose because the tooth beneath is decaying.  The decay causes shape changes in the teeth – meaning that the crown no longer fits.

If a crown has dropped out of the mouth, make a dental appointment as soon as possible.  Keep the crown in a cool, safe place because there is a possibility that the dentist can reinsert it.  If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.

When the dentist is not immediately accessible, here are the steps to take:

1. Apply clove oil to the tooth to alleviate pain.
2. Clean the crown and affix it onto the tooth with dental cement.  This can be purchased at the local pharmacy.
3. If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
4. DO NOT use any kind of glue to affix the crown.

The dentist will check the crown to see if it still fits.  If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.

Cracked or broken teeth

The teeth are strong, but they are still prone to fractures, cracks and breaks.  Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme.  Fractures, cracks and breaks can take several different forms, but are generally caused by trauma, grinding and biting.  If a tooth has been fractured or cracked, there is no alternative but to see the dentist as quickly as possible.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

1. Call the dentist.
2. Rinse the tooth fragment and the mouth with lukewarm water.
3. Apply gauze to the area for ten minutes if there is bleeding.
4. Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
5. Cover the affected area with over-the-counter dental cement if there is no way to see the dentist immediately.
6. Take a topical pain reliever.

The nature of the break or fracture will limit what the dentist is able to do.  If a fracture or crack extends into the root, root canal therapy may be the only effective way to retain the tooth.  In the case of a complete break, the dentist will usually affix the fragment back onto the tooth as a temporary measure.

Dislodged/loose teeth

When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it.  If the tooth remains in the mouth and attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.

It is important to call the dentist immediately to make an appointment.  In the meantime, use a cold compress and over-the-counter medications to relieve pain.  The dentist will reposition the tooth and add splints to stabilize it.  If the tooth fails to heal, root canal therapy may be required.

If you have questions or concerns about dental emergencies, please contact your dentist. Dr. Bill Rubiano 310-832-4916

Bad breath is preventable

http://www.thesmilesaver.com/

Bad breath (halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning. There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent. What may cause bad breath? Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath. Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled. Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth. Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums. Dental cavities and improperly fitted dental appliances – May also contribute to bad breath. Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing. Tobacco products – Dry the mouth, causing bad breath. Dieting – Certain chemicals called ketones are released in the breath as the body burns fat. Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away. Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath. Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses with your dentist. What can I do to prevent bad breath? Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush.  Floss daily to remove food debris and plaque from in between the teeth and under the gumline.  Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning. See your dentist regularly – Get a check-up and cleaning at least twice a year.  If you have or have had periodontal disease, your dentist will recommend more frequent visits. Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit. Drink water frequently – Water will help keep your mouth moist and wash away bacteria. Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor.  Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem. In most cases, your dentist can treat the cause of bad breath.  If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

Bad breath (halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning. There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent. If you have further questions please call Dr. Bill Rubiano at 310-832-4916.