Whole Body Health Archives - Emerginnova

Q&A with Dr. Sam Low on COVID-19 and inflammation, plus personalizing the oral-systemic link

Jennifer Reyes — Thu, 01 Oct 2020 10:55:07 +0000

By Kevin Henry, DrBicuspid.com editor in chief

September 21, 2020 — I recently had the opportunity to once again connect with Sam Low, DDS, an associate faculty member of the Pankey Institute for more than 25 years and professor emeritus at the University of Florida’s College of Dentistry.

During our wide-ranging discussion, we talked about myriad subjects, including COVID-19 and inflammation, as well as why generalizing the effects of the oral-systemic link won’t help your patients truly grasp its importance.

Q: COVID-19 is still a big part of our daily lives. How do you see it affecting our discussions with patients about the connection between oral health and overall health?

A: Everything is pointing to chronic inflammation. I saw a word today that’s an interesting word: “inflammaging.” It deals with this whole cascade of how chronic inflammation, especially with aging, now is becoming the buzzword of most disruptions that are occurring within the body.

Look at what are called COVID-19 comorbidities: heart disease, diabetes, respiratory complications, and hypertension. Those diseases are similar to comorbidities that we find in periodontal disease. If I were to rank them, it is heart disease, followed by diabetes, followed by respiratory diseases, and others. We have tons of studies showing the links. We have links to asthma. We have links to lung infections. We have studies about respiratory deaths in nursing homes where roughly 10% of all deaths in nursing homes have a comorbidity of severe periodontitis. So, we know the science is there, and we know the link is inflammation.

I still believe that many dental practitioners do not appreciate that what results in death is not only the COVID-19 virus, but the inflammatory reaction to the virus. That’s really creating the sepsis that is considered the cytokine storm to the system.

During the dental shutdown time, the patient’s oral hygiene was not being reinforced for three months. For our perio patients, debridement was not being performed. And if they’re already susceptible to heart disease, diabetes, and respiratory diseases, we have to make sure we are being more vigilant than ever before.

Q: I know we talked about the value of lasers in the dental practice recently. What are you hearing about this technology now and its effect on periodontal disease?

A: We know that patients with moderate to severe periodontitis may not seek referrals with periodontists. There are multiple reasons for that, but that also means that the general dentist needs to widen what he or she does and increase the capacity to manage periodontitis. Dentists can’t manage moderate to severe periodontitis nonsurgically unless they want to take a risk.

My point is that the advent of lasers such as the Waterlase (Biolase) is now allowing dentists to manage moderate and even sometimes severe periodontitis with all-tissue lasers in a minimally invasive fashion. It suggests that more people are getting care, without the fear of gum surgery. And it also means we’re losing fewer teeth. Dental lasers can help dentists treat periodontitis and make patients more willing to receive treatment. In fact, recent data from the McGuire study published in the Journal of Periodontology demonstrate how the Repair Perio protocol is superior in procedure time and patient-reported outcomes such as swelling and bruising to traditional periodontal treatment.

Additionally, with a diode laser, like the Epic Hygiene (Biolase) for the dental hygienist, there’s a decrease in aerosols so that they don’t have to rely as much on the ultrasonic. Therefore, from a hygiene standpoint, the laser comes into play.

One of my colleagues, Dr. Scott Froum, recently stood in front of an audience and simply said, “A periodontist must have a laser if you want to save teeth.” He is very much into saving teeth now, as we all are, but he showed case after case after case that now, from a minimally invasive standpoint, we can connect the dots between laser usage and better patient care.

Q: Speaking of connecting the dots, you believe we, as an industry, have to do a better job of explaining the oral-systemic link, correct?

A: I’ve always said, “Don’t use the bumper sticker that reads floss or die.” In other words, we need to stop telling patients that if they don’t see us, they’re going to die of heart disease. No, you’re only going to die of heart disease maybe earlier if you already are genetically susceptible to periodontitis and other chronic inflammatory diseases.

As dental professionals, we have to have the correct perspective. If we’re not careful about the oral-systemic link, people are going to think we’re crying wolf. This isn’t about just talking about the oral-systemic link, but rather personalizing it for each patient. It is taking into consideration the patient’s medical history and dental history and matching the two together.

I think so often dental practices cookie cut when explaining the oral-systemic link. You must boil it down so it is simple and meaningful for that patient in your chair. Link it to that patient and his or her medical history, including familial history.

Here’s an example. This is the way I’ve always dealt with the smoking issue among my patients. My parents were smokers, so I have a history there.

How do you handle patients who smoke because you know there’s a great link between nicotine and periodontal disease? Here’s what I say: “You know your chances of losing your teeth are five times greater if you smoke. I’m OK if you want to continue smoking. That’s up to you. I’m just suggesting to you that it’s going to be a five times greater risk. I’m not going to harass you about it, but you’re the one who has to make that decision, not me. And we will modify that we need to see you more often and your home care must be better than average.”

Q: So if someone has really never jumped into the oral-systemic link and wants some research to share with those patients who might be affected, what do you suggest?

A: The American Academy of Periodontology still is the best resource. And for studies, refer to the American Journal of Cardiology when it comes to heart disease. I would start with this paper from Friedewald et al.

Q: Any final thoughts?

A: We dentists, on occasion, still think we are “dentists,” but we don’t realize that we’re actually oral physicians and oral healthcare professionals. Until we see the mouth as an organ and just as important as any other organ, it’s going to be really difficult to truly impact the lives of our patients in a more meaningful way. However, there is still hope.

The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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The mouth-gut axis: How poor oral health may worsen gut inflammation

Jennifer Reyes — Thu, 02 Jul 2020 12:18:01 +0000

By Danielle Masterson

Is the mouth the gatekeeper of the gut? A new collaborative study suggests IBD may be worsened by poor oral health.

Read about the Study and Implications by clicking the link below.

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Oral cancer diagnoses in the U.K. increased 50% in 10 years

Jennifer Reyes — Wed, 20 Nov 2019 00:35:51 +0000

By Melissa Busch, DrBicuspid.com assistant editor

November 6, 2019 — Approximately 8,300 people in the U.K. are diagnosed with oral cancer every year. That number is about 50% higher than it was a decade ago and 135% higher than it was 20 years ago, according to U.K. officials. Thus, the Oral Health Foundation is stressing the need for greater awareness of oral cancer and its signs and symptoms for this year’s Mouth Cancer Action Month.

“The sad fact is that the number of mouth cancer cases continues to increase year on year,” said Nigel Carter, PhD, chief executive of the Oral Health Foundation, addressing the U.K. Parliament. “When we took on this campaign nearly two decades ago, we were looking at just over 3,000 cases each year. In the last year or so, we have had over 8,300 recognized cases of mouth cancer. That is a huge increase, and it is one of the few cancers where the number of cases has started to increase.”

In 2018, approximately 2,700 people died from mouth cancer, according to the U.K.’s State of the Mouth Cancer Report, which was published by the foundation and Simplyhealth Professionals.

Other troubling findings from the report include that about 45% of British admitted to not knowing anything about oral cancer, including risk factors. A whopping approximately 75% were unaware of the symptoms, and about 80% didn’t know where oral cancer appears.

The numbers reveal a dangerous, widespread lack of awareness about the disease, which is most often caused by smoking, drinking alcohol excessively, poor diet, and the human papillomavirus (HPV), which can be transmitted through oral sex.

Depending on where the cancer strikes and how early it is diagnosed, the 10-year survival rate is between 19% and 58%. That is why it is equally important for individuals to check their own mouths for changes in between dental visits, Rutland added.

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Oral health plays an increasing role in overall health during aging

Jennifer Reyes — Tue, 19 Nov 2019 22:19:44 +0000

by Courtney Chandler, University of Connecticut

Oral health is a critical component to overall health for all ages, but according to dental and medical experts from UConn Health, vigilance is especially critical for the elderly.

In a review article recently published in the Journal of the American Geriatrics Society, the authors outline the potential complications that can arise from poor oral hygiene in older adults and cite the role of all health care professionals in working to promote good oral hygiene in this population.

“All health care professionals should work to promote good oral hygiene for their older patients,” said Dr. Patrick Coll, professor of family medicine and medicine at the UConn School of Medicine and lead author of the review article. They “should consider an oral examination during an annual wellness visit, especially for those patients who are not receiving regular dental care.”

The need is evident, say the authors. Data from the National Center for Health Statistics indicates that the prevalence of cavities is more than twice as high in older adults than younger adults. The prevalence of periodontitis—a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth—also increases with age. As many as 64% of older adults in the U.S. have periodontitis.

Periodontitis is associated with a variety of medical conditions including cardiovascular disease and diabetes. Patients with replacement heart valves and prosthetic joints should be particularly careful regarding their oral hygiene, according to the authors.

It is well recognized that manipulation of teeth and their support structures can result in bacteria present in the oral cavity being released into the bloodstream, which may lead to infections in parts of the body far removed from the oral cavity, they write.

“Even tooth brushing for those who have poor oral hygiene can cause bacteria to be released into the bloodstream and these bacteria can potentially cause joint infections and heart valve infections,” says Coll.

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You’re probably brushing your teeth wrong – here are four tips for better dental health

Jennifer Reyes — Tue, 19 Nov 2019 00:39:27 +0000

January 9, 2019 12.33am AEDT

We all know the advice for healthy teeth – brush twice daily and don’t eat too much sugar. So why do those of us following these instructions find we sometimes need a filling when we visit the dentist? The truth is, there’s a little more to preventing tooth decay than these guidelines suggest. Here’s what you need to know.

Brush up on your skills

How you brush makes a big difference. The mechanical act of brushing removes the very sticky dental plaque – a mixture of bacteria, their acids and sticky byproducts and food remnants. It forms naturally on teeth immediately after you’ve eaten but doesn’t get nasty and start to cause damage to the teeth until it reaches a certain stage of maturity. The exact amount of time this takes isn’t known but is at least more than 12 hours.

Bacteria consume sugar and, as a byproduct, produce acids which dissolve mineral out of the teeth, leaving microscopic holes we can’t see. If the process isn’t stopped and they aren’t repaired, these can become big, visible cavities.

Use fluoride toothpaste and disclosing tablets

Most of the benefit from brushing comes from toothpaste. The key ingredient is fluoride, which evidence shows prevents tooth decay. Fluoride replaces lost minerals in teeth and also makes them stronger.

For maximum benefit, use toothpaste with 1350-1500 ppmF – that’s concentration of fluoride in parts per million – to prevent tooth decay. Plaque is difficult to see because it is whitish, like your teeth. Disclosing tablets are available in supermarkets and chemists and they make plaque more visible, showing areas you may have missed when brushing.

No more than four ‘sugar hits’

Intrinsic sugars are found naturally in foods like fruit and they are far less likely to cause tooth decay than added or free sugars. Free sugars are generally those added to foods by manufacturers but also include honey, syrup and fruit juices. These are all easy for bacteria to consume, metabolise and produce acids from.

However, it can be difficult to tell which are the worst sugars for teeth. For example, although normal amounts of fruit are fine, fruit juices have sugar liberated from the plant cells and heavy consumption can cause decay.

The World Health Organization and NHS recommend free sugars should ideally make up less than 5% of your daily calorie intake. So what does this look like? For adults and children over about 11 years old, this is around 30g – about eight teaspoons – of sugar daily.

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Cleaner Teeth Can Brush Away Health Risks

Jennifer Reyes — Mon, 18 Nov 2019 23:30:40 +0000

by Kimberly Rae Miller, AARP Bulletin, October 2018

Prevent diabetes, cancer and more by spending more time with your toothbrush .

Think twice the next time you’re tempted to skip brushing your teeth — you might just save your life. When gums are inflamed and bleeding, it’s often gingivitis; a dentist’s care and good daily teeth cleaning can reverse it. But let the problem continue and the bones and tissue that hold your teeth in place begin to get damaged.

That’s called periodontitis. Once it sets in, you’re at risk of something much larger than a few missing teeth. “Periodontal disease is a chronic inflammatory disease that stimulates the body’s immune system,” says Jeffrey R. Lemler, a periodontist in New York City. Bleeding gums allow bacteria and inflammation to enter the body and wreak havoc. Where? Pretty much everywhere.

Poor dental habits can have a surprising ripple effect throughout your body.

Sharper brain

People with severe periodontal disease were three times more likely to have Alzheimer’s disease, according to a statistical review. In another study, stroke patients had higher levels of certain bacteria in their saliva, demonstrating a link between oral hygiene and stroke risk.

Clearer lungs

If you find yourself headed to the hospital, bring your toothbrush. A recent study found that providing patients with oral care decreased instances of hospital-related pneumonia by 39 percent.

Lower cancer risk

Postmenopausal women who’ve experienced periodontal disease are at increased risk for breast, esophageal, gallbladder, skin and lung cancers, according to a 2017 study.

Healthier kidneys

The correlation between poor periodontal health and atherosclerosis has been well established for a few decades now. Atherosclerosis can be the root of a bunch of health problems you want nothing to do with, like chronic kidney disease.

CLICK HERE to continue reading the article to know more about the effects of poor dental habits throughout your body

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Soft drinks found to be the crucial link between obesity and tooth wear

Jennifer Reyes — Mon, 18 Nov 2019 23:22:42 +0000

Date: October 28, 2019 | Source: King’s College London

A new study has found that sugar-sweetened acidic drinks, such as soft drinks, is the common factor between obesity and tooth wear among adults.

A new study published in the journal Clinical Oral Investigations, has found that sugar-sweetened acidic drinks, such as soft drinks, is the common factor between obesity and tooth wear among adults.

Scientists from King’s College London found that being overweight or obese was undoubtedly associated with having tooth wear. Significantly, they also found that the increased consumption of sugary soft drinks may be a leading cause of the erosion of tooth enamel and dentine in obese patients.

Drawing on data from the National Health and Nutrition Examination Survey 2003-2004, they analysed a representative sample of survey participants of 3,541 patients in the United States. Patient BMI and the level of tooth wear were the exposure and outcome measurements in the analysis. The intake of sugar-sweetened acidic drinks was recorded through two non-consecutive 24-hour recall interviews where the patients were asked to provide details of diet intake across these two days.

“It is the acidic nature of some drinks such as carbonated drinks and acidic fruit juices that leads to tooth wear,” said lead author Dr Saoirse O’Toole from King’s College London.

Tooth wear is ranked as the third most important dental condition, after cavities and gum disease and the consumption of acidic food and drink is a leading cause of this. Obese patients also have other risk factors such as increased likelihood of gastric reflux disease (heartburn) which was controlled for in this study.

“This is an important message for obese patients who are consuming calories through acidic sugar sweetened drinks. These drinks may be doing damage to their body and their teeth. There is also an important message for dentists. We should be asking our patients who are obese and have tooth wear what calories they are drinking as this may be having an effect on their full bodies — not just their teeth,” Dr O’Toole added.

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How to start talking to patients about the oral-systemic connection

Jennifer Reyes — Mon, 18 Nov 2019 22:21:09 +0000

By Kevin Henry, DrBicuspid.com editor in chief

November 7, 2019 — There is no question that there is a direct link between patients’ oral health and overall health. However, many dental professionals have reported that communicating that connection is more difficult than expected. Additionally, when topics are difficult, we human beings often push them into the background of our priorities.

With those difficulties in mind, the team reconnected with dental pharmacology expert Tom Viola, RPh on the latest episode of the Dental Assistant Nation podcast series, powered by IgniteDA.net. Viola is passionate about dental professionals discussing the oral-systemic connection with their patients as well as making connections with medical professionals for referrals, etc.

In this episode, Viola talks about the importance of every dental team member (including the dentist, hygienist, and assistant) feeling comfortable talking to patients about their overall health and the effects that periodontal disease and other oral issues can cause. Kevin Henry also got to talk with Viola about how dental professionals can start the conversation, and they were able to touch on some of the changes happening with dental insurance in the coming year that are going to help bridge the gap between the dental and medical worlds.

Click below to hear the discussion and some frank talk about the important role every dental professional plays in patients’ oral and overall health.

er with the 10th Emirates Cardiac Society Congress. The conference is Oct. 3-5 in Dubai, United Arab Emirates.

The causal association between oral disease and cardiovascular disease is not well known, so researchers in this study conducted a secondary analysis of the 2014 Behavior Risk Factor Surveillance System that looked at tooth loss not caused by trauma, as well as cardiovascular disease, including heart attack, angina and/or stroke.

“Our results support that there is a relationship between dental health and cardiovascular health,” said Hamad Mohammed Qabha, MBBS, lead author of the study and Chief Medical and Surgical Intern at Imam Muhammad Ibn Saud Islamic University. “If a person’s teeth fall out, there may be other underlying health concerns.

Listen to the Podcast by CLICKING HERE

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Oral infections in childhood may increase risk of cardiovascular diseases in adulthood

Jennifer Reyes — Mon, 18 Nov 2019 22:08:28 +0000

A new study has suggested that common oral infection in childhood is associated with an increased risk of cardiovascular diseases such as atherosclerosis in adulthood.

A new study has suggested that common oral infection in childhood is associated with an increased risk of cardiovascular diseases such as atherosclerosis in adulthood. Atherosclerosis is a disease of the arteries characterised by the deposition of fatty material on their inner walls. “The observation is novel since there are no earlier follow-up studies on childhood oral infections and the risk of cardiovascular diseases,” said researcher Pirkko Pussinen. More progressed oral infections and inflammations are known to be associated with several cardiovascular risk factors and disease risk in adults according to the details published in the Journal of JAMA Network Open.

Periodontitis in particular has been studied extensively, and currently, it is considered an independent risk factor for atherosclerotic vascular diseases. The treatment of periodontitis is also known to decrease cardiovascular risk factors. The study was initiated in 1980 when clinical oral examinations were conducted. Cardiovascular risk factors were measured at several times. Cumulative exposure to the risk factor was calculated in both childhood and adulthood.

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Tooth loss associated with higher risk of heart disease

Jennifer Reyes — Sat, 16 Nov 2019 02:13:47 +0000

October 3, 2019 | American College of Cardiology

Adults missing one or more teeth from non traumatic events more prone to heart attack, stroke.

Adults who have lost teeth due to nontraumatic reasons may have a higher risk of developing cardiovascular disease according to a presentation at the American College of Cardiology Middle East Conference 2019 together with the 10th Emirates Cardiac Society Congress. The conference is Oct. 3-5 in Dubai, United Arab Emirates.

Read the full article by CLICKING HERE

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