Posts Tagged ‘Periodontal Disease’

This month I would like to discuss another dental issue and problem that many people (approximately 40 Million Americans) suffer with: Sensitive teeth.

Teeth are composed of enamel on the outside and the dentin which lies just under the enamel. Dentin contains very small tubes that have fluid in them.  When hot, cold, chemicals such as whitening agents or sweets pass by the surface of the dentin on the exposed roots and edges of teeth it moves the fluid in the micro tubes and this causes the pain by stimulating the nerve.  So when pain is felt it is actually an indirect contact with the nerve through this system and not a direct touching of the nerve.

The following are the most frequent causes of tooth sensitivity:

• Brushing with excessive pressure with hard toothbrush bristles. Over time this aggressive act will take away the gum tissue, the bone and then the tooth leading to exposed root dentin which will make the teeth sensitive.  The use of a soft toothbrush using a gentle circular motion aiming at the gumline is the best way to safely brush the teeth without harm. I am often asked what is the best toothbrush?   I say a soft manual brush or even better is an electric brush like the Sonicare.  They are gentle on the teeth and effective on plaque removal while infusing oxygen into the plaque which helps to kill the bacteria between the teeth.
• Periodontal disease will cause bone loss around the teeth giving the “long in the teeth” appearance. Some people falsely believe that this is a part of the natural aging process but it isn’t.  Periodontal disease is caused by a bacterial invasion under the gum line which eventually causes the bone to be lost.  Smokers and uncontrolled diabetics are the ones who are most likely to be diagnosed with this disease.
• Grinding of the teeth from stress can create loss of bone and tooth structure where the root meets the gum. This is called an abfraction and is like a deep notch in the tooth.  When one grinds their teeth the teeth flex and under the right conditions these notches can deepen and become sensitive.  A small guard can prevent this from happening and an evaluation is necessary to make sure the bite is proper.  Sometimes it may be necessary to adjust the bite.
• Abrasive toothpastes such as those containing baking soda can be harmful and abrade the tooth roots.
• Acidic foods and beverages such as soft drinks can cause tooth pain by decaying the tooth. I had a patient recently ask me if lemon in the water can cause the sensitive teeth because she was using a lot of lemon.  This certainly increases the acid level in the mouth and causes them to be sensitive. Acid reflux especially at night is a contributing factor in that the stomach acid is very strong which leads to loss of enamel.  Bulimia  also makes the teeth exposed to the strong acids in the stomach, leading to really sensitive teeth.

These are the most common causes that lead to sensitive teeth.  Treatment includes such things as: fluoride rinses at home, tooth pastes such as Sensodine, Renamel and a number of other toothpastes which have a chemicals in them that literally “clogs” up the small microtubes in the dentin.  When these get “clogged up” they can’t transmit the fluid within the micro tubes and pain is reduced.  We have stronger “clogging agents”  that can be applied in the office which can make a significant difference in pain.   You must remember that  hard tooth brushing and acids will dissolve the reparative plugs that are formed so it is necessary to change the habits that have created the sensitive teeth in the first place.  It is best to visit your dentist to have this evaluated.  If you don’t have a current dental home then I would be happy to evaluate your situation so give us a call at (586)247-3500.

About The Author

Dr. Robert Antolak, DDS graduated from the University of Michigan in 1987 with his Doctor of Dental Surgery degree. He is dedicated to providing the highest quality and appropriate cosmetic, sedation and general dentistry in the most comfortable and gentle way possible. Because being a dentist has been a lifelong dream, Dr. Antolak has a passion for the profession. He enjoys helping people feel better about their smiles and therefore their self-image with dental implant and cosmetic dentistry. His Dental Practice is located in Shelby Township, Michigan.  For more information visit The Gentle Dentist.

Do you have bad breath, bleeding gums when brushing or flossing, loose teeth or history of tooth loss?  If you answer yes to any of these questions, then you may have periodontal disease. Gum disease is very common. Unfortunately most people don’t even know that they have periodontal (gum) disease.  It isn’t until it is too late when their teeth start getting loose that they want to do something about it and many times it is too late and they have to have their teeth removed or need extensive treatment.  In fact, with recent research linking the risk of heart disease, diabetes, stroke and low birth weight babies with periodontal disease and bleeding gums it is critical to have your mouth assessed for this infective disease. The bacteria in the gums leach out in the blood stream requiring the body’s immune system to constantly fight off these invaders.

This constant and chronic immune response is not a good thing because it causes chronic inflammation. Over the past 3-4 years research has been showing that chronic systemic inflammatory diseases such as periodontal disease can increase the level of a substance called c-Reactive protein. The liver releases this substance in response to systemic inflammation.  As the level of c-reactive protein increases so does the risk of cardiovascular diseases such as stroke, heart attack, and diabetes according to multiple clinical studies. In fact, testing for C-reactive protein in a blood test may be an effective early warning test for asymptomatic, or presymptomatic heart disease.

Listed are chronic systemic diseases that can increase the c-Reactive protein levels in the blood.

We find that the c-reactive protein levels can significantly fall once the periodontal disease is treated which in effect can reduce their risk for heart attacks, stroke, diabetes and low weight preterm babies. In addition to the treatment in our office, we work to boost the body/s immune system by using anti-oxidants. For smokers, we highly suggest to them that they become part of a smoking cessation program. If you are in a high risk category and don’t know your status of periodontal disease then have it evaluated.  The c-reactive protein levels are evaluated by blood tests and since this is important indicator your periodontal status should also be tested.  This is to protect you and your heart.  If you don’t have a dentist you can contact our office at (586) 247-3500.  Our Dental Office is located in Shelby Township, Michigan — Southeast Michigan in Macomb County.

I asked Helen, a patient of mine in her late 70’s who regularly reads my “Ask The Gentle Dentist” column what she would like to see in my June Ask the Dentist column.  She thought it would be a good idea for me to write an article on the Periodontal Disease / Gum Disease.  This was inspired because a friend of hers was recently diagnosed with adult onset diabetes and Periodontal and Gum Disease.  I posted an article some time ago on the co-relationship between Periodontal and Gum Disease and other systemic diseases like diabetes and heart disease.  Smoking, high cholesterol, high blood pressure and Periodontal Disease / Gum Disease all create inflammation in the body and are potential agents that can cause heart disease.

There is accumulating evidence and data that shows that the bacteria that causes Periodontal Disease / Gum Disease gets into the blood system creating chronic inflammation.  This chronic inflammation activates a protein called C-Reactive Protein into the blood eventually creating a higher risk of stroke, heart attacks by hardening of the arteries (atherosclerosis) in coronary (heart) and carotid arteries.

Diabetes is a growing problem that now affects over 7% of Americans and is still on the rise.  In fact, in the 1980s there were 5 million people diagnosed and now there are over 23 million. About 30% of diabetics are not even diagnosed. The most common reason why there is such a rapid rise in the incidence is because of the sedentary lifestyle that Americans are living.  Fast foods, high sugar drinks, lack of exercise has created an obese population. In fact the CDC states that over 26% of Americans are obese (120% of normal body weight)!!   Obviously watching diet and exercise can go a long way to a better, healthier body.

What is diabetes?  Insulin is a naturally occurring hormone made naturally in the body.  When carbohydrates are eaten the body rapidly breaks it down to simple sugars which are rapidly absorbed into the blood stream.  Insulin is then released in response to the high levels of blood sugar.  Insulin allows the sugars to penetrate into the cells of the body when it is needed.  Diabetes is therefore the inability of the cells to absorb the blood sugar due to a lack of this insulin

There are three types of diabetes:

• Type 1 is where the body’s immune system actually destroys the cells that make insulin.  This is genetic in nature and is usually diagnosed at an early age. It is also the most severe form of diabetes.
• Type 2 is also known as adult onset diabetes.  In this situation the body doesn’t create enough insulin.  90-95% of diabetics are type 2, but this number is rising at an alarming rate.
• Gestational diabetes develops during pregnancy, but after birth the body rebounds back to health.

Diabetics are at risk for blindness, Stroke, amputation of toes and legs, Heart attack, numbness, kidney failure, early death, and Periodontal Disease / Gum Disease. A well controlled diabetic who exercises and eats properly has the same risk of these problems as a healthy individual.  It is therefore important to take medicines along with diet and exercise to live a somewhat normal life.

Periodontal (gum) disease is described as a bacterial infection and inflammation of the bone and soft tissues that hold the teeth into the jaw.  This infection usually is not painful or sometimes not easily seen without a proper diagnosis by your dentist.  The bone around you teeth that is dissolved from the disease will never come back but with proper treatments the bone level can stabilize.

You know you have Periodontal Disease / Gum Diseaseif you have bad breath, your gums bleed when brushing or flossing and/or your teeth are loose and shift around.    Since it is usually not painful (like most chronic diseases) you may have Periodontal Disease / Gum Disease and not even know about it.

Periodontal Disease / Gum Disease is considered to have a bidirectional relationship with diabetes.  In other words diabetes affects the severity and complications of Periodontal Disease / Gum Disease and the periodontal disease affects diabetes and the ability to control blood sugar levels.  The National Diabetic Association states this and research supports this claim.

The bottom line is that if you or a loved one has been diagnosed with diabetes you are at risk for Periodontal Disease / Gum Disease.  If you have a difficult time in regulating your blood sugar then a periodontal evaluation is critical so that you not only can save your teeth, but potentially save your life.

Do me a favor and mention this article to your physician so that they can also be informed and team up with dentist’s to combat this serious problem.

For more information on this please visit the American Heart Association www.AmericanHeart.org website.

If you have questions or comments you can email me at DrAntolak@TheGentleDentist.com or phone us at (586)247-3500

If you have diabetes and desire a free dental consultation please give us a call.  Our dental office is located in Shelby Township, Michigan (Macomb County) at 22 Mile and Hayes.