Episode
3

Can Skipping Your Routine Cleaning Be Hazardous to Your Health?

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In this week's episode, in honor of February being American Heart Month, we talk about the connection between periodontal disease and heart disease.  We also answer the question - can skipping your routine cleaning be hazardous to your health along with a very interesting Fact or Fiction.  We also explore new research in the fight again Alzheimer's disease.  Join us today on Talkin' Teeth.

Transcript

A smile says it all. If your teeth could talk, what would they say? Find out today on Talking Teeth with Dr. Kyle Bogan.

Welcome to episode three of Talking Teeth. My name is Dr. Kyle Bogan of North Orange Family Dentistry right here in Lewis Center, Ohio. So today the main topic is can skipping your cleaning be hazardous to your health? So in honor of February being American Heart Month, stick around to find out if skipping your routine dental cleaning causes any health hazards. In addition, we're going to talk fact or fiction and answer your questions today on Talking Teeth. But first, lets start with fact or fiction.

Fact or Fiction.

Today's fact or fiction comes by way of a question we received last week. We're going to talk dental sealants. So we all know dental sealants as the things that we recommend for kids at age six and age twelve when the first set of permanent molars come in in the back at age six and again when the second set of permanent molars comes in at age twelve. But the question today is do adults see any benefits from having dental sealants placed or is it just for kids?

So it is fact that adults do benefit from dental sealants. You know, it's kind of funny. Some offices get in the habit of being very insurance driven. Obviously we want to make sure that we maximize insurance benefits when at all possible. And make sure that everyone understands their coverage. But just because insurance doesn't cover something doesn't mean it's not beneficial to the overall oral health. Sealants are a great example of that. So most insurance companies will stop paying for dental sealants at about age 13 or 14. And after that, they just say they're not covered. They're a non covered benefit. Which is great for kids and that's one of the reasons why when you think sealants, we just think kids because some people are so insurance driven that they allow that to kind of drive healthcare options and dental and oral healthcare options.

And so when we're looking at teeth in general, whether it's an adult or a child, especially those molar teeth, the purpose of a sealant on a molar tooth is that molar teeth are very groovy. And basically the groves in those teeth hark and harbor bacteria and if you take microscopically and pull out one tooth brush bristle out of toothbrush and hold it over the groove in our molar teeth, that bristle ... one single bristle in our toothbrush is wider than those grooves. And so what that means is you can scrub the tops of our teeth, the chewing surface of those molar teeth, all day long. You can brush your teeth for six hours but that bristle still isn't getting down in that groove to sweep the bacteria from those areas. And so as a result, whether you're six years old or whether you're 60 years old, bacteria can accumulate in that groove and form a cavity.

So if I see a patient that's 30 years old and they have very deep grooves in their molar teeth, there's definitely a benefit there as a preventative measure to put a sealant on there to prevent that bacteria from getting down in that groove and causing a cavity down the road.

The downside is that insurance companies for whatever reason don't see that preventive measure as something that they want to cover. And so average cost of a dental sealant is probably about $25 dollars. And so I would much rather see my patients invest in a $25 dollar sealant versus not putting a sealant on there, allowing the bacteria to get down in that groove, and causing a cavity which later needs a filling which is much more than $25 dollars to have it fixed. And so definitely in my practice we are very preventive focused. You know, we can definitely treat disease and we do it every day. But if there's a way that we can help people prevent oral disease, whether that's gum disease, whether that's cavities, whether that's other things. We definitely try to do that. So definitely a fact that dental sealants are beneficial for adults and kids alike.

And now.

On this week's episode, we're going to talk about February being American Heart Month. And as a result, there are a few oral conditions that can actually contribute to conditions of the heart and things like that. But first, the American Heart Association in February does a program called Go Red For Women. And basically the focus of this program is that the traditional symptoms of heart attack and stroke that we're used to hearing and are in the news all the time just really aren't the same for women and men. So the traditional elephant sitting on your chest type of pain, that's very common for a man to have those symptoms if they're having a heart attack. But a lot of times, women don't experience those same symptoms.

And so straight from the American Heart Associations website, signs and symptoms of a heart attack for females is uncomfortable pressure, squeezing or fullness and pain in the center of your chest, and it can last for a few minutes or it goes away and comes back. And again, traditionally that's the elephant sitting on your chest type of feeling. But it can be much less than that for females. Pain or discomfort in both arms, the back neck, jaw, or stomach. And so that obviously comes into our neck of the woods with jaw pain. Shortness of breath with or without chest pain. So again, this is another one of those areas where chest pain doesn't necessarily come out for women in those types of symptoms. Other signs like breaking out in a cold sweat, nausea, lightheadedness. And again, women can have that chest crushing pain that is stereotypical of a heart attack but again, it's not the most common for females to have that.

Signs of a stroke, and again a lot of these are common. Sudden numbness or weakness of the face, arm, or leg. Especially just affecting one side of the body. Sudden confusion in speaking or understanding what's being said. Blurred vision or double vision in one or both eyes. Trouble walking, dizziness, loss of balance, or sudden headache. It's almost described as like the worst headache you've ever had in your life with really no reason for it.

So like I said, I wanted to touch on that because I think that's a great campaign that the American Heart Association's doing and with February being American Heart Month, it kind of fits right in.

Today for our main segment talking about periodontal disease and can skipping your cleaning be hazardous to your health, I'm going to tie that right into heart disease. But I'm going to combine that with dentistry is the new, because if you've been listening to the news outlets lately, there has been a story on the correlation between periodontal disease and Alzheimer's and some new research that's come out. So we'll talk about that a little bit. But first, I brought periodontal disease expert with me today. One of our hygienists is Stacey, she's with me today. We're going to kind of dive into exactly what gum disease is, who is at risk for it, how is it treated, all those topics. So let's go ahead and dig right in. Stacey, thanks for being with me today.

You're welcome. It should be fun.

Yeah, right. Absolutely. So for people who aren't familiar with periodontal disease or gum disease as we call it, why don't we go ahead and just start. We can talk about what it is.

The technical definition I guess would infections of structures around your teeth and gums. But you might hear people refer or commercials refer to gingivitis or periodontitis.

And that's a big ... it's funny. When you listen to it on the radio, everyone considers that kind of the same thing. And gingivitis is that step before gum disease.

Yeah. Gingivitis is reversible. If you kind of cross over into that periodontitis, that's when your dentist needs to get involved and your hygienist needs to get involved to help get that periodontitis disease under control.

So those of you who have been to the dentist, I'm sure you've met our periodontal probe. Some people don't love our periodontal probe but that's the screening that we do here at our office. A full screening once a year. We check every six months. But when the hygienist or the assistant in the back is calling off numbers three two three three two three four, you know, all those numbers. Stacey, won't you tell us just so they know what those numbers mean and what's healthy and what's not healthy.

So when we are taking those measurements, we're looking for measurements between one and three millimeters. So the next time you're in, just have us show you what it looks like. It's a little yellow probe. Some look a little different but there's little hash marks on them that let us know what the depth measurement is. So one to three millimeters is what we consider a healthy measurement, where your gums are protecting your teeth and structures underneath properly. Four starts to show us that inflammation. Sometimes you'll notice some bleeding with that. And anything five or higher lets us know that that gum tissue is starting to pull away from your tooth basically and bacteria is getting underneath and destroying bone and other structures that hold your teeth into your jaw basically. Which could cause tooth loss if it's left untreated.

So speaking of bacteria, that's kind of the answer. But let's talk about what causes gum disease and kind of the difference ... I mean, what's the difference in bacteria, what it does or where it goes, between like gingivitis and when it turns into gum disease.

So there's good bacteria and bad bacteria in your mouth. And sometimes if you haven't been to the dentist in a long time or you're genetically disposition or you have other risks factors, that bad bacteria can take over and it actually just works its way under the gums which that's where it's happiest because it's dark. It's a moist area. Causes bleeding and you may not notice pain until maybe we probe or help floss or anything like that. But that's that bacteria that's causing that response. And basically it's causing some type of ... your gums are just not in a healthy state at that point.

Yeah and that's the big thing, you know. If you figure if you break your leg or sprain your ankle, you know, there's pain. And so you know if you have a condition that it hurts and you know you have it. So with gum disease, almost until it's too late there's really no symptoms. And so making sure that your dentist is screening you for that is very important. I would assume it's kind of standardized but obviously that's something you want to check on. And just making sure that we don't see those changes from appointment to appointment. And so since it doesn't have any symptoms, who are those people that I guess are at higher risk for it and should be more concerned to be talking with their dentist about are they somebody that should be watching out for gum disease?

So there are like tobacco users ... like I said, your genetics can play a huge role of what bacteria is present in your mouth. And then stress can actually cause or be a factor. If your body can't fight infection because it's under stress, it just leaves you a little more susceptible. And since we're talking about heart disease, it's one of those systemic diseases along with diabetes that can also lead you to be more at risk for periodontal disease.

In fact, it's one of the only oral conditions that we've had direct hard scientific evidence that if you have gum disease, you're at a higher risk for developing heat disease in the future.

Scary.

Yeah absolutely. So I'm going to pause real quick on the heart disease and the gum disease and I'm going to kind of veer off into this news story that just came out this week. Actually a couple weeks ago. Came out January 24th it looks like. And these scientists are saying they may finally know what causes Alzheimer's and they're linking it to one of the key bacteria in chronic gum disease called porphyromonas gingivalis. And they're saying that you know gum disease is fairly prevalent. And what they've done is they've done some research in studying brains of patients that have had Alzheimer's and also using mice. They've found that if they inject this bacteria into the mice, they see the neurologic changes that happen in Alzheimer's in these mice. And so they're really thinking that the actual research goes pretty far in saying they really think it's a cause. I'm not sure that I'm necessarily see it's the only cause. But definitely it could be a contributing factor.

And in fact, they're talking about possibly developing a vaccine to this bacteria to help stop this process. And they're saying, you know, obviously it'll help Alzheimer's but then the question comes to my mind is if they develop a vaccine against the bacteria that causes periodontal disease, could it possibly be a vaccine that could prevent periodontal disease in the future? Obviously it's very early research. Sounds promising for Alzheimer's disease and so it was obviously in the news and the news loves to pick up on these really sensationalized, really cool studies. So I'm anxious to see what happens as things move forward with that.

Yeah, that'd be cool.

Yeah. So kind of touched on the prevalence of periodontal disease. We see it a decent amount obviously in our office. If you ask the CDC, about 47.2% of adults 30 years and older have some form of gum disease. And I guess that's something that we didn't really touch on, Stacey, is that it's often times it's not healthy or 100% gum disease. Sometimes it's kind of this in between road.

Yeah. We see ... that percentage, it seems like it should be higher. I don't have somebody that doesn't regularly come in with a spot or two of bleeding and technically that's not healthy. So that is a little bit of gingivitis and it may not be everywhere but it's definitely something to talk about with your patients to make sure that doesn't get out of control.

And, excuse me. And so I guess I should have finished reading that CDC stat. So 47.2% of adults age 30 and older have some form of periodontal disease. But the prevalence increases with age. And so as we get older, as we look at that cohort, the 65 years and older, that rises to 70.1%. So it's definitely something you should keep a look out not only for your oral health but systemically for your heart health as well. And again, Stacey mentioned it earlier, but if you are a diabetic, you're at a higher risk for periodontal disease. And if you have periodontal disease, you're at a higher risk for heart disease. And it just kind of ... the oral systemic connection in this area is really, really strong.

So we've kind of talked about what it is, what causes it, how you get it, who's more at risk for it, what it does systemically. So what happens if you have it? How do we treat it and does it ever go away?

So once we find out that it is something that you have, we treat it with ... we try the non surgical way first here at this office. It's calling scaling and replaning. Otherwise known as a deep cleaning. You may have heard one or the other but they mean basically the same thing. We recommend that in the areas or full areas that has that infection present. So we just get you numb, make you nice and comfortable, and we just clean root surfaces to make sure we get all that bacteria out. So those gum tissues can heal and protect like they're supposed to. And then we like to have you come in more regularly so every three to four months to manage that. We take those measurements each time to make sure you're still in a good improving state basically. And making sure that your hygiene at home is impeccable. We make sure that you're brushing two times a day for at least two minutes and flossing. And we may even give you a prescription mouth rinse or recommend an over the counter just to keep that bacteria reduced in your mouth.

So we call it a deep cleaning and the official word is scaling and replaning. So literally what we do is, in removing that bacteria, we try to get those roots almost like a freshly planed piece of wood. Nice and smooth, because believe it or not within about forty five minutes to a couple hours of us being done, bacteria likes to try to reattach to stuff. And so by making that root surface perfectly smooth, it makes it harder for that bacteria to reattach and helps in the healing process. And so last thing I want to talk about. Obviously the name of the segment was can skipping your cleaning be hazardous to your health. Obviously that's yes. But we kind of talked about what to do when you have it and how we treat it. But what do we do to prevent it? Like what's the best thing that they can do to help make sure they never get periodontal disease? You kind of touched on it a minute ago.

Well if you know that you have any of these unmanaged systemic diseases, any heart disease or diabetes or even you know somebody in your family that has had periodontal disease, make sure you get into your dentist as soon as possible and keep going for your six month checkups or more frequently if you tend to have more bleeding at your cleanings. Or more build up. Stuff like that. And then just making sure you're brushing and flossing at home. I know everybody hates flossing. I don't like it either, but I do it because I see it every day what happens when that does not. You are not getting that bacteria out with your toothbrush in between your teeth. And that's a pretty important area. We see a lot of bone loss and infection and buildup in those areas.

And home care is really important not only in preventing it but once we've treated it and removed all of the bacteria, maintaining that home care at home is essential in making sure to manage the disease itself. So a lot of people think that, "I've got gum disease. I've got my deep cleaning. And I'm healthy again." But really, we should think of periodontal disease like diabetes. It's not really something that you ever get rid of. Once you have it, it gets better. We manage it. And that's why we ask you to come in a little bit more often so that we can help you stay on top of it. But it can definitely come back if home care isn't kept up and all that fun stuff. Brushing and flossing and using a healthy gum mouth rinse and that sort of thing. It can definitely come back and then we end up right back in the same kind of cycle of gum disease to healthy and back to gum disease. So that's why we really stress that home care.

It works better when we're a team.

Yeah for sure. So again, with February being American Heart Month, I thought it was no better time to talk about gum disease than this time, because there is that direct connection. If you are experiencing any heart issues, any heart conditions, any heart symptoms, any gum disease symptoms, reach out to your dentist. Reach out to your physician. Definitely this area of medicine and dentistry is not something you want to ignore, because it's not something that goes away on its own and it can only lead to further problems down the road.

So we are all set with the main segment can skipping your cleaning be hazardous to your health. Stacey, thanks for sticking around and helping me out.

Oh yeah, no problem.

I hope you enjoyed our episode today and just a reminder, because February is American Heart Month, I wanted to put one more plug in there for the American Heart Association. Someone dies from heart disease, stroke, or another cardiovascular disease every 43 seconds in this country. And so I'm hoping today's episode has kind of helped spread the word a little bit about not only that but the connection between oral health and cardiovascular health. And as always, those of you that happen to be looking for somewhere to make a contribution that will be well used to help others, you can always log online to the American Heart Association's website. There's a donate now button at the upper right corner of their website. And it would help out a great cause.

Well that's it for episode three. Just like always, if you have questions that you'd like me to answer next week, please send them via email to info. That's I-N-F-O @NorthOrangeFamilyDentistry.com. And I'll answer them on the next show.

Finally, if you're looking for a dental home, please give us a call at 740-548-1800 or visit us online and schedule an appointment online at NorthOrangeFamilyDentistry.com. Have a great day. Look forward to talking to you next week.

Thanks for listening to Talk and Teeth with Dr. Kyle Bogan. Be sure to visit NorthOrangeFamilyDentistry.com to join the conversation, access the show notes, and discover our fantastic bonus content. Please remember, this podcast is for educational purposes only. It is not intended or implied to be professional, medial, or dental advice. Or a substitute for professional care by a dentist. Or other qualified medical professional. Guests who speak in this podcast express their own opinions, experience, and conclusions. And North Orange Family Dentistry and Dr. Kyle Bogan do not endorse or oppose any particular treatment option.

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