Periodontal Disease
Health Issues & Gum Disease
Bad Breath
Over 25 million Americans suffer with chronic bad breath. They resort to mints and sprays to mask the odor, but these products do not address the cause of the problem. Dr. Scharf will perform a thorough examination to discover the cause of the problem and devise a treatment plan to address it.
While certain medical conditions such as lung infections, diabetes and digestive imbalances can cause bad breath, most cases of halitosis originate in the mouth. Bacteria that cause gum disease also release gasses called volatile sulfur compounds. These gasses are responsible to the odor of halitosis.
Treatment consists of a detailed review of your medical history and a thorough dental examination. Once the cause of the halitosis has been determined, Dr. Scharf can recommend a course of treatment to address the problem. Many times the results are quick and dramatic.
Tobacco
Of all the risk factors for developing gum disease, smoking is the most powerful. Smokers are more than three times more likely to lose their teeth due to periodontal disease than non-smokers. Nicotine in the blood stream decreases the bodies ability to defend itself against gum disease then impairs the bodies ability to repair itself. We also know that periodontal therapy is less effective in smokers than in nonsmokers. Pockets tend to reform more quickly and regenerative therapy is not as successful. We know that quitting smoking is not easy, but it can add decades to your teeth.
For Women
From puberty to menopause, periodontal disease has implications for women.
- Puberty
- During puberty increased levels of sex hormones will occur. This will cause the gum to become more reactive to bacteria and other irritants in the mouth. This may appear as gums that bleed easily. During this time it is especially important to practice good oral hygiene and have frequent professional cleanings. If not treated, the bone and gum surrounding the teeth may be compromised.
- Menstruation
- Gum irritation can become very common during menstruation. This is due to increased hormone levels. Increased irritation, sensitivity and bleeding can occur just before a woman’s period. Good oral hygiene and periodontal health can minimize or eliminate these findings.
- Pregnancy
- Many women feel that tooth loss from pregnancy is inevitable because the baby takes the calcium from the mother. This is an old wives tale. The gums are affected by pregnancy though. Increased levels of hormones beginning in the second month and increasing through the eighth month can cause a disease called pregnancy gingivitis. This condition is marked by red, swollen, tender, bleeding gums. This occurs in response to very little plaque and calculus.
- It is very important to make sure your gums are healthy before becoming pregnant. Many times an existing periodontal problem is greatly exacerbated during pregnancy. This can result is tooth loss. Working in concert with your OB/GYN, Dr. Scharf can tailor a preventative maintenance program to keep both your gums and your baby healthy during the pregnancy.
- Low Birth Weight Babies
- It's possible that if you have periodontal disease and are pregnant, you may be at risk for having a premature, low birthweight baby.
- For a long time we've known that many risk factors contribute to mothers having babies that are born prematurely at a low birthweight -smoking, alcohol use, drug use and infections.
- Now evidence is mounting that suggest 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 or too small.
- If you are planning to become pregnant or are at risk for periodontal disease be sure to include a periodontal as part of your prenatal care - because healthy gums may lead to a healthier body and a healthy baby.
- Oral Contraceptives
- Women taking oral contraceptives (birth control pills) may experience the same changes in the gums as pregnant women do. This is due to the fluctuations in hormone levels. If you are taking oral contraceptives and notice bleeding, reddened or sensitive gums, please contact our office.
- Menopause
- Many women take hormone replacement therapy during menopause. This may cause your gums to become more sensitive to local irritants like plaque and calculus. Some studies show that estrogen supplements may improve a women’s oral health.
Respiratory Disease
Bacteria in your mouth can be aspirated into the lungs to cause respiratory diseases such as pneumonia, especially in people with gum disease.
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 diseases (COPD) cause 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 frequents bouts of respiratory disease in COPD patients.
Heart Disease and Stroke
For a long time we've known that bacteria may affect the heart. Now evidence is mounting that suggests people with periodontal disease - a bacterial disease, may be more at risk for heart disease than patients without periodontal disease.
One study showed that heart disease was 25% more common in people with gum disease. Men under the age of 50 had a 75% greater risk of heart disease than men with healthy gums. Another study demonstrated that men with gum disease had twice the death rate from heart disease than men without gum disease. These studies suggest that gum disease could be a strong a risk factor for heart disease as smoking which is blamed for 40,000 heart-related deaths per year.
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.
One study showed that heart disease was 25%
more common in people with gum disease.
Diabetes
Diabetic patients know how important it is to control their disease. But many diabetics do not know there is a relationship between diabetes and gum disease. Each one can make the other one worse. A diabetic is has a greater risk of periodontal disease if the diabetes is not well controlled.
Uncontrolled periodontal disease can make it
more difficult to control the diabetic state.
Diabetics know that an infection will raise their blood sugar. Periodontal disease is an infection that has the same result. If you are a diabetic it is especially important to make sure that your gums are healthy. Your physician may be having difficulty controlling your blood sugar. This may become easier once the periodontal disease is controlled. In addition, your diabetic medications may need to be reduced once the gum disease is controlled. Dr. Scharf will work very closely with your physician to coordinate your care. Healthier gums can lead to a healthier body.
Genetics
For years we have known that not all people get periodontal disease at the same rate or the same severity. Both environmental factors (bacteria) and genetics influence periodontal disease. We now have a test that will determine an individual’s genetic susceptibility to periodontal disease. The test is simple and inexpensive. Individuals who test positive have between a 6 to 19 times increased risk of developing severe periodontal disease. Smokers who test positive have even worse odds. The good news is that this information can be used to design a preventive program to minimize the genetic effect of periodontal disease. It also assures that you are not under or over treated.
The test is done by collecting a small sample of saliva. The saliva contains DNA, which is sent to a lab for analysis. The lab will tell us if you are positive or negative for the gene that causes your body to overreact to bacteria involved in periodontal disease. This information will be used to determine your overall risk profile and tailor your individual treatment plan. Many of our patients ask to have their children tested for this gene. They want their kids to start on the right preventive program before disease develops.
Alzheimer's Disease
Exposure to inflammation early in life from ailments such as chronic periodontal disease quadruples an individual's risk of developing Alzheimer's disease, researchers reported at the first Alzheimer's Association International Conference on Prevention of Dementia.
Because chronic periodontitis is a treatable infection, it seems wise to control it and rather than increase ones risk of Alzheimer's disease.
The molecular and cellular mechanisms responsible for Alzheimer's disease have not been defined. Although the whole story is not known, inflammation in the brain is considered to be a component of Alzheimer's disease. Studies suggest inflammation in the rest of the body may contribute to inflammation in the brain. Chronic periodontal disease contributes to the overall level of inflammation in the body and this may increase ones risk of Alzheimer's disease. Because chronic periodontitis is a treatable infection, it seems wise to control it and rather than increase ones risk of Alzheimer's disease.
Cancer and Gum Disease
Most people already know that maintaining oral health is a vital component of achieving overall health, but a recent study reveals why it is especially crucial that men pay close attention to their teeth and gums. 
Research published in The Lancet Oncology found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. In fact, researchers uncovered that men with periodontal disease may be:
- 49 percent more likely to develop kidney cancer
- 54 percent more likely to develop pancreatic cancer
- 30 percent more likely to develop blood cancers
Chronic Kidney Disease
A study published in the Journal of Periodontology suggests that the effects of untreated periodontal disease may be linked to chronic kidney disease.
According to the National Kidney Foundation, one out of nine Americans suffers from chronic kidney disease (CKD), and millions more are at risk. A debilitating disease, CKD can affect blood pressure and bone health, and can eventually lead to heart disease or kidney failure. A study published in the Journal of Periodontology suggests that adults with no teeth may be more likely to have CKD than adults with teeth. Oral care may play a role in reducing the prevalence of chronic kidney disease in the U.S. population.
Oral care may play a role in reducing the prevalence
of chronic kidney disease in the U.S. population.
While additional research is needed to fully understand why tooth loss is associated with higher rates on chronic kidney disease, the destructive nature of chronic inflammation may play a role. Both periodontal disease and chronic kidney disease are considered inflammatory conditions, and previous research has suggested that inflammation may be the common link between these diseases. Since untreated periodontal disease can ultimately lead to tooth loss, edentulous patients may have been exposed to chronic oral inflammation.