Inflammation: Friend or Foe?

As a dentist, I work with the body’s inflammatory responses nearly every day. Bacteria builds up around a tooth, and the gums swell with blood in an effort to fight the growing infection. This can happen for the simplest of reasons: a change in diet or home-care habits being the most common. But sometimes the mouth can have a more generalized reaction. Instead of inflammation developing in a single, localized area of infection, the gums swell and bleed uniformly throughout the entire mouth. Gingivitis like this may still be a reaction to too much bacteria all throughout the mouth, but sometimes gingivitis can develop even in a healthy mouth where plaque and bacteria are seemingly under control. Stress, dietary or environmental allergens and irritants, or an underlying systemic inflammatory disorder can all contribute to the development of chronic inflammation in the mouth.

Inflammation anywhere in the body is never a good sign, but in most cases it is a normal response to a physical injury, a localized infection, or an allergen. Your body is trying to help you fix the problem by sending extra blood to the area to speed healing and fight unwanted intruders. In a healthy system, this inflammation subsides as soon as balance is restored to the area: the bone is set, the infection is under control, or the allergen has been removed and processed out of the body. Sometimes, however, the body can get stuck in an inflammatory response even though the allergens, infecting bacteria, or physical injuries have been resolved. When this happens, inflammation is no longer a helpful partner in defending and healing your body. Inflammation and the immune system that triggers it are now at odds with your body – seemingly attacking otherwise healthy systems for reasons we still don’t completely understand.

What we do understand so far is that inflammatory disease anywhere in the body seems to be multifactorial in nature. Stress, diet, environment, and physical activity all seem to have a role in the progression or stabilization of nearly all chronic inflammatory conditions. Systemic inflammatory conditions also seem to have a unique relationship with inflammatory conditions of the mouth. We still don’t know if that relationship is actually causative, but the correlations between the two are extremely strong.

Inflammation, like pain, is a message from your body that something is wrong somewhere. Understanding that message can be tricky sometimes, especially when the body’s inflammatory response is the problem. To help you begin unravelling what your body may be trying to tell you, I’ve created a new resource article this month entitled Inflammatory Disease and the Mouth. It is my hope that anyone who has or suspects they may have a chronic inflammatory condition will read this article and share their concerns, questions, and self-observations with their medical and dental providers.

As always, if you are a current patient of mine, or you would like to become a patient, please feel free to call my office during our regular business hours with any questions or concerns you may have about inflammation in your mouth or a suspected inflammatory disorder.

Martha (Signature)

Exercise, Nutrition, and Your Teeth

Exercise and a healthy diet are the cornerstones of a healthy lifestyle. But being healthy is about much more than simply looking slim and fit. Many very athletic adults and teenagers believe that their boosted metabolisms allow them to eat pretty much anything they want to so long as they continue to look slim and fit. But the consequences of a poorly constructed diet on the internal systems of your body, on your teeth, and even on your athletic performance, are the same regardless of how much you weigh or how healthy you may appear on the outside.

A diet filled with excessive amounts of highly refined sugar and grains, as well as foods and beverages that are high in acid, can have equally negative effects on the teeth and bodies of extremely active people as they do on sedentary individuals over time. And when it comes specifically to the teeth, very active individuals may actually be at a higher risk of tooth decay when consuming sugary or acidic foods and beverages during workouts in order to stay fueled and hydrated.

A quick burst of energy from a gel, sports beverage, or even a candy bar, may be exactly what you need to push you through the last leg of your athletic performance or training session, but that quick energy generally comes from a highly-concentrated combination of simple sugars and caffeine. Citric acid, and other acidic flavor enhancers, are often in the mix as well. Sugar and acid in the mouth create the perfect environment for cavity-causing bacteria to multiply and thrive. And introducing these elements into the mouth during intense exercise, when the saliva flow is often compromised, leaves your teeth even more vulnerable to these bacteria and accelerated tooth decay.

Certainly, there are many preventive measures that we can all take before, during, and after exercise to help protect our teeth and our bodies from the negative effects of the concentrated forms of sugar and acid we might consume during a workout. Our newest resource article, entitled Oral Health for Athletes, outlines several adjustments you can make the way you care for you teeth and fuel your body during a workout or race in order to better protect your teeth from accelerated decay.

For everyone, regardless of your level of athleticism, the first and best preventive measure you can take in protecting the health of your teeth and your body is to eat a well-balanced diet low in sugar and refined carbohydrates, and filled with plenty of whole fruits and vegetables, lean sources of protein, some whole grains, and moderate amounts of healthy fats. A strong metabolism should never be an excuse to regularly offer your body inferior sources of nutrition. No matter how athletic any of us may aspire to be, we should all be practicing healthy dietary choices every day and teaching our children that eating well isn’t just about protecting our health today or fueling an athletic performance next week – it’s about building and maintaining a healthy foundation for a vibrant and active lifestyle for years to come.

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The Truth About Kids, Cavities, and Fluoride

This year Portland, Oregon made national headlines when the majority of voters rejected a measure to add fluoride to the city’s public water system. The debate was heated, and as a whole, the final decision was criticized by many as ill-informed and not in the best interests of our children. As a dentist, it may surprise you to know that I do not believe Portland was wrong in their decision, but my reasons have little to do with the fluoride itself.

Certainly, I am fully aware of the dental benefits that topical fluoride can provide to children and adults under the right circumstances. The scientific evidence is clear that fluoride does contribute to stronger enamel development and thus helps prevent cavities. In our modern society, however, tooth decay simply does not happen because we lack fluoride. It happens because of what we eat and how we take care of our teeth. Fluoride can be a helpful aid in the battle against decay, but it is not the cause or the ultimate solution to the problem.

Tooth decay is caused by pathogenic bacteria that live in our mouths. Everyone has this bacteria and there is no way to remove it completely without also removing beneficial forms of bacteria that live in the mouth as well. Preventing the development of tooth decay is all about controlling the numbers of these pathogenic bacteria through diet and home care (brushing and flossing).

The bacteria responsible for tooth decay thrive on sugar, refined flour, and acid. Diets high in sugar, high-fructose corn syrup, white flour, and acid are the quickest way to multiply the number of pathogenic bacterial colonies in the mouth. Sugar-sweetened beverages are especially attractive to these bacteria because they often contain high amounts of both sugar and acid.

The most common chronic condition in Oregon children is tooth decay. In 2011, the Oregon Public Health Division reported that in Oregon, more than 177 million gallons of sugar sweetened beverages are consumed each year (read report here). That amounts to approximately one gallon per week for every man, woman, and child in the state. The same report quoted a survey of Oregon mothers indicating that about half of the 2 year olds in Oregon drink sugar-sweetened beverages at least once per week.

What troubles me most about these statistics is that they do not include all the other food sources of sugar and acid in a child’s diet that also contribute to tooth decay (and childhood obesity). Fruit juice, for example, may not be sweetened with sugar but can still have the same effects on the teeth and the body. Fructose is a naturally occurring form of sugar found in all fruit and bacteria feed on it just as easily – especially when all the fiber of the fruit itself is removed during the juicing process. And certainly, when a child is drinking a sugary beverage, the likelihood that he or she is also eating a meal or treat that is high in sugar, acid and/or refined white flour is fairly high.

In the battle against tooth decay, every little bit counts, and when tooth decay in children reaches epidemic proportions, water fluoridation as a stop-gap is an option we all need to consider. But consider this as well: If a child’s diet is filled with sugars, highly-refined flours, and acid, fluoridated water is simply not enough. And if that same child also does not brush and floss his or her teeth – or they do not know how to do it correctly – then nothing (including fluoridated water) will be able to prevent tooth decay from developing.

Information is perhaps the most powerful tool there is in preventive medicine. In my continuing effort to provide relevant information on how to care for your teeth and prevent decay no matter where you live or what kind of water you drink, I have created several informational resources that I hope you will take the time to review for your own health and the health of your children.

Kids and Cavities
How to Brush and Floss Your Teeth
A Parent’s Guide to Oral Health for Kids and Teens
Drinks That Eat Teeth
A Guide to Added Sweeteners

As always, I encourage you to read and learn as much as you can from as many reputable sources as possible in order to make the best decisions possible for yourself and your family.

Martha (Signature)

Women and Oral Health

In my more than 30 years of private dental practice, I have been privileged to work with many families through three – and sometimes even four – generations. Young parents who were once new to my practice 30 years ago now have full-grown children and grandchildren of their own, many of whom are now my patients as well. Becoming ‘the family dentist’ is one of the greatest joys of my practice. It has also taught me a great deal about the different ways teeth and gums can change over a lifetime.

Men and women each experience many different health challenges that affect the health of the teeth and gums as they grow older, but women specifically experience three major transitions that can have a regular and lasting effect on their oral health. The physical changes that come with menstruation, pregnancy, and menopause each present their own unique challenges when it comes to the health of the mouth. Over the years, I have been able to help many women maintain or even improve their oral health through each of these phases. But I am continually surprised at how little many women who are new to my practice know about the interrelationships between their regular hormonal fluctuations and the health of their mouths.

This month, I have created a new resource specifically designed to help women of all ages understand these relationships better, improve their home-care regimens during major physical transitions, and recognize when it is prudent to consult with a dentist or hygienist further. I hope that you will share this resource with your friends and loved ones – and most especially with your daughters. The more we all understand about how our bodies work, the better we will be able to help and support one another – and ultimately be healthier women for it.

Martha (Signature)