Fresh Breath

Halitosis
Tongue scrapers reduce bad breath
Bad breath is a common problem for many people, given the wide variety of substances traveling through our mouths daily. Some people avoid offensive foods and drinks, chew gum, use mouth rinses, or eat mints to mask unpleasant odor. Others cannot escape bad breath quite so easily. At least 40 million Americans suffer from halitosis.

We have MANY ways to reduce halitosis and make breath more pleasant.  But, first, we have to test and see if we can figure out WHERE it's coming from.

For this we use a Halimeter that can sniff out the nasty smelling sulfur compounds.  Sometimes it's from the sinuses and not the mouth at all.

Then we go after the germs that can lead to the breath problems.  We also can trap the smelly sulfur compounds.

And bad breath is NOT just an embarrassment.  It can signify problems with the entire body.  Don't just let it go and hope the neighbors won't complain...

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BANNING SODAS IN SCHOOLS

It looks as if school vending machines are dumping sweet sodas for 'healthier" drinks.

That sounds great, but there seems to be an epidemic of disguised junk food marketed as healthy stuff. It's a complete scam as far as we're concerned.

Raisins, Fruit Rollups and granola bars. Even Gatorade, which is not only loaded with sugar, but it's also somewhat acidic.

Latest thing we've seen is called "Fruit to go" which is found in the produce section, to make it seem highly virtuous. They claim each bar is like a couple of servings of fruit.  Well, it's got all the sugar from a few servings, and maybe some of the vitamins, but it's still junk.Kids would eat these by the kilogram if they could.  I call it stealth junk food.

Makes it a lot tougher for all but the most informed patients.  I've had some kids recently who said they never eat candy or drink sweet sodas.  They only eat sweets at dessert.  BUT... on closer examination the kids love those mini boxes of raisins, fruit bars and fruit juice.  These dudes are full of decay. 

Even unsweetened fruit juice will cause decay and acid erosion if the kids are popping them several times a day between meals.

Take look at Stop the Pop designed by the Missouri State Dental Association.click here There's a wealth of references and things you can print out to give to your kids.

The Centre for Science in the Public Interest, who publish Nutrition Action Newsletter, have done some good work there. They had an earlier expose on sugar in drinks called "Liquid Candy".

HEART DISEASE FROM GUM PROBLEMS?

Further evidence is piling up that ties gum disease in with heart disease caused by plugged arteries in the heart muscle.

Recent studies show that if you take out the factors of age, sex, economic status, smoking, high blood pressure, blood fats, and diabetes, people with active gum disease have significantly greater risks for coronary heart disease.

This effect was observed for individuals with periodontal disease, and not gingivitis. Gingivitis is more surface attack, but periodontal disease gets into the bone.

People with deep gum disease, "perio", constantly have germs getting into the blood stream. We believe this is what causes increased levels of fibrinogen, one of the starting materials for clot formation, scarring and plugging of arteries.

The constant work of heart muscle without any rest makes it a particular target for shrunken arteries.

These papers follow other disturbing research pointing to damage to the fetus in pregnant mothers with perio.

Now you may understand why we make such a fuss here about gum disease. It's not just worry about bad breath and loosening of the teeth!

Inflammation from gum disease raises C-reactive protein levels (CRP) and this can lead to a variety of other damage in the body.

In a research group, the top 25% CRP participants had 2.5 times rate of colon cancer compared to the bottom 25% CRP group!

In a research group, the top 1/3 in CRP values had twice the heart attack rate compared to the bottom 1/3 CRP group!

Some important links to investigate:

See - How Gum Disease Works - http://www.howstuffworks.com/gum-disease.htm

FLOSS OR DIE??

We've noted in past issues the connection between infection in the mouth and damage to the rest of the body.

This was the topic of a major talk at the International Academy of Oral Medicine and Toxicology meeting in Colorado Springs.

Bill attended the meeting and also made a presentation on lesions of the jaws that can follow incomplete cleaning up after extractions.

Dr. Walter Loesche discussed the consequences of quiet, hidden infections that can occur under and around teeth. The conclusion: gum disease and chronically abscessed teeth can lead to increased risk of heart problems, pneumonia, brain infection, stroke and disturbances of sugar balance.

Moreover, much evidence is pointing toward gum disease as one of the causes of low birth weight or premature babies.

There's a lot of evidence pointing toward gum disease as a significant factor in hardening of the arteries. In fact, gum disease is a much better predictor of coronary artery blockage than is high cholesterol!

Questions? Contact US!click here

The oral / systemic disease connection came into prominence with the U.S. Surgeon General's report in May of 2000. (US Department of Health and Human Services) Oral Health in America: A Report of the Surgeon General-- Executive Summary., 2000. The report states: "The terms oral health and general health should not be interpreted as separate entities". Oral health is integral to general health; this report provides important reminders that oral health means more than healthy teeth and that you cannot be healthy without oral health. Studies have demonstrated an association between periodontal diseases and diabetes, cardiovascular disease, stroke, and adverse pregnancy outcomes. The past half century has seen the meaning of oral health evolve from a narrow focus on teeth and gingiva to the recognition that the mouth is the center of vital tissues and functions that are critical to total health and well-being across the life span. Periodontal disease may increase risk for a variety of health concerns including heart disease, stroke, pre-term birth, diabetes, osteoporosis, lung disease and others. The statistical relationship between periodontal disease and systemic diseases has been well documented and was referred to in the Surgeon General's report. While the statistical relationship has been well documented, it has remained until recently to demonstrate that the periodontal disease is a causal factor and not just a correlated bystander, and that in fact removing the gum disease reduces the risk of the systemic disease. The mouth, with it's 500 different naturally occurring organisms is only second to the intestines in the number of bacteria present, and periodontal disease allows these bacteria to enter the bloodstream and create problems. Additionally, periodontal disease can be a main cause of inflammation in the system the most important of which is increasing the level of C-reactive protein (CRP).   Levels of CRP may be a stronger predictor of potential heart attack or stroke than cholesterol, according to a study published in the Nov. 14, 2003 issue of the New England Journal of Medicine. Researchers have found that levels of both cholesterol and C-reactive protein were indicative of potential heart attacks and strokes, although the latter was more so. Also, women with high levels of one didn't necessarily have high levels of the other. University of California Davis study identifies C-reactive protein as cause of blood clot formation. (Jan. 25, 2003 print edition of the journal Circulation - a publication of the American Heart Association). "The study provides further conclusive evidence that CRP, until now viewed as an 'innocent bystander' in the formation of heart disease, is in fact a key culprit that causes inflammation in the arteries, resulting in formation of clots and plaque that lead to heart attacks and strokes. Treatment of Periodontal Disease significantly reduces CRP levels. Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan. Treating periodontal disease can significantly lower the levels of two inflammatory proteins associated with a heightened risk of heart disease, ," Dr. Sara Grossi, senior author of the study, said. "Our results showed that in people who had elevated levels of CRP at baseline, removal of dental plaque bacteria by scaling or scaling combined with topical antibiotics produced a statistically significant reduction, bringing CRP levels close to the low-risk level. SUNY Buffalo. Just one example J Med Microbiol 54 (2005), 93-96; DOI: 10.1099/jmm.0.45845-0 © 2005 Society for General Microbiology ISSN 0022-2615 Molecular detection of Treponema denticola and Porphyromonas gingivalis in carotid and aortic atheromatous plaques by FISH: report of two cases Pregnant women who receive treatment for their periodontal disease can reduce their risk of giving birth to a low birth-weight or pre- term baby . Of the women who received treatment during pregnancy, 2 percent gave birth to either a low birth-weight or pre-term infant. By comparison, 10 percent of the women who did not receive treatment after birth had either a low birth-weight or pre-term baby. University of Chile- were published in the Journal of Periodontology August 2002   Dr. Robert Genco, Chairman of the Oral Biology Department at SUNYAB, shows in studies that treating periodontal infection may reduce a diabetic's blood sugar. Grossi et al. 1997: Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J. Periodontal 68(8): 713-719.   Stroke patients are three times more likely to have PI. Individuals with periodontal disease are more likely to have thickened carotid arteries, which can lead to stroke, according to a study released at the American Academy of Neurology's 51st annual meeting in Toronto.   Scientists have found that bacteria that grow in the oral cavity can be aspirated into the lung to cause respiratory diseases such as pneumonia, especially in people with periodontal disease.   The relationship between bone mineral density and periodontitis in post-menopausal women. J. Periodontol. 71(9): 1492-1498. Preliminary results indicate that, as dental bone density decreases, so does hip bone density.Wactawski-Wende et al. 1998. s. Even when H. pylori was eliminated from the stomach with antibiotic therapy, it was not completely eradicated from the mouth, where it continues to grow in colonies deep within periodontal pockets. These pockets could be a source of re-infection for the stomach. Heller et. al. The Carbohydrate Addict's Healthy Heart Program. New York: Ballantine Books.   Researchers found that seniors with the highest levels of inflammation (those whose blood levels of IL-6 and CRP were in the upper one-third) had substantially more cognitive decline than those with blood levels in the lowest one-third. These results were published in the journal Neurology in 2003.

Many Women Don't See Dentist During Pregnancy
About half of women do not visit a dentist during a pregnancy, according to two recent studies, despite recent research that shows a link between oral health and a healthy pregnancy. Both a U.S. and a Kuwaiti study found that only about half of pregnant women visit the dentist. Most Kuwaiti women who made a dental visit did so because they were in pain. Access article online at: http://www.simplestepsdental.com/SS/ihtSS/r.EMIHC252/st.32571/t.32571/pr.3/d.dmtNewsContent/c.423846.html

New Saliva Test Can Predict Cavities

Researchers at the University of Southern California School of Dentistry have developed a new test that can predict the number of cavities a child will get from now up through his or her early thirties. The Caries Assessment and Risk Evaluation, or CARE test, measures the relative proportions in saliva of different types of sugar chains — sugar chains also present on tooth surfaces. Access article online at: http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=1448.

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NEW DRUG ELIMINATES CLEANINGS

Right. And if you believe that, we’ve got a bridge to sell ya…

With some fanfare, a ‘new’ medication has broken on the scene. We are seeing some wild claims for Periostat keeping gums healthy for those with active gum disease even without periodic deep cleaning.

In a word: hogwash. The drug is a much lower dose of the antibiotic Tetracycline. Ideally, it cuts down the attack on the protein collagen that holds our gums together.

Measurable improvements seem to have been small, and patients will have to take the drug for at least nine months, perhaps life. The good news is that many patients in the study did not get WORSE.

Now that's a step forward!

We’ll be watching this one…

CHANGING RECOMMENDATIONS

We are now recommending the Philips Sonicare electric toothbrush as probably the best of its type on the market today.

In the past we've only been suggesting the Interplak type electric brush, but new data suggest this is now our number two recommendation in terms of effectiveness, convenience and reliability.

We've come to this decision after reading a lot of the literature and testing the brush for several years.

Are other electric brushes OK? It's hard to comment at this time, since many have not taken the trouble to do the university testing that Interplak and nowSonicare have.

But the bottom line is that, no matter how well you brush, it's not enough to fully protect against cavities and gum disease.

All about electric toothbrushes
http://www.smiledoc.com/dentist/elctbrs.html

FLUORIDE

California is at the bottom of the list in the US for having fluoride in its water supplies. As a result, children and adults here sport more cavities than is necessary.

Nevertheless, it appears that most kids in our area do get enough fluoride without any supplementation.  So, except in special cases, we do NOT prescribe fluoride tablets any longer.

But surface-applied fluoride such as is found in Prevident 5000 prescriptions IS a great aid in cutting cavities for targeted adults.

So you think you want your tongue pierced?

Check out the information on Dr. Steve Hendry's site: CLICK HERE!

Questions? Contact US!click here