oral health affects your family’s overall health · here are some of the dangerous effects that...

DR. NANCY NEHAWANDIAN

ORAL HEALTH AFFECTS YOUR FAMILY’S OVERALL HEALTH

Comprehensive Dental Care 1

It’s an unfortunate truth that most people in this country aren’t taking good enough care of their teeth. Nationwide surveys show that only two-thirds of Americans saw a dentist in the last year. There are many reasons why people opt not to see a dentist. For some people, it’s because budgets are tight. Other times it’s because they’re busy. Still others avoid the dentist out of fear.

But no matter what reason you give for not going to the dentist, part of the excuse is that you think your dental visits aren’t actually important for your health. There is a sense that dental care is somehow a luxury that’s not as important as some of the other things you need to do.

But the truth is that oral health is critical: it may even be a matter of life and death.

ORAL HEALTH


MORE THAN JUST TEETH

Part of the problem is that people think dentists just take care of your teeth. While taking care of your teeth is an important part of our jobs, it’s not all that we do.

At your checkup, we’ll start by looking at the health of your teeth and gums. We’ll also examine the muscles of the head, neck, and jaw. We’ll check the health of your tongue and your salivary glands as well. We’ll perform tests that can check on your body’s routine functions, screen for cancer, and watch for signs that can signal poor health in other parts of your body.

One health problem that people don’t realize can be treated by a dentist is headaches. Many people have temporomandibular joint disorder (called TMJ or TMD). This is a disruption in the normal function of your teeth and jaws that can lead to symptoms in the ears, head, neck, back, and even arms. For some people, this is easy to treat, but if left untreated, it can worsen. It may become disabling and eventually require costly invasive surgery to treat.

We can also help if you are having problems sleeping at night. If you are waking up tired or un-rested even if you’re spending enough hours “asleep,” you may have sleep apnea. One of the most common signs of sleep apnea is loud snoring. We can treat snoring and sleep apnea so you (and your spouse) can sleep peacefully.

These are just a few of the ways that your dentist can help improve your overall health. To understand the true scope of benefits you’ll get from visiting your dentist regularly, you have to understand the links between oral health and systemic disease.


THE LINK BETWEEN ORAL & SYSTEMIC HEALTH

As we come to understand the way the body works, we see better how tightly interwoven all its systems are. This means that we see how important oral health is to overall health, and health recommendations reflect this.

The World Health Organization (WHO) has integrated oral health into its chronic disease prevention programs. The American Medical Association (AMA) acknowledges that the link between oral health and systemic health is a two-way street. This means that your mouth will contain clues to your overall health, clues that your dentist can read to recommend treatment for potentially serious conditions. It also means that poor oral health can lead to poor overall health.


BENEFITS OF REGULAR DENTAL VISITS

The American Dental Association (ADA), recommends that children start seeing a dentist around the time of their first birthday. This helps establish a “dental home,” creates good habits for oral healthcare, and allows dentists to give parents guidance to properly care for their children’s teeth. In addition, dentists can provide preventive dental care as necessary and watch out for oral disease at its earliest stages. This will help children maintain good oral health throughout their lives.

Maintaining a regular habit of preventive dental visits has many benefits for you. If you make these visits, you may:

• Spend less money on dental care• Spend less money on other health expenses• Enjoy life more• Avoid worrying about what could be wrong• Manage other health conditions better• Keep your teeth beautiful and healthy for life

Overall, you will see an improved quality of life and improved health for less cost than if you avoid dental visits.

One benefit of dental visits is that people often make them more routinely than visits to their doctor. This allows dentists to be watchmen on the frontiers of health, vigilant for signs that dangerous health conditions may be developing.


HOW ORAL HEALTH IMPACTS YOUR OVERALL HEALTH

The mouth is the gateway into the body. Nearly everything that enters the body passes through the mouth. This means that illness in the mouth is more likely to spread to other parts of the body, either through your digestive system, your lungs, or your bloodstream. Poor oral health often leads to a chronic infection (either gum disease or an abscessed tooth) that can last for months or even years. This leads to systemic inflammation that can damage your body.

Here are some of the dangerous effects that can be triggered by poor oral health:

• Endocarditis: Endocarditis is an infection of the heart. Bacteria from the mouth can travel through the blood to the heart and infect your heart. This can lead to congestive heart failure.

• Cardiovascular Disease: As oral bacteria flows through your blood, it can attach to damaged areas in your arteries, becoming part of your arterial plaque, and worsening coronary artery disease. This plaque can break off and travel to the heart, brain, or lungs, causing heart attack or stroke. The risk that plaque will break off is increased by elevated blood pressure that is related both to systemic inflammation and sleep apnea.

• Pregnancy and Birth Complications: Gum disease has been linked to premature birth and low birth weight of babies. Sleep apnea has been linked to elevated blood pressure during pregnancy, and the developing fetus seems to be affected by the intermittent drops in the mother’s oxygen levels.

• Diabetes: Diabetes and gum disease have a mutually reinforcing relationship People with diabetes are more likely to develop gum disease. People with gum disease may also have more difficulty controlling their blood sugar, worsening the impact of diabetes.


HOW ORAL HEALTH IMPACTS YOUR OVERALL HEALTH (CONT.)

• Alzheimer’s Disease: The chronic inflammation caused by oral bacteria infection can damage the brain, and is strongly correlated with gum disease and early tooth loss. Sleep apnea also seems to interfere with the brain’s nightly maintenance, increasing the risk of early onset dementia.

• Pneumonia: Bacteria from the mouth can be inhaled and may lead to infection in the lungs. This risk may be increased if you use a CPAP machine, whose forced air pressure can drive bacteria into the lungs.

• Rheumatoid Arthritis: Rheumatoid arthritis is an autoimmune disorder where your immune system attacks you joints. There is some evidence that serious gum disease (periodontitis) is caused in part when bacterial infection alters your body’s immune response. These changes may also trigger rheumatoid arthritis.

• Systemic Infection: Thousands of people go to the hospital every year because tooth infections have spread to the entire body. These infections can be expensive to treat and can be fatal.

• Cancer: Many types of cancer have been linked to gum disease, including head and neck cancer, pancreatic cancer, lung cancer, breast cancer, and colon cancer. Chronic inflammation can increase the risk of cancer developing, and some oral bacteria can prevent your immune system from recognizing cancer in its early stages.

An eye opener, isn’t it? Few people realize just how potentially deadly oral disease can be. The health of yourself and your family is one of your top priorities, and you just can’t achieve it without taking care of everyone’s oral health.


SAVING MEDICAL COSTS

Once you realize all the critical health connections between oral health and other conditions, it should come as no surprise that caring for your oral health can reduce your overall healthcare costs.

One study looked at how much treating gum disease reduced the cost of care for four related health conditions: coronary artery disease, ischemic stroke, diabetes, and pregnancy. Significant savings were seen for all four conditions. Treating gum disease saved about 11% per year for coronary artery disease patients, about $1100 annually. Ischemic stroke patients could save about 41% per year, or $5700. Diabetes patients saw a 40% reduction in annual medical expenses, about $2800 a year, and the cost of pregnancy by 74%, or about $2400.

Tooth infections can also lead to very expensive hospital care. More than 800,000 emergency room visits a year are caused by oral health problems. In addition, thousands of people every year are hospitalized for tooth infections that become systemic infections. Treating these infections can cost hundreds of thousands of dollars.

In addition, sleep apnea has been shown to significantly increase your medical expenses. Some studies have shown that treating your sleep apnea could cut your annual health expenses in half. One study showed that people with untreated sleep apnea paid about $4000 a year in health costs, while people without sleep apnea pay an average of $2000 a year. Overall, studies have estimated that untreated sleep apnea may cost the US economy a total of $150 billion a year.


GUM DISEASE, A SILENT KILLER

We describe health conditions like high blood pressure as “silent killers” because they have serious health effects without many visible symptoms. Gum disease belongs in this category because of its links to many serious health conditions, including heart disease.

There have been many studies linking gum disease and heart disease. In one of the largest and most convincing studies, it was shown that tooth loss could double your risk of cardiovascular death. Since gum disease is the chief cause of tooth loss among adults, this study strongly implicates gum disease as a cardiovascular killer.

Other studies have shown that there are many potential pathways by which gum disease can trigger heart disease. Oral bacteria can infect the heart, can contribute to arterial plaque that clogs the arteries, and it can lead to inflammation (swelling) of blood vessels that can cause heart disease.

Some people still dispute that gum disease actually causes heart disease. Here’s what we know for sure:

• Gum disease is strongly associated with heart disease• There is a plausible mechanism that gum disease could cause heart disease• Treating gum disease improves cardiovascular health.

The last point is perhaps the most important. While there may be dispute about the causal relationship between gum disease and heart disease, there is no dispute that treating gum disease improves your heart health, and it’s highly likely that avoiding gum disease in the first place will reduce your risk of developing heart disease.


WHAT CAUSES GUM DISEASE?

Your tooth roots are surrounded by bone, called alveolar bone. Your teeth aren’t directly con-nected to this bone, they’re bound by a tough, flexible membrane known as the periodontal ligament. Your gum tissue covers the bone and attaches to your teeth, creating a protective layer for bone, tooth root, and periodontal ligament.

Oral bacteria are small organisms that live in your mouth, feeding off your food. There are also fungi in your mouth, and they can sometimes cause problems, but bacteria cause the most seri-ous forms of gum disease. Bacteria can feed off any type of food you eat, but the most harmful bacteria are best at exploiting sugars and simple carbohydrates.

As these bacteria grow, they bond together in colonies with a protective blanket on them. These colonies cling to your teeth and gums and are called plaque. Brushing and flossing can help re-move plaque.

While brushing and flossing can help reduce plaque buildup, it’s not enough to completely con-trol gum disease. While plaque is on your teeth and gums, the bacteria are eating sugars and secreting acid, which can damage your teeth—causing cavities—and gums—leading to pockets between your gums and teeth. In addition, minerals in your saliva (which help your teeth main-tain and restore their enamel) get incorporated into plaque, essentially fossilizing it. This hard-ened plaque is called tartar or dental calculus. You can’t effectively remove this with brushing or flossing, and it creates a shelter for oral bacteria.

In the shelter of these hardened deposits and the pockets around your teeth, oral bacteria are freer to reproduce and create more damaging acid, which leads to deeper pockets and eventual-ly receding gums, bone loss, and other effects of gum disease.


“SILENT” GUM DISEASE

One big problem with gum disease is that at first the symptoms may not be noticeable. At first, inflammation and redness may seem like it’s no big concern. Pain may be limited. Bleeding gums may not be noticed, or they may be dismissed as unimportant. Or maybe people respond to irritated and bleeding gums by brushing less or brushing less thoroughly, which can accelerate the course of the disease. Gum disease can also cause chronic bad breath, which many people dismiss or try to treat in other ways.

About half of all adults have some degree of gum disease. Minor gum disease, called gingivitis, can be irritating, but it’s not always harmful. But gingivitis can transition to periodontitis, a serious form of gum disease that leads to bone loss around the teeth. This can cause painful sores filled with pus, loose teeth, and even tooth loss.

The transition from gingivitis to periodontitis is related to oral hygiene and regular dental visits, but it’s also mediated by your genes and by the types of oral bacteria in your mouth.


PREVENTING & TREATING GUM DISEASE

There are many things you can do to help prevent gum disease. Since you can work with your teeth every day, you have the most power in preventing gum disease. Regular brushing and flossing are one of the best ways to prevent gum disease.

It’s also critical that you make your regular dental appointments. In addition to removing tartar, we can evaluate the health of your gums and recommend changes to your oral hygiene routine. This may include different brushing techniques, the use of an electric toothbrush, changing to interdental cleaners or oral irrigators instead of floss, and the use of mouthwash.

If you experience bleeding gums, loose teeth, chronic bad breath, or other symptoms of gum disease, it’s important to get dental care to evaluate the symptoms and get proper treatment.


TOOTH DECAY & ORAL HEALTH

Tooth decay occurs when the bacteria in plaque release acid onto your teeth. This acid attacks the minerals in your teeth, eventually creating small depressions. These depressions are known as cavities.

Once a cavity starts, oral bacteria can shelter in it. This increases the amount of bacteria that escape your tooth brushing and concentrates the acid in the area, accelerating the rate of decay. Once tooth decay starts, it can begin to accelerate, and if you aren’t receiving regular dental visits, you may find that cavities progress quickly and without symptoms. Symptoms such as toothaches, tooth discoloration, foul breath or foul tastes in the mouth, and sores on the gums, are often signs that your tooth has become seriously infected, and that serious care like root canal therapy is necessary.

Bacteria in your teeth can also spread to other parts of the body, causing systemic infection. As with gum disease, infected teeth have been linked to heart disease. And an infected tooth can lead to an acute systemic infection, requiring hospitalization and potentially leading to death.


THE ROLE OF GENETICS IN TOOTH DECAY

As with gum disease, your risk of tooth decay is related to your genetics.

There are some people with very favorable genetic makeup who are highly resistant to tooth decay. With brushing, flossing, and regular maintenance, they will get few or no cavities.

On the other end of the spectrum are people who are highly susceptible to cavities. I belong to this group myself! My parents have always had extensive dental work and that gene was passed down to me. I attribute this to why I chose the field of dentistry as I spent a great deal of my childhood visiting the dentist. This is confirmed by a study from the University of Pittsburgh School of Dental Medicine that concluded genetic factors account for 60% of the risk for tooth decay in patients. This includes patients whose family history includes weak enamel and even low salivary flow. You see healthy salivation is a protector of your teeth.

Fortunately, for high-risk patients we have many options for supporting your routine oral hygiene. We offer dental sealants to protect your teeth from decay. We also offer periodontal treatments that help control the level of oral bacteria in your mouth.


TOOTH COLORED METAL FREE FILLINGS - NO MERCURY!

The standard treatment for a cavity is a filling. We remove the decay from your tooth and place an inert substance in its place.

It’s important to treat cavities when they’re small. Because cavities give bacteria shelter, they can also serve as a “base of operations” that bacteria use to spread to other teeth. If you delay treatment of a cavity, you are more likely to develop cavities on other teeth or other surfaces on the same tooth. Bacteria from cavities can even spread to your gums, and may increase the risk of infection around dental implants.

As cavities grow, they can have many impacts on the health of your teeth. If the cavity penetrates the living interior of the tooth, it becomes an infected tooth, also called an abscessed tooth. The only way to treat an abscessed tooth is with root canal therapy. If that’s not successful or the tooth is too far gone, the tooth will have to be extracted.

The timely placement of a filling prevents this consequence. For over 100 years, metal amalgam fillings—whose chief ingredient is mercury—were used to treat cavities. More recently, we have developed alternatives that are tooth-colored and may be healthier for your teeth and your body.

We have been offering composite resin fillings for over 20 years. They are strong and durable, as well as being very attractive. We also offer ceramic fillings that are even more durable and can strengthen teeth. All composites and bonding agents used in our office are BPA-free.


DENTAL CROWNS

CEREC SYSTEM

Dental crowns are used when teeth have been significantly weakened by decay or trauma. As with our fillings, all our dental crowns are metal-free. We utilize the latest high-strength ceramics to give you restorations that are as close as possible to what Mother Nature provided.

These all-ceramic crowns are possible in part because new ceramics are much stronger than the porcelain we used in the past. Some of them can withstand over 150,000 pounds per square inch of force!

But we rarely need to rely on these very high strength ceramics because I am trained to understand how the bite works. Properly designed dental crowns fit harmoniously in your bite and shouldn’t be subjected to any force greater than what your tooth enamel can handle, about 7000 psi.

As a bonus, these materials are also extremely attractive. They are practically indistinguishable from your natural tooth enamel.


DIGITAL DENTISTRY: INSTANT INFORMATION YOU CAN SEE

We also use digital cameras to capture views of your teeth so you can see what we see. This helps you make informed decisions about the health and appearance of your teeth. You don’t have to take our word for it: you can see the problems for yourself!

We also utilize 3D scanning technology that can allow us to better diagnose the condition of your oral cavity, sinuses, and even your airway. This allows us to perform more precise diagno-sis based on a true view of your condition. This means less time in the chair for you—and more accurate diagnosis and treatment!

It also means that we can sometimes detect problems that are not properly in our scope to treat. We are happy to be able to refer people to an ear, nose, and throat specialist (ENT) or oth-er doctor for treatment of specific problems. We can also help follow up on treatment from your ENT, too, or give you an alternative to an outpatient center for this type of imaging. Offering these types of imaging helps us provide you with the most comprehensive dental care modern technology allows.

Our office was one of the first to use digital x-rays over 20 years ago. Digital x-rays have changed dentistry for the better. They expose you to significantly less radiation, perhaps as much as 90%. But perhaps the biggest benefit of this is that we can instantly display the information on a com-puter monitor for you to see. No more straining to try to read those bitewing films.


ORAL CANCER SCREENING

Beyond looking at your teeth and gums for signs of decay and infection, we want to provide you with a comprehensive oral health assessment. That includes an oral cancer screening.

Unlike other forms of cancer, oral cancer rates are not dropping, nor are survival rates improv-ing. The main problems is a lack of early diagnosis. With early diagnosis, survival rates for oral cancer are about 83%. Once the cancer has spread locally, the survival rate drops to 52%.

There are many oral cancer screening tools available. We use Identafi ®, which was developed by a dentist who was diagnosed with oral cancer. Identafi works using a multi-spectral inspec-tion. We use a powerful white light to inspect for visible anomalies in your oral tissue. Then we use violet light to shine on your oral tissues. Under this light, your healthy tissues will fluoresce (give off light of their own), while suspicious tissues remain dark. Special glasses filter the light to highlight this contrast. Once the violet light has highlighted suspicious areas, an amber light can be used to show the blood vessels under the skin. Cancer depends on the growth of new blood vessels and can be given away by an abnormal concentration of blood vessels.

Oral cancer can be found on many parts of the mouth, including the tongue, gums, lips, tonsils, roof and floor of the mouth, and the cheeks. As we noted, oral cancer survival rates are not improving as are other cancers. Oral cancer remains one of the deadlier cancers, claiming more lives than cervical cancer, skin cancer, Hodgkin’s lymphoma, thyroid cancer, and testicular can-cer.

Screening and early detection may be crucial to turning the corner against this type of cancer. You can look out for visible signs of the cancer, such as redo or white sores in the mouth. Most likely, though, you won’t see or feel any symptoms, which is why oral cancer screening remains vital.


CAUSES & SOLUTIONS OF TMJ/TMD

As with any other joint, the temporomandibular joint (sometimes called the TMJ, but this can be confusing) can develop problems. These orthopedic problems are similar to those other joints are subject to and include inflammation, strained tendons and ligaments, sore muscles, and disc problems. Unlike some of these other joint problems, though, when the temporomandibular joint experiences problems, the symptoms are often widespread and can be hard to link to the root cause. People experience many different symptoms and there is a possibility that there are actually several different types of disorders that are linked under the term temporomandibular joint disorder. The nomenclature for the disorder is confusing. It was originally called TMJ back in 1948, but in 1991, it was “officially” renamed TMD, and a lot of people still call it TMJ (fortunate-ly, nobody uses the 1973 moniker TMJ-PDS for temporomandibular joint pain dysfunction syn-drome!).

About a third of people in the US develop some degree of jaw joint problems at some point in their lives. For most people, these are transient and don’t require professional treatment. But for many people, TMD develops into a much more serious condition. Genetics plays a role in your risk for serious TMD. Women are also more likely to develop a serious version of the condition, and the risk of TMD increases with age. Psychological stress and physical injury can trigger TMD symptoms. TMD is one of the most common complications of a car accident.

In our office, we make comprehensive examination of the jaw joints a part of your routine dental visit. This allows us to identify TMD when you’re either asymptomatic or haven’t connected prob-lems like headache, earache, neck pain, dizziness, and ringing in the ears to a jaw joint problem. If you do have TMD, we offer drug-free treatment that can begin with a minimally invasive and reversible treatment protocol. We can upgrade the treatment to a permanent correction, but how much and what type of treatment you want to receive is entirely up to you.


DENTAL APPOINTMENTS FOR CHILDREN

Children should start coming to the dentist as soon as their first teeth appear. This not only helps get them started in a lifetime of good oral health, it can save par-ents money. Some parents put off dental visits for their children to save money. But studies have shown that children who get started on regular dental visits early can save their parents $360 on dental care by the time they reach age 8.

We welcome children in our practice. There is good evidence that children benefit from attending the same dentist as their parents. Genetics and lifestyle factors that impact parents’ health may also impact children’s health. We can use what we’ve learned about your oral health problems to head off similar problems before they affect your children.

For your child’s first visit, we recommend that you bring them to sit in your lap and watch what we do with your teeth. We may examine and even gently polish their teeth, if they’re willing, but the first visit is mostly about helping them to get accustomed to the dentist’s office.Some parents think that it’s not important to take care of baby teeth because they’re going to be lost anyway. But this isn’t true. Your child’s baby teeth (also called deciduous teeth) are import-ant because these provide a guide for the adult teeth as they come in. Illness of the baby teeth can also be painful for your child, and it can lead to health problems that may persist for your child’s life. Plus, establishing your child in a good dental care regimen will serve your child for their lives.

“TRAIN A CHILD UP THE WAY HE SHOULD GO, AND WHEN HE IS OLD, HE WILL NOT DEPART FROM IT.”


CONCLUSION

I hope that through this article I have convinced you that your health is key to your overall health. By having your teeth, gums, and oral cavity regularly examined, you will be adding years to your life.

I can share my family experience with you. I have family that are in their 80s and I know predict-ably which family members will live the longest based on watching who cares for and protects their teeth. Not only are they able to avoid the health problems related to gum disease and tooth infection: they can eat a healthier diet and can enjoy a more active lifestyle.

I also want to show you that in our office we are sincerely dedicated to caring for your whole health, not just your teeth. If you haven’t been to the dentist in a while, we understand that you might be avoiding it out of embarrassment. But don’t worry: you’re not alone. We’ve seen worse, and, in any case, we won’t judge you or criticize. Our key focus is going to be on improving your oral health from today on, not dissecting what happened in the past. There’s no better time to start your new course of treatment than today. The first step is to contact us. You can call (408) 354-5600 or visit our website www.TopDownDental.com.

When you become our patient, we promise that we will be as thorough in examining your dental needs as if we were treating our own families. I will gladly show you anything that I see so you can understand what is going on with your oral health and make the right decisions about your care. We are here to help when you are ready and welcome the opportunity to take great care of your dental needs.

I have taken the time to write this to make you aware of life-changing journey to good oral health. We hope you invite us to take this journey with you. Together we can help you achieve and maintain a healthy, beautiful smile that shows the world that you are not only healthy, but happy as well.

If you are ready to take the first step on this journey, please call (408) 354-5600.

Dr. Nancy Nehawandian

oral health affects your family’s overall health · here are some of the dangerous effects that...

Documents