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February 22, 2007

Gum disease,and its relation to systemic diseases

Blogged under Dental Education,Gum health by DrJean on Thursday 22 February 2007 at 11:25 pm

In recent years,there has been a lot of studies done on the possible links between gum disease and several common systemic diseases.

Diabetes is a disease where the metabolism of glucose in the body is impaired .Glucose is a necessary fuel for all our body cells to function properly.Therefore,when glucose is not metabolised,cells begin to break down and malfunction.Persons with uncontrolled or poorly-controlled diabetes will be much more prone to rapid bone loss from gum disease.Gum disease as we know now,is caused by the presence of plaque and calculus.Therefore,in a nutshell,poor oral hygiene and uncontrolled diabetes is a sure prescription for losing one’s teeth.However,good oral hygiene will prevent gum disease even in the presence of diabetes.

There has also been published studies on the link between the presence of severe gum disease and cardiovascular disease,particularly the occurance of stroke.Our liver produces a protein marker called C-reactive protein(CRP) in the presence of inflammation.The concerntration of CRP in the blood determines the amount of inflammation caused in a stroke. And in periodontal/gum inflammation.It is currently believed that the severity of periodontal bone loss in gum disease may serve as a marker for susceptibility to heart disease or a stroke.

In one of the publications by the British Medical Journal in 1989,it stated an association between dental health and acute myopcardial infarction ie heart attack.

Acccording to articles published in the Journal of Periodontology,pregnant women with high levels of pathogenic(disease causing) bacteria in their mouths are at high risk of delivering preterm babies with low birth weight.

And from researches done and published,individuals with uncontrolled gum inflammation are also 4 times at risk of developing Alzheimer’s disease.

In one of the most recent publications by the Journal of National Cancer Institute,dated Jan 17 2007,the Harvard School of Public Health has actually found a relationship between periodontal/gum disease with the increased risk of pancreatic cancer.In this report,an individual male with periodontal disease is 64% more likely to develop pancreatic cancer in his lifetime.

All these researches,publications,reports blah,blah may mean nothing to most of us,but I do believe that it is good to be aware of the risks that are involved and not to become slack in mantaining our oral and dental health.

Zig Ziglar,a famous moitivational speaker and author(and incidentally one of my heroes) once said,”When you choose a habit,you are choosing the RESULTS of the habit”.How true! If we choose to brush and floss well and have our regular dental check up and scaling,we are choosing to have good teeth and healthy gums and inevitably, a healthy body.

February 12, 2007

Gum disease,how to prevent it and how can it be treated

Blogged under Dental Education,Gum health by DrJean on Monday 12 February 2007 at 10:09 pm

How can we keep our teeth and gums healthy so that they last us till our old age and still functioning?

Daily brushing and flossing will help to eliminate the main portion of plaque from our teeth.Done PROPERLY.If you do a 30 second job on your tooth brushing,you are not going to get rid of the zillions of bacteria proliferating all over your teeth and gums.And if you do not floss,all the plaque sitting comfortably in between all your teeth and within the gums will be more than pleased to have a ball!

Daily cleaning will keep calculus formation to a minimum,but regular visits to your dentist is important too.Professional cleaning done evey 6 month by your dentist will remove the tartar from places where your tooth brush and floss had missed.

If you have been diagnosed with gum disease,then the treatment that follows has to be aimed at controlling the existing infection and stopping the progress of the disease.Your treatment options range according to the severity of the disease.

Whatever the treatment options,the most improtant thing to remember is still to keep your teeth clean by proper brushing and flossing.Your dentist may recommend some specialise toothbrushes like power brushes which runs on rechargeble batteries and has a smaller rotating brush head,to get more effective cleaning.


You can also use a regular manual tooth brush but the bristle must be soft .The soft bristles can reach the crevices of the gums better and will irritate the gums less.You may also be required to return for your professional cleaning at the dental clinic more regularly than the half yearly visits.Your dentist may also recommend mouthrinse and toothpastes that contains active ingredients like chlorhexidine in mouthwashes and triclosan in toothpastes, to help fight gum disease.Chlorhexidine,as much as it is an effective antibacterial agent,binds to tannin which is found in tea,coffee and red wine and causes staining on the teeth with long term  and regular use.Examples of chlorhexidine mouthwashes are Oradex.

Triclosan is an extremely potent anti-bacteriai agent found in certain toothpastes,one example is Colgate Total.


If your gum disease has led to substantial bone loss that causes your gums to recede considerably,your dentist may have to do a deep scaling and root planing on the affected teeth.Root planing is a treatment where the exsposed and roughened  root surface of your teeth is smoothened to eliminate and prevent bacteria collection.This procedure will have to be done under local anaesthesia.

This is a comparison between healthy periodontium on the left and bone and gum loss on the right due to poor oral hygiene.The condition can be arrested but will never be restored back to its original level.It is infinitely easier to prevent it by good brushing and flossing habits than it is to stop it onces it starts!!

Your dentist may also presribe an adjunctive antibiotic regime along with the scaling and root planing that is done.However it has to be stressed that antibiotics will only work IN ADDITION to root planing and stringent daily oral hygiene.  

Poor oral hygiene is the primary cause of gum disease,but other contributary factors include smoking and paranormal jaw functions like grinding and clenching.There has been many published researches since year 2000 on how smoking plays a significant role in more than half the gum diseases that has been diagnosed.THerefore,for smokers,quitting smoking is one of the most important steps to regaining gum health.

I will be writing a little bit more in my next post about the links between gum disease and some of the common systemic diseases that are prevalent,like hypertension,heart disease,stroke,diabetes and of late,pancreatic cancer.

February 7, 2007

Gum disease,it’s more serious than what you think

Blogged under Dental Education,Gum health by DrJean on Wednesday 7 February 2007 at 11:03 pm

Most people think that it is normal to have bleeding gums when they brush their teeth.They only get a little alarmed when their gums bleed spontaneously,and rush to the dentist to have it seen to.That is a very sad thing.What if they wash their hands and it starts to bleed?That would worry them sick!

I believe the ignorance on the bleeding gums is due to the fact that there has not been enough education going around on the importance of gum health and the severity of it having gum disease that is left untreated.

So,what is gum disease?In a very simple way,it is basically colonies of bacteria growing around the gum area and these bacteria produce toxins that gradually destroys the tissues surrounding the teeth.This eventually lead to much destruction of gums and bones supporting the teeth.


How does gum disease occur?It begins with plaque formation on the teeth,which is the sticky yellowish substance you find on your teeth when you do not brush your teeth.Plaque is basically packed with bacteria.When it is excessively accumulated,it will harden to form tartar or calculus.And tartar will bind tightly to the teeth surface and can only be removed by professional cleaning at your dentist’s clinic.

At the early stage of gum disease,the gums will be swollen and will bleed easily ,usually during tooth brushing.This is what we call gingivitis,ie inflamation of the gums.If left untreated,it will progress to a more severe condition where the inner layers of the gums and bone will separate from the teeth.The gums will recede and roots will be exposed.At this point,the periodontium(tissues surrounding the teeth) are inflammed,hence the condition called periodontitis.

Our body’s immune system will fight the bacterial toxins by producing enzymes to counter it.The potent combination of toxins and enzymes will cause more severe destruction of the periodontium.As more gum and bone tissues are destroyed,deep pockets will appear on the gums.

So,what are the signs and symptoms of gum disease?

-Gum bleeding during and after toothbrushing

-Red,swollen and sometimes painful gums

-Persistent bad breath

-Receding gums

-Deep pockets between teeth and gums

-Loose teeth or teeth that shift from their original position

-Changes in the way we bite

I will be talking about prevention and treatment of gum disease next.It is important to be aware that gum disease is very prevalent,and it has serious consequences on our general health.More about this in my next article.

January 24, 2007

Gum disease,you can do something about it

Blogged under Gum health,Oral health care,Testimonial by DrJean on Wednesday 24 January 2007 at 2:22 am

I have a friend,who is my patient at iSmile.Steven had been avoiding the dentist’s clinic for years.When he finally made it to see me,I had to give him plenty of credit for that.Unfortunately,I couldn’t do the same for him oral health at that time.

I took some pictures,encouraged him to beef up his oral hygiene and did quite a thorough cleaning for his teeth.I also taught him to floss his teeth correctly.

Well,when I reviewed him a month later,there was tremendous improvement.This time,he really deserved much credit!


When Steven first came to see me………….and a month after.

I must say that there is so much more motivation on Steven’s part to keep his teeth clean and more importantly,his gums healthy.Gum disease,also known as periodontitis,is increasingly becoming a rampant disease and widely linked to many systemic diseases ie heart disease and diabetes,to mention a few.More about that later.

Steven has also written a very animated testimonial for me which I am putting on this blog,with his permission.It brought a huge smile to my face when I first read it.Here it is.

The question about which part of the body is more important; the ear shall not tell the mouth that I am more important; in the same way the eye shall not tell the nose that you are not important, each part depends on one another for a integrated effort to keep the body alive and healthier.

How about my teeth?
I must confess that, I did not understand the basic principle on what I need do.
In the past I was always skeptical about making an appointment with the dentist.I still remember the pain, blood and the sound from the grinding and polishing …

Definitely  not a good idea to go to a dentist, what you get is a lot of pain, complaints about my teeth being in a very bad condition etc, and after which I still need to pay the dentist for making me feel bad and telling me all the bad news…….

In the past I mistreated my teeth without love and used them like a slave worker, with my command each of them cannot refuse to work for my eating; I did not take good care of them until I was introduced by a church friend to Dr. Jean. As usual, I missed my first appointment with her and I had to reschedule another appointment.I could recall my last time seeing a dentist was more then 5 years ago, and I choose not to remember them…..
Thank God I finally repented.
I discover that Dr.Jean is different .She is most passionate about what she does and would go to great length to take away my fears.With her gentle encouragement, I began to fall in love with my teeth again, and learning all the techniques to brush and floss my teeth…still trying very hard to change and to appreciate my teeth everyday.
I am very thankful to Dr.Jean for her gentleness, In fact I do enjoy the visits to the dental clinic now compared to the past. She provides me the best music and brings a smile to my face every time I visit  “i-Smile” dental clinic… 
Prepared by Steven

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