Mark D. Phipps, D.D.S. - Implants & General Dentistry
Ask Dr. Phipps

Dental Health

Gum Disease Links to Heart Disease, Stroke and Diabetes

Gum disease in the US may be as much as 50% more common than previously thought, according to new research from the CDC and American Academy of Periodontology (AAP).
A pilot study of 450 American adults found significantly higher levels of periodontal disease than expected.
Previous estimates of periodontitis in the US relied on partial-mouth examinations. When full-mouth periodontal exams were conducted instead, researchers discovered significantly more perio disease, leading them to suspect that previous estimates may have underestimated the population's level of gum disease by up to 50%.
Why is this important? Researchers have found that people with gum disease are almost twice as likely to suffer from coronary artery disease!  Several theories exist to explain the link between periodontal disease and heart disease.  One Theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation.  Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins.  Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly.  This may lead to heart attacks.
Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries. 
Periodontal disease can also exacerbate existing heart conditions.  Patients at risk for infective endocarditis may require antibiotics prior to dental procedures.  Dr. Phipps and your cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.
Additional studies have pointed to a relationship between periodontal disease and stroke.  In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.
While it has been established that people with diabetes are more prone to developing periodontal disease, new research is suggesting that periodontal disease may, in turn, be a risk factor for diabetes.
When you come into the office for your regular dental cleaning, you will be asked questions that will help us assess your need for antibiotics prior to any dental treatment.  Dr. Phipps and the hygienist will determine an appropriate interval for you to return for your regular teeth cleanings based on your current periodontal condition and the effectiveness of your home care.  6 months is a general guideline for dental cleanings but that interval may be shortened if indicated.  If you have questions about your oral health, drop us a note or call our office, we are happy to answer them!

Your Health History - What We Need To Know And Why

     Everyone hates to fill out health history forms, gosh, I know I do.  Especially when I just filled them out last year or the year before.  Isn’t once enough?   Well the simple answer to that is No.  It is important for us to know current and accurate health information which includes changes in medications, joint replacements, heart complications and any new developments since your last visit. 
     You can help make this process easier by bringing a current list of medications and the amounts that you take, both prescribed and over the counter, including aspirin, vitamins and any supplements, whether prescribed or not.  Bring this to each visit, particularly if there has been a change in your medications. 
     If you have had a joint replacement or have a heart condition, we will ask for the name of your treating physician and their phone number.  They will be contacted to determine the need for antibiotic prophylaxis.  Patients who have certain heart conditions and those with artificial joints may be at risk of developing an infection in the heart or at the site of the artificial joint respectively.  Antibiotics taken prior to dental treatment reduce this risk. 
     Certain diseases of the body can have a direct effect on your teeth as well.  If you have GERD (Gastroesophageal reflux disease) the reflux of acid from the stomach back up into the esophagus can ultimately make its way to the mouth. Because this acid is in constant intimate contact with the teeth, it can demineralize or remove layers from them. In general, the enamel on the lingual, or the tongue and palate surfaces of the tooth, is affected rather than the outer or cheek side of the enamel of the tooth. It is also true that patients with GERD experience dry mouth, which intensifies dental bacteria and plaque and can lead to an increase in cavities and decay. Medications that GERD patients take can also dry out the mouth, which contributes to stronger dental plaque. A number of patients say that sucking on breath mints, candies, or lozenges soothes burning in the mouth. Sucking on lozenges can also stimulate saliva production, which helps to fight dry mouth. Beware of mints or sucking on candies that contain sugar, as they can also contribute to increased decay.
     Cancer and Chemotherapy is another important health issue we need to know about.  You may have certain side effects in your mouth from chemotherapy. Each persons experience may be different.  The problems depend on the chemotherapy drugs and how your body reacts to them. You may have these problems only during treatment or for a short time after treatment ends.  These can include:  painful mouth and gums, dry mouth, burning, peeling, or swelling tongue, infection,  and/or change in taste.  You may be surprised that your dentist is important in your cancer treatment. If you go to the dentist before chemotherapy begins, you can help prevent serious mouth problems. Side effects often happen because a person's mouth is not healthy before chemotherapy starts. Not all mouth problems can be avoided but the fewer side effects you have, the more likely you will stay on your cancer treatment schedule.
     Allergies are another area where we need accurate information.  What are you allergic to and what kind of reaction did you have.  If you check the box, allergic to antibiotics, we need to know specifically which one and what happened when you took it last.
     These are just a few examples of why it’s important to have an accurate health history completed and up to date.  Each item on the health history form is there for a reason and helps us provide you with the best care.