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Monday, February 4, 2013

PERIODONTAL DISEASE, LEFT UNTREATED, CAN LEAD TO TOOTH LOSS AND OTHER DISEASES


Nearly half of the people over age 30 in the U.S. have periodontal disease according to the Center for Disease Control (CDC). It occurs more frequently in men than women, is more likely to occur in current smokers and is most prevalent in Mexican-Americans. In those 65 and older, the rate increases to over 70%. Men with this gum disease are 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer and 30% more likely to develop blood cancers according to the American Academy of Periodontology (AAP).
The common factor in all of these diseases is inflammation, which is the body's response to insult. According to Dr. Greg Fauth, “Our immune system that produces inflammation is like a well-functioning army.” He explains that, “When it becomes necessary for the army to go in too many directions, fighting too many battles, the army's ability to effectively control each insult is compromised and disease will occur in the weakest link in an individual's body. Periodontal disease is one of the inflammation points that will compromise the immune system.”
According to the AAP, people with diabetes are more likely to develop periodontal disease, probably because they are more susceptible to contracting infections. Those who don't have their diabetes under control are especially at risk. Severe periodontal disease can lead to increased blood sugar levels. These periods of time when the body functions with a high blood sugar level put people with diabetes at increased risk for diabetic complications.
While no cause and effect relationship has been proven between periodontal disease and heart disease, scientists believe that inflammation caused by periodontal disease may be responsible for an association between the two. In addition, periodontal disease can also cause existing heart conditions to worsen.
Additional studies have pointed to a relationship between periodontal disease and stroke. In one study, people diagnosed with acute cerebrovascular ischemia (stroke) were more likely to have a periodontal infection than those who did not have an infection.
The good news is that your general dentist, dental hygienist or a periodontist can perform a comprehensive periodontal evaluation at your regular yearly dental check-up. The evaluation is relatively painless and non-invasive. It consists of examining each tooth above and below the gum line. An instrument called a ‘periodontal probe’ is passed gently along the side of the tooth beyond the gum line. The probe will stop at about the level of the bone attachment to the tooth. It allows the dental professional to measure the distance from the gum line to the bone level, feel the texture of the tooth (rough or smooth) and see if the gum bleeds when the probing is done. Bleeding on probing is a good indicator of inflammation in the gums. Rough texture of the root indicates dental plaque hardened on the tooth that makes it impossible to clean the root surface effectively. Probing depth greater than 3-4 mm indicates an area that cannot be predictably cleaned with home care instrumentation.
The warning signs of gum disease include the following:
• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing or eating hard food
• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures
Periodontal disease is known as a silent disease and the onset of the disease may be present without the symptoms. Therefore, it is very important to have a yearly exam that allows your dental professional check for any warning signs that you may not notice, but may be present. As more evidence unfolds indicating the association between periodontal disease and an individual’s well being, it becomes more important for each of us to establish a regimen of evaluation and care.
If you would like to take an assessment, click on http://service.previser.com/aap/default.aspx.
WHAT IS A PERIODONTIST AND WHAT DOES HE DO?
A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease and are also trained in performing cosmetic periodontal procedures.
Periodontists often treat more problematic periodontal cases, such as those with severe gum disease or a complex medical history. Periodontists offer a wide range of treatments, such as scaling and root planing (in which the infected surface of the root is cleaned) or root surface debridement (in which damaged tissue is removed). They can also treat patients with severe gum problems using a range of surgical procedures. In addition, periodontists are specially trained in the placement and repair of dental implants.
During the first visit, the periodontist usually reviews the patient’s complete medical and dental histories. It is extremely important for the periodontist to know if any medications are being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.
The periodontist examines the gums, checks to see if there is any gum line recession, assesses how the teeth fit together when biting, and checks the teeth to see if any are loose. The periodontist will also take a small measuring instrument called a probe and place it between the teeth and gums to determine the depth of those spaces, known as periodontal pockets; this helps the periodontist assess the health of the gums. X-rays may also be taken to observe the health of the bone below the gum line.
Who Should See a Periodontist?
Some periodontal needs can be managed by the general dentist. However, as more and more patients are exhibiting signs of periodontal disease, coupled with research that suggests a relationship between periodontal disease and other chronic diseases of aging, periodontal treatment may necessitate a greater understanding and increased level of expertise by a trained specialist. Patients who present with moderate or severe levels of periodontal disease, or patients with more complex cases, will be best managed by a partnership between the dentist and periodontist.
This information comes from the American Academy of Periodontology and can be seen at http://www.perio.org/consumer/periodontist2.htm.

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