Dry Mouth (Xerostomia)



 

Dry Mouth, or Xerostomia, is a condition in which your body produces less saliva and can be caused by a variety of reasons:   side effect of certain medications, diseases or infections, certain medical treatments (such as radiation) and dehydration.  Dry mouth can increase a person's risk of developing gingivitis, gum disease, tooth decay and mouth infections such as thrush.  If you are experiencing dry mouth, be sure to talk with Dr. James B. Miller at your next dental visit or schedule an appointment to discuss your possible treatment options. 

 

James B. Miller, D.M.D.

9821 N. 95th Street, Suite 110

Scottsdale, AZ  85258

Office: (480) 451-5435 

Website: www.DrJamesMiller.com

Dr. James Miller is Offering a Special $250.00 Zoom! Whitening Promo for the Holidays! (thru 12/31/13)

Improving Gum Health May Reduce Heart Risk

Researchers at Columbia University in New York suggest that if you look after your gums, you could also be reducing your risk of heart disease. They claim that improving dental care slows the speed with which plaque builds up in the arteries.

Writing in a recent online issue of the Journal of the American Heart Association, they report a prospective study that shows how improving gum health is linked to a clinically significant slower progression of atherosclerosis, the process where plaque builds up in arteries and increases a person's risk of heart disease and stroke death.

Lead author Moïse Desvarieux, associate professor of Epidemiology at Columbia's Mailman School of Health, says:

"These results are important because atherosclerosis progressed in parallel with both clinical periodontal disease and the bacterial profiles in the gums. This is the most direct evidence yet that modifying the periodontal bacterial profile could play a role in preventing or slowing both diseases."

For their study, the researchers followed 420 adults aged between 60 and 76 from northern Manhattan who were taking part in the Oral Infections and Vascular Disease Epidemiology Study (INVEST).

Measuring Artery Thickness

All participants underwent oral infection and artery thickness exams at the start of the study and at the end of follow-up, which was a median of 3 years.

The oral infection exams retrieved a total of over 5,000 plaque samples. For each participant, the samples came from several teeth and under the gums.

The oral plaque samples were analyzed for the presence of 11 strains of bacteria known to be involved in periodontal disease and seven control bacteria.

Samples of fluid from around the gums were also taken and assessed for levels of Interleukin-1β, a marker of inflammation.

The extent of atherosclerosis, was assessed using high-resolution ultrasound scans to measure artery thickness or intima-medial thickness (IMT) in both carotid arteries.

The results showed that both improved gum health and a reduction in the proportion of bacteria linked to periodontal disease correlated to a slower progression of atherosclerosis, as measured by IMT.

These results did not change significantly when adjusted for factors that could influence them, such as body mass index, cholesterol levels, diabetes and smoking.

Previous studies have linked an increase in carotid IMT of 0.033 mm per year (about 0.1 mm over 3 years), to a more than double increase in risk of heart attack and stroke.

In this study, the participants whose gum health got worse over the 3 years showed a 0.1 mm increase in carotid IMT, compared with the participants whose gum health improved.

Co-author Panos N. Papapanou, professor at Columbia's College of Dental Medicine, says:

"Our results show a clear relationship between what is happening in the mouth and thickening of the carotid artery, even before the onset of full-fledged periodontal disease. This suggests that incipient periodontal disease should not be ignored."

Atherosclerosis and Periodontal Infections

Although the researchers did not look into how bacteria in the mouth can lead to atherosclerosis, one theory suggested by animal studies is they increase inflammatory markers, which can trigger or worsen the inflammation in atherosclerosis.

In a previous study that took measures at one point in time, the team had already found that higher levels of disease-causing bacteria were linked to thicker carotid IMT. This new study builds on those results by looking at the participants over time.

Prof. Desvarieux adds:

"It is critical that we continue to follow these patients to see if the relationship between periodontal infections and atherosclerosis carries over to clinical events like heart attack and stroke and test if modifying the periodontal flora will slow the progression of atherosclerosis."

Funds from the National Institutes of Health (NIH), the National Institute of Neurological Disorders and Stroke (NINDS), the Institut National de la Santé et de la Recherche Medicale (INSERM), among others, helped finance the study.

In 2010, UK researchers reported that gum bacteria can increase risk of heart attack and heart disease, because the same bacteria that cause dental plaque can escape from the mouth into the bloodstream and trigger clots.

medicalnewstoday.com

Tooth Anatomy

What Are the Different Parts of a Tooth?

Crown— The top part of the tooth, and the only part you can normally see. The shape of the crown determines the tooth's function. For example, front teeth are sharp and chisel-shaped for cutting, while molars have flat surfaces for grinding.

Gumline— Where the tooth and the gums meet. Without proper brushing and flossing, plaque and tartar can build up at the gumline, leading to gingivitis and gum disease.

Root— The part of the tooth that is embedded in bone. The root makes up about two-thirds of the tooth and holds the tooth in place.

Enamel— The outermost layer of the tooth. Enamel is the hardest, most mineralized tissue in the body — yet it can be damaged by decay if teeth are not cared for properly.

Dentin— The layer of the tooth under the enamel. If decay is able to progress its way through the enamel, it next attacks the dentin — where millions of tiny tubes lead directly to the dental pulp.

Pulp— The soft tissue found in the center of all teeth, where the nerve tissue and blood vessels are. If tooth decay reaches the pulp, you usually feel pain.

What Are the Different Types of Teeth?

Every tooth has a specific job or function (use the dental arch in this section to locate and identify each type of tooth):

Incisors— The sharp, chisel-shaped front teeth (four upper, four lower) used for cutting food.

Canines— Sometimes called cuspids, these teeth are shaped like points (cusps) and are used for tearing food.

Premolars— These teeth have two pointed cusps on their biting surface and are sometimes referred to as bicuspids. The premolars are for crushing and tearing.

Molars— Used for grinding, these teeth have several cusps on the biting surface.

Bacteria in Mouth May Cause Colon Cancer

A kind of bacteria commonly found in the mouth, which is often the culprit in gum disease, also spurs the formation of tumors in colon cancer.

Scientists had previously found that the level of Fusobacterium nucleatum in the gut was higher among people with colon cancer. That was noteworthy because fusobacteria aren’t one of the usual strains found in the healthy gut.
However up to now it hasn’t been clear whether the foreign bacteria caused tissue to turn cancerous or whether the bacteria was a result of the cancer. Now, researchers report that the bacteria in fact stimulates tumors, and they identify the molecule responsible for the bug’s harmful effects.

A Common Cancer
Colon cancer is the second-leading cause of cancer death in the United States, and more than 1 million new cases are diagnosed worldwide each year. By figuring out how fusobacteria spur cancerous tumors, scientists can work toward therapies that may inhibit the bacterium’s activity and possibly eradicate it altogether from colon tissue.  Previous studies have focused on a subset of colon cancer that is caused by inflammatory bowel disease, or conditions linked to inflammation of the colon and small intestines. The teams publishing studies today focused instead on a bacterium that drives cancerous tumors but isn’t related to apparent intestinal inflammation.

Colon Cancer and Bacteria
In the first research paper, a team from Harvard and the Dana-Farber Cancer Institute report that fusobacteria are prevalent in colon adenomas, essentially early-stage benign tumors that over time can turn malignant. Working with mice that were known to develop intestinal tumors, the team was able to accelerate early tumor formation by feeding them fusobacteria.  Researchers also fed them three other bacteria strains, such as Streptococcus, that are known to be associated with colon cancer. Tumors formed at a higher rate in mice fed with fusobacteria versus those who got Streptococcus.  Unlike the other bacteria, fusobacteria were stealthy and worked at the micro-inflammation level—the Harvard team saw no large-scale intestinal inflammation.

Molecular Culprit
A second research team from Case Western Reserve University found the specific molecule that allows such stealthy invasion: a molecule called FadA. Gene expression levels of FadA were 10 to 100 times higher in colon tissues from patients with adenomas and cancerous tumors when compared with healthy participants.  Researchers also determined how FadA worked its dangerous magic: by blocking the expression of a gene that inhibits tumor growth. Both studies are published today in Cell Host & Microbe.  “We showed that FadA is a marker that can be used for the early diagnosis of colon cancer and identified potential therapeutic targets to treat or prevent this common and debilitating disease,” says Yiping Han of Case Western Reserve University School of Dental Medicine.

discovermagazine.com

Arthritis Sufferers May Find Some Relief in Periodontal Therapy

It may seem strange how some diseases are linked, but as more and more research is done, we find those links do exist. Take rheumatoid arthritis, an autoimmune disease. 
Symptoms include pain, swollen joints and stiffness. Several studies examining the relationship between rheumatoid arthritis and periodontal disease have been made in the past ten years. Perhaps the strongest statement made by any of the studies was from Australia and reported in the Journal of Periodontology, "The results of this study provide further evidence of a significant association between periodontitis and rheumatoid arthritis." The researchers measured for periodontitis using probing depths, attachment loss, bleeding scores, plaque scores, and radiographic bone loss scores. Their measurements for rheumatoid arthritis included tender joint analysis, swollen joint analysis, and pain index, physician's global assessment on a visual analogue scale, health assessment questionnaire, levels of C - reactive protein (CRP), and erythrocyte sedimentation rate.

In both diseases, the inflammation destroys the soft and hard tissue. The inflammation is caused by the toxins from bacterial infection. Even historically, some treatments for arthritis were to pull teeth or give antibiotics to the patient to relieve their arthritic pain. Once the inflammation from their teeth was controlled, the patients got better. More recently, two studies in 2012 found that the fewer the teeth and individual had, the more severe the arthritis. Out of a normal 32 teeth, those with fewer than 20 teeth were eight times more likely to have swollen joints.

As with periodontal disease and other systemic diseases, rheumatoid arthritis is a chronic inflammatory disease. Chronic infection shows up in the blood by increased levels of CRP. One inflammatory disease that produces high levels of CRP exacerbates the other. And this is also true with arthritis. And those with rheumatoid arthritis tend to have more periodontal disease. Treating the periodontal disease often gives relief to the arthritis. And treating the arthritis with antibiotics often improves the gum disease. More studies are being conducted to ascertain more quantitative data on the association between the two diseases. The once thought of as myth, is slowly being proven as fact, that periodontal disease impacts total health.

The issue is more complex than just stating that arthritis causes periodontal disease or that periodontal disease causes arthritis. However, it is evident that there is a link. And more importantly, providing the best oral care possible and getting periodontal therapy if you have the disease, will also positively impact your arthritis and potentially reduce your pain.

Dr. Piero, a Holland, MI dentist for over thirty years, is the inventor of Dental Air Force® (http://www.dentalairforce.com). Articles published are on periodontal health related to heart disease, respiratory health, diabetes, strokes, and other systemic diseases. He is the Executive Editor for Journal of Experimental Dental Science, a contributing author to Hospital Infection Control: Clinical Guidelines and soon-to-be published book, Put Your Money Where Your Mouth Is.

1888pressrelease.com

Implant Supported Dentures

An implant-supported denture is a type of "overdenture" that is supported by and attached to implants. A regular denture rests on the gums, and is not supported by implants.

An implant-supported denture is used when a person doesn't have any teeth in the jaw, but has enough bone in the jaw to support implants. An implant-supported denture has special attachments that snap onto attachments on the implants.

Implant-supported dentures usually are made for the lower jaw because regular dentures tend to be less stable there. Usually, a regular denture made to fit an upper jaw is quite stable on its own and doesn't need the extra support offered by implants. However, you can receive an implant-supported denture in either the upper or lower jaw.

You should remove an implant-supported denture daily to clean the denture and gum area. Just as with regular dentures, you should not sleep with the implant-supported dentures at night. Some people prefer to have fixed (permanent) crown and bridgework in their mouths that can't be removed. Your dentist will consider your particular needs and preferences when suggesting fixed or removable options.

How Does It Work?

There are two types of implant-supported dentures: bar-retained and ball-retained. In both cases, the denture will be made of an acrylic base that will look like gums.  Porcelain or acrylic teeth that look like natural teeth are attached to the base. Both types of dentures need at least two implants for support.

• Bar-retained dentures — A thin metal bar that follows the curve of your jaw is attached to two to five implants that have been placed in your jawbone. Clips or other types of attachments are fitted to the bar, the denture or both. The denture fits over the bar and is securely clipped into place by the attachments. 

• Ball-retained dentures (stud-attachment dentures) — Each implant in the jawbone holds a metal attachment that fits into another attachment on the denture. In most cases, the attachments on the implants are ball-shaped ("male" attachments), and they fit into sockets ("female" attachments) on the denture. In some cases, the denture holds the male attachments and the implants hold the female ones.

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TYPES OF GUM DISEASE

Untreated periodontal disease can eventually lead to tooth loss and other health problems.

GINGIVITIS

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.

Factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.

PERIODONTITIS

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.

perio.org