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Oral Hygiene, Periodontal Disease And Heart Disease

The well-known risks for heart disease include smoking, obesity, high cholesterol, and high blood pressure. Now evidence suggests that having gum disease puts you at greater risk for cardiovascular (heart) disease.

The bacterial infection that causes periodontal disease also may affect the heart. In fact, all other conditions being equal, people with periodontal disease may have twice the risk of having a fatal heart attack as people that don't have periodontal disease. By taking care of your periodontal health, you can prevent or help control one of the risk factors for heart disease.

Although the exact mechanism of infection has not been determined, it is possible that the bacteria that cause periodontal disease enter the blood stream directly through the gum tissue. This can be precipitated by normal oral activities, such as brushing and chewing, that create tiny injuries in the gum and then release bacteria into the blood stream.

The bacteria can contribute to small blood clots that clog the arteries. There also is the possibility that the inflammation caused by periodontal disease contributes to the build-up of fatty deposits inside the heart arteries and the formation of blood clots. These clots can obstruct the normal blood flow, restricting the amount of nutrients and oxygen to the heart and resulting in a heart attack.

Oral bacteria can also travel to the heart and cause an infection of the lining or valves of the heart called infective endocarditis. People with a history of rheumatic heart disease, mitral valve prolapse with regurgitation, or heart murmur associated with various heart conditions are at greater risk of developing infective endocarditis and may require antibiotic treatment before dental procedures that may induce bleeding.

These procedures include oral surgery, tooth extraction, and routine cleanings. The best way to avoid infective endocarditis is by maintaining good oral health. But if you have any of the conditions that put you at greater risk for infective endocarditis, consult your cardiologist and dentist before starting any dental treatment.

Treatment of periodontal disease may be one of the ways you can help prevent heart disease and a heart attack. With meticulous oral hygiene, daily brushing and flossing, professional cleanings, and periodontal screenings, you may help save your teeth and your life.

By Laura Minsk, DMD

Periodontal Regeneration Dentistry Treatment

Periodontal regeneration means restoring the bone and supporting tissues adjacent to teeth with advanced bone loss. Frequently, periodontal regeneration treatment will prolong the use of the involved teeth. A periodontist or dentist will diagnose the problem by taking a careful medical and dental history.

The tissues adjacent to the teeth will be gently probed with a calibrated, ruler-like instrument. These measurements, together with a dental X-ray, will help determine the appropriate treatment for the involved teeth.

There are many regenerative techniques and methods. Bone purchased from bone banks has been used effectively as a regenerative material for over 30 years. This bone is procured from healthy individuals, is carefully processed, and has been proven safe. Treatment consists of carefully moving the gum tissue away from the involved teeth and removing tarter (calculus) deposits from the root surfaces.

The bony defect is gently filled with the bone bank material (allogenic bone) or other synthetic materials. The gums are then replaced around the neck of the teeth with small sutures. The sutures are removed within five to seven days, and gentle tooth brushing can resume.

Synthetic bone substitutes have been developed to simulate natural bone. These materials are safe, and may help support the involved teeth. Such substitutes are implanted through periodontal surgery. Recently, cow bone, which is carefully prepared, sterilized, and safe, has been used to repair defects next to teeth. This bone is porous, allowing bone from the patient to grow into the pores. New technologies have developed porcine (pig) proteins, which, when painted onto teeth, allow for natural regeneration of tooth cementum and bone. These materials have demonstrated early promising clinical results.

The use of barrier membranes to protect and isolate bony defects has been used for over 15 years. These are made from synthetic, non-dissolvable materials, dissolvable materials, or bovine collagen (cow collagen). Membranes are frequently used either with synthetic graft materials or with bone purchased from bone banks. Recently, proteins have been joined to synthetic bone.

This material enhances cell attachment to root surfaces and may provide an effective method for periodontal regeneration. In the future, proteins that stimulate bone formation and enhance formation of new root cementum will make periodontal regeneration a simple, effective method to save teeth with advanced disease.

The materials discussed above have been published in dental journals, are safe, and generally result in tooth retention with bone fill of the treated bony defects. Articles relating to periodontal regeneration can be researched from PubMed using the following key words: "periodontal," "regeneration," "allogenic bone," "synthetic bone grafting," and "barrier membranes."

By William Becker, DDS