The Tooth Bone's Connected...Oral Health and Older Adults People are living longer and healthier lives. And, older adults also are more likely to keep their teeth for a lifetime than they were a decade ago. However, studies indicate that older people have the highest rates of periodontal disease and need to do more to maintain good oral health.
What you may not realize is that oral health is not just important for maintaining a nice-looking smile and being able to eat corn on the cob. Good oral health is essential to quality of life. Consider a few of the reasons: Every tooth in your mouth plays an important role in speaking, chewing and in maintaining proper alignment of other teeth. A major cause of failure in joint replacements is infection, which can travel to the site of the replacement from the mouth in people with periodontal disease. People with dentures or loose and missing teeth often have restricted diets since biting into fresh fruits and vegetables is often not only difficult, but also painful. This likely means they don't get proper nutrition. Most men and women age 65 and older report that a smile is very important to a person's appearance. And, maybe most importantly, recent research has advanced the idea that periodontal disease is linked to a number of major health concerns such as heart disease, stroke, respiratory disease and diabetes. While your likelihood of developing periodontal disease increases with age, the good news is that research suggests that these higher rates may be related to risk factors other than age. So, periodontal disease is not an inevitable aspect of aging. Risk factors that may make older people more susceptible include general health status, diminished immune status, medications, depression, worsening memory, diminished salivary flow, functional impairments and change in financial status The Gum Disease/Heart Disease Connection Periodontal disease, a chronic inflammatory disease that destroys the bone and gum tissues that support the teeth, affects nearly 75 percent of Americans and is the major cause of adult tooth loss. Cardiovascular disease, the leading killer of men and women in the United States, is a major public health issue contributing to 2,400 deaths each day. And while the prevalence of these diseases seems grim, research suggests that managing one disease may reduce the risk for the other. Recently, a consensus paper on the relationship between heart disease and gum disease was published in the online versions of two leading publications, the American Journal of Cardiology (AJC), a publication circulated to 30,000 cardiologists, and the Journal of Periodontology (JOP), the official publication of the American Academy or Periodontology (AAP). Developed by periodontists, the dentists with advanced training in the treatment and prevention of periodontal disease, and cardiologists, the physicians specialized in treating diseases of the heart, the paper contains recommendations for managing patients living with, or who are at risk for, either disease. As a result, cardiologists may now examine a patient’s mouth, and periodontists may begin asking questions about heart health and family history of heart disease. According to Dr. John Bonner, “We know that inflammation is a major risk factor for heart disease, and periodontal disease may increase the inflammation level throughout the body. Several studies have shown that patients with periodontal disease have an increased risk for cardiovascular and carotid disease, so we feel it’s important to develop a partnership between us and pro-active cardiologists to c help our patients.” “We have developed a special relationship with Florida Heart and Vascular Center and Florida Heart and Vascular Center Multi-Specialty Group physicians to help raise awareness among our respective patients about the gum disease/heart disease connection,” said Dr. Bonner. “We’re not only informing our patients of the increased risk of cardiovascular disease associated with periodontal disease, but also helping them assess their risk for future cardiovascular disease while we guide them to be evaluated for risk factors or the presence of heart disease.” Florida Heart & Vascular Center David C. Lew, MD, FACC, FSCAI recommends that his cardiologists managing patients with cardiovascular disease evaluate their patients’ mouths for the basic signs of periodontal disease such as significant tooth loss, signs of oral inflammation, and receding gums. “We believe additional research will help identify the precise relationship between periodontal disease and cardiovascular disease, however, it looks like inflammation - the body’s reaction to fight off infection, guard against injury or shield against irritation -- is playing a key role,” said Dr. Lew. “While inflammation’s role initially is to have a protective effect, untreated chronic inflammation can lead to dysfunction of the affected tissues, and therefore to more severe health complications “Both periodontal disease and cardiovascular disease are inflammatory diseases, and inflammation is the common mechanism that connects them. Working together, we have a unique opportunity to reduce further disease progression, and ultimately to improve our patients’ overall health. That is our common goal.” For information about the link between gum disease and heart disease, talk with Dr. Bonner, your doctor, or contact Florida Heart & Vascular Center at (352)728-6808 to make an appointment. Periodontal Disease and Tobacco Use You are probably familiar with the links between tobacco use and lung disease, cancer and heart disease. Current studies have now linked periodontal disease with tobacco usage. These cases may be even more severe than those of non-users of tobacco. There is a greater incidence of calculus formation on teeth, deeper pockets between gum tissue and teeth as well as greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of tobacco. Chemicals in tobacco such as nicotine and tar slow down healing and decrease the predictability of a successful outcome following periodontal treatment. Problems caused by tobacco include: Lung disease, heart disease, cancer, mouth sores, gum recession, loss of bone and teeth, bad breath, tooth staining, less success with periodontal treatment and dental implants. Successfully quitting tobacco will reduce the chance of developing the above problems Diabetes and Oral Health Clinical guidelines from the International Diabetes Federation (IDF) emphasize the importance of periodontal health for people with diabetes. Diabetes affects approximately 285 million people worldwide, and this number is only expected to increase. Individuals suffering from diabetes, particularly uncontrolled diabetes, have a higher risk of developing periodontal disease. A periodontal infection may impair your ability to process insulin, resulting in greater difficulty with controlling your diabetes. Periodontal disease in diabetic patients tends to be more severe than that of a non-diabetic. Healing time can also be delayed. Well controlled diabetics can expect to have better resolution of a periodontal infection. The IDF oral health clinical guideline supports what research has already suggested: that management of periodontal disease — which affects the gums and other supporting tissues around the teeth — can actually help reduce the risk of developing diabetes and can also help people with diabetes control their blood sugar levels. Studies have suggested a two-way relationship between diabetes and periodontal disease. The IDF guideline contains clinical recommendations on periodontal care, written in collaboration with the World Dental Federation (FDI), that encourage health professionals to conduct annual inquiries for symptoms of periodontal disease such as swollen or red gums, or bleeding during tooth brushing; and to educate their patients with diabetes about the implications of the condition on oral health, and especially periodontal health. Women and Periodontal Health Throughout a woman’s life, hormonal changes affect tissue throughout the body. Fluctuations in hormone levels occur during puberty, pregnancy and menopause. During these times, your susceptibility to periodontal disease may increase, requiring special care of your oral health. Puberty During puberty, there is increased production of sex hormones. These higher levels increase gum sensitivity and lead to an increased incidence of irritation from plaque and food particles. The gum tissue can become swollen, turn red and feel tender. Menstruation Similar symptoms occasionally appear several days before menstruation. There can be bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek. The symptoms clear up once the cycle has started. As the amount of sex hormones decrease, so do these problems. Pregnancy Your gums and teeth are also affected during pregnancy. Between the second and eighth month, your gums may also swell, bleed and become red or tender. Large lumps may appear as a reaction to local irritants. However, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear after pregnancy. Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk. The best way to prevent periodontal infection is to begin with healthy gums and continue to maintain your oral health with proper home care and careful monitoring by your physician, general dentist, or periodontist. Oral contraceptives Swelling, bleeding and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones. You must mention any prescriptions you are taking, including oral contraceptives, prior to medical or dental treatment. This will help eliminate risk of drug interactions, such as antibiotics with oral contraceptives – where the effectiveness of the contraceptive can be lessened. Menopause Changes in the look and feel of your mouth may occur if you are menopausal or post-menopausal. They include feeling pain and burning in your gum tissue and salty, peppery or sour tastes. Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of “dry mouth.” Medications and Periodontal Health Older adults are likely to take medications that can impact oral health and affect dental treatment. Hundreds of common medications - including antihistamines, diuretics, pain killers, high blood pressure medications and antidepressants - can cause side effects such as dry mouth, soft tissue changes, taste changes, and gingival overgrowth. Numerous medications produce dry mouth or xerostomia, which can have a damaging effect on gum tissue and teeth. Dry mouth leaves the mouth without enough saliva to wash away food and neutralize plaque, leaving you more susceptible to tooth decay and periodontal disease. In addition, dry mouth can cause sore throat, problems with speaking, difficulty swallowing and hoarseness. Your dentist or periodontist can recommend various methods to restore moisture, including sugarless gum, oral rinses or artificial saliva products. Other drugs may cause gingival enlargement, which means the gums grow over part of the tooth. Medications with sugar as a main ingredient, such as over-the-counter cough drops and syrups, may increase plaque as well as enhance the ability of plaque to adhere to your teeth better. Be sure to tell your periodontist and other dental professionals about any medications that you are taking, including herbal remedies and over-the-counter medications. |