To Floss or Not To Floss

Post by: Gerarda on 23 Feb 2022

A common question we hear at Stockholm Dental is, “Do I really need to floss, or is brushing enough?” Unlike many things in life, flossing isn’t a mere suggestion; it’s actually an integral part of good oral hygiene, therefore, an indispensable part of your daily routine.

The purpose of flossing is to remove plaque and food particles from tight spaces between your teeth and hard to reach places. Flossing helps to keep your gums protected from bacteria which can cause periodontal disease. Flossing also keeps your teeth free of decay and your smile white.

The purpose of daily flossing is not only to promote healthy teeth, it further contributes to your health in other ways. There is increasing evidence linking periodontal disease to an increased risk of heart disease and an increase of inflammatory substances in the blood. (See blog post Jan 11, 2022)

Teeth brushing alone may not protect you from gum disease and subsequent tooth loss in extreme cases; however, adding flossing to your daily routine helps improve the health of your gums which in turn prevents gums from bleeding and feeding bacteria which causes tooth decay.

The American Dental Association has recommended flossing since 1908 and that recommendation hasn’t changed. Make the most of your oral care routine.

Don’t skip the flossing.

Link Between Gum Disease and Systemic Conditions

Post by: Gerarda on 11 Jan 2022

Many of the patients who sit in our chair suffer from some form of gum disease. Some of those patients may also have an increased risk for developing, or may already have a systemic condition. A systemic condition is one that affects the entire body and not just a particular organ or body part. For example, systemic conditions can be high blood pressure, cardiovascular disease, diabetes, rheumatoid arthritis, lupus, kidney disease, anemia or bleeding disorders to name a few. Most likely patients are unaware that there is a link between gum disease and systemic conditions and this article will address this.

Gum disease is prevalent among many adult patients. The World Health Organization Europe (WHO) has found that severe periodontal (gum) disease can be found in 5–20% of middle-aged (35–44 years) adults and up to 40% of older individuals (65–74 years). Gum disease is also a major contributor to the loss of natural teeth. The Centers for Disease Control & Prevention (CDC) estimates that in the U.S. approx. 47% of adults over 30 years old have gum disease, as well as 70% of adults over the age of 65. It is not just a European phenomenon.

For more than 20 years, the U.S. Surgeon General has recognized the link between periodontal disease and other systemic conditions such as cardiovascular disease, stroke, and diabetes; additionally, it found an increased risk for adverse pregnancy outcomes.

Research conducted by The American Dental Association (ADA) likewise found a link between gum disease and serious systemic health conditions. They say their data is clear and suggests two possible explanations1:

  1. Chronic inflammation in the oral cavity could increase bloodstream inflammatory markers that affect the patient’s immune response or increase the patient’s burden of inflammation.
  2. The oral cavity collects pathogenic bacteria that infiltrate the bloodstream and affect other parts of the body or systemic pathologies.

The American Dental Association (ADA) also suggests that gum disease and other conditions share common factors such as poor diet and smoking that increase the risk for disease. To date though no research has provided a direct link to the cause between gum disease and systemic health conditions. Neither have they proven that if a person receives treatment for gum disease that it will avert any health condition or prevent any progression of systemic conditions.2

The importance of good oral hygiene at home cannot be understated, but in conjunction with ending your smoking habit, exercising on a daily basis along with a balanced diet. This will not only keep your teeth healthy, but could have a major impact on your body as a whole.

 

References

  1. Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91(10):914 -920. doi:10.1177/00220345124573732.
  2. Oral-systemic health. American Dental Association. September 23, 2019. Accessed January 3, 2022. https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/oral-systemic-health

Tooth Enamel Erosion and How to Prevent it

Post by: Gerarda on 19 Apr 2021

Even though you have the body’s hardest tissue covering your teeth, enamel, it is still very susceptible to damage especially from crunching or grinding hard substances, consuming acidic drinks, or chipping from opening a bottle with your teeth or biting your fingernails.

Enamel covers the crown of a tooth and is the only part visible outside the gum. Enamel serves a function of protection, providing a layer of insulation against temperatures and chemicals. If you have a tooth that has eroded you can have sensitivity for hot or cold when eating and drinking. Breathing cold air or eating sweets can also give you that same sensitivity. Once the tooth has eroded it leaves openings for the sensitivity to get through to the layer of tooth that contains the nerve fibers.

What causes tooth enamel erosion?
Eating too much food or drink containing sugar and acids erodes the enamel on teeth. Normal bacteria in your mouth thrive on sugar and unless you maintain good oral hygiene, bacteria are left to feed on the sugar which wreaks havoc on your teeth.

Tooth enamel erosion can be caused by the following:
• Soft drinks & fruit drinks
• Sour foods or candies – any food that tastes sour indicates the presence of an acid
• Foods high in sugar and starches – bread, pasta, rice, couscous, potatoes, breakfast cereals, oats and other grains
• Bulimia or alcoholism – frequent vomiting can erode the tooth enamel
• Dry mouth or low saliva flow (xerostomia)
• Environmental conditions – grinding (bruxism), wear and tear, stress
• Abrasion – brushing your teeth too hard or using a hard toothbrush
• Acid reflux disease (GERD) or heartburn
• Gastrointestinal problems
• Medications (antihistamines, aspirin, vitamin C)

How to avoid tooth erosion?
• Limit the amount of acidic food and drink you consume. If you are having a soft drink or fruit juice then have a glass of water or milk after to rinse your mouth or eat a piece of cheese.
• Drink water throughout the day.
• Use a soft toothbrush.
• Use fluoride toothpaste.
• Get treatment for any health conditions.
• Ask your dentist about sealants or dental bonding to prevent tooth erosion.

What to do if I have tooth erosion?
The tooth needs treatment in the form of tooth bonding or depending on the amount of tooth substance lost, it may need a veneer or a crown to protect it from further damage.

The Teeth & Kidney Connection

Post by: Gerarda on 15 Mar 2021

March is National Kidney Month, a time when people take part in activities to raise awareness about kidney disease. While this year’s focus is on “taking charge of your health and the many factors that go into managing your kidney disease”, my focus is on teeth and kidney disease.

Despite the fact that chronic kidney disease (CKD) affects 1.7 million people in Europe and 37 million people in America, it is often overlooked until symptoms appear. By that time it is usually very advanced. CKD is progressive and can put a person at risk for other serious health complications including heart disease, stroke, high blood pressure, anemia, weak bones and of course kidney failure.

Although good dental care is important for everyone, it is especially so for people with kidney disease.

Cavities and gum disease are chronic bacterial infection. It is essential for everyone to have these treated, but even more so for someone with kidney disease. If left untreated oral bacteria and inflammation don’t stay in the mouth, but travel throughout the body, especially if you have a weak immune system. Chronic infections create continuous inflammation which is especially harmful to people with kidney disease.

Along with screening for all types of infections, even a dental check-up is required for any person being evaluated for a kidney transplant. That is how important infection and inflammation are to the transplant process. If problems are identified during the examination, the kidney transplant will be delayed or even cancelled depending on the severity of them.

It is important to remember what might start out being a minor infection for a healthy person could become a major problem for someone with kidney disease. Infections in the body that are normally helped by the body´s natural healing system of inflammation cause serious harm in CKD patients who have prolonged or chronic infection. Anti-rejection medication used after a transplant weakens the body´s defenses against infection.

If you have kidney disease, are on dialysis, have had a kidney transplant or in the screening process, it is important that you tell your dentist.

The Bitter Truth of Lemons

Post by: Gerarda on 10 Mar 2021

The biggest delinquent in tooth erosion (loss of tooth enamel) is acidic drinks. People are constantly being told that drinking the juice of a lemon the first thing in the morning is a great detox for the liver or the gastrointestinal tract. What you are not told is the fact that lemon is a highly acidic food. While lemon might be good for your digestive system and a good source for Vitamin C it is not good for your teeth.

If you must drink lemon juice, drink it with 250ml of warm water (not hot) to lessen the acidity. After drinking the lemon water, rinse your mouth with water immediately. This removes any acid that may remain on the tooth surface and reduces the acidity of your saliva.

DO NOT brush your teeth for at least 30 minutes after drinking the lemon water.

Use a soft toothbrush with a fluoride toothpaste (fluoride strengthens tooth enamel) and brush gently. The acid in the juice softens tooth enamel and makes it more prone to erosion during brushing.