Inflammation is your body’s normal way of healing itself after injury or infection. It is a natural process that lets your defense cells enter the site of injury or infection and allow for healing to occur. However, if the inflammation process goes on for a period of time it causes tissue damage. This is the case in long-term, chronic diseases such as arthritis. Oral inflammation can also lead to gingivitis, periodontitis and eventually, tooth loss.

The mouth may contribute to your body’s overall amount of inflammation. Your mouth is home to many different types of bacteria. Many of these types of bacteria are harmless but some cause cavities while others cause inflammation of the gums or gingivitis. When the bacteria get out of control it results in red, swollen, puffy and tender gums. A common sign of gingivitis is gums that bleed easily when you brush or floss.

Your mouth is directly related to the body by the bloodstream. This means that when you have inflammation in the mouth it affects your overall health or parts of the body. Studies have shown that oral inflammation may be linked to problems in other parts of the body. Some of these problems are heart disease, diabetes, arthritis and periodontal disease.

Dental Professionals associate gum disease to fall under 3 stages:

Gingivitis

This is the first stage of gum disease. Some indications that you may have gingivitis may involve tender and some bleeding of your gums when you brush or floss. Gingivitis is reversible when corrective measures are undertaken. Some of these measures involve routine professional cleanings and proper brushing and flossing on a daily basis. Usually when the above measures are undertaken no bleeding or tenderness of the tissues should result. This lack of bleeding and tenderness indicates that the gingivitis has been reversed back to a degree of health. Untreated gingivitis can advance to periodontitis.

Periodontitis

This is considered the second stage of periodontal disease. At this stage plaque and tarter forms under the gums which is not accessible by brushing and flossing alone, and professional therapeutic methods need to be incorporated. Plaque and tarter causes an infection, which may damage the bone and the attachment of the gums to the teeth. You may notice that your gums start to pull away from the gums and more tenderness and bleeding may result. Proper dental care may involve tissue and root therapy or "deep cleanings" with the incorporation of other therapies depending on the involvement of the disease. Professional intervention is very important to prevent further damage of this disease. The first step involves a special deep cleaning or tissue and root therapy. This procedure helps gum tissue heal and periodontal pockets to shrink. A local anesthetic is often used to make you more comfortable. Usually, treatment occurs in one appointment. Sometimes antibiotics may be inserted under the gums to aid in healing of the gingival tissues. Also, a medication via a pill may be recommended to control infection or to aid in healing. A month after therapy an examination will determine if further treatment is required.

Advanced Periodontitis

In this final stage of gum disease, the bone and the attachment of the gums to the teeth has been destroyed. This may cause your teeth to shift or loosen and can affect how your teeth come together. You may notice a bad taste or smell in your mouth. Proper dental care must be initiated to save the teeth or they may need to be removed. Professional intervention may involve pocket reduction therapy and bone grafting along with the incorporation of other therapies.

Pocket reduction therapy is required when the gingival tissues have not resolved after initial treatment or tissue and root therapy. This is usually necessary when gingival tissues have not shrunk enough or when the supporting bone around the teeth has been lost. Since the gingival tissue have not shrunk they provide a greater place for bacteria to live and attack the bone and tissue causing further damage to occur. Pocket reduction therapy turns or pulls back the gingival tissue and removes tartar and smoothes the roots so that the gingival tissue can reattach. Diseased tissue is also removed to allow the gingival tissue to heal. The gingival tissue is sutured back into place into a new position to make the gingival tissue snug around the tooth and aid in healing. Sometimes bone grafts may be necessary to correct for bony defects that occur around teeth and where roots divide to prevent loss of teeth.

Heart Disease

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries. Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Stroke

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.

Prevention and Maintenance

Once your periodontal treatment is completed it is very important you maintain regular professional cleanings. Research states that a three month recall is adequate and recommended. This is necessary because it takes three months for the bacteria to repopulate and start to cause destruction of gingival tissue attachment and bone loss. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or from reoccurring. A few minutes a day is enough to care for your teeth and gums. You do not have to lose teeth to periodontal disease. Brush and clean between your teeth, eat a balanced diet, stay active and schedule regular dental visits for a lifetime of healthy smiles.

How do I know if I have gum disease?

Your dental professional will determine if you have gum disease at every professional cleaning, which should occur every 6 months. Since early gum disease or gingivitis is reversible, it is important you see your dental professional if you see any of the following:

• Gums that bleed or are red, puffy, swollen or sore
• Gums that have pulled away from the teeth
• Changes in the way your teeth fit together
• Pus or a creamy discharge that appears around the teeth or gums
• Constant bad breath or a bad taste in your mouth

What should I do if I have gum disease?

• Get regular professional cleanings and checkups. Your dental professional will remove the plaque and tartar that forms under the gums that has been shown to cause gum disease
• Do not smoke cigarettes or use other forms of tobacco
• Brush and floss daily to keep the gum tissue healthy

Studies have indicated links between your mouth and overall health, such as:

• People with diabetes are more likely to develop gum disease and result in tooth loss. · · · The plaque in your mouth has been found to clog arteries around your heart leading to heart disease and stroke.
• Pre-term low birth weight babies are more likely to occur in mothers with gum disease.
• The chemicals that lead to gingivitis are the same chemicals that play an important role in heart disease and rheumatoid arthritis.

Good Oral Hygiene-Daily Brushing and Flossing

Brushing

Step One: For the outer tooth surfaces, place the toothbrush at a 45-degree angle toward the gumline. Use gentle, short strokes, moving the brush back and forth against the teeth and gums.
Step Two: Use this same motion to clean the chewing and inner tooth surfaces.
Step Three: To clean the inner front tooth surfaces, hold the brush upright and use gentle up-and-down strokes with the tip of the brush.
Step Four: Don't forget to brush along the gumline, and make sure you reach the teeth right at the back Also give your tongue a brushing - it'll help keep your breath fresh!

Flossing

Step 1: Take about 18 inches (50cm) of floss and loosely wrap most of it around each middle finger (wrapping more around one finger than the other) leaving 2 inches (5cm) of floss in between.
Step 2: With your thumbs and index fingers holding the floss taut, gently slide it down between your teeth, while being careful not to snap it down on your gums.
Step 3: Curve the floss around each tooth in a "C" shape and gently move it up and down the sides of each tooth, including under the gumline. Unroll a new section of floss as you move from tooth to tooth. At first, flossing might feel awkward. But stick with it! With just a little patience and practice, it will begin to feel as natural as brushing your teeth.

Bacterial respiratory infections are thought to be acquired through aspiration (inhaling) of fine droplets from the mouth and throat into the lungs. These droplets contain germs that can breed and multiply within the lungs to cause damage. Recent research suggests that bacteria found in the throat, as well as bacteria found in the mouth, can be drawn into the lower respiratory tract. This can cause infections or worsen existing lung conditions. People with respiratory diseases, such as chronic obstructive pulmonary disease, typically suffer from reduced protective systems, making it difficult to eliminate bacteria from the lungs.

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. This discovery leads researchers to believe that these respiratory bacteria can travel from the oral cavity into the lungs to cause infection.

Chronic obstructive pulmonary disease (COPD) causes persistent obstruction of the airways. The main cause of this disease is thought to be long-term smoking. Chemicals from smoke or air pollution irritate the airways to cause obstruction. Further damage to the tissue and working function of the lungs can be prevented, but already damaged tissue cannot be restored - untreated or undetected COPD can result in irreversible damage. Scientists believe that through the aspiration process, bacteria can cause frequent bouts of infection in patients with COPD. Studies are now in progress to learn to what extent oral hygiene and periodontal disease may be associated with more frequent bouts of respiratory disease in COPD patients.

For a long time we've known that risk factors such as smoking, alcohol use, and drug use contribute to mothers having babies that are born prematurely at a low birth weight. Now evidence is mounting that suggests a new risk factor – periodontal disease. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.

More research is needed to confirm how periodontal disease may affect pregnancy outcomes. It appears that periodontal disease triggers increased levels of biological fluids that induce labor. Furthermore, data suggests that women whose periodontal condition worsens during pregnancy have an even higher risk of having a premature baby.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. Dental experts recommend that women considering pregnancy have a periodontal evaluation.

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because diabetics are more susceptible to contracting infections. In fact, periodontal disease is often considered the sixth complication of diabetes. Those people who don't have their diabetes under control are especially at risk.

A study in the November issue of the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are. Research has emerged that suggests that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts diabetics at increased risk for diabetic complications. Thus, diabetics who have periodontal disease should be treated to eliminate the periodontal infection.

This recommendation is supported by a study reported in the Journal of Periodontology in 1997 involving 113 Pima Indians with both diabetes and periodontal disease. The study found that when their periodontal infections were treated, the management of their diabetes markedly improved.

Most people have wisdom teeth -- those teeth that grow in the very back of your mouth -- as young adults. Although some people may have enough room in their mouths to accommodate their wisdom teeth, others may need to have them extracted to prevent other dental problems, including overcrowding.

According to the American Dental Association, your wisdom teeth may need to be extracted if they are growing in sideways and could impact other teeth. They should also be removed if the teeth are only partially emerged for an extended period. This allows the bacteria to form around the teeth and could cause an infection.

If you experience pain, stiffness or swelling in your jaw or other tooth pain, you should consult your dentist to see if your wisdom teeth may be causing the problems. Your dentist may refer you to an oral surgeon to see if your wisdom teeth need to be extracted.

Gum recession or root exposure is a disease or pathological process that is characterized by visible roots, sensitivity to cold or touch, and in extreme cases, loose teeth. Age is not a proven primary factor for gum recession. Significant concerns regarding root recession are as follows (least to most important):

• Cosmetics
• Tooth sensitivity to cold stimuli or touch
• Loss of a "firm collar" of tissue around the neck of the tooth that functions as a protective mechanism for the underlying bone
• Root caries, or cavities in the roots
• Permanent loss of bone support for the roots

Roots are porous in nature, much like a sponge. They have holes and tunnels in them, called tubules that accumulate food particles, by-products and bacteria when exposed. This invasion very rapidly results in loss of mineralization of the tooth, and cavities invade the root when it is exposed. A firm band of tissue called “attached tissue” is usually attached to a root and provides a cinching affect around the teeth, much like a tie around a neck, to protect foreign material from getting down between the teeth and gums and thus infecting the bone. This important protection is lost with gum recession. Therefore, when the bone is exposed to foreign materials, it recedes to protect itself along with the gum. This provides significant loss of bone support for the tooth that is permanent. Bone loss usually cannot be replaced.

Simple snoring is caused by the lower jaw (or mandible) relaxing and falling back. This restricts the airway and allows the tongue to rub against the soft tissue at the back of the throat. This combination of events causes the snoring noise. Holding the lower jaw (or mandible) forward relieves this condition eliminating the snoring noise.

Being overweight is one of the main causes of snoring. Simply put, being overweight causes the airway to be smaller, the tongue larger, and soft palate larger (and softer). All of these changes contribute to snoring, breathing, and sleeping problems. You can often predict a snorer by the size of the neck.

Snoring is usually the precursor to sleep apnea and is a possible combination of snoring and the cessation of breathing. Sleep apnea is a very serious health hazard. Medical advice is highly recommended. The currently recognized treatment is CPAP, or Continuous Positive Airway Pressure device. With this device, you must have a noisy air pump in your bedroom and wear a mask. There are many studies indicating that mandibular advancement is effective in the treatment of sleep apnea.

You may not discover the symptoms yourself, but your partner may notice that you stop breathing momentarily during sleep and often make choking sounds. You may also wake up abruptly and start gasping for air. Other signs are: limbs jerking during sleep, morning headaches, waking up tired and thirsty, irritability, memory problems, daytime fatigue, having an irresistable urge to nap.

Snore Guard is an oral appliance that resembles an athletic mouthpiece. Small and flexible, it has no moving parts, masks, hoses, or batteries. Snore Guard is made from sterile thermoplastic. It is easy to clean with a regular toothbrush.

Snore Guard is fitted by a dentist. It takes one simple, painless visit. There are no needles, no drugs, no tools in your mouth. No lab work or X-rays are required.

Snore Guard is worn during sleep. It uses normal body reflexes to keep the airway open. The device fits snugly on the upper teeth. When the lower jaw closes, the lower teeth close onto the lower ramp of the Snore Guard. This keeps the jaw in a normal position, rather than sagging open and back. In addition, the tongue reflexively seeks the small center orifice between the upper and lower ramp. This reflex keeps if from sagging back into the throat. With the airway open, breathing is relaxed and normal during sleep.

Users of Snore Guard report significant improvement of sleep quality, and a return of symptoms when it's not used. 99% reported reduced snoring and 50% reported elimination of snoring ("Oral Appliances for the Treatment of Snoring and Obstructive Sleep Apnea: A Review," Schmidt-Nowara, et. al., Sleep, Vol. 18, No. 6, March 1995, pages 501-510). 80% reported decreased sleep disturbance with treatment ("Treatment of Snoring and Obstructive Sleep Apnea with a Dental Orthosis," Schmidt-Norwara, et. al., Sleep, November 1990). "Anti-snore device works: Product Name Snore Guard." A study of 75 people wearing the device showed snoring improved in all patients except one, and sleep quality and sleepiness also improved. (Clinical Research Associates Newsletter, Vol. 16, No. 12, December 1992, page 4) How much does Snore Guard® cost? Snore Guard costs less than other medical snoring treatments, which can run to thousands of dollars. Snore Guard is available only through dentists, please, call our office for more details (614) 443-3400.

Tooth Decay Definition

Tooth decay, which is also called dental cavities or dental caries, is the destruction of the outer surface (enamel) of a tooth.

Description

Tooth decay results from the action of bacteria that live in plaque. Plaque is a sticky, whitish film formed by a protein in saliva (mucin) and sugary substances in the mouth. The plaque bacteria sticking to tooth enamel uses the sugar and starch from food particles in the mouth to produce acid, which destroys the tooth's enamel.

Tooth decay requires the simultaneous presence of three factors: plaque bacteria, sugar, and a vulnerable tooth surface. Although several microorganisms found in the mouth can cause tooth decay, the primary disease agent appears to be Streptococcus mutans. The simple sugars used by the bacteria are glucose, sucrose, and lactose. They are converted primarily into lactic acid. When this acid builds up on an unprotected tooth surface, it dissolves the minerals in the enamel, creating holes and weak spots (cavities). As the decay spreads inward into the middle layer (the dentin), the tooth becomes more sensitive to temperature and touch. When the decay reaches the center of the tooth (the pulp), the resulting inflammation (pulpitis) produces a toothache.

It is easier and less expensive to prevent tooth decay than to treat it. The four major prevention strategies are: proper oral hygiene, fluoride, sealants, and attention to diet.

The best way to prevent tooth decay is to brush the teeth at least twice a day, preferably after every meal and snack, and floss daily. Cavities develop most easily in spaces that are hard to clean. These areas include surface grooves, spaces between teeth, and the area below the gum line. Effective brushing cleans each outer tooth surface, inner tooth surface, and the horizontal chewing surfaces of the back teeth, as well as the tongue. Flossing once a day helps prevent gum disease by removing food particles and plaque at and below the gum line, as well as between teeth. Patients should visit their dentists every six months for oral examination and professional cleaning.

Parents can easily prevent baby bottle tooth decay by not allowing a child to fall asleep with a bottle containing sweetened liquids. If a bottle is necessary when the child is falling asleep it should be filled only with plain, unsweetened water. The child should be introduced to drinking from a cup around six months of age and usually weaned from bottles by 12 months. If an infant seems to need oral comfort between feedings, a pacifier specially designed for the mouth may be used. Pacifiers, however, should never be dipped in honey, corn syrup, or other sweet liquids.

Bruxism (pronounced BRUK-sizm) is the technical term for forcible grinding and clenching of the teeth. It usually happens at night, during sleep, although some people grind their teeth during the day as well. People who suffer from bruxism may also bite their fingernails or pencils, or chew the insides of their cheeks.

About half of US adults grind their teeth at night, and about 20% (over 40 million people) grind their teeth in a destructive way. Most people who grind their teeth are over 25 years old, and the disorder affects women and men about equally. Children also grind their teeth, but usually in response to discomfort caused by colds, ear infections or allergies. Most cases of bruxism in children resolve on their own without causing tooth damage or other problems.

Bruxism can have a variety of causes, but the most common are probably emotional factors such as daytime stress, anxiety, anger, pain and frustration. Certain sleep disorders can trigger grinding of the teeth as well. People who are competitive, aggressive, and rushed may also be at greater risk for bruxism. Lastly, alcohol and some types of medications may worsen tooth grinding.

When you chew your food, your deliver a force of about 175 pounds per square inch (psi) to your teeth. But when you grind your teeth at night, there's no food to absorb the impact, so the force on your teeth can be 300 psi or more. That's enough to cause permanent damage to your teeth, including cracked and chipped enamel, hairline fractures, and even wearing down of the teeth to the gumline. The enamel may become so worn that the inside of the tooth (called the dentin) is exposed.

If bruxism isn't treated, it can lead to gum damage, loss of both natural teeth and restorations, and other more complicated jaw-related disorders (such as temporomandibular joint disorders). Over time, your teeth may become sensitive due to exposed dentin, and your jaws may even move out of proper balance. Grinding your teeth can also cause a wide variety of other symptoms including soreness and fatigue in your jaw and facial muscles, and earaches or headaches, especially when you wake up in the morning.

There is no known cure for bruxism but there are ways to reduce or stop your grinding and even ways to limit further damage and pain due to grinding.

Temporomandibular disorders can cause symptoms that are similar to other diseases.

Do you notice clicking or popping when you open your mouth? Is it difficult or painful to open your mouth? Does your jaw occasionally lock, so it is stuck open or closed? If so, you should see your dentist for a consultation and examination. You may have a temporomandibular disorder (TMD). These disorders include problems of the chewing muscles, the jaw joint (called the temporomandibular joint or TMJ), or both.

Here are some key symptoms linked to TMD.

• Unusual sounds — Clicking, grinding or popping sounds when you open your mouth are common in people with TMD. The sounds may or may not be accompanied by pain. According to the National Institute of Dental and Craniofacial Research, researchers believe that most people with popping or clicking in the jaw joint probably have a displaced disc. However, they also note that as long as the displaced disc causes no pain or problems with jaw movement, no treatment is needed.
• Locking or limited movement — The jaw joint is similar to a ball-and-socket joint except that the socket itself is movable. The jaw joint sometimes may lock in an open or closed position. You may have difficulty opening your mouth either because the joint is locked or because of pain.
• "Ear" pain — You may think you have an ear infection, but ear pain may be related to jaw joint inflammation or muscle tenderness. Pain from TMD is usually felt in front of or below the ear.
• Headaches — People with TMD often report headaches. Your dentist can help to determine if your specific headache symptoms are a result of TMD. In some situations, you may need to consult a physician to help diagnose and treat certain headaches not related to TMD.
• Morning stiffness or soreness — If your jaw muscles are stiff and sore when you wake up, it may by a sign that you are clenching or grinding your teeth in your sleep. Clenching or grinding teeth can exhaust jaw muscles and lead to pain.
• Difficulty chewing — You may have difficulty chewing as a result of a change in your bite—the way your upper and lower teeth fit together. This shift in your bite may be related to TMD.
• Previous injuries and related conditions — A recent injury to the jaw joint or one from many years past can lead to TMD symptoms. Arthritis in the joint also may arise from injury. Arthritis already affecting other joints may affect the jaw joint and lead to TMD.
• Others — Though the research is controversial, a feeling of fullness of the ears or ringing in the ears may sometimes be related to TMD. In these cases, consultation with an "ear, nose and throat" physician can help establish the final diagnosis.

If these symptoms sound familiar, talk to your dentist. Your dentist will test your ability to open and close your jaw, examine other jaw movements, and feel the jaw joint and muscles for pain or tenderness. The dentist will listen with a stethoscope in front of the ear for any clicking, popping or grinding sounds and will feel the jaw joint while you open and close it.

X-rays are often taken to look at the jaw joint and to rule out other diseases. In some cases, a computed tomography (CT) scan may be needed to further examine the bony detail of the joint. In addition, magnetic resonance imaging (MRI) is sometimes recommended to analyze the soft tissues.

While it is advisable to discuss any TMD symptoms with your dentist, occasional discomfort in the jaw joint and chewing muscles is quite common and usually not a cause for concern. However, if you are diagnosed with TMD, the good news is that simple self-care practices are highly effective in relieving the discomfort. These include eating soft foods, applying heat or ice packs and avoiding extreme jaw movements. Effective, conservative treatments include nonsteroidal anti-inflammatory drugs, muscle relaxants, physical therapy and oral appliances.

Halitosis is bad or sour smelling breath. Bad breath can be acute (short term) or chronic (long term) depending on the cause. It may indicate the need to clean the teeth and mouth more often, tooth or gum disease, or intestinal disorders. Consult your dentist and/or physician if the condition persists.

Halitosis is usually caused by poor oral hygiene. However, it can also can be caused by retained food particles or gum disease. Proper brushing that includes brushing the tongue, cheeks, and the roof of the mouth will remove bacteria and food particles.

In most cases, halitosis originates from the gums and tongue. The odor is caused by bacteria from the decay of food particles, other debris in your mouth, and poor oral hygiene. The decay and debris produce a sulfur compound that causes the unpleasant odor.

Other causes of halitosis are: diabetes, drugs, gum disease, heavy metal accumulation, infection, liver disease, not eating, poor diet, poor dental hygiene, smoking, sulfur, stress, and tooth decay.

Some ways to lower your risk of developing halitosis are:

• Brush and floss teeth regularly
• Clean and replace your toothbrush regularly
• Avoid mouthwashes with flavorings, dyes, and alcohol
• Avoid stress and seek out ways to relax and resolve stressful conditions in your life
• Get sufficient sunlight, exercise, and sleep
• Avoid spicy foods and those that leave residues or get stuck in the teeth (alcohol, cheese, meat, sweets)
• Chew parsley after meals, which is very rich in chlorophyll and serves as a natural mouthwash

Saliva is the key ingredient in your mouth that helps keep halitosis from developing. It does this by washing away food particles and bacteria, which are the primary causes of bad breath.

When you sleep, your salivary glands slow down the production of saliva allowing the bacteria to grow inside the mouth. Brushing your teeth should get rid of the odor. However, if you skip breakfast, the bad odor may reappear. Brushing your teeth with an electronic toothbrush can provide a better cleaning than using a manual toothbrush