Dentists See Increase In Dental Caries

Former New York City Mayor Michael Bloomberg was so adamant about the effect of soda consumption  on the health of New Yorkers that he tried tirelessly but unsuccessfully to impose a soda tax in New York much to the dismay of many New Yorkers. Now he seems adamant to spend more of his own money having just  launched a $3 million television advertising blitz in the Chicago area  using his own personal money in support of the “Cook County sweetened beverage tax.”

His aim, the same as his aim in New York, is to reduce the effect of soda consumption on children and teens in working class backgrounds  particularly since it is a known fact that 40 percent of them will develop type-2 diabetes in their lifetime.  Now he is trying to do the same in Cooke County, Illinois. This looks like it might be more than possible as  Berkeley, California was the first community in the United States that passed a  targeted tax on soda in 2014.

As the summer comes to an end, sports drink manufacturers will be high-fiving after another record breaking years of sales for sugar-based sports drinks. However, many dentists are seeing the effects of dental caries mostly among young men and women under the age of 30 who are the prime target for consumption. PepisCo’s Gatorade brand has become the undisputed leader in these sugar-based sports drinks that are prevalent in the U.S. market. A  recent report by Euromonitor International shows that Gatorade captured a 77 percent market share of the $6.8 billion industry in 2014, according to the Wall Street Journal.

As the carbonated drink industry becomes more aware of people’s aversion to aspartame, they have been making significant inroads into the sports drink and fruit juice industry with  Coca-Cola acquiring a 30 percent stake in Suja Juice – a  manufacturer of California-based organic juices that uses HPP technology. Suja Juice generated $42 million in revenue in 2014.

Sugar-Based Beverages

However, dentists are quick to point out that these organic juices have sometimes just as high sugar content as sports drink and the effect can be seen in the dental chair increasingly. Between 1989 and 2008 the average consumption of sugar-based beverages increased by 60 percent in the age group six to 11. The percentage of children consuming them grew 79 percent to 91 percent during that time period. The production in the U.S. for sugar-based ‘soda pop’ is staggering. The beverage industry produces 10.4 billion gallons of soda pop each year. This is enough to serve every American a 12 ounce can every day for a whole year.

Dr. David Pinkhsaov spends a lot of his  time preaching common sense guidelines to children and their parents at his practice Right Family Dental P.C.  in the Bronx. He uses hard facts to break it down to children and parents where they see that soda consumption is a problem. “ I tell my patients how much sugar they are consuming when they drink sodas and most are very alarmed,” says Dr. Pinkhasov. “When you drink a can of soda you are consuming 150 calories, 90 percent of this being derived from high fructose corn syrup. Let’s forget about the obesity problem in New York for a minute, the damage that can happen to your teeth over time is huge. Once you consume one of these drinks the sugar entering your mouth combines with the bacteria present – this is when acids are created that attack your teeth. This period lasts for about 20 minutes with the end result after over consumption being that there is enamel erosion and your teeth and are then very vulnerable. “

His partner, Violeta Skevas, DDS, says she sees no change in the trend and points to recent industry figures such as the  2013 study which showed that  manufacturers of soft drinks spent a staggering $866 million dollars in advertising across all types of media. “This is a huge amount of money, but more worrying than this is the effect that this can have on our economy – we spend nearly $200 billion in the U.S. treating the obesity epidemic. It has a trickle down effect for all us – higher taxes, higher health insurance, everything. We see a lot of patients coming in with an emergency toothache or root canals and many have failed root canals, so there is really no option other than extraction or dental implants. In many of these patients we see that there is over consumption of sports and sugar-based drinks that patients use for hydration in the New York heat. In my opinion the overconsumption of sports drinks can contribute greatly to dental caries.”

The overconsumption of sugar-based drinks seems to be the same all over New York. Jim Sarji, DDS of Advanced Gentle Dentistry of Park Slope, says he sees patients, many of whom are very athletic but now realize that overconsumption of sugar-based sports drinks has had a debilitating effect on their teeth and are now looking to remedy it.  “For some people it is not unusual for them to drink one of these sports drinks a day, sometimes more on a hot day. This is a lot of sugar.”

The Vicious Circle

David Pinkhasov, DDS  says that  the effects of sugar consumption in the Bronx has undoubtedly led to the high incidence of type-2 diabetes which he bases on the medical evidence he has read and the effects of which he sees every day. “There is a large incidence of periodontal disease in the Bronx. This is largely due to the high incidence of type-2 diabetes. If you have type-2 diabetes then you are more prone to periodontal disease and if you have periodontal disease this can exacerbate your diabetes. It is a vicious circle.”

He is quick to point out a recent Epi Data Brief published by the New York Department of Health and Mental Hygiene in 2015 which stated that 47 percent of adults ages 30 and older in New York City  have periodontitis (gum disease) and that 26 percent of these adults in the age range  20 to 64 have untreated caries (cavities) which can lead to tooth loss, pain, infection and trouble eating and speaking.

Dr. Steven Cisternas  of Richmond Hill Dental Design Studio and Bay Dental sees a similar situation at his Staten Island practice. “The over-consumption of these drinks can be seen daily when I step out of my office and walk down the street. Everybody is drinking sports drinks, especially the younger generation and especially in the heat.” He offers some advice for those unwilling to give up sports drinks to reduce the harmful effects: “Always use a straw to minimize contact with your teeth, limit your consumption to below 12 ounces a day, never consume before going to bed, and always drink water after consumption only brushing one hour afterwards due to the fact that your enamel will be temporarily weakened.”

Dr. Arkadiy Takhalov of Dr. T’s Pediatrics has a completely different philosophy. “We start educating parents when they first come into their office with their newborns. We point out the amount of sugar in these drinks and that even apple juice has a huge amount of sugar for a young child. This can damage the first set of teeth and the second set of teeth. Milk is a better option and is more nutritious. The American Academy of Pediatrics warns that children drinking a lot of juice, even just an eight-ounce sugar sweetened drink can increase a child’s odds that they will become obese by 60 percent. Education of young mothers is the key.”

Study: Oral Health Problem Looms For Aging Population

Urgent attention needs to be paid to frail older New Zealanders’ oral health, a University of Otago study has highlighted. In a world first, Otago researchers surveyed the oral health of 987 people living in aged residential care and found those with dementia, and older men in general, have dirtier and more decayed teeth. Otago Head of Department of Oral Sciences and lead author, Professor Murray Thomson, describes poor oral health as one of the “geriatric giants” with the situation a “major clinical and public health problem which is going to get worse.”

Older people have higher rates of cognitive and physical impairments that can adversely affect their oral self-care and complicate the provision of oral care, he says. “Neither the aged care sector nor the dental profession, in most countries, is prepared. Not only do we have more and more older people every year, but more and more people are entering old age with their own teeth, rather than full dentures, as was the situation just a couple of decades ago. “In some ways, dentistry has been a victim of its success – we have long emphasized the idea of ‘teeth for life’ without much thought to what happens towards the end of life. We also now know that half of those in old age will end up in residential aged care, and that more and more of those will have some form of dementia.”

Professor Thomson believed that “slow progress” was being made in the area. “It’s a very complex situation involving a lot of players – the aged care sector, the Ministry of Health, the dental profession, and the public. An encouraging sign is the inclusion of oral health in New Zealand’s Healthy Ageing Strategy. That’s a starting point, but there is a lot of work to be done,” he says.

Greater Rates Of Tooth Decay

Of those examined in the study – representative of the more than 14,000 New Zealanders living in aged care – recently published in the journal Gerodontology, about half had severely impaired cognitive function, and more than a third required fillings or extractions. Those with severely impaired cognitive function had greater numbers of teeth with decay. They also had higher oral debris scores, reflecting poorer daily oral hygiene care.

Professor Thomson says greater rates of tooth decay can result in dental and facial infections, poorer quality of life, malnutrition and difficulties in communication. The researchers also found that even the most cognitively impaired participants were able to be examined fairly easily, meaning that regular, routine removal of oral debris by carers should not be difficult. “The issue that we currently face is that much of that debris removal is not being done, and this, along with frequent exposure to sugary, over-processed meals and snacks, and poor salivary function, is enabling plaque and dental caries to flourish in aged residential care populations.”

For those wanting to improve or maintain their oral health, Professor Thomson has some simple advice: brush twice daily; clean carefully between the teeth at least two to three times per week; avoid having sweet drinks or snacks between meals – and that includes sugar in tea or coffee – it takes only a couple of days to get used to not having it; and avoid smoking. “For people who have poor oral health in middle age, it is not going to be any better in old age, and an honest, open conversation with a dentist about the options, which may include complete extraction, may be a very good idea.”

Periodontitis And Lifestyle Changes

Having a healthy immune system makes a huge impact on your body’s ability to respond to periodontitis. Neglecting other health conditions such as obesity or diabetes may make it harder for you to address your periodontitis concerns and symptoms because your immune system is already strained. Here are some simple tips to help fight periodontitis in a truly holistic manner:

Work Out To Fight Plaque
Stimulating your cardiovascular system can prevent plaque biofilm from accumulating in large amounts throughout your cardiovascular system. That’s right – the plaque from your mouth can also enter into your arteries and heart!

Kick The Tobacco Habit
Nearly every patient with periodontitis who also smokes will never see an improvement in their condition. No matter how dedicated they are, smoking can counteract everything good that you do for your gums.

Eat A Balanced Diet
Fibrous fruits and vegetables stimulate gum tissue as you chew, while also providing essential nutrients to the rest of your system. They actually cleanse the teeth while you eat them! When your body has healthy nutrients going in, it makes it easier for you to fight infections as they occur.

Limit Sugar And Alcohol Intake
Sugars and refined sugars often found in processed food and alcoholic beverages create an acidic environment inside of the mouth and the rest of the body. Bacteria thrive in these areas and as they feed on the sugar the result is lots and lots of plaque biofilm. The more sugar you eat – whether it be through your coffee, juice, packaged food, alcoholic drink or other source – the more bacteria that you are going to produce in your mouth. The more bacteria you have, the easier it is for your periodontitis to advance.

More Facts About Periodontitis

Periodontitis can almost always be cured. Dedicated preventive routines, along with supplementation and necessary lifestyle changes, can allow your body to rid itself of the infection. Depending on how advanced the condition is you may need professional treatment ranging from maintenance visits to surgical therapies. In extremely advanced stages of the disease it may be impossible, requiring extraction of the teeth to rid the body of the chronic infection.

In some cases periodontitis can be reversed. Unfortunately, the more the advanced the periodontitis is, the less likely it is to reverse it. You can however stop the disease process from progressing further in most cases with professional care and dedicated home routines. It is easier to reverse periodontitis when symptoms are in the beginning stages.

Periodontitis can be spread between close family members such as husband and wife or parent to child. This is due to the bacteria passing between people through saliva, making it even more important for you to treat the condition.

Symptoms of periodontitis may not be visible for patients that smoke, have undergone radiation therapy or are taking certain medications. In these cases swelling and bleeding may not be evident, but the disease can lie deep below the gums. Other symptoms such as food packing between the teeth or under the gums or shifting teeth may prove to be identifying factors.

Mild periodontitis can be efficiently treated through dedicated oral hygiene routines and supplementation. By preventing the condition to continue, you reverse the bone loss process and may also encourage some tissue reattachment. Periodontitis is a serious condition and requires extremely dedicated oral hygiene practices on a daily basis to prevent relapse.

Brushing and flossing alone does not necessarily remove the bacteria associated with periodontitis. If you have mild periodontitis with only minimum gum detachment or bone loss, it may be just fine. However, due to the loss of attachment with moderate or more severe forms of periodontitis, the concave root surfaces on the sides of the teeth often harbor disease bacteria that cannot be reached with typical oral hygiene methods. A water flosser may be a more efficient method of home cleansing for these areas.

Genetic predisposition may play a factor in your body’s risk to develop periodontitis. Many people with periodontitis identify that one or both of their parents or a sibling has suffered from the same condition. While genetics play a part, it may also be due to the bacteria spreading back and forth among family members through saliva. Simply being predisposed to the disease does not mean that you cannot effectively treat and prevent the symptoms.

Many people complain that simple oral care routines at home such as brushing or flossing cause their gums to bleed or be uncomfortable. Bleeding or irritation is simply a symptom of periodontitis. You must begin cleaning the teeth correctly each day for up to two weeks before expecting symptoms such as bleeding or tenderness to go away. If they do not improve you may need professional treatment as well.

Putting off care for periodontitis could result in advancement of the disease condition into a more severe stage. As the stage of disease progresses, treatments become more invasive and costly in an attempt to retain your teeth. Otherwise, the disease continues to destroy gum attachment and bone levels, ultimately resulting in the loss of teeth.

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How To Prevent Periodontitis

Periodontitis has been linked with many other systemic health conditions. The severity of those diseases is often also directly related to the severity of periodontitis. One example is periodontitis and diabetes. The higher the blood sugar levels are, the more likely you are to suffer from uncontrolled periodontitis.

When you suffer from disease conditions, it places a significant strain on your body’s ability to cope with infection. Progression of periodontitis can occur when you do not adequately manage other conditions. In contrast, periodontitis bacteria can also enter into your bloodstream and make you more likely to suffer from conditions such as heart attack and stroke.

Common health conditions associated with periodontitis include:

  • Heart attack
  • Stroke
  • Cardiovascular diseases
  • Diabetes
  • Erectile dysfunction
  • Obesity
  • Premature labor
  • Low birth weight

Gingivitis Beginnings

Did you know that preventing periodontitis is the primary concern of your dental hygienist? There is a reason that she is always nagging her patients to brush and floss each day. Periodontitis begins as gingivitis, and if the symptoms aren’t addressed early on they can easily result in damaging consequences. In order to prevent periodontitis you must have exceptional oral hygiene, and reassess what you are already doing to ensure you’re doing it the right way. Here we will review everything your hygienist wants you to know about preventing the invasive dental disease known as periodontitis.

Brush Effectively
Use a soft-bristled toothbrush angled 45 degrees toward your gums, focusing on just two teeth at a time. Apply very gentle pressure and make short strokes back and forth, removing the debris near the surface of the gum lines. Consider an electric toothbrush, as those are typically more effective in removing plaque biofilm and can greatly improve your chance of preventing gum infections like periodontitis.

Flossing – Don’t Ignore it
Flossing, not brushing, removes bacteria between the teeth and under the gum lines – where periodontitis starts to begin. Neglecting to floss at least once per day can allow bacteria to settle in and calcify, harboring disease conditions. Once calcified, bacteria cannot be brushed or flossed off and must be removed by a dental professional. To floss effectively, wrap your floss tightly around the tooth and slide up and down under the gums as far as it will go when gentle pressure is applied.

Bleeding is a sign of infection so don’t let that stop you. Healthy gums do not bleed, and it may take flossing daily for up to two weeks before areas of gum infection stop bleeding. Consider a water flosser. These devices are easy to use and can access areas deeper below the gums where flossing cannot.

Routine Preventive Care
Visiting your hygienist on a recurrent schedule allows them to screen for areas of disease as well as remove any bacterial deposits. Even allowing small areas of tartar (calcified bacteria) to remain on the teeth when you skip a cleaning can allow an area to harbor ideal conditions for periodontitis.

Supplementation
Nutritional and holistic supplements can increase your body’s immune health and reduce the risk of developing more advanced stages of periodontitis. Essential oils and supplementing with things like CoQ10 can greatly decrease your chance of developing advanced periodontitis.

Choose Your Oral Hygiene Products Wisely
Conventional wisdom tells us to brush with fluoride toothpaste and rinse with alcohol-containing mouthwash. But research has shown that there are real potential dangers in using these substances.  For optimal oral health and hygiene it is best to use 100% pure and natural botanical ingredients whenever possible when brushing and rinsing.

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Periodontitis Stages And Types

While periodontitis is a specific condition, there are various periodontitis classification categories that help identify the type of infection when being described among dental professionals. These classifications usually describe to what degree the infection has advanced, and how much of the mouth has been affected.

Mild Periodontitis/Early Periodontitis
This is the earliest form of periodontitis. Clinical findings show mild gum detachment with mild bleeding. There may be minimal bone loss evident on dental X-rays.

Moderate Periodontitis 
Moderate periodontitis exists when gum pockets measure between four and six millimeters in depth and there is clinical evidence of bone loss evident on the X-rays.

Severe Periodontitis
Severe periodontitis involves advanced bone loss with gum pockets deeper than six millimeters found during a dental examination. Bone has often receded so much that the furcation – division – of the back molar teeth are involved.

Chronic Periodontitis
This is the most common form of periodontitis. It is related to the amount of bacterial biofilm and calculus on the tooth surfaces.

Acute Periodontitis
Acute infections may affect only a localized area, but are often painful and quickly advanced. Acute infections may also involve periapical abscess – around the apex of the root – of the tooth due to the invasive condition.

Localized Periodontitis
When periodontitis is limited to just a few teeth in the mouth without having spread to other teeth it is considered localized. You can still have localized aggressive periodontitis, so being localized doesn’t simply mean it is minor.

Generalized Periodontitis
Generalized periodontitis affects several areas throughout the mouth. It may be a more mild form or can be generalized aggressive periodontitis.

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Periodontitis Causes, Signs And Symptoms

 

What is periodontitis? Periodontitis is also known as periodontal disease or an advanced stage of gum disease. The meaning of the name describes the condition: perio = around; dont = tooth; itis = inflammation of. So periodontitis is the inflammation and infection of the area surrounding the root of the tooth. It is a severe condition that simply begins as gingivitis but ultimately leads to the destruction of gum attachment, bone and results in tooth loss if left untreated.

Causes

What causes periodontitis? Periodontitis is a natural immune response to bacteria along and underneath the gum lines around the teeth. When plaque biofilm is not removed effectively, antibodies from the immune system seek the bacteria out in order to destroy it. When initial symptoms of gingivitis are left untreated, the condition worsens into periodontitis. Simple swelling becomes an area of more advanced infection, causing the destruction of gum and bone attachment around the teeth.

Periodontitis may be due to:

  • Inadequate oral hygiene
  • Lack of professional preventive care (routine cleanings)
  • Susceptibility from conditions such as a family history of periodontitis, uncontrolled systemic health conditions or badly misaligned teeth.

Signs And Symptoms

Periodontitis is more than just gingivitis. Here are some warning signs to watch for if you suspect you may be developing the condition:

Bleeding Gums – Healthy gums should never bleed. Bleeding during brushing or flossing that persists for more than two weeks is a sign of gum infection such as periodontitis or more advanced gingivitis.

Bad Breath – The bacteria involved in periodontitis often contribute to halitosis, or breath malodor. Because the problem exists deep under the gums, mouth rinses, gums or mints do not easily cover it up.

Swollen, Red Gums – Gum lines become inflamed and red along the margins of the teeth when gum disease exists. Mild inflammation is typical of gingivitis, while more diffuse not concentrated or localized. Inflammation and redness (or even purple colored gums) is a sign of more advanced periodontitis.

Receded Gums – As periodontitis advances, the gums become detached from the teeth and creep down the surface of the roots, leaving exposed root surfaces. This makes teeth appear longer than normal.

Sore Teeth – Infection around the tooth may make chewing or applying pressure to the tooth uncomfortable.

Shifting Or Loose Teeth – When gum detachment or bone loss has occurred, it may cause the teeth to be mobile or shift out of their natural position.

Drainage Of Pus – During very advanced stages of periodontitis, there may be signs of pus that drains along the gum lines when the tooth or gums is depressed. Pus usually appears clear, white or yellow.

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