Cosmetic, Implant , General Dentist in Smithtown Long Island, NY. This blog has been created to bring up all oral health topics and dental treatment. I welcome any discussions of any dental topics or dental treatments that are important to you. Videos and articles can be found on my website, www.WeCaterToCowards.com. I look forward to helping and using my personal experiences in dentistry in the past 15 years in all aspects of dentistry. Talk to you soon.
Often taken for granted, the monotonous task of brushing and flossing our teeth daily has never been more important in order to avoid periodontal disease known as gum disease and the risk it places on our overall health. It has been estimated that 75 percent of Americans have some form of gum disease, which has been linked to serious health complications and causes various dental problems that like periodontal disease, are often preventable.
What Is Gum Disease?
Periodontal disease, also called gum disease, is mainly caused by bacteria from plaque and tartar buildup. Other factors that have the potential to cause gum disease may include:
Clenching or grinding your teeth
Types of periodontal disease (gum disease) include:
Gingivitis – The beginning stage of gum disease and is often undetected. This stage of the disease is reversible.
Periodontal disease – Untreated gingivitis may lead to this next stage of gum disease. With many levels of periodontal disease, the common outcome is chronic inflammatory response, a condition when the body breaks down the bone and tissue in the infected area of the mouth, ultimately resulting in tooth and bone loss.
Recent studies suggest periodontal or gum disease may contribute to or be warning signs of potentially life-threatening conditions such as:
Heart disease and stroke – Studies suggest gingivitis may increase the risk of heart disease and stroke because of the high levels of bacteria found in infected areas of the mouth. As the level of periodontal disease increases, the risk of cardiovascular disease may increase with it. Other studies have suggested that the inflammation in the gums may create a chronic inflammation response in other parts of the body which has also been implicated in increasing the risk of heart disease and stroke.
Diabetes – People with diabetes often have some form of gum disease, likely caused by high blood glucose, according to the U.S. Centers Disease Control and Prevention. People with diabetes need to take extra care to ensure proper brushing and flossing techniques are used to prevent the advancement of the gum disease. Regular check-ups and cleanings with your dental hygienist should be followed.
Chronic kidney disease – A study, conducted by Case Western Reserve University, suggests that people without any natural teeth, known as edentulous, are more likely to have chronic kidney disease (CDK), than people with natural teeth. CDK affects blood pressure potentially causing heart disease, contributed to kidney failure, and affects bone health.
Preterm birth – Babies that are born premature (before 37 weeks of gestation), may face numerous health complications. Research indicates that women with periodontal disease are three to five times more likely to have a baby born preterm compared to women without any form of gum disease. Women are more susceptible to gingivitis when pregnant and should follow their regular brushing habits, and continue with dental cleanings and examinations.
Treatments for Gum Disease
Depending on the type of periodontal disease, some of the available treatment options are:
Removal of plaque and calculus by way of scaling done by your dental hygienist or dentist.
Medications such as chlorhexidine gluconate, a mouth rinse prescribed by your dentist or hygienist to help kill the bacteria in your mouth, along with frequent cleanings.
Surgery may be necessary in certain cases to stop, halt, or minimize the progression of periodontal disease. Surgery is also used to replace bone that was lost in advanced stages of the disease.
Preventing Gum Disease
Proper brushing and flossing is the easiest way to reduce and prevent gum disease, but regular cleanings with your dental hygienist or dentist are necessary to remove calculus and treat advanced gum disease. If you are concerned that you may have gum disease, contact your dentist .
Drs. Scott Froum and Alisa Neymark examine the effects of e-cigarette ingredients and their notable deterioration on oral health. They offer insight into how explosions while vaping and e-cig burn injuries can disfigure oral soft tissue.
THE USE OF ELECTRONIC CIGARETTES (E-CIGARETTES) represents a significant and increasing proportion of tobacco consumption, posing a tremendous threat to oral health. This article will look at the following aspects of e-cigarettes:
Overview of e-cigarette usage
Statistics on the current prevalence of e-cigarettes
Three chemicals contained in e-cigarettes and their effects on oral health
Using e-cigarettes, referred to as vaping, works by heating a liquid to generate an aerosol that the user inhales. The liquid in the e-cigarette, called e-liquid, is usually made up of propylene glycol, glycerin, flavorings, water, and nicotine, although some users will substitute THC for nicotine. In practice, e-cigarette users tend to reach lower blood nicotine concentrations than tobacco smokers, although it is difficult to make a direct comparison because nicotine concentrations in e-cigarettes vary widely.
Reasons individuals vape include the following:
The thought that vaping is less harmful than cigarettes
Circumvention of smoke-free areas
Recreational enjoyment (1)
Researchers and antitobacco advocates are especially concerned that irresponsible marketing has made e-cigarettes appeal to the segment of the young population that had no history of tobacco usage and never intended to start smoking. Because of the known dangerous effects of traditional tobacco methods, use among middle and high school students has been steadily decreasing since 2014. However, since the introduction of the e-cigarette, that number is now increasing, and it is estimated that one in five high school students may now be using tobacco products. (2) E-cigarette use from 2017 to 2018 increased 78% among high school students and 48% among middle school students. (3)
The first danger of e-cigarettes is associated with the carrier product known as propylene glycol (PG). PG is primarily used in the production of polymers and in food processing. It can be found in various edible items, such as liquid sweeteners, ice cream, and whipped dairy products. It can also act as a carrier for various inhalant pharmaceutical products, including nicotine. PG is a viscous, colorless liquid that possesses a faintly sweet taste and is one of the major ingredients of the e-liquid used in e-cigarettes. When used orally, the breakdown products of PG include acetic acid, lactic acid, and propionaldehyde, which are all toxic to enamel and soft tissue. (4) In addition, PG is a hygroscopic product, which means water molecules in saliva and oral tissue will bond to the PG molecules, leading to tissue desiccation. (5) The result of this is xerostomia, or "dry mouth," which has been shown to lead to an increase in cavities, gum disease, and other oral health issues.
Vegetable glycerin and flavorings
The second danger of e-cigarettes is due to other major component of e-liquid: glycerin and flavorings. Vegetable glycerin (VG) is a colorless, odorless, viscous, and sweet-tasting liquid. It has a myriad of applications, including medical, pharmaceutical, and personal care. In the food industry, it serves as a humectant, solvent, and sweetener. It is 60% as sweet as sucrose and is not metabolized by cariogenic bacteria, and is therefore thought not to cause cavities. However, studies have shown that the combination of VG with flavorings produces a fourfold increase in microbial adhesion to enamel and a twofold increase in biofilm formation. (6) In addition, a 27% decrease in enamel hardness was demonstrated when flavorings were added to e-liquid as compared to unflavored controls. The viscosity of the e-liquid also allowed Streptococcus mutans to adhere to pits and fissures. In other words, e-liquid allows more cavity-causing bacteria to stick to a softer tooth and can lead to rampant decay.
Another danger associated with e-cigarettes has to do with nicotine. Although the percentage of nicotine is much lower (0.3%–1.8%) than traditional tobacco products, one electronic cartridge (200–400 puffs) can equal the smoking of two to three packs of regular cigarettes. The dangerous effects of nicotine on gum tissue are well known. The literature suggests that nicotine affects gingival blood flow as it is a vasoconstrictor. It also affects cytokine production, neutrophil function, and other immune cell function. (7) In addition, nicotine decreases connective tissue turnover. All of this results a much higher chance of developing gum disease and tooth loss.
Recently, a 24-year-old man from Texas was killed when his vape pen exploded, and part of the device wound up severing his jugular vein. (8) Although these types of sensationalized deaths are rare with e-cigarettes and vaping pens (only two reported to date), the explosions of these pens are not. The problem lies within the vape pen and the lithium batteries overheating and exploding. These explosions are usually attributed to improper charging of the device or have been linked to a type of device called a mechanical mod that has no internal safety and can overheat and explode.
One report found that 195 of these adverse events occurred between the years of 2009 and 2016. (9) However, Dennis Thombs, dean of the School of Public Health at UNT Health Science Center, published a study that concluded the number of vape explosions in the US were most likely underestimated. Thombs estimated that there were 2,035 e-cigarette explosions and burn injuries in the US between 2015 and 2017—more than 40 times the initial estimate by the US government. (8) These injuries are serious and often lead to disfigurement of oral soft tissue (figure 1).
Figure 1: Oral soft-tissue injuries due to e-cigarette explosion (photo courtesy of Nicole Angemi)
The bottom line is vaping can be just as dangerous, if not more dangerous, when compared with smoking. The problem is that vaping is thought to be a safer alternative to traditional tobacco products, and companies are adding flavoring products to attract younger generations. According to a 2013–2014 survey, 81% of current youth e-cigarette users cited the availability of appealing flavors as the primary reason for use. (10)
For example, one patient of a general dental practice had a caries-free history for 35 years. He ceased smoking traditional cigarettes and decided to vape as he thought this was a healthier alternative. Within a year, cervical enamel demineralization and interproximal lesions were present on the mandibular anterior sextant, consistent with the primary point of contact of the e-liquid aerosol (figure 2).
Figure 2: Effects of e-cigarette usage
In another example, a young patient had been using e-cigarettes for five years. He started vaping as a method to quit smoking traditional tobacco products thinking vaping was a healthy alternative. Because of its ease of use, he smoked a cartridge of one of the more popular vaping products a day. Admittedly, he also drank energy drinks (high sugar content), stating that his mouth was often dry after vaping. This combination led to rampant decay with smooth-surface lesions and future tooth loss (figure 3).
Figure 3: Effects of e-cigarettes
Many advocates of vaping claim that e-cigarette use and vaping poses 5% the health risks of traditional tobacco smoking and claim its use to be helpful in getting people to quit. (11) This particular use does have merit and has helped many individuals quit smoking. Unfortunately, these studies have only analyzed e-cigarette use in former smokers using vaping as a way to stop smoking. The studies have not looked at the health effects of nonsmokers who start vaping because of the perceived innocuous health effects and because it "tastes yummy." In addition, these studies have not looked at vaping in middle school and high school individuals, the group where e-cigarette use is increasing the most in percentage of use. Because of this, a tidal wave of oral health problems is heading our way.
Flossing in between your teeth means you are cleaning the areas that your
toothbrush (yes, even your smart electric toothbrush) cannot reach. This
the build-up of plaque, which is a sticky coating which forms on your teeth.
is made up of bacteria and sugars. It is constantly forming, and it is
colorless, so it can quickly build up without you realizing.
As plaque is colorless, it is easy for you to assume that simply brushing
your teeth twice a day is enough. Why would you do more if your teeth are fine as they are?
But the problem is that if you leave plaque, it will harden and turn into tartar,
which is a yellow or brown color. Once you have tartar on your teeth, you will only remove it by visiting your dentist for a scale and polish.
Different people make plaque at different rates, so therefore tartar will form
at different rates too. Even if you cannot see the plaque, you can notice that
after flossing, your smile appears brighter and cleaner.
As tartar builds up, it can cause gingivitis, which is the swelling of
your gums, which is the first stage of gum disease. The plaque and tartar can easily travel downbelow the gum line, where the bacteria they carry can cause severe gum disease, which is
also known as periodontal disease. Gum disease might not mean
much to you, but it can become very painful, and will eventually lead to tooth decay and eventually tooth loss.
Flossing Prevents Gum Disease
By removing plaque from between your teeth and along/below
the gum line where your tooth brushing cannot reach, you are reducing your chance of gum disease. Periodontal disease affects as many as half of adults, and while some people are more prone to it than others, it can affect anyone.A study on twins in 2008 compared the effects of flossing and not flossing associated with periodontal disease. The study found that the group which flossed their teeth had significantly lower numbers of bacteria associated with gum disease than the group which did not floss.
Good Oral Hygiene Keeps You Healthy
Keeping your mouth healthy is an important part of keeping yourself
healthy overall. Periodontal disease has been linked to many chronic illnesses, in particular, chronic heart disease. In fact, it is thought that those who have periodontal disease are nearly twice as likely to have heart disease.There have been a number of studies looking into the links between gum disease and heart disease. It is thought that the bacteria causing gum disease can enter the bloodstream,
where it attaches to fatty deposits. This can cause bloodclots which can then cause heart attacks or stroke. It can also cause swelling in the blood vessels, causing them to harden, which means your heart has to work harder to pump theblood around the body, meaning you can get raised blood pressure.Gum disease has also been linked to other illnesses, although the
causes have not all been determined. Patients with diabetes may find that it is harder to control their blood sugar level if they have unhealthy gums than those who havehealthy gums,and the bacteria in gum disease can cause or exacerbate lung conditions, particularly
in elderly people. Poor oral health in pregnant women has also been
linked to premature births, meaning babies are born with lower birth
So it is not just your teeth you are looking after when you brush and floss,
it is your overall, long-term health, and potentially that of your unborn child.
Surely spending an extra minute or two a day on your tooth care routine is
Flossing Makes Brushing Your Teeth More Effective
The combination of brushing and flossing your teeth is far better
than just brushing them. Ideally, the best time to floss your teeth, as recommended by dentists, is before you brush them.This is because it will not only loosen and remove plaque but also remove food debris from between your teeth that would otherwise block the action of the toothbrush. By removing these from your teeth and gums before you rush, it also enables the toothpaste to reach more areas within your mouth, so the fluoride can have a greater effect on strengthening your tooth enamel.This goes for using mouthwash too. After you have flossed and brushed your teeth,
you can use a fluoride-based mouthwash to finish off your teeth-
This will give your teeth a little more resilience against cavities,
and it has an
antibacterial action to reduce germs in your mouth which can cause
Flossing Can Save You Money
By ensuring you floss and brush your teeth regularly, as
recommended, as well as having regular dental check-ups, you are doing all you can to prevent gum disease
and tooth decay. This will save you a huge amount of money,
as the cost of one filling along can be in the $100s!
Flossing takes very little time or effort and can easily form part of
your daily tooth
ritual. An extra minute or two per day will be well worth it when
you don’t have to pay for painful fillings or tooth extractions.
You can make it even easier for yourself by getting a water flosser,
which is a great
alternative if you don’t like using traditional dental floss. If you
would like to know
more about water flossing and see our reviews of some of the best water flossersaround, take a look at our buyer’s guide.
Flossing Keeps Your Smile Clean!
This is probably the most obvious one. Many people only think
to use floss when we have something stuck in our teeth. Flossing
is one of the most effective ways of getting rid of stubborn food
debris from between our teeth. It is great for people with braces
too, although flossing with regular dental floss is harder when you have to navigate around braces. Other methods of flossing are better for this, such as water flossing, How Else Can I Keep My Mouth Healthy?
Maintaining good oral hygiene practices is the most important
way to ensure your mouth is healthy. By ensuring dental bacteria and plaque build-up is kept to a minimum, you will be well on the way to having a healthy mouth. But there are
other lifestyle considerations which you should take on board too:
Low sugar diet – the bacteria that cause plaque love
sugar as it helps them to respire. Try to limit your sugar
intake, as well as cutting down on particularly
starchy or sticky foods. Eating a well-balanced diet will
boost your immune system and give your body the best
resistance against bacteria.
Limit acidic foods and drinks – acidic products such
as orange juice
weaken the minerals in your tooth enamel, causing cavities