A substantial amount of research has recently pointed up the connection between oral health and systemic (whole-body) health. But recently, one study went a step further: It seems to show that having certain dental-health issues in middle age — for example, tooth loss and gum disease — could signal a deterioration in cognitive function.
Study author Gary Slade, a professor at the University of North Carolina at Chapel Hill, summed it up: “We were interested to see if people with poor dental health had relatively poorer cognitive function, which is a technical term for how well people do with memory and with managing words and numbers,” he said in an interview with U.S. News and World Report. “What we found was that for every extra tooth that a person had lost or had removed, cognitive function went down a bit. The same was true [for] patients with severe gum disease.”
Does this mean that losing teeth is a little like losing brain cells? Not really, because it isn’t clear which condition occurred first… or even if one caused the other. For example, it could be that a poor diet is responsible for both poor dental health and a decline in cognitive ability; on the other hand, there could be a genetic link between both conditions. Or, it could simply mean that people with cognitive difficulties don’t take good care of their teeth.
Still, the association is intriguing — especially because it echoes some previous studies, which indicate that systemic inflammation could be a major cause of both problems. What’s the oral-systemic connection? No one is exactly sure yet, but research suggests a relationship between periodontal disease and other diseases such as heart disease, stroke and diabetes. The common link may be bacteria: The same microorganisms that cause problems in the mouth might be able to spread through the body, producing a low-grade inflammation — one that’s waiting for the right conditions to burst into fire.
So, should you rush out and grab everything off the drugstore’s oral health products shelf? Well, we wouldn’t necessarily go that far… but here’s a more sensible suggestion: Take good care of your teeth and gums. Both tooth decay and periodontal disease can cause a number of problems with your health — yet both can be treated effectively… and they’re largely preventable!
If you haven’t visited our office in a while, why not come in for an exam? When you do, ask us what’s the best way to keep your smile looking great and feeling clean and healthy. Our goal is to help you maintain proper oral hygiene — for life. If you would like more information about oral health and systemic diseases, call our office for a consultation. You can learn more in the Dear Doctor magazine article “The Link Between Heart & Gum Diseases.”
Electric-powered toothbrushes have been in use for decades, and continue to enjoy wide popularity. But since their inception in the 1950s, there’s been a continuous debate not only about the best choice among powered toothbrushes, but whether powered toothbrushes are as effective in removing plaque as manual toothbrushes.
These debates are fueled by a large body of research over many years on powered toothbrushes. For instance, an independent research firm known as the Cochrane Collaboration has evaluated over 300 hundred studies of powered toothbrushes (over a thirty-year span) using international standards to analyze the data.
Surprisingly, they found only one type of powered toothbrush (using a rotation-oscillation action) that statistically outperformed manual toothbrushes in the reduction of plaque and gingivitis. Although from a statistical point of view the difference was significant, in practical terms it was only a modest increase in efficiency.
In all actuality, the most important aspect about toothbrushes in effective oral hygiene isn’t the brush, but how it’s used — or as we might say, “it’s not the brush so much as the hand that holds it.” The fact remains, after first flossing, a manual toothbrush can be quite effective in removing plaque if you brush once or twice a day with a soft-bristle brush using a gentle brushing motion.
Although a powered toothbrush does much of the work for you, it still requires training to be effective, just as with a manual toothbrush. We would encourage you, then, to bring your toothbrush, powered or manual, on your next cleaning visit: we would be happy to demonstrate proper technique and give you some useful tips on making your brushing experience more effective.
Remember too: brushing your teeth and flossing isn’t the whole of your oral hygiene. Although a critical part, brushing and flossing should also be accompanied with semi-annual professional cleanings to ensure the removal of as much disease-causing plaque as possible.
If you would like more information on types of toothbrushes, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Manual vs. Powered Toothbrushes.”
All children encounter sickness as they grow; thankfully most of these conditions are relatively mild and fade away in short order. But some children endure more serious, longer lasting conditions. The health of children with chronic diseases can be impacted in numerous ways, including the health of their teeth and gums.
Unfortunately, dental care is often pushed to the side as caregivers understandably focus on the primary disease. In addition, many chronic conditions involving behavior, such as autism, attention deficit and hyperactivity disorder (ADHD) or intellectual disabilities, may inhibit the child’s ability to cooperate with or even perform daily oral hygiene. Many special needs children have an acute gag reflex that makes toleration of toothpaste, spitting matter from the mouth, or keeping their mouths open more difficult. However difficult it may be, though, it’s still important to establish daily hygiene habits to reduce the risk of tooth decay and gum disease.
There are techniques for building a daily routine for children with physical and behavioral limitations. For example, using “modeling and shaping” behavior, you (or perhaps a sibling) brush your teeth with your child to demonstrate how it should be done. If there’s a problem with cooperation, you can also position the child “knee to knee” with you as you brush their teeth. In this way you’ll be able to meet their eyes at a level position and lessen the chance of a confrontation.
We encourage all children to have their first dental visit before their first birthday. This is especially true for children with chronic conditions. The Age One visit helps establish a benchmark for long-term care; it then becomes more likely with regular visits to discover and promptly treat dental disease. This is especially important for special needs children who may have congenital and developmental dental problems, like enamel hypoplasia, a condition where the teeth have not developed sufficient amounts of enamel.
Teeth are just as much at risk, if not more so, in children with chronic diseases. Establishing daily hygiene and regular checkups can reduce that risk and alleviate concern for their long-term oral health.
If you would like more information on oral healthcare for children with chronic diseases, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Managing Tooth Decay in Children With Chronic Diseases.”
If you have noticed white spots or enamel pitting on your teeth, something in your diet may be the cause. If accompanied by other general symptoms, these dental problems may stem from a possible intolerance to gluten.
Gluten is a protein found in grains like wheat, barley or oats. Some people (an estimated one in 130 Americans) have a condition called Celiac Disease (CD) in which their immune system mistakenly treats gluten as a threat and initiates an attack of antibodies (individual proteins made by the immune system to target and kill specific foreign substances) against it. Tiny hair-like structures in the small intestine called cilia that aid in nutrient absorption may be destroyed in the process. As a result, the body can't properly absorb nutrients.
CD can be difficult to diagnose because its symptoms resemble other conditions like Irritable Bowel Syndrome. Typically, though, CD causes digestive issues like diarrhea, bloating and stomach aches, as well as fatigue, growth abnormalities and vitamin deficiencies. In the mouth, the most common symptoms are enamel defects like spotting and pitting. Patients may also lose a portion of their enamel in the grooves of the central incisors where the enamel may appear chalky or opaque rather than shiny, evidence of a condition called decalcification. CD may also cause canker sores.
Determining if you have CD is a two-step process. You must first undergo a blood test to see if antibodies are present for gluten. If the test returns positive confirming you have CD, the next step is a biopsy in which a small amount of intestinal tissue is removed and analyzed. This measures the degree of damage to the stomach lining, which will indicate whether or not you should remove foods containing gluten from your diet.
While research is ongoing to develop counteracting medications, removing gluten from your diet remains the most effective treatment for CD. Enamel defects caused by CD can also be treated with fluoride toothpastes and other aids to foster re-mineralization (restoring calcium and other mineral content to the enamel), and with cosmetic techniques to reduce any discoloration effect. CD patients should continue with normal oral hygiene efforts, with one exception: hygiene products (including polishing pastes and fluoride gels used in professional cleanings) should be gluten-free.
If you would like more information on how gluten may affect your oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gluten & Dental Problems.”
Clenching, or grinding of your teeth (also known as bruxing) are common habits. Biting forces are normally small, gentle, fleeting and very frequent throughout the day. In fact, it's the normal stimulus necessary to keep your teeth and jawbone healthy. When you clench or grind your teeth you apply forces up to ten times normal (in the 200 lb range). And it's not just the force, it's the duration and frequency with which they're applied. High forces lasting for seconds or minutes, frequently exerted, can affect some or all of the masticatory system. This includes the teeth, jaws, jaw joints and muscles, causing aching jaws, headaches, earaches, neck and even backaches; and the teeth themselves causing excessive wear, fractures, or even loose teeth.
Why does grinding occur? Habitual grinding is most frequently a reaction to stress. Sometimes abnormalities in your bite or malocclusion (“mal” – bad; “occlusion” – bite) can trigger clenching or grinding. It is normal for children to sometimes grind their teeth when new teeth are coming in, but it may be indications of stress too. You may be grinding your teeth subconsciously in your sleep, but it may be so loud as to awaken your sleeping partner. Or our office may be the first to suspect it during a dental exam because of the apparent signs of change to muscles, joints and teeth especially abnormal tooth wear.
What can be done about teeth grinding or bruxing? If you are symptomatic, having pain, muscle, joint or tooth soreness, the first step is to get you comfortable. Generally, a mild non-steroidal anti-inflammatory medication (aspirin, ibuprofen) and muscle relaxants will help in addition to moist heat and mild jaw exercises. Stress management is also helpful. To prevent further damage, we may recommend a bite guard made of wear-resistant plastic that fits over the biting surfaces of your upper teeth. These customized unobtrusive appliances when properly fitted and adjusted stop clenching and grinding activity, or at least the damage they can do. A bite guard can be worn day or night especially during stressful periods.