Written By DR. MIRJANA JOJIC, ABC News Medical Unit Nov 13, 2011

Going to the dentist can be stressful, frightening and painful — but it may also help your heart.

Research presented Sunday at the American Heart Association’s (AHA) annual conference in Orlando, Fla., suggests that not only do frequent dental cleanings ward off plaque and gum disease, but they can also reduce risk of heart disease and stroke.

“Periodontal, or gum health, as a risk factor for heart attacks and strokes, has been looked at several times over the past 10 years,” said Dr. Thomas Gerber, an AHA spokesman and a professor of medicine and radiology at the Mayo Clinic. “Some prior studies found a relationship between gum disease and heart or other disease, whereas others didn’t.”

The exact mechanism of how gum disease may be linked to heart disease and stroke is unclear.

One thought is that poor dental hygiene leads to an overgrowth of oral bacteria. These organisms, fairly benign in the mouth, can get into the bloodstream through the gums and, once there, they can clump on blood vessel walls and grow into plaques that clog arteries and lead to heart attacks and strokes. Moreover, because these bacteria are foreign to the body, once they infiltrate the bloodstream, blood vessels think they are being attacked and try to kill them, just as they would an infection. This results in inflammation and swelling that narrows blood vessels and prevents adequate blood flow to vital organs like the brain and heart.

The recent study was less concerned with the details of why gum disease increases risk of heart disease and stroke, but whether the risk can be reduced through frequent dental visits.

“Poor oral hygiene has been associated with increased risk of cardiovascular disease,” the study’s abstract acknowledged. “However, the association between preventive dentistry and cardiovascular risk reduction remained underdetermined.”

Dr. Zu-Yin Chen and colleagues at Taipei Veterans General Hospital in Taiwan followed more than 100,000 patients over a seven-year period, only half of whom had ever had their teeth cleaned.

They found that the participants who had ever had their teeth cleaned had a 24 percent decreased risk of heart attack and a 13 percent lower stroke risk compared to those who had never had a dental cleaning.

Not only did any dental cleanings reduce risk of heart disease and stroke, but Chen said in the news release, “Protection from heart disease and stroke was more pronounced in participants who got tooth scaling at least once a year,” meaning that the more often people had their teeth cleaned, the lower their risk of heart disease and stroke.

Although the results suggest that preventative dental care can lower risk of heart disease and stroke, the study did not account for other cardiovascular risk factors that could have contributed to the association.

“We can’t lose sight of the fact that most heart attacks and strokes are related to the so-called traditional risk factors, and those are high blood pressure, high cholesterol, high blood sugar, smoking, weighing too much and not exercising enough. It remains very important to take control of those risk factors,” said Gerber. “People shouldn’t think that by going to the dentist more often they’re going to reduce their risk of heart disease.”

Dr. Daniel Meyer, the American Dental Association’s (ADA) senior vice president of science and professional affairs, agreed that it is too early to make that assumption, but stressed, “Regular dental visits are important to diagnose and treat dental disease. Some conditions in the mouth may indicate disease elsewhere in the body, so by maintaining a schedule of regular dental visits, the dentist can certainly refer patients to physicians or other health care providers for evaluation for a potential systemic disease.”

Clearly, science has yet to establish a direct cause and effect between dental hygiene and health, but researchers are continuing the quest.

In fact, a second study, also presented at this week’s AHA conference, suggested that the number of teeth one has is associated with risk of heart disease, stroke and heart failure.

Most people have 32 teeth, wisdom teeth included. The study, conducted by dentist and researcher Anders Holmund at the Centre for Research and Development of the County Council of Gävleborg, Sweden, found that people with only 21 teeth had a 69 percent increased risk of heart attack, and those with the fewest teeth had a 2.5 times increased risk of congestive heart failure.

The researchers also looked at the gum disease, gingivitis, and found that people with gum bleeding had a 2.1 times increased risk of stroke, while those with gum infections had more than a 50 percent increased risk of heart attack.

“These studies appear to be done well, with large patient populations and long follow-up time,” said Gerber of both studies, “but more research needs to be done before someone can definitively say there is a link between dental visits and heart health.”

He encouraged people to continue following the American Dental Association (ADA) guidelines, which recommend visiting the dentist at least once every six months for a professional exam and cleaning.

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Most tooth loss in people over age 35 is from Periodontal Disease.

Everyone knows to brush their teeth twice a day, but many people forget about their gums! The word disease sounds scary— and it can be if you don’t take care of your gums. Here is some information about what gum disease is, what causes it, and how you can prevent it.

What is periodontal (gum) disease? Periodontal means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth.

It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. Gingivitis is the mildest form of the disease. In this stage, the gums redden, swell, and bleed easily. There is usually little or no discomfort.

What causes gum disease?

As mentioned, plaque is recognized as the primary cause of gum disease. If plaque isn’t removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar). Toxins produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets that fill with even more toxins and bacteria. As the dis- ease progresses, pockets become deeper, and the bacteria move down until the bone that holds the tooth in place is destroyed. Eventually, severe infection may develop with pain and swelling. The tooth may loosen and later require removal.

There are other factors, too. Smokers and tobacco users are at a higher risk of developing gum disease. Changing hormone levels in pubescent teenagers and

women who are pregnant also can increase the risk of gum disease. Stress, clenching or grinding your teeth, an unhealthy diet, and diabetes can increase your chances of developing gum disease as well. And, in some cases, it’s in your genes nearly 30 percent of the human population is genetically predisposed to gum disease.

How is it treated?

In the early stages of gum disease, most treatment involves a special cleaning called scaling and root planing, which removes plaque and tartar around the tooth and smooths the root surfaces. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, scaling and root planing and proper daily cleaning will definitely help. More advanced cases may require surgical treatment, which involves cutting the gums—sometimes with the assistance of a laser to remove the hardened plaque build-up and then recontouring the damaged bone. The procedure also

is designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean. This procedure may be performed by your general dentist or by a specialist, like a periodontist.

How can I maintain treatment at home? Sticking to a maintenance program is crucial for patients who want to sustain

Removing plaque through daily brushing and flossing and professional cleaning is the best way to minimize your risk.

the results of periodontal therapy. You should visit the dentist every three to four months (or more frequently, de- pending on the patient) for spot scaling and root planing and an overall exam. Between visits, brush at least twice a day and floss daily.

How can I prevent gum disease?

Removing plaque through daily brushing and flossing and professional cleaning is the best way to minimize your risk. You also should try to reduce the activities mentioned above (smoking, eating an unhealthy diet, grinding your teeth, and so forth). Talk to your dentist and he or she can design a personalized program for home oral care to meet your needs.

Contact Dr. Jerry Paz by phone at 636-456-2454 or learn more at www.pazdental.com

When people lose or break their teeth, the teeth may be replaced with implants. What’s involved, and what are the benefits? Read on to learn more.

What are implants? Dental implants are artificial tooth roots that are surgically anchored to the jaw to hold a replacement tooth or bridge in place. One of the major benefits of implants is that they do not rely on neighboring teeth for support and they are permanent and stable. Implants are a great solution to tooth loss because they look and feel like natural teeth.

What are implants made of? Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissues. Most implants are made of titanium, which bonds well with bone and is biocompatible, making it an ideal material for implants.

How are implants placed? First, Dr. Paz will perform surgery to place the implant’s anchor in the jaw. The surgery can last several hours, and it may take as long as six months for the jaw bone to grow around the anchor to hold it firmly in place. Once the implant is stable and the gums have healed, Dr. Paz makes the artificial teeth and fits them to the post portion of the anchor. Dr. Paz will work with you to create an implant that fits well and is comfortable and attractive..

Who should get implants? Implants are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, and have adequate bone structure to support the implants. While lack of adequate bone support is a limitation, additional procedures may be available to create a good implant site. People who are unable to wear dentures also may be good candidates. The success rate for implants decreases dramatically among those who suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes. Additionally, people who smoke or drink alcohol may not be good candidates. To find out if dental implants are a fit for you talk to Dr. Paz at your next visit.

What is the difference between implants and dentures? While implants are permanently fixed in the mouth, dentures are removable. A conventional removable full denture depends upon support from the bone and soft tissues rather than being solidly fixed in place; as a result, dentures may not offer as much stability as implants. Implants are a good solution to tooth loss because they look and feel like natural teeth.

How do I care for implants? Poor oral hygiene is a main reason why some implants fail. It is important to floss and brush around implants at least twice a day. Dr. Paz will give you specific instructions on how to care for your new implants. Additional dental cleanings (up to four times per year) may be necessary to ensure that you retain healthy gums.

How will I adjust to implants? Most people adjust to implants immediately; however, some people feel slight discomfort and notice differences in chewing or speech for a short time. Patients will soon see a difference in their confidence level and enjoy their new smile.
Contact Dr. Jerry Paz by phone at 636-456-2454 or learn more at www.pazdental.com

Rodney

I really liked the non-institutional feel. The waiting room was great. Lots of stuff to look at, comfortable seating, TV to watch. Few things disgust me more than your ‘average’ waiting room. In yours I would actually want to grab a beer and hang out.

Michele

Your pleasant atmosphere, friendly conversation, and honest answers to questions are not only enjoyed, but a good reminder for my life as well.

Sarah

I love you guys! My girls are so comfortable there, and after my visit, I see why! You made even the uncomfortable molding trays experience ok. You are doing a great job!

Joanne

I am very comfortable seeing you. I started with you this summer for a root canal and tend to continue for a long time. I really enjoyed and relaxed with the Ocean story on the tv in the waiting room. How relaxing and comfortable. Sincerely,

Mark / St. Peters, MO

Seems like everytime I come in there is something new, whether it be a new xray machine or a high definition video camera shot of my teeth. As a patient I find it encouraging when people want persue excellence and I don’t have to go to Clayton, Ladue or Hollywood to find excellent dental care. Thank you for what have provided to me and the community you serve

In 2009 Fans missed Whoopi Goldberg during a episode of ABC’s TV Talk Show, “The View.” It may be hard for some to fathom that a high profile celebrity like Whoopi Goldberg could have “tooth problems” bad enough to keep her from co-hosting her show. How could this have happened?

Whoopi’s Emergency Medical (Dental!) Surgery

The 52 year-old star said, “I had emergency surgery. People don’t pay attention to it… we think we know you’ve got to take care of your teeth… I neglected them and I discovered I had so much bone loss that I’m probably going to be losing my two front teeth.” The day after root canal surgery Whoopi spoke publicly about the serious nature of her dental problems. “I hadn’t been to the dentist since Noah” she says referring to her lack of regular “routine” dental visits for prevention and maintenance.

Whoopi Goldberg, Celebrity Advocate for Whole Body Health through Oral Health

“I’ve neglected my mouth to the point of distraction.” “I know you don’t want to go to the dentist… but the health of your entire body depends upon keeping your mouth healthy.” Unfortunately what Whoopi’s going through now is not at all uncommon. In fact according to the FDA, “More than 75 percent of Americans over 35 have some form of gum disease. At its worst, you might lose your teeth. The bottom line? If you want to keep your teeth, you must take care of your gums.” Source: fda.gov “Fighting Gum Disease: How to Keep Your Teeth.”

Too Late and Without Warning

Gum disease is a silent killer. Not only of teeth. It can creep up on you without a single warning sign. Sure, everyone “knows” that your gums bleed if you have gum disease. But the biggest problem with that bit of knowledge is that painful, bleeding, or swollen gums might not occur until the very late stages of this insidious disease. In fact many patients, like Whoopie, are taken by surprise when during routine examination we’re the first to break the news to them about their gum infection, abscesses… and often severe bone destruction.

Whoopie May Lose Her 2 Front Teeth

During an episode of “The View,” Whoopie Goldberg openly discussed her dental prognosis. Already severe destruction of the bone around her top two front teeth will likely result in the loss of both teeth. Whoopi made several good points not the least of which was that undetected dental disease can be a threat to more than just your teeth… it can threaten the overall health of your entire body. Research cited in JAMA, the Journal of the American Medical Association highlights the relationship between gum disease and increased risk of heart attack and stroke.

There’s Only One Way to be Certain

The only way to know whether or not you are in the 75% suffering from gum disease is a professional examination.We routinely perform a totally comfortable “gum exam” each time you visit for your checkup and cleaning appointments. Don’t delay your visit! Contact Dr. Jerry Paz by phone at 636-456-2454 or learn more at www.pazdental.com

Using tobacco can harm your mouth, including your teeth and gums, in a number of ways. There is no safe form of tobacco— using it produces many problems and risk factors, from tooth discoloration and gum disease to throat, lung, and oral cancer, and, ultimately, even death. It’s important to understand what happens to your mouth when you use any form of tobacco, and to discuss those effects—and how to quit—with your dentist and physician.

What happens to my mouth when I smoke?

Smoking reduces blood flow and the supply of vital nutrients to your gums, including vitamin C. Without the proper nutrients, you can develop gum disease, bone loss, and even tooth loss. This is because smoking triggers the accumulation of bacteria in plaque. Smoking also reduces the amount of saliva that flows through your mouth. Saliva is important for cleaning your mouth and preventing tooth decay. In addition, when you smoke, the temperature in your mouth increases and the heat kills important cells in your mouth.

You also can see the effects of tobacco use. Nicotine and tar, the major ingredients of cigarettes, discolor your teeth—yellow and brown stains will appear and the sticky tar deposits will adhere to crevices. The roof of your mouth will become inflamed and turn red. You also will lose a lot of your sense of taste, and the smell of your breath may become offensive.

Is smokeless tobacco safe?

No! Just because you don’t smoke the tobacco, it doesn’t mean that there aren’t harmful effects. Smokeless tobacco—which includes snuff, dip, or chewing tobacco—eats away at your gums, exponentially increasing the chances for gum disease. You also are four to six times more likely to develop oral cancer from chewing tobacco. In fact, the area of your mouth where you place the tobacco is 50 times more likely to be the site of an oral cancer.

What about cigars?

Cigars contain the same toxic and carcinogenic compounds that cigarettes do, and even though you might not inhale cigar smoke, cigars are not a safe alternative. Regular cigar smoking increases the risk for oral cancers, lung cancer, and larynx and esophageal cancers.

What are the signs of oral cancer?

Oral cancer can develop at any time. It’s important to know what to look for and to tell your dentist and physician right away if you have any concerns. If you experience any sign of irritation, like tenderness, burning, or a sore that will not heal, tell your dentist or physician. Also, tell your dentist or physician if you have pain, tenderness, or numbness anywhere in your mouth or lips. The development of a lump or a wrinkled or bumpy patch inside your mouth also can be a sign of oral cancer. In addition, if the tissues in your mouth change color to gray, red, or white, make an appointment to see your dentist or physician.

What can I do to stop the effects?

The most obvious way to stop the effects of smoking and tobacco use on your mouth—and body—is by quitting. Although it can be extremely difficult to quit because the toxins in tobacco products are addictive, there are ways to stop using tobacco. Call us about proven ways to stop smoking today.

Once you have made the steps toward quitting, it is important to improve your dental hygiene with regular brushing and flossing. It is advised for smokers to get a professional cleaning (scaling and polishing) for the removal of stains. But without quitting, the cleaning and stain removal will have only a temporary effect. Contact Dr. Jerry Paz by phone at 636-456-2454 or learn more at www.pazdental.com