Local Dental Care - Gum Swelling

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

Gingivitis - Everything You Need To Know

Gingivitis is the most common periodontal disease, affecting 90% of the population. It is an infection of the gums caused by bacteria that form plaque.

In small amounts (when it is newly formed), plaque is invisible and relatively harmless. But when left to accumulate, it increases in volume and the proportion of harmful bacteria grows. These gingivitis bacteria release toxins that result in inflammation of the gum tissue and bad breath.

Eventually, the plaque hardens and forms hard deposits called calculus or tartar. If not properly treated, gingivitis may progress to periodontitis, a periodontal disease in which there is loss of the bone that supports the teeth.

Signs of Gingivitis

Gingivitis can be identified by red or swollen gums. In some circumstances, the gingivitis can cause bleeding gums when brushing or eating, and there may be bad breath. To diagnose gingivitis, a dentist may probe gently under the gums. In healthy gums, there should not be any bleeding with this gentle probing. A bleeding gum indicates that there is gum inflammation or gingivitis.

Who's At Risk for Gingivitis?

Certain people are more susceptible to gingivitis. Stress, smoking and poor nutrition can contribute to the development of gingivitis. Certain medications such as steroids, heart medications, cancer therapy drugs, anti-epilepsy drugs, and anti-depressants also increase the risk for gingivitis.

In the presence of plaque, these medications can lead to gum overgrowth. The enlarged gums can further interfere with oral hygiene, precipitating a vicious cycle of further gum enlargement.

Changes in female hormones can also increase the vulnerability to gingivitis. Adolescent women, pregnant women and women who take hormone replacement or birth control pills also have a greater risk of developing gingivitis.

There are several systemic illnesses that are associated with gingivitis. These include

• acute leukemia
• Addison's disease
• diabetes
• hemophilia
• immunodeficiency diseases (including HIV)

The swelling and redness of the gums may be disproportional to the amount of plaque present. To prevent further complications, meticulous plaque control is critical for people with these illnesses.

Gingivitis Treatment

For gingivitis treatment, the bacterial plaque and tartar have to be removed from the surfaces of the teeth by a dentist or hygienist. Then, the factors that contribute to plaque retention have to be altered in order to facilitate oral hygiene procedures.

This can involve re-shaping existing restorations or even moving teeth with braces so that they are not crowded. Essential to the success of the gingivitis treatment is the person's ability to control plaque build-up after initial treatment. Daily brushing and flossing are key to gingivitis prevention and helps prevent bad breath.

If there is a lot of gum inflammation, if the gums are very sensitive, or if there is a lot of tartar buildup, it may be necessary to numb the gums in order to remove the buildup of bacteria underneath the gum margins. If the gum is very inflamed and swollen, it may be necessary to remove some of the excess gum tissue surgically.

Gingivitis is reversible, and with proper gingivitis treatment and maintenance, it can be controlled. However, untreated gingivitis can result in gum defects, bone loss around the teeth, and eventual tooth loss and systemic complications. The best way to prevent gingivitis is by brushing and flossing daily, and by visiting the dentist for a routine cleaning and an examination at least every six months.

By Laura Minsk, DMD