The Best Way to Treat Gum Disease? Avoid it!

healthy gums
But how do you go about doing that?

You can start by not adding fuel to the fire:

  • If you smoke or use tobacco, quit. It’s the number one risk factor for periodontal disease and tooth loss.

  • Make sure you get 7 to 9 hours of quality sleep each night. If you brux (clench or grind your teeth) during sleep or suspect you may have sleep apnea, talk with your dentist about solutions so you can get a good night’s sleep. Research suggests that lack of sleep may be second only to smoking as a risk factor for gum disease.

  • If you eat a lot of sugar, flour-based foods, and other refined carbs, cut back on them. Gum disease is marked by chronic inflammation, and these foods make inflammation worse.

  • Evaluate the stress in your life and take steps to bring it under control.

Then there’s the matter of oral hygiene.

According to new research in the Journal of Clinical Periodontology, even just tooth brushing can make a difference. Participants who reported brushing at least twice a day were found to have deep periodontal pockets on about two fewer teeth, on average, than those who brushed less.

Those pockets deepen as the disease process causes the gums to pull away from the teeth. With healthy gums, the natural space between the gums and teeth – the sulcus – is one to three millimeters deep. Neglected, the spaces get even deeper, allowing more room for harmful bacteria to colonize and thrive.

Once this happens, tooth brushing can only be a partial help. At this point, additional tools such as floss and oral irrigators are needed to control the pathogens harbored within the pockets.

All of these are also tools that you can use right now to keep gum disease from developing in the first place.

Flossing is basic, but it needs to be done correctly in order to make a difference. And if your gums bleed, that’s all the more reason to get diligent about flossing. That bleeding is a sign of gum disease.

If you don’t like to floss, try cleaning with interproximal brushes instead. These small brushes fit between your teeth and are great for cleaning at the gum line.

You can also use these “proxy” brushes to apply ozonated oils to your gums. These oils are commonly made by infusing medical grade ozone into an organic oil such as olive, sunflower, coconut, hemp, or castor. Ozone is a powerful disinfectant that’s ideal for controlling oral pathogens. (We use it in a wide variety of ways here in our office!)

Oil pulling can be a helpful addition to your daily hygiene routine. A simple swish of a tablespoon of coconut oil every morning for 10 to 15 minutes before you brush can have a positive impact.

Oral irrigators such as Waterpiks have also proven quite helpful for keeping the gums healthy. Antimicrobial botanical tonics can even be added to the water to enhance their cleaning power. (The Dental Herb Company’s Under the Gums Irrigant is one good option.)

In addition to amped up hygiene, a few nutritional changes can have a big impact, as well. It’s not just about avoiding the harmful stuff but making sure you get the full complement of vitamins, minerals, and other nutrients your body needs to function as designed.

Also look to getting more movement into your daily routine. Research has consistently shown that exercise helps lower your risk of gum disease, as well as reduce chronic inflammation in general.

Unfortunately, there’s no silver bullet against gum disease. But working a variety of the above tools into your daily health routine will take you far in keeping perio problems at bay, keeping your smile healthy and whole.

Got Gum Disease? Treatment Could Save Your Life

ultrasonic scalingPeriodontal disease affects up to 80% of Americans. It’s not just a problem in the mouth, either. It’s been linked to many other conditions, including heart disease, stroke, diabetes, rheumatoid arthritis, and some cancers.

The good news? Periodontal therapy can help reverse gum disease. This may, in turn, help improve your overall health – and, as we noted before, even save you a good chunk of change in the long run.

For instance, a new review of the science suggests that non-surgical perio therapy may improve glycemic control in people with diabetes, at least in the short term.

Patients who underwent [nonsurgical] periodontal treatment had about half a percent lower HbA1c levels three months after treatment than those who did not undergo periodontal therapy.

“Evidence from the literature suggests that successful periodontal treatment, which results in the reduction of inflammation from the periodontal tissues, improves the metabolic control of people with diabetes mellitus,” the authors wrote.

Another recent study looked at the impact of intensive periodontal treatment on blood pressure. In this case, 95 patients were randomly split between control-treatment and intensive-treatment over the course of 4 weeks, then followed for 6 months.

After one month, systolic blood pressure – the top number – was almost 3 points lower in patients who had intensive treatments. After three months, it was almost 8 points lower. Diastolic pressure dropped, too, by nearly 4 points.

At 6 months, systolic pressure had dropped almost 13 points, and diastolic had dropped by nearly 10.

“The present study demonstrates for the first time that intensive periodontal intervention alone can reduce blood pressure levels, inhibit inflammation and improve endothelial function,” said study lead author Jun Tao, M.D., Ph.D., chief of the department of Hypertension and Vascular Disease and director of the Institute of Geriatrics Research at The First Affiliated Hospital of Sun Yat-sen University in Guangzhou, China.

The study was published last summer in the Journal of Periodontology.

Other research has found evidence that periodontal treatment may help those with chronic kidney disease and atherosclerosis (“hardening of the arteries). The latter was especially so for those “already suffering from CVD and/or diabetes.”

On the flipside, some research has found that patients who don’t respond well to periodontal therapy had “an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.”

So what are the options for treatments?

While in its early stages, gum disease may often be reversed by more intensive home hygiene, nutritional improvements, and other lifestyle changes, dental help is needed when it becomes more advanced.

This can include frequent deep cleanings, such as with an ultrasonic scaler, along with regular ozone treatment to keep harmful bacteria under control. Probiotics may also be recommended to help right the microbial balance in your mouth.

Between cleanings, a system like PerioProtect can also help keep harmful bacteria at bay so friendly microbes can proliferate.

And when gum disease is particularly advanced? LANAP (Laser Assisted New Attachment Procedure) can be used to remove diseased tissue while preserving healthy tissue and destroying pathogens. It’s a kind of super deep cleaning for your gums and tooth roots, less invasive than conventional surgery yet potentially more effective. Research suggests it may even stimulate the growth of new bone in the jaw, restoring support to the teeth. And it’s comfortable for the patient, essentially pain-free.

Research published in the Journal of Periodontology has stated that LANAP should be considered the first line therapy in restoring health to diseased gums.

But the absolute best way to treat gum disease? Keep it from arising in the first place.

Why You Need to Tend to Your Teeth: Meet the Bacteria in Your Mouth

S. mutansSome are good guys; others, not so much. Good oral health means maintaining a proper balance of good to bad – and not just bacteria, but fungi and other microbial critters that hang out in even the cleanest of mouths. (In fact, recent research has shown that the yeast Candida interacts with the bacterium S. mutans to create especially strong oral biofilms [plaque].)

Unfortunately, those bad guys don’t necessarily stay confined to the mouth. And that’s the beginning of the link between gum disease and other inflammatory health problems such as heart disease, diabetes, stroke, rheumatoid arthritis, Alzheimer’s, cancer, and more.

This excellent short video will help you visualize what’s happening in your mouth when the balance is upset and how bacteria get from there to other parts of your body:


Treating Gum Disease May Lower Blood Sugar Levels

gum diseaseEarlier this week, folks observed World Diabetes Day in response to growing concerns about the global epidemic. A joint project of the International Diabetes Federation and World Health Organization, the annual campaign reaches a billion people in 160 countries around the world.

But despite casting such a wide net, half of all people with diabetes will stay undiagnosed. Considering that more than 370 million have the condition, that’s more than a few in the dark about their health. And those numbers are only expected to grow.

What you may not know is that the mouth suffers right along with the rest of the body when it comes to diabetes. As a 2012 study in the Journal of Pharmacy & BioAllied Sciences puts it,

Diabetes is a systemic disease which is a serious oral co-morbidity. Most oral complications occur in uncontrolled diabetics, involving the periodontium, the calcified tissue, and the oral mucosa. Therefore, poor metabolic control, periodontal disease, dental caries, xerostomia (dry mouth), and fungal infections go hand in hand.

The good news? Treating your gum disease may actually lower your blood sugar levels and keep diabetes in check.

Another great video for getting to know more about the link between your mouth and diabetes is Dr. Evie Lalla’s “Unscrambling the Periodontitis-Diabetes Connection.” Though her talk is geared toward doctors, don’t let that scare you. It’s valuable information. It’s also likely to spark questions you can ask your dentist or doctor.

We see education as a vital component of good oral health. It provides a foundation of understanding – the first step toward action. Good oral practices can prevent or control inflammation, helping you return to your desired state of health.

Image by AJC1






Your Mouth Is the Gateway to Your Body

In honor of October’s designated status as National Dental Hygiene Month, we’d like to share an excellent video we recently ran across – “Gums to Guts: Periodontal Medicine,” Professor Mark Ryder’s talk on oral health and its relationship to the body’s systematic health.

It not only offers great visuals and useful info on markers of health and disease; it supports the importance of seeing the mouth as an integrated part of the body, not a separate feature.

If it’s been awhile since your last hygiene visit and exam, remember this key message: The mouth is a gateway to the body and has much to do with what’s going on in your body. Good oral health not only supports good body health and wellness; it’s a key factor in it.

Know Your Nutrients: Iron

Periodontal disease isn’t just about your gums. It’s not even about your mouth. It’s about your whole body health.

The latest reminder? A follow-up study in the Journal of Indian Society of Periodontology recently confirmed that periodontitis – severe, advanced gum disease – may lead to anemia of chronic disease (ACD), a form of anemia seen in chronic infection and chronic inflammation. The researchers also found that treating the gum disease can improve anemic status.

iron from periodic tableGum disease triggers inflammation. In the short-term, this is exactly how your body should react. Over the long-term, though, inflammation is damaging, and that chronic inflammation is part and parcel of gum disease. Among other things, it interferes with your body’s ability to absorb iron.

Other factors that can lead to iron deficiency include blood loss, intense exercise or simply not getting enough through diet – especially during times of increased need, such as pregnancy, growth spurts, and lactation.

Lack of iron is a big problem. Your blood cells need it. Without enough, your red blood cells can’t carry enough oxygen throughout your body. Fatigue, dizziness, difficulty concentrating and other symptoms of anemia are the result. Your body isn’t getting what it needs to work properly.

It is getting more vulnerable to infections and illness.

So how much iron do you need? The general recommendation is 8 mg daily for men, 18 mg daily for women under 50, and 8 mg for women over 50. (Recommendations are even higher for women during pregnancy and lactation, and vary for children according to age.)

While iron supplements are available, your best first source is – always and again – real whole foods. Meats and other animal source foods provide heme iron, while plants provide non-heme iron. Since non-heme iron isn’t absorbed as well as heme, it’s especially important for vegans to watch their intake and eat in ways that promote iron-absorption. Especially iron-rich foods include

  • Liver and other organ meats
  • Red meat
  • Egg yolks
  • Oysters, clams, mussels and squid
  • Chickpeas
  • Beans
  • Lentils
  • Spinach
  • Tofu and edamame (be sure to get non-GMO)
  • Quinoa

For healthy adults, there’s little risk of overdoing it with dietary iron. Iron supplements, however, – like all supplements – are best taken under a health practitioner’s guidance, as overconsumption can cause problems (as well as interfere with your ability to absorb other essential nutrients, such as zinc). If you are taking any pharmaceutical medications, talk with your doctor before you start taking any kind of supplement to avoid any potential negative interactions.

Image via Bertucio Design @ Shapeways

The Mouth-Body Connection: Obesity and Gum Disease

obese man in waiting areaThe numbers are not encouraging.

According to the latest numbers from Gallup and Healthways, the US obesity rate has climbed once again, nearing 28%. That’s more than one in four of us. Not just overweight but obese. Here in Texas, the rate is even higher: 30%.

Meanwhile, cancer specialists speaking at the annual meeting of the American Society of Clinical Oncology in Chicago cautioned that obesity may overtake smoking as the leading cause of cancer within the decade. According to Harvard oncology specialist Jennifer Ligibel, the relationship between the two conditions is “clear.”

“It’s the case with breast cancer, a prostate cancer, cancer of the colon and all the gynaecological cancers,” she said. She highlighted research showing that obesity increased the risk of womb cancer sixfold.

Experts said obesity was driving cancer because it results in hormones imbalances that can fuel tumour growth.

Cancer and obesity are also both inflammatory conditions – like periodontal disease, which has also been linked to both.

The obesity link, in particular, has been highlighted by recent studies, such as the new research review just published in the Journal of Clinical Periodontology. The studies that met the authors’ criteria included more than 42,000 subjects and all together showed that those

who became overweight and obese presented higher risk to develop new cases of periodontitis…compared with counterparts who stayed in normal weight.

A review in the Journal of Periodontology similarly found “that overweight, obesity, weight gain, and increased waist circumference may be risk factors for development of periodontitis or worsening of periodontal measures.”

Research published earlier this year in the same journal found more pronounced markers of periodontitis (advanced gum disease) among those who were overweight and less physically fit.

So are exercise and more healthful eating the ticket? Perhaps not entirely. For one of the other findings in the Gallup/Healthways report was that social and economic factors may be fueling the rise in obesity rates, as well. Environmental factors also play a role. For instance, a new study in Environmental Health Perspectives showed how BPA may be contributing to the obesity crisis, as well:

The study is the first to find that people’s bodies metabolize bisphenol-A (BPA) — a chemical found in most people and used in polycarbonate plastic, food cans and paper receipts — into something that impacts our cells and may make us fat.

The research, from Health Canada, challenges an untested assumption that our liver metabolizes BPA into a form that doesn’t impact our health.

“This shows we can’t just say things like ‘because it’s a metabolite, it means it’s not active’,” said Laura Vandenberg, an assistant professor of environmental health at the University of Massachusetts Amherst who was not involved in the study. “You have to do a study.”

Like most modern chronic health problems, obesity is multifactoral. But eating better and getting more active do make a great start. Ramped up oral hygiene and nutritional therapy can offer big help, as well, in putting the brakes on chronic inflammation.

Image by Tony Alter

Green Tea for Healthy Gums

green tea leaves in bowlTeeth alone don’t make a smile. They need healthy gum and bone tissue to support them. The way to do that, of course, is through optimal hygiene, nutrition and overall healthy habits. Supplements, herbal medicaments and other natural substances can give a boost to those measures. Case in point? Green tea.

We’ve looked before at some of the oral health benefits of green tea. Now a more recent study – small but compelling – adds to the earlier evidence.

Subjects were split into two groups. One brushed with conventional fluoride and triclosan toothpaste; the other brushed with a green tea paste. After four weeks, the researchers looked for changes in several aspects of oral health, including pocket depth, bleeding upon probing, plaque and clinical attachment level (an estimate of a tooth’s stability). Both groups showed improvement in most areas, but by the end of the study, the green tea group had improved more.

The research was published in the International Journal of Dental Hygiene.

One of the virtues of green tea is that it is loaded with antioxidants that help keep your body’s cells healthy. It may boost levels of glutathione, a super antioxidant that is especially helpful in heavy metals detox. It is also has antimicrobial properties, having been shown effective in controlling growth of Candida – a yeast which may team up with S. mutans to make tooth decay even worse.

And, of course, green tea’s benefits are hardly limited to the mouth.

Despite the benefits, some find it hard to drink green tea on a regular basis. They may not be big fans of tea. They may find the mild flavor gets boring after a while. But whether you’re a novice tea drinker or an old pro, there are lots of ideas and recipes out there for jazzing up your brew. Here are a few for starters:

And keep in mind that there are other ways to enjoy green tea beyond brewing it. For instance, you could cook a green tea cake or Japanese green tea rice ororor

Image: Brandie Kajino

Stress & Periodontal Disease

stressed out personAs we mentioned last time, stress may increase your chances of developing poor oral health.

Recent research out of Tufts University shows that emotional and oral health are connected, as both bruxism (teeth grinding) and gum disease may be triggered by stress.

Stress can even the most oral-health conscious person to become lax about oral hygiene. Ineffective flossing and brushing allows bacteria to build up in your mouth.

Consider: More than 150 species of bacteria live in a person’s mouth. As many as a billion bacteria can cover the surface of a tooth in forming biofilm (plaque). That bacteria releases toxins whose goal, says Tufts professor Evangelos Papathanasiou, “is to create more space so more bacteria can form.”

Those toxins attack your gums, creating holes where the bacteria live and reproduce. In turn, your gums swell. Your body, trying to reduce the irritants, may actually hurt itself.

In a perfect world, immune cells and bacteria are in balance and thus protect teeth and gums. At a certain point, however, immune cells become so numerous that they begin to inflame tissue and hasten disease rather than prevent it—the same way an allergic reaction can cause the body more harm than good. At this point, gingivitis, which is reversible, gives way to bone loss around teeth and full-blown periodontitis, which is not.

Fueling inflammation are the hormones that spike when you’re stressed. One of these is cortisol, which helps you deal by increasing your energy, memory, and pain tolerance. But while it may sound like there’s only an upside, it, too, can cause problems.

When cortisol is produced peripherally in the gums, it stimulates mast cells to produce more proteins, simultaneously increasing inflammation and the progression of periodontal disease.

What’s more, gum disease increases your chances of developing infection elsewhere in your body.

The oral cavity works as a continuous source of infectious agents, and its state often reflects succession of systemic pathologies and various aspects affecting the disease progression must be considered before planning a true treatment plan.

There also appears to be a link between stress and bruxism, which can further put your gums at risk. Bruxism is the habit – often unconscious – of grinding teeth, which some have suggested may be a coping mechanism for stress. It can also do a real number on your teeth and gums. Not only can it wear down the teeth and damage enamel; the excess pressure inflames your gums, as well.

Even after all that, it’s important to remember that not all stress is bad. Sometimes it helps you survive. Your stress response can help you rescue a kitten or finish the annual report before the deadline.

But stress shouldn’t consume your life. Most health conditions linked to stress happen when you are exposed to daily pressure, known as chronic stress:

This is stress resulting from repeated exposure to situations that lead to the release of stress hormones. This type of stress can cause wear and tear on your mind and body. Many scientists think that our stress response system was not designed to be constantly activated. This overuse may contribute to the breakdown of many bodily systems.

While chronic stress is not good, you can control how you respond or cope. Typically, there are two response types: 1) emotion-focused coping and 2) problem-based coping. Emotion-focused coping may address your emotional needs and keep your mind off of the experience, but it’s often at the expense of finding a solution. In comparison, problem-based coping searches for practical solutions, but often does not do enough to soothe and calm your emotions.

Both responses may be appropriate, but again, it depends on your situation.

The main thing is that coping skills matter. One study found that poor coping skills may double your likeliness of developing a periodontal disorder. Another found that coping style can affect the severity of gum disease.

But again, how you deal depends on your specific situation and needs. Still, some general guidelines may be helpful to most anyone:

Stress & Sleep: A Match Not Made in Heaven

insomniaDo you wake up every morning feeling refreshed? For many people, that doesn’t happen. Stress keeps them tossing and turning all night, often waking up for unusual stretches of time.

You already know that stress is the bane of life. It makes you feel gloomy, irritable, hyper, tense, pressured. It’s effects are physical, as well. Chronic – ongoing – stress is a drag on health, as well. A recent poll from the Robert Wood Johnson Foundation found that

People who identified as being in poor health were more than twice as likely (60%) to report experiencing a ‘great deal’ of stress within the past month. Eight in 10 (80%) of those in poor health reported that their own health problems contributed to their stress, and more than half (58%) attributed the health problems of a family member.

Just this month, a new study found that stress raised the risk of stroke or “mini stroke” by nearly 60%!

Stress compromises your body’s immune system, increasing your chances of getting sick. For instance, normally, your body is typically able to fend off oral pathogens. But under stress?

this delicate balance is thrown off. Inflammation tends to increase due to stress, allowing bacteria to thrive and cause gingivitis, a precursor to periodontal disease.

The biological effects of stress don’t end when you fall asleep. As University of Pittsburgh sleep researcher Martica Hall recently explained to NPR, this is because chronic stress keeps you in “fight or flight” mode.

Stress hormones, such as cortisol and adrenalin, are pumped out, your heart rate goes up, sugar is released into the blood, and more blood is sent to your brain and muscles. Hall says it’s really hard to stay asleep through all that biological activity. She has found, for example, that cortisol — which surges to deal with that deadline or cope with that car payment — stays elevated throughout the night. So, even if you’re sound asleep, cortisol is constantly nudging your brain to wake up, deal with danger — real or perceived.

“Daytime stress follows you into the night,” Hall says.

And so you wake up intermittently during the night, don’t reach REM sleep, and don’t feel energized and refreshed the next day. Stress-induced bruxing – habitual clenching or grinding of teeth – may also interfere with sleep.

A pattern of unnatural sleep disruptions may have long-term health consequences – diabetes, obesity, heart disease, muscle aches, and brain damage. Yes, brain damage.

In one recent animal study, sleep deprived mice lost 25 percent of the neurons located in their locus coeruleus, a nucleus in the brainstem associated with wakefulness and cognitive processes. The research also showed that “catching up” on sleep on the weekend will not prevent this damage.

Other research published in the journal Neurobiology of Aging suggests that people with chronic sleep problems may develop Alzheimer’s disease sooner than those who sleep well.

Luckily, lifestyle changes you make today can greatly benefit you today and tomorrow. You’ll find some excellent tips for better sleep here and here and here.

True, one night of poor sleep isn’t going to cause too many issues, but you should still be mindful of the effects that stress has on your body. Overall, you want to make sure you’re getting quality sleep for approximately 7 to 9 hours a night – not 7 to 9 hours in bed but 7 to 9 hours actually sleeping.

Good sleep is needed to recharge you. After all, you’re not the energizer bunny… you can’t just keep going and going and going…

Image by Sarah