CHICAGO—April 18, 2012—The American Academy of Periodontology (AAP) supports the American Heart Association’s (AHA) scientific statement “Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association?” recently published in Circulation. The statement concludes that observational studies to date support an association between periodontal disease and cardiovascular disease, independent of shared risk factors. The AHA’s statement confirms the conclusions of the statements published by the AAP and the American Journal of Cardiology in 2009 and the U.S. Preventive Services Task Force in 2008.
While current research does not yet provide evidence of a causal relationship between the two diseases, scientists have identified biologic factors, such as chronic inflammation, that independently link periodontal disease to the development or progression of cardiovascular disease in some patients.
The lack of causal evidence should not diminish concern about the impact of periodontal status on cardiovascular health. According to Pamela McClain, DDS, president of the American Academy of Periodontology and a practicing periodontist in Aurora, Colorado, “Periodontal disease and cardiovascular disease are both complex, multi-factorial diseases that develop over time. It may be overly simplistic to expect a direct causal link. The relationship between the diseases is more likely to be mediated by numerous other factors, mechanisms, and circumstances that we have yet to uncover. However, as the AHA statement points out, the association is real and independent of shared risk factors. Patients and healthcare providers should not ignore the increased risk of heart disease associated with gum disease just because we do not have all the answers yet.”
The AAP believes additional long-term interventional studies are needed to better understand the specific nature of the relationship between periodontal disease and cardiovascular disease. Patients’ periodontal status should also be added to future longitudinal studies of cardiovascular disease. The AAP hopes that the American Heart Association’s statement brings attention to the association between the two diseases and the need for additional research in this area.
Dr. McClain encourages physicians and dentists to communicate the association between cardiovascular disease and periodontal disease to patients. “It is not as simple as telling a patient that brushing and flossing will ward off a heart attack,” says Dr. McClain. “Patients should be aware that by maintaining periodontal health, they are helping to reduce harmful inflammation in the body, which has been shown to reduce the risk of cardiovascular disease.”
Patients should expect to receive a comprehensive periodontal evaluation from their dental professional at least once a year, adds Dr. McClain. This includes a detailed examination of the teeth and gums, and an assessment of risk factors such as smoking, age, and overall health status. In addition, patients diagnosed with periodontal disease should be sure to inform their general health care provider and/or cardiologist to encourage better integration of their care.
“There is no compelling evidence to support that treating periodontal disease will reduce cardiovascular disease at this time,” says Dr. McClain, “but we do know that periodontal care will improve your oral health status, reduce systemic inflammation, and might be good for your heart as well.”
CHICAGO—December 12, 2011—Routine tooth brushing and flossing and regular check-ups by a dental professional remain the cornerstone of a healthy mouth. However, according to the American Academy of Periodontology (AAP), pairing a few well-known healthy-lifestyle habits with your daily oral health regimen may also help reduce your risk for periodontal disease.
Periodontal disease is a chronic inflammatory disease that affects the gum tissue and other structures supporting the teeth. According to Dr. Pamela McClain, President of the American Academy of Periodontology and a practicing periodontist in Aurora, Colorado, “If left untreated, periodontal disease can lead to tooth loss and may also interfere with other systems of the body. Several research studies have indicated that one’s periodontal health may be related to overall health. Therefore, it is crucial that you do everything you can to establish good periodontal health.”
According to the AAP, the following tips may help sustain healthy teeth and gums while also helping you live an overall healthy lifestyle:
- Eat and drink up. It is well known that eating a balanced diet leads to proper nutrition and helps keep the body running effectively. Studies published in the Journal of Periodontology (JOP) have also shown that certain foods can promote teeth and gum health. Foods containing omega-3, calcium, vitamin D and even honey have all been shown to reduce the incidence or severity of periodontal disease.
- Hit the gym. Frequent exercise is a recognized way to avoid being overweight, and it may ultimately reduce your risk of periodontal disease. In a study published in the Journal of Periodontology, researchers found that subjects who maintained a healthy weight and had high levels of physical fitness had a lower incidence of severe periodontitis than those that did not exercise.
- Stress less. Stress can lead to a variety of health complications, including periodontal disease. Research published in the JOP showed a relationship between stress and periodontal disease. Increased levels of cortisol, which the body releases when experiencing stress, can intensify the destruction of the gums and bone due to periodontal disease. In addition, another JOP study indicated that people experiencing stress are more likely to neglect their oral hygiene.
- Kick the habit. Smoking is not only a leading cause of respiratory and cardiovascular disease in the United States, it is also a major risk factor for periodontal disease. Several research studies have shown that smoking not only increases the chance of developing periodontal disease, but it can also affect the success of treatments for existing periodontal disease.
- See the doctor. Regular check-ups by a physician can help with early diagnosis of several health issues, including periodontal disease. A large body of research associates gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis. Therefore, by screening for systemic disease early and receiving any needed treatment, you may also benefit your periodontal health.
Dr. McClain stresses that while these tips may contribute to healthy teeth and gums, the benefit of routine oral care cannot be discounted. “Taking good care of your periodontal health starts with daily tooth brushing and flossing. You should also expect to get a comprehensive periodontal evaluation, or CPE, every year,” she advises. A dental professional, such as a periodontist, a specialist in the diagnosis, treatment and prevention of gum disease, can conduct a comprehensive exam to assess your periodontal health.
Tooth whitening is the leading dental procedure requested by people under the age of 20 and between the ages of 30 and 50. In the last 10 years alone, this procedure has exploded by 300 percent, according to The American Academy of Cosmetic Dentistry.
Perhaps one reason for the explosion has to do with the vast numbers of people having their teeth whitened, which then sets a new standard for how “normal” teeth are supposed to look. Even if your teeth are a healthy shade, they may look yellow when compared to the pearly whites of celebrities and, now, the average person walking down the street.
The problem with most current tooth-whitening products, both over-the-counter versions and those performed in your dentist’s office, is that they use hydrogen peroxide to whiten your teeth.
This is not your best choice because peroxide can cause your teeth to become sensitive. Additionally, hydrogen peroxide forms radical intermediates that can damage and destroy your gums and nerves.
What causes your teeth to become discolored in the first place? Tooth discoloration is caused by colored molecules such as tannins and polyphenols — found in red wine, coffee, and tea — which become absorbed by your tooth enamel’s surface.
Cigarettes, blueberries, and other foods that contain dark pigments can also discolor your tooth enamel, as can certain medications. Some of the staining can be removed by brushing, but over time the compounds can seep into your enamel.
If you’re looking for a safer alternative to brighten your teeth, you can try this simple trick:
- Crush one ripe strawberry and mix it with 1/2 teaspoon of baking soda.
- Spread the mixture onto your teeth and leave on for five minutes.
- Brush your teeth with a little toothpaste (non-fluoride, of course) and rinse.
This natural mixture works because of the malic acid it contains, which acts as an astringent to remove some of the surface discoloration on your teeth. Though this method is perfectly safe to use on occasion, don’t use it too often (no more than once a week) because the acid could potentially damage your tooth enamel.
A study published in the Journal of Periodontology found that current and past users of the contraceptive depot medroxyprogesterone acetate (DMPA) had increased markers of poor periodontal health compared to women who have never used it.
CHICAGO—February 6, 2012—Injectable progesterone contraceptives may be associated with poor periodontal health, according to research in the Journal of Periodontology. The study found that women who are currently taking depot medroxyprogesterone acetate (DMPA) injectable contraceptive, or have taken DMPA in the past, are more likely to have indicators of poor periodontal health, including gingivitis and periodontitis, than women who have never taken the injectable contraceptive. DMPA is a long-lasting progestin-only injectable contraceptive administered intermuscularly every three months.
Periodontal disease is a chronic inflammatory disease that affects the gum tissue and bone that supports the teeth. Gingivitis, the mildest form of gum disease, causes the gums to become red, swollen, and bleed easily. Periodontitis is the most severe form of gum disease and can lead to tooth loss. Additionally, research has associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis.
The data for this study were obtained from the NHANES 1999-2004 public use datasets. The participants chosen were non-pregnant, premenopausal women aged 15-44 who had provided complete DMPA usage data, indicating current usage of DMPA, past usage of DMPA, or no usage of DMPA at all. All participants received a dental examination that noted clinical attachment (CA) loss, periodontal pocket assessment at two or three sites per tooth, and presence of gingival bleeding.
After adjusting for age, race, education, poverty income level, and smoking status, the study found that current and past DMPA users had significantly increased periodontal pockets, gingival bleeding, and CA loss than women who have never used DMPA. Current DMPA users were more likely to have gingivitis, while past DMPA users were more likely to have periodontitis.
According to Dr. Pamela McClain, President of the American Academy of Periodontology (AAP) and a practicing periodontist in Aurora, Colorado, women currently taking DMPA or that have used DMPA in the past should pay careful attention to their teeth and gums. “Hormones can play a role in woman’s periodontal health. These findings suggest that women that use, or have used, a hormone-based injectable contraception such as DMPA may have increased odds of poor periodontal health. I would encourage women that use or previously used this form of contraception to maintain excellent oral care, and to be sure to see a dental professional for a comprehensive periodontal evaluation on an annual basis.”
November 11, 2011 — The U.S. Centers for Disease Control and Prevention (CDC) will retain its Division of Oral Health (DOH), according to a story in ADA News.
Earlier this year, the CDC came under fire after announcing a restructuring proposal that would have folded the division into the Division of Adult and Community Health.
The ADA, Academy of General Dentistry, American Academy of Developmental Medicine and Dentistry, Rep. Mike Simpson (R-ID), and a group of former chief dental officers of the U.S. Public Health Service all sent letters to U.S. Department of Health and Human Services Secretary Kathleen Sebelius and CDC Director Thomas Frieden, MD, MPH, voicing their opposition.
In each case, the authors emphasized that if the consolidation occurred, oral health would inevitably become less of a priority.
“Dissolving one of the separate dental divisions from the department would only seem to decrease and take away from highlighting the importance of preventing and treating oral disease,” the ADA letter stated.
“Such organizational changes would diminish the visibility of oral health at CDC during a time of critical need for public health leadership less than a year after the Department of Health and Human Services announced and began to implement a department-wide oral health initiative,” the letter from former chief dental officers of the U.S. Public Health Service stated.
The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,400 members worldwide.
Once considered an inevitable part of aging, dry mouth is now commonly associated with certain medications and autoimmune conditions such as Sjogren’s syndrome. Both of these can reduce salivary production or alter its composition, but experts agree that the primary cause of dry mouth is the use of medications.
Radiation treatment for head and neck cancer is also an important cause of severe dry mouth. The treatment can produce significant damage to the salivary glands, resulting in diminished saliva production and extreme dry mouth in many cases.
“Saliva plays an important role in maintaining oral health,” says Dr. Donald Clem, president of the American Academy of Periodontology. “With decreased saliva flow, we can see an increase in plaque accumulation and the incidence and severity of periodontal diseases.”
More than 500 medications can contribute to oral dryness, including antihistamines (for allergy or asthma), antihypertensive medications (for blood pressure), decongestants, pain medications, diuretics and antidepressants.
CHICAGO—August 11, 2011—Leading dental and pharmacy organizations are teaming up to promote oral health and raise public awareness of dry mouth, a side effect commonly caused by taking prescription and over-the-counter medications. More than 500 medications can contribute to oral dryness, including antihistamines (for allergy or asthma), antihypertensive medications (for blood pressure), decongestants, pain medications, diuretics and antidepressants. In its most severe form, dry mouth can lead to extensive tooth decay, mouth sores and oral infections, particularly among the elderly. Nearly half of all Americans regularly take at least one prescription medication daily, including many that produce dry mouth, and more than 90 percent of adults over age 65 do the same. Because older adults frequently use one or more of these medications, they are considered at significantly higher risk of experiencing dry mouth.
The American Dental Association (ADA), Academy of General Dentistry (AGD), American Academy of Periodontology (AAP) and the American Pharmacists Association (APhA) are collaborating to expand awareness of the impact of medications on dry mouth, a condition known to health professionals as xerostomia.
With regular saliva production, your teeth are constantly bathed in a mineral-rich solution that helps keep your teeth strong and resistant to decay. While saliva is essential for maintaining oral health and quality of life, at least 25 million Americans have inadequate salivary flow or composition, and lack the cleansing and protective functions provided by this important fluid. “Each day, a healthy adult normally produces around one-and-a-half liters of saliva, making it easier to talk, swallow, taste, digest food and perform other important functions that often go unnoticed,” notes Dr. Fares Elias, immediate past president, Academy of General Dentistry. “Those not producing adequate saliva may experience some common symptoms of dry mouth.”