Pregnancy Gingivitis Can Affect More Than The Mother’s Health

Posted on Jul 14, 2022 by William J. Claiborne, DDS MS

Is there any other time in a female’s life when they must be as health conscious as during pregnancy?

Pregnant women, it seems, are given a long list of guidelines to follow… What they should not eat or drink, what medications to avoid, and even down to what beauty products to give up. Yet, the 9 months of discipline is well worth the greater potential to bring a healthy baby into the world.

Along with the other health guidelines, obstetricians are now urging pregnant women to pay particular attention to their oral health. For decades, research has tracked a correlation between inflammatory bacteria in the mouth to a number of serious health problems, including many far beyond the mouth.

Once the infectious bacteria of gum disease enter the bloodstream (typically through tears in weakened gum tissues), it can trigger inflammatory reactions, many serious and some that can have deadly consequences. It is the nation’s’ leading cause of adult tooth loss and has been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

However, because of their susceptibility, the risk for full-blown gum disease is higher for pregnant females with nearly a third developing gum disease. Yet, it’s not just the oral (and overall) health of the mother that can be affected.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and babies of low birth weight (less than 5.5 lbs.). One study showed the preterm birth rate for females without gum disease to be approximately 11% compared to nearly 29% for pregnant women with moderate to severe periodontal disease.

One study showed that pregnant women with gum disease were 4 – 7 times more likely to deliver prematurely (before week 37) and underweight babies than mothers with healthy gums. Too, the women with the most severe periodontal (gum) disease delivered most prematurely, at 32 weeks.

Other findings show that gum disease increases the risks of late-term miscarriage and pre-eclampsia. When oral bacteria reach placental membranes via the bloodstream, inflammatory reactions can trigger pre-eclampsia or early labor.

In one study, for example, pregnant females with higher blood levels of antibodies to oral bacteria also had higher rates of preterm birth and babies of low birth weight. These elevated antibodies have been found in amniotic fluid and fetal cord blood samples of infants who were preterm or of low birth weight at birth.

Oral problems in pregnant females can begin even when the mother-to-be is following the same oral hygiene routine as they have previously. The greater susceptibility can be blamed on fluctuating hormone levels during pregnancy. These changes increase the risk for gingivitis (inflammation of the gums) and periodontal disease.

This is why approximately 40% of women develop gingivitis during pregnancy, known as pregnancy gingivitis. Pregnancy gingivitis is a mild form of gum disease that causes gums to become swollen, tender and bleed easily when brushing.

This is the result of an increased level of progesterone in pregnancy, which makes oral bacterial growth easier. Progesterone also makes gum tissues more sensitive to plaque. For those who have significant gum disease prior to pregnancy, being pregnant can make the condition worse.

Gum inflammation typically appears between months 2 and 8 of pregnancy. Signs of pregnancy gingivitis range from gums that are red rather than a healthy pink. Gums will often bleed when brushing teeth and be swollen and tender in spots.

The goal is to prevent pregnancy gingivitis before it occurs. Be committed to a thorough oral hygiene regimen at home, which includes brushing twice a day, flossing daily and swishing with an antimicrobial mouth rinse. Be sure to keep your 6-month cleanings and exams. These will remove any plaque buildup that has occurred between visits.

A periodontist has specialized training in the diagnosis and treatment of all levels of gum disease – in a way that is safe for pregnant women (as well as all patients). Signs and symptoms of gum disease include gums that bleed when brushing, frequent bad breath, swollen or tender gums, gums that loosen or pull away from the base of teeth, or gums that darken in color.

If you have any of these symptoms (whether pregnant or not), you are urged to schedule an appointment at your earliest convenience. Call our Asheville periodontal dental office at 828-274-9440 to arrange an examination to begin.

There Are Good Reasons To Keep The Mouth Moist

Posted on May 11, 2022 by William J. Claiborne, DDS MS

Having good oral health takes a commitment. It requires us to devote time each day for oral hygiene, at least twice per day. However, it’s in-between these brushings that can impact the good that we are doing at the sink.

Nearly everything that causes problems in the mouth has to do with oral bacteria that has gone beyond manageable levels. Although the mouth is home to some very “good” bacteria, an overload of “bad” bacteria is what becomes the origin of many problems.

The reason people are advised to brush at least twice a day and floss daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, a sticky film of bacteria form, which coats the teeth and gums. This film is known as plaque. Without sufficient and frequent removal of plaque, it begins to harden at the base of teeth.

This is tartar (or calculus), which is actually a hardened mass of oral bacteria. Tartar cannot be brushed or flossed away; it requires removal by a dental professional who uses special tools during dental cleanings to scrap tartar from tooth surfaces.

Your periodic dental cleanings are important. If tartar is allowed to further amass, the bacteria can become inflamed, attacking gum tissues. As bacteria continue to reproduce, they create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth, including tooth roots, tissues, ligaments and bone.

Periodontal disease is the leading cause of adult tooth loss. The advanced stage of gum disease, known as periodontitis, creates a bacteria so potent that research has linked it to serious diseases elsewhere in the body. These include some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency.

To help control bacteria in the mouth, saliva serves as a rinse that removes food particles from the mouth. Combined with brushing and flossing, good saliva flow helps to keep bacteria levels under control.

When saliva flow is compromised, oral bacteria are able to reproduce and multiply quickly.  As bacteria accumulate, a sticky film forms on teeth and gums from this buildup. As bacteria coat the interior of your mouth, bad breath begins. Then, the sequence of plaque, tartar and potential for gum disease (as mentioned above) begins.

Oral dryness is one of the biggest influences in developing gum disease. Even though poor oral hygiene is a key factor when it comes to bacteria overload, dry mouth is a common contributor because it has many causes.

A dry mouth can occur from:

• The aging process (affecting about 1 in every 5 adults)

• As a side effect of many medications (including prescription and OTC)

• Radiation therapy, especially for head and neck cancer

• Mouth-breathing, which may be due to nasal congestion or snoring

• Medical conditions, such as diabetes, Alzheimer’s disease, stroke and Sjogren’s syndrome

In addition to your twice daily brushing and flossing routines, it is important to know how you can support saliva flow and avoid the risks created by a dry mouth. These include:

• Drink plenty of plain water throughout the day. Leave off the lemon wedge, which is hard on tooth enamel.

• Avoid (or limit) caffeinated beverages, such as coffee, tea and colas. If you drink these beverages, rinse your mouth after or alternate with gulps of water.

• Consider using an oral rinse designed to replenish moisture in the mouth (available OTC).

• Be aware of medications that have a side effect of oral dryness. Some of the worst are antihistamines, depression and incontinence medications, and some that control blood pressure. If you take one of these, ask your doctor about options that may be less drying to the mouth. Or, increase your water intake and use a daily rinse to replenish oral moisture.

• If you snore or breath through the mouth during sleep, oral tissues are dry during these hours. Consider adjusting your sleeping position or adding a side pillow. Your physician may also have some suggestions, including an oral appliance.

• Certain health conditions can cause dry mouth, including acid reflux, sinus infections, diabetes and bronchitis . A bad cold can also force people to breathe more through their mouth. For these conditions, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.

• Alcohol (including beer and wine) are very drying to oral tissues. Wine and mixed drinks have high levels of acidity and sugar that adds extra challenges to oral tissues. You can help to dilute the severity of these by swishing with water between drinks. Or, keep a glass of water nearby for occasional gulps that wash over teeth before swallowing.

• Smoking (cigarettes, cigars, vaping) are all laden with toxic chemicals (including e-cigs). Be aware of the added risks and be highly committed to your at-home care and drinking plenty of water to keep your mouth clean and moist.

It is also important to know the signs and symptoms of periodontal (gum) disease. It begins with gingivitis, which causes the gums to become tender and swollen. When brushing, blood may be present in the sink when rinsing.

Gingivitis, at this stage, can be contained and resolved if quickly addressed.  If not, the bacteria will continue to multiply. This creates inflammation in the gums. This means the inflammation has progressed to periodontal disease, which requires treatment since it is now below the gum line.

Beneath the gum line, the bacteria continue their attack on the structures that support natural teeth. This includes the bone structures surrounding tooth roots. At this point, the gums bleed easily and breath odor is persistently bad. The gums become red and swollen and may pull away from the base of some teeth (gum recession).

If the disease is not treated, it will worsen to the stage of periodontitis. This is an advanced level of gum disease that is highly infectious and destructive. Because it leaves the gum tissues in such a weakened state, the infection can easily penetrate the gums and enter the bloodstream.

Periodontitis causes the gums to turn spongy with a putrid breath odor. Pus pockets form on the gums and it may become painful to eat. Some teeth may loosen and eventually need removal.

Periodontal disease is the nation’s leading cause of adult tooth loss. Yet, it becomes even more destructive once in the bloodstream. Researchers have linked these bacteria to a wide range of serious health problems.

The bacteria of gum disease have been correlated to heart disease, stroke, some cancers, diabetes, arthritis, preterm babies, memory loss and even impotency. This is rather telling as to the potency of this harmful bacteria and the destructive nature.

As a periodontal specialist, I find that most cases of dry mouth are due to factors that can be easily controlled with simple changes. If you have delayed or avoided dental care, call 828-274-9440 to request a consultation, or begin with a thorough examination in our Asheville periodontal office.

We offer the latest techniques, technology, and skills while always making patient comfort a top priority.

 

How Periodontal Health Affects Your Overall Health

Posted on Apr 28, 2022 by William J. Claiborne, DDS MS

There are many benefits to having a clean, healthy mouth… fresh breath, bright teeth, avoiding cavities and preventing periodontal (gum) disease. However, much research shows that the health of your mouth can also affect your overall health to a rather significant extent.

Over the years, numerous studies have been able to pinpoint how certain diseases, such as coronary artery disease, diabetes, arthritis, etc. can be triggered. While there is still much to learn with some of these, the origins often point to internal (or “systemic”) inflammation.

Inflammation in the body has been shown to set actions into play that cause the onset or worsening of a wide variety of health problems. Periodontal disease is a chronic inflammatory disease. This means the bacteria that attack tooth enamel and gum tissues are in a consistently active state.

When the bacteria of gum disease enter the bloodstream (through tears in weakened gum tissues), it can create inflammatory triggers far beyond the mouth. This bloodborne inflammation, in turn, results in higher risks for heart disease, stroke, diabetes, preterm babies, arthritis, respiratory diseases and even impotency.

To clarify, inflammation is not necessarily a bad thing. It’s the body reacting to an overload of bacteria. For example, the redness or slight swelling you see as a cut heals is a sign that the body’s defense system is fighting off bacteria that could create infection.

In chronic inflammation, however, the body’s defense mechanism becomes stuck in the ‘on’ position. This sets into motion a chain of reactions that transform a beneficial response into a harmful one. When an area in the body that stays in an inflammatory setting, there is a risk for damaging reactions.

One of the first correlations between oral bacteria and other serious health problems was found in heart disease. According to information published by the Harvard Medical School:

“In people with periodontitis (erosion of tissue and bone that support the teeth), chewing and toothbrushing release bacteria into the bloodstream. Several species of bacteria that cause periodontitis have been found in the atherosclerotic plaque in arteries in the heart and elsewhere. This plaque can lead to heart attack.

“Oral bacteria could also harm blood vessels or cause blood clots by releasing toxins that resemble proteins found in artery walls or the bloodstream. The immune system’s response to these toxins could harm vessel walls or make blood clot more easily. It is also possible that inflammation in the mouth revs up inflammation throughout the body, including in the arteries, where it can lead to heart attack and stroke.”

http://www.health.harvard.edu/press_releases/heart-disease-oral-health

Another good example is in the similarities between the tissues of gum disease and those taken from arthritic joints (another inflammatory disease). For decades, it was perceived that RA (rheumatoid arthritis) patients had such a high risk of gum disease due to poor oral hygiene because of dexterity problems with using a toothbrush. However, continued studies showed that gum disease is actually a risk factor for arthritis.

And, it was found that one can contribute to the other. Gum disease is a risk factor for developing RA and having arthritis patients have a greater risk for gum disease.

While genetic factors certainly contribute to greater RA susceptibility, the true source has been determined to be inflammatory reactions. This inflammation is triggered primarily by bacterial infections and the list of damaging outreach of oral bacteria seems to get longer and longer.

Studies have shown that pregnant women with periodontal disease have a greater risk of having pre-term and low birth weight babies. These indications have been found in amniotic fluid and in fetal cord blood samples of infants.

Also alarming is research that revealed that the bacteria of periodontal disease may contribute to a higher risk of pancreatic cancer. For years, researchers at the National Cancer Institute and the American Cancer Society have conducted a cancer prevention and screening study.

By studying oral samples, notably higher levels of two types of oral bacteria were measured in study participants with pancreatic cancer. One oral bacteria was found to create a 50 percent increased risk for pancreatic cancer and the second oral bacteria led to a 59 percent greater likelihood.

Chronic inflammation, in any area of the body, is a health risk that poses severe challenges. Not surprisingly, we occasionally see patients who have been advised by their surgeons to have their gum health checked prior to surgery. This proactive measure is to reduce risk factors that could complicate surgical outcome.

If you have symptoms of gum disease, please be seen by a periodontist promptly. Symptoms include tender gums that bleed easily when brushing, frequent bad breath, swollen and tender gums and gums that redden in color from a healthy pink. Remember, gum disease will only worsen without treatment and is the nation’s leading cause of adult tooth loss.

Maintaining good at-home care of your oral health is easy and takes just minutes a day. Follow a thorough oral hygiene regimen by brushing twice a day (two minutes each time) and floss daily. Drink plenty of plain water throughout the day and limit sugar. Have dental cleanings every six months and follow your dental hygienist’s recommendations to keep oral bacteria at minimal levels between visits.

If you suspect you have gum disease or have delayed (or avoided) having regular dental care, call our Asheville periodontal dental office to schedule an examination. Or, ask to begin with a consultation appointment. During this time, we can discuss any concerns and I’ll gladly answer any questions. Call 828-274-9440.

New Studies Reinforce Obesity-Gum Disease Connections

Posted on Apr 01, 2022 by William J. Claiborne, DDS MS

The first quarter of 2022 has concluded. If your New Year’s resolution to lose weight has waned by now, here’s an incentive to hopefully recommit to it. Researchers at Case Western Reserve University School of Dental Medicine recently conducted a study that found the human body with fewer fat cells is better able to combat periodontal (gum) disease. This is because fat cells trigger inflammation in the body.

In the study, 31 obese people who had clear indications of gum disease were monitored. Half of the group had gastric bypass surgery with fat cells removed from the abdomen. Those in the other group had not had gastric bypass surgery or fat removed.

Researchers noted that the majority of the bypass surgery group had a drop in their glucose levels following the procedure. This is a positive outcome based upon the higher risk of overweight people for diabetes and insulin-related problems.

All study participants underwent non-surgical periodontal treatments and were provided oral hygiene instructions for at-home care. While both groups showed improvement, the surgery group had better results.

https://www.sciencedaily.com/releases/2011/11/111109111540.htm

Inflammation in the body that continues without being able to resolve itself is known as systemic inflammation. This can have harmful effects over time, even eroding bone and that can lead to tooth loss. The inflammation can also cause breaks in the gums where harmful oral bacteria can enter the bloodstream. The potent bacteria of periodontitis (advanced gum disease) have been linked to preterm birth, stroke, heart disease, some cancers, diabetes and arthritis.

Years of scientific studies have long shown that insulin levels in diabetics improve when their gum health improves. Not surprisingly, the pathological processes that occur in both gum disease and rheumatoid arthritis (RA) are almost identical. Both have similar clinical structures, which are agents that cause disease or illness.

Based on the clinical makeup of gum disease and arthritis, the genetic similarity causes both conditions to cause chronic inflammation in tissues that connect to bone. It has also been shown that, by treating periodontal disease in RA patients, symptoms often improve. This has been attributed to a reduced burden of oral inflammation to the system.

Because excessive fat cells cause insulin to be more resistant to function as needed, a higher accumulation of sugar in the blood (hyperglycemia) occurs. By losing weight, insulin becomes less resistant and improves the diabetic status. Similar to improving inflammation levels in arthritic joints, gum disease treatment can also calm the inflammatory load from being overweight.

Another influencer of inflammation the researchers noted is the presence of the leptin hormone. This hormone is what regulates metabolism. Leptin has been linked to inflammation by increasing the production of a particular protein, which is also linked to inflammation (having a domino effect, of sorts). Because leptin production is reduced after bariatric surgery, the levels of inflammation are lower with better outcomes in periodontal treatment.

https://www.sciencedaily.com/releases/2021/11/211112083106.htm

In yet another recent study, the inflammation caused by obesity appeared to be a trigger for the development of cells that break down bone tissue. Natural teeth are held in place by the upper and lower jaw bone. To improve the understanding of the obesity-gum disease connection, research conducted at the University at Buffalo examined two groups of mice over a 16 week period. The mice were fed vastly different diets. The mice in one group were fed a low-fat diet (10% fat). In the other, the diet consisted of 45% fat, nearly half of that fed.

The high-fat diet group experienced obesity as well as higher inflammation and less bone mass where teeth are held in place. The researchers also noted that excessive inflammation resulting from obesity causes the cells that break down bone tissue. These cells, which originate in bone marrow, increase during illness in order to regulate immune function.

Bone loss is a leading symptom of gum disease, often leading to tooth loss. Gum disease affects nearly half of American adults ages 30 and older, according to the Centers for Disease Control & Prevention (CDC).

In NC, according to 2020 statistics, the CDC also reported that the obesity level of adults ages 30+ was 33.6. That’s one-third of our state’s population being obese. (https://www.cdc.gov/obesity/data/prevalence-maps.html#overall)

The relationship between the degree of obesity and gum disease is clear. However, as a periodontal specialist, I hope continued studies on the inflammation-bone connection that accompanies obesity (such as arthritis and osteoporosis) can improve the health of our U.S. population.

So, is the message here to improve your weight by improving your oral health? Research is certainly finding that one helps the other. After all, being at a healthy weight should make you smile, and we all want a smile that shows our confidence and overall well-being.

Know the common symptoms of gum disease and respond promptly by seeing a periodontist. Symptoms can include puffy gums that turn red in color; inflamed, swollen, or bleeding gums; gums that loosen from the base of teeth; persistent bad breath; gums that become spongy and bleed easily; and, pus pockets that form on the gums at the base of teeth.

If you are experiencing any of these, please contact our Asheville periodontal dental office. If dental fear of anxiety has prevented you from having regular dental care, we will be happy to discuss features such as oral and I.V. sedation (“twilight sleep”). Too, our office offers some of the most advanced dental technology in the Southeast. These options often save the patient much time in treatment, improve outcomes, and enhance comfort.

Call 828-274-8448 to begin with a consultation appointment. A referral is not necessary.