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Maintaining healthy teeth and gums can brighten your smile and lengthen your life.
If you’re one of those people who would rather be stranded in the middle of the Mojave with no water than be subjected to even one minute in a dentist’s chair, here’s something you should know: You’re not alone.
According to the Centers for Disease Control and Prevention, only 62 percent of adults ages 18 to 64 visit a dentist in any given year, and that percentage decreases even further as age increases. Those discouraging numbers come as no surprise to dental hygienist Lindsey Wells.
“Dentistry is the forgotten part of health,” Wells says. “Your mouth is connected to your whole system, and keeping your mouth healthy is as important as any other part of health care.”
The good news is that patients now have more options than ever before when it comes to improving their smiles. October is National Dental Hygiene Month, so here’s a look at the latest advances in the areas of gum health, adult orthodontics and cosmetic dentistry.
GUM HEALTH AND YOUR HEART
As a dentist, Dr. Mark Davis has seen the impact of poor gum health on both a professional and a personal level. His father died of a heart attack eight years ago, and Davis is convinced that poor dental health was a contributing factor.
“He didn’t go to doctors, and he had one of the worst cases of periodontal disease I’ve ever seen,” Davis admits. “I cannot escape the idea that if he had gotten that under control, he might still have had a heart attack, but it might not have been catastrophic, and he might still be alive.”
Shortly after his father’s death, Davis began seeing journal articles linking oral health and cardiovascular health. In the years since, the evidence of a connection between the two has only grown stronger. The current wisdom is that the same bacteria that cause gum inflammation and destroy teeth can also enter a patient’s bloodstream and set off a chain-reaction inflammatory response in other parts of the body, including the cardiovascular system. This insight is prompting many cardiologists — such as Dr. C. William McEntee of Warren Cardiology — to pay strict attention to the oral health of their patients.
“Studies have shown that periodontitis, or inflammation in the dental tissues around the teeth, is associated with abnormal function of the lining of blood vessels, cholesterol accumulation within blood vessels and an increased risk of heart attack and stroke,” McEntee says.
One study reported last year in the Journal of General Internal Medicine found that patients with periodontal disease were as much as 35 percent more likely to develop coronary artery disease than patients with healthy gums. Other studies suggest links between periodontal disease and diabetes, respiratory illnesses and pre-term births.
Fortunately, new tools are emerging in the fight to maintain good gum health. One high-tech example: dental lasers. Dr. Bert Johnson was one of the first dentists in Oklahoma to use a Waterlase laser, the most advanced laser on the market used in dentistry.
“Patients appreciate it because it’s non-invasive,” Johnson says. “The laser very precisely kills bacteria and there’s no discomfort. You can use it on most levels of severity, and it typically only takes one to two visits of less than 20 minutes each.”
Dental lasers are also used to help detect cavities, as an alternative to a traditional drill when preparing teeth for fillings and to reshape gum tissue.
ADULT ORTHODONTICS
If you wore braces as a child, the term “orthodontics” is sure to evoke images of brackets, wires and rubber bands. For adults needing help with crowded, protruding or crooked teeth, there is now an alternative to traditional braces: clear, removable aligners customized to your mouth.
“Invisalign is the brand name you often hear associated with clear aligners,” Davis says. “Each tooth to be adjusted requires its own aligner, so patients can customize their treatment with however many aligners are needed.”
In much the same way that traditional braces require adjustment on a regular basis to gradually move teeth, a new series of aligners is introduced about every two weeks until alignment issues are fully corrected. When in place, the aligners are virtually invisible, and patients can remove the aligners to brush and floss as usual.
As with most products, there are limitations. Clear aligners are not suitable for anyone with baby teeth remaining, so children and teenagers will still typically require traditional metal braces. Because clear aligners utilize computer-imaging technology to chart the planned tooth movement in advance, the costs can sometimes be higher than with traditional braces. And since aligners are removable, they can also be misplaced, meaning replacement costs may become a factor.
COSMETIC DENTISTRY
When it comes to the search for a perfect smile, the old adage about less being more may well be true. At least that’s how longtime Tulsa dentist Dr. Gene McCormick sees it.
“The best dentistry,” McCormick says, “is no dentistry. Studies have shown that teeth are always healthier if you don’t have to touch them. The truth is, the more you do to a tooth, the more likely you are to have complications.”
McCormick is not the only dentist who feels this way, and a number of products are available that can significantly improve a patient’s smile without requiring extensive modification to existing teeth. Case in point: porcelain veneers, thin shields bonded to the front of teeth without the need for injections or preparatory grinding of healthy tooth structure. Lumineers is a well-known brand name for these contact-thin veneers, which are designed to address gaps between teeth, as well as chipped, stained or crooked teeth.
“A lot of times, we’ll use both veneers and bleaching,” Johnson says. “The upper teeth are more visible when a person smiles, so we’ll use veneers up there but bleaching on the lowers to save patients some money since bleaching is less expensive.”
Veneers are extremely customizable, allowing them to be color-matched to adjacent teeth, and they can last for decades. By comparison, bleaching (also known as tooth whitening) is a temporary fix for discolored teeth and requires regular maintenance. Depending on the level of discoloration, some teeth respond better than others; yellow teeth respond well to bleaching while gray teeth do not, according to Johnson. In some cases, combining in-office bleaching with at-home bleaching, as directed by your dentist, helps. Starting with a healthy mouth is key; bleaching can be painful and non-productive if you have periodontal disease or tooth decay, Johnson says.
And the technological advances keep on coming. For example, tooth-colored ceramic resin fillings are replacing traditional silver fillings. Available in a wide variety of shades, ceramic fillings are infused with fluoride, making them both less noticeable and more resistant to decay than standard fillings.
Another recent advance is digital X-rays, Johnson says, which emit as much as 90 percent less radiation than traditional X-rays and do not require processing, so they’re available for the dentist to review immediately.
Periodontal primer
Want to improve your dental IQ? Some terms to know:
Periodontal disease: unhealthy gums and teeth.
Gingivitis: mild gum inflammation, an early form of periodontal disease.
Periodontitis: serious gum infection, an advanced form of periodontal disease.
Plaque: buildup of a sticky film on the teeth.
Tartar: hardened accumulation of plaque at the gum line.
Systemic: something affecting your whole body; left unchecked, periodontal infection can result in systemic health problems.
Source: The Journal of the American Medical Association, www.jama.com
Signs of periodontal disease
Think you might have periodontal disease? Some telltale signs:
Bleeding when you brush your teeth.
Red, swollen or tender gums.
Gums that have pulled away from the teeth.
Persistent bad breath unrelated to food.
Pus draining from the gums.
Loose teeth.
Changes in the way your teeth fit together when you bite.
Changes in the fit of partial dentures.
Source: American Dental Association, www.ada.org
Maintaining oral health
Want to prevent problems with your teeth and gums? Some proven strategies:
Brush teeth twice daily using a soft-bristled toothbrush to remove bacteria buildup.
Clean between teeth daily using floss or interdental cleaners.
Eat a balanced diet with a variety of foods from the basic food groups.
See a dentist regularly, generally twice a year.
Source: American Dental Association, www.ada.org
Piercing concerns
Considering an oral piercing, or know someone who is? Some potential concerns:
Common side effects include pain, swelling and bleeding.
Infections are common because of the presence of bacteria in the mouth.
Mouth jewelry can chip or break teeth, and interfere with dental examinations.
Mouth jewelry can also wear away gums, increasing the chances for periodontal disease.
The American Dental Association opposes oral piercing because of the health risks.
Source: American Dental Association, www.ada.org
