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

Should you suck on a pacifier before giving it to your baby?

A new study in Pediatrics, journal of the American Academy of Pediatrics, reports that parents sucking their infant’s pacifier may reduce the risk of allergy development.

The ADA wants parents to be aware that licking a pacifier can transfer the cavity-causing bacteria from parents to children—increasing the possibility of tooth decay as they grow.

"A child's teeth are susceptible to decay as soon as they begin to erupt," said Dr. Jonathan Shenkin, a pediatric dentist in Maine and a pediatric dental spokesperson for the ADA. "Cavity-causing bacteria, especially Streptococcus mutans, can be transferred from adult saliva to children, increasing their risk of getting cavities."

Sharing eating utensils with a baby, or the parent sucking on a pacifier to clean it, can also increase the likelihood of transmitting decay-causing bacteria.

The ADA recommends that parents protect the dental health of young children by promoting a healthy diet, monitoring their intake of food and drink, brushing their teeth or wiping gums after mealtimes, and by having infants finish their bedtime or naptime bottle before going to bed. The ADA recommends that children receive their first dental visit within six months of eruption of the first tooth and no later than 12 months of age.

May 2013 - ADA.org

Office of Dr. James B. Miller - 
Offering Oral DNA Testing (Salivary DNA Testing) 

Our office is pleased to announce the availability of 3 laboratory tests relating to oral health. We think that some of our patients may benefit from these tests, but they are usually not covered by your insurance. Therefore, we will only perform them at your request. So, it’s important for you to understand the tests and their related conditions.

One of the conditions is gum disease, which can result in loss of your teeth. Bacteria and inflammation cause gum disease. More than 50% of Americans have gum disease. The other condition is oral cancer. Oral cancer can be caused by infection with a virus called HPV and by tobacco and alcohol use. HPV-related oral cancer occurs most often in people who don’t smoke or drink very much. A different kind of oral cancer occurs in smokers who drink a lot. About 36,000 Americans get oral cancer every year.

The MyPerioID^Ò PST^Ò test can tell if you have specific changes in your DNA. These changes might mean that you have a greater risk of getting gum disease.

The MyPerioPath^Ò test is for patients who actually have gum disease. It finds out which bacteria are triggering the gum disease. Once we know which bacteria are in your mouth and at what amount, we can come up with a treatment plan that’s right for you. For example, this information can help us select the right antibiotic for you. We highly recommend this test if you have gum disease that has not responded to previous treatment.

The OraRisk^Ò HPV test can tell if you have an HPV infection in your mouth. If you do, you might have a greater risk of getting HPV-related oral cancer. Like most cancers, it’s important to detect oral cancer early. If we know you have an HPV infection, we can watch you very closely for signs of oral cancer. We suggest you consider having this test if you are a non-smoker and don’t drink a lot.

All 3 of these tests are performed using a saliva sample, which is collected in our office. The sample is easy and fast to collect. Simply swish a sterile saline (salt) solution in your mouth and spit it into a container. The sample is then sent out for testing.

When the results come back, Dr. Miller will tell you what your results are and what they mean to your oral health.

If you are interested in Oral DNA testing, please contact our office at (480) 451-5435 for more information or to schedule an appointment.

Periodontal Disease and Heart Disease

The biggest problem with the American Heart Association's report is that it is based on previous studies over the last 60 years that do not have a uniform definition of Periodontal Disease. Let's remember that Periodontal Disease has been defined the same way for over 50 years: a simple observational, just looking at it, measuring with a probe that is often misread. But actually we now are assessing this subject in regards to "oral inflammation, genetic variability, verified testing, and microbial burden," none of which were taken into account in the studies used in the discussion. 

For example I will use my own health situation: I have no traditional signs of Periodontal Disease: no pocketing, no bleeding. I'm a dentist and a son of a dentist. And yet I test Il-1 positive, meaning that I am a hyper-responder to oral inflammation. And, even though I do not present with a traditional observational view of Periodontal Disease, I had a microbial burden that is associated with oral inflammation and systemic disease. Also, I'm physically active, have a reasonable diet, healthy weight, and have controlled cholesterol numbers. I should be in the less than 50% risk for Cardiovascular disease....and yet I have a buildup of plaque in my carotid. I "had" elevated Lp-PLA2 (a huge marker and player in Cardiovascular Disease) and was at large risk for a Heart Attack and/or Stroke in the near future. In the studies reviewed by the American Heart Association, I would have been missed because they were not looking for anything but a "simple traditional observational view of Periodontal Disease" rather than the advanced tests that more advanced healthcare providers are incorporating, including leading healthcare facilities of the world. 

So if we use the old way of evaluating Periodontal Disease, we are not addressing what the leading preventive cardiology approaches are suggesting. 

Also, the American Heart Association's recent report states that upon reviewing the past 60 years of research there is no definitive proof that a traditional view of Periodontal Disease is THE Cause of Heart Disease. They say that larger prospective studies are needed to prove causality. They are correct. These studies are extremely expensive and will not be able to prove causality in my lifetime. With that said, they fail to emphasize that no study
disproves the theory that oral disease is one of the many causes of vascular disease. The American Heart Association acknowledges that there is an association between oral disease and systemic disease. They even acknowledge that treatment of periodontal disease reduces systemic inflammation and endothelial dysfunction, both known risk factors for cardiovascular disease. 

In my opinion and in the opinion of many of the Physicians involved with preventive cardiology, the AHA is irresponsible by making a statement that deceptively leads people to believe that oral disease does not contribute to vascular disease. Although Cause has not been proven, there is strong evidence to suggest that certain high risk bacteria may be an under-identified cause of heart attacks, strokes, and progression of atherosclerosis. 

I applaud the American Heart Association for their noting that "oral health is important for overall health." And I formally thank the American Heart Association for their extensive literature review which confirms our recognition of the oral/systemic association. According to Bale/Doneen, the nation's leading preventive cardiology educators, "We believe that a strong association of periodontal disease and vascular disease exists with the trend for reduced systemic inflammation and improved endothelial health when effective periodontal therapy is achieved. We also recommend that the evaluation and treatment of periodontal disease along with appropriate medical care be included in any strategy for the prevention of cardiovascular disease. Both the medical and dental communities should realize that there are positive health benefits when both fields of medicine work in harmony for the prevention of atherosclerotic vascular disease." 

Dr. Dan Sindelar Director, Foundation for Oral Systemic Health 
Co-founder, American Academy for Oral Systemic Health

CAN CHILDREN BE AT RISK FOR DEVELOPING PERIODONTAL DISEASE?

 Periodontal disease is rarely found in children, and only sometimes found in adolescents. However, children should still learn the importance of keeping their teeth and gums healthy to prevent periodontal disease in the future. Children should brush their teeth twice a day and learn how to floss properly- if children learn how to floss at an early age, they will be more likely to make it a lifetime habit. These two simple acts will help protect their teeth and gums from periodontal disease.

 As a parent, you should also be aware of the warning signs of periodontal disease, which include red, swollen, bleeding gums or bad breath that won’t go away. If your child develops any of these symptoms, tell your dental professional right away. It’s also a good idea to ensure your dental professional knows your complete family history, as genetics can play an important role in the early development of periodontal disease. 

 perio.org