Women who are menopausal or post-menopausal may experience changes in their mouths.
Recent studies suggest that estrogen deficiency could place post-menopausal women at higher risk for severe periodontal disease and tooth loss.
In addition, hormonal changes in older women may result in discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.
In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition.
Most women find that estrogen supplements help to relieve these symptoms.
Bone loss is associated with both periodontal disease and osteoporosis. Osteoporosis could lead to tooth loss because the density of the bone that supports the teeth may be decreased. More research is being done to determine if and how a relationship between osteoporosis and periodontal disease exists. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth as well as other parts of the body.
Sometimes when you lose one or more teeth, you can get an indention in your gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place.
Not only is this indentation unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth.
A periodontist can fill in this “defect” with a procedure called ridge augmentation, recapturing the natural contour of your gums and jaw. A new tooth can then be created that is natural looking, easy-to-clean and beautiful.
Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
There are many forms of periodontitis. The most common ones include the following.
- Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
- Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
- Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
- Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.
A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you’ve lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.
Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material. Your periodontist can explain your options for graft materials, which can regenerate lost bone and tissue.
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented.
Sinus augmentation has been shown to greatly increase your chances for successful implants that can last for years to come. Many patients experience minimal discomfort during this procedure.
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.”
Twin study published in the Journal of Periodontology demonstrates that flossing can decrease the occurrence of gum disease-causing bacteria.
CHICAGO—August 5, 2008—In dental offices all over the world, patients are often told they are not flossing enough or instructed to floss more. As the old saying goes, you only need to floss the teeth you want to keep. After all, not flossing regularly can lead to tooth decay and to periodontal disease, the leading cause of tooth loss in adults.
A study published in the Journal of Periodontology (JOP), the official publication of theAmericanAcademy of Periodontology (AAP) demonstrates that including flossing as part of one’s routine oral care can actually help reduce the amount of gum disease-causing bacteria found in the mouth, therefore contributing to healthy teeth and gums.
The study, conducted atNew YorkUniversity, examined 51 sets of twins between the ages of 12 and 21. Each set was randomly assigned a two-week treatment regimen with one twin brushing with a manual toothbrush and toothpaste and the other twin brushing with a manual toothbrush and toothpaste and flossing. At the end of the two-week trial, samples were taken from both pairs of twins and compared for levels of bacteria commonly associated with periodontal disease.
The study findings indicated that those twins who did not floss had significantly more of the bacteria associated with periodontal disease when compared to the matching twin who flossed in addition to tooth-brushing with toothpaste.
“This study illustrates the impact flossing can have on oral health. The twins experimental model is a powerful tool to help sort out genetic and environmental factors that often confound the interpretation of treatment studies. This study demonstrates that flossing can have an important and favorable impact on an individual, as compared to that of a non-flossing individual with similar genetics and possibly similar habits,” explains Dr. Kenneth Kornman, editor or the Journal of Periodontology. “Twins tend to share the same or similar environmental factors such as dietary habits, health and life practices, as well as genetics. In this case, the only difference was flossing, and the outcome was significant. Flossing may significantly reduce the amount of bad bacteria in the mouth.”
The study results support that old saying, and show that including flossing as an integral part of your regular oral care can help reduce the amount of periodontal disease-causing bacteria in the mouth, thereby helping you keep your teeth. Periodontal disease is an infection caused by a build-up of bacterial plaque, a sticky, colorless film that constantly forms on your teeth. Flossing, or using interdental cleaners, helps clean the bacterial plaque from between your teeth that regular brushing can’t reach.
“As a practicing periodontist, I am constantly telling my patients to clean between their teeth more using dental floss or interdental cleaners,” says Dr. Susan Karabin, President of the AAP. “Patients tend to think that flossing can’t possibly make that much of a difference. But this study demonstrates that the addition of flossing to your dental hygiene routine can significantly reduce the amount of periodontal disease causing bacteria. Even after just two weeks!”
Chronic gingivitis is common in children. It usually causes gum tissue to swell, turn red and bleed easily. Gingivitis is both preventable and treatable with a regular routine of brushing, flossing and professional dental care. However, left untreated, it can eventually advance to more serious forms of periodontal disease.
Aggressive periodontitis can affect young people who are otherwise healthy. Localized aggressive periodontitis is found in teenagers and young adults and mainly affects the first molars and incisors. It is characterized by the severe loss of alveolar bone, and ironically, patients generally form very little dental plaque or calculus.
Generalized aggressive periodontitis may begin around puberty and involve the entire mouth. It is marked by inflammation of the gums and heavy accumulations of plaque and calculus. Eventually it can cause the teeth to become loose.
Periodontitis associated with systemic disease occurs in children and adolescents as it does in adults. Conditions that make children more susceptible to periodontal disease include:
- Type I diabetes
- Down syndrome
- Kindler syndrome
- Papillon-Lefevre syndrome
For example, in a survey of 263 Type I diabetics, 11 to 18 years of age, 10 percent had overt periodontitis.
Studies have shown a relationship between periodontal disease and preterm, low birthweight babies. In fact, pregnant women with periodontal disease may be seven times more likely to have a baby that’s born too early and too small. The likely culprit is a labor-inducing chemical found in oral bacteria called prostaglandin. Very high levels of prostaglandin are found in women with severe cases of periodontal disease.
Tooth loss can cause an indentation in the gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indention unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth.
Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.
Research shows that smokers loose more teeth than nonsmokers do. In fact, according to data from the Centers for Disease Control and Prevention, only about 20 percent of people over age 65 who have never smoked are toothless, while a whopping 41.3 percent of daily smokers over age 65 are toothless.
In addition, research shows that current smokers don’t heal as well after periodontal treatment as former smokers or nonsmokers. But these effects are reversible if the smokers kick the habit before beginning treatment.