• How to prevent periodontal disease?
• Nutrition and Gum Disease, is there a relation?
• Smoking, tobacco and gum disease, is there a problem?
• Women and gum disease, what are the risks?
• Diabetes and gum disease, are there links?
• When to visit the Periodontist?

How to prevent periodontal disease?

Brushing is the most effective method for removing harmful plaque from your teeth and gums. Getting the debris off your teeth and gums in a timely manner prevents bacteria in the food you eat from turning into harmful, cavity -causing acids.

Most dentists agree that brushing three times a day is the minimum; if you use a fluoride toothpaste in the morning and before bed at night, you can get away without using toothpaste during the middle of the day. A simple brushing with plain water or rinsing your mouth with water for 30 seconds after lunch with generally do the job.

Brushing techniques

Since everyone's teeth are different, see me first before choosing a brushing technique. Here are some popular techniques that work:

• Use a circular motion to brush only two or three teeth at a time, gradually covering the entire mouth.
• Place your toothbrush next to your teeth at a 45-degree angle and gently brush in a circular motion ? not up and down. This kind of motion wears down your tooth structure and can lead to receding gums, or expose the root of your tooth. You should brush all surfaces of your teeth - front, back, top, and between other teeth, rocking the brush back and forth gently to remove any plaque growing under the gum.
• Don't forget the other surfaces of your mouth that are covered in bacteria - including the gums, the roof and floor of your mouth, and most importantly, your tongue. Brushing your tongue not only removes trapped bacteria and other disease-causing germs, but it also freshens your breath.
• Remember to replace your brush when the bristles begin to spread because a worn toothbrush will not properly clean your teeth.
• Effective brushing usually takes about three minutes. Believe it or not, studies have shown that most people rush during tooth brushing, spending less.

What is flossing?

Flossing is a method for removing bacteria and other debris that cannot be reached by a toothbrush. It generally entails a very thin piece of synthetic cord you insert and move up and down between the sides of two adjoining teeth.

Why is flossing important?

Many dentists believe that flossing is the single most important weapon against plaque. In any event, daily flossing is an excellent and proven method for complementing your brushing routine and helping to prevent cavities, periodontal disease, and other dental problems later in life. It also increases blood circulation in your gums. Floss removes plaque and debris that stick to your teeth and gums.

How often to floss
Floss at least once every day. Like brushing, flossing should take about three minutes and can easily be done while doing another activity, such as watching television. Do not attempt to floss your teeth while operating a motor vehicle or other machinery.

Flossing techniques

There are two common methods for flossing, the "spool method" and the "loop method".

The spool method is the most popular for those who do not have problems with stiff joints or fingers. The spool method works like this: Break off about 18 inches of floss and wind most of it around your middle finger. Wind the rest of the floss similarly around the middle finger of your other hand. This finger takes up the floss as it becomes soiled or frayed. Move the floss between your teeth with your index fingers and thumbs. Maneuver the floss up and down several times forming a "C" shape around the tooth. While doing this, make sure you go below the gum line, where bacteria are known to collect heavily.

The loop method is often effective for children or adults with dexterity problems like arthritis. The loop method works like this: Break off about 18 inches of floss and form it into a circle. Tie it securely with two or three knots. Place all of your fingers, except the thumb, within the loop. Use your index fingers to guide the floss through your lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gum line and forming a "C" on the side of the tooth.

With either method of flossing, never "snap" the floss because this can cut your gums. Make sure that you gently scrape the side of each tooth with the floss.

Your gums may be tender or even bleed for the first few days after flossing - a condition that generally heals within a few days.

For Those With Special Needs

If you have dexterity problems or a physical disability, you may find it difficult to hold onto your toothbrush or dental floss. Try these techniques:

• Enlarge the brush handle with a soft material such as a sponge, rubber ball or bicycle handle grip.
• Lengthen the handle with a piece of wood or plastic such as a ruler, popsicle stick, or tongue depressor.
• Tie floss into a loop for easier handling.
• Use a wide elastic band to attach the brush to your hand.
• Use an electric toothbrush or commercial floss holder.

Plaque is a film of bacteria that forms on your teeth and gums after eating foods that produce acids. These foods may include carbohydrates (starches and sugars), such as candy and cookies, and starchy foods such as bread, crackers, and cereal.

Tooth decay leads to cavities and occurs when plaque remains on your teeth for an extended period of time, allowing the bacteria to 'eat away' at the surfaces of your teeth and gums. Ironically, the areas surrounding restored portions of teeth (where fillings, or amalgams have been placed) are particularly vulnerable to decay and are a breeding ground for bacteria.

Plaque can lead to gum irritation, soreness, and redness. Sometimes, your gums may begin to bleed as a result of plaque. This gradual degeneration can often cause gums to pull away from teeth. This condition is called receding gums.

Long-term plaque can lead to serious problems. Sometimes, the bacteria can form pockets of disease around tooth structures, eventually destroying the bone beneath the tooth.

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Nutrition and Gum Disesae, is there a relation?
All dentists believe that people can prevent two of the most common diseases today - tooth decay and periodontal disease - simply by improving their diet.
Decay results when the hard tissues are destroyed by acid products from bacteria. Although poor nutrition does not directly cause periodontal disease, many researchers believe that the disease progresses faster and is more severe in patients whose diet does not supply the necessary nutrients. Poor nutrition can suppress your entire immune system, increasing your vulnerability to many disorders. People with lowered immune systems have been shown to be at higher risk for periodontal disease.
Eat a well-balanced diet; use moderation and choose a variety of foods. The important foods to choose include those from the four basic food groups: fruits and vegetables, breads and cereals, milk and dairy products, meat, chicken, fish or beans. And remember that so-called "fad diets" often restrict or eliminate entire food groups. Leading to serious vitamin or mineral deficiencies. Eating foods with antioxidant properties,-for example, those containing vitamin E or vitamin C (vitamin E-containing foods include vegetable oils, nuts, green leafy vegetables; vitamin C-containing foods include citrus fruits, broccoli, potatoes) can help your body repair damaged tissue. Avoid clenching and grinding your teeth. These actions may put excess force on the supporting tissues of the teeth and could increase the rate at which these tissues are destroyed.
When snacking, try to avoid soft, sweet, sticky foods, such as cakes, candy and dried fruits. Better choices include nuts, raw vegetables, plain yogurt, cheese and sugarless gum or candy.
When you eat foods such as crackers, cookies and chips, include them as part of your meal, instead of by themselves. Believe it or not, some combinations of foods can actually neutralize harmful acids in the mouth and inhibit tooth decay.

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Smoking, tobacco and gum disease, is there a problem?
Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. Smokers are much more likely than non-smokers to have calculus form on their teeth, have deeper pockets between the teeth and gums and lose more of the bone and tissue that support the teeth. Smoking also causes bad breath and stains your teeth. It also can, over time, lead to serious periodontal problems. People who smoke or chew tobacco are more likely to have deposits of plaque and tartar on their teeth, and are more likely to suffer from gum disease. Moreover, smokers are also slower to heal after a tooth extraction or oral surgery, and are more likely to suffer from oral cancer. We may be able to help you calm nicotine cravings with medication such as nicotine gum and patches. There are also smoking-cessation classes and support groups.

Dentistry health care that works: tobacco
The American Dental Association has long been a leader in the battle against tobacco-related disease, working to educate the public about the dangers inherent in tobacco use and encouraging dentists to help their patients break the cycle of addiction. The Association has continually strengthened and updated its tobacco policies as new scientific information has become available.
Frequently asked questions: tobacco products
What effects can smoking have on my oral health? Are cigars a safe alternative to cigarettes? Are smokeless tobacco products safe? The American Dental Association has some alarming news that you should know.
Smoking and Implants
Recent studies have shown that there is a direct link between oral tissue and bones loss and smoking.
Tooth loss and edentulism are more common in smokers than in non-smokers. In addition, people who smoke are more likely to develop severe periodontal disease.
The formation of deep mucosal pockets with inflammation of the peri-implant mucosa around dental implants is called peri-implantitis. Smokers treated with dental implants have a greater risk of developing peri-implantitis. This condition can lead to increased resorption of peri-implant bone. If left untreated, peri-implantitis can lead to implant failure. In a recent international study, smokers showed a higher score in bleeding index with greater peri-implant pocket depth and radiographically discernible bone resorption around the implant, particularly in the maxilla.
Many studies have shown that smoking can lead to higher rates of dental implant failure. In general, smoking cessation usually leads to improved periodontal health and a patient's chance for successful implant acceptance.

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Women and gum disease, what are the risks?
Women have special needs when it comes to their oral health. That's because the physical changes they undergo through life - things like menstruation, pregnancy and childbirth, breast-feeding and menopause - cause many changes in the body, some harmful to teeth and gums.
Lesions and ulcers, dry sockets, as well as swollen gums, can sometimes occur during surges in a woman's hormone levels. These periods would be a prime time to visit the dentist. Birth control pills have been shown to increase the risk of gingivitis, and hormone replacement therapy has been shown to cause bleeding and swollen gums. Gum disease can also present a higher risk for premature births.
Some research has shown that women may be more likely to develop dry mouth, eating disorders, jaw problems such as temporomandibular joint disorders, and facial pain - all of which can be difficult from a physical and emotional standpoint.

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Diabetes and gum disease, are there links?
People living with diabetes are vulnerable to a host of systemic problems in their entire body. Unfortunately, the mouth and teeth are not immune from such problems, and many diabetics with oral problems go undiagnosed until conditions become advanced.
Infections and other problems such as receding gums and gum disease, or periodontal disease, are common afflictions among diabetics for many reasons; for instance, diabetics often are plagued by diminished saliva production, which can hamper the proper cleansing of cavity-causing debris and bacteria from the mouth. In addition, blood sugar levels that are out of balance could lead to problems that promote cavities and gum disease.
As with any condition, good oral hygiene, including regular brushing, flossing and rinsing, as well as the proper diabetic diet, will go a long way in preventing needless problems.

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When to visit the Periodontist?
Anytime is a good time to see our office for a proper evaluation.
Often, the only way to detect periodontal disease is through a periodontal evaluation. A periodontal evaluation may be especially important if:
* You notice any symptoms of periodontal disease.
* You are not satisfied with your current tooth replacement option, such as a bridge or dentures, and may be interested in dental implants.
* You are thinking of becoming pregnant. Pregnant women who have periodontal disease may be seven times more likely to have a baby born too early and too small. In addition, about half of women experience "pregnancy gingivitis." However, women who have good oral hygiene and have no gingivitis before pregnancy are very unlikely to experience this condition.
* You feel that your teeth are too short or that your smile is too "gummy." Or, if you are missing one or more of your teeth and are interested in a long-lasting replacement option.
* You have a family member with periodontal disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.
* You have heart disease, diabetes, respiratory disease or osteoporosis. Ongoing research is showing that periodontal disease may be linked to these conditions. The bacteria associated with periodontal disease can travel into the blood stream and pose a threat to other parts of the body. Healthy gums may lead to a healthier body.

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