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)

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)

does flossing matter?

I really try not to give the dreaded “flossing lecture.” I really do. I believe that people should have control over their own health and if they choose not to do something, that is their prerogative.

But the more I read about the connections between gum disease and other chronic health conditions, the harder it is to keep quiet. I don’t pretend that flossing will change the world, but it might change your health.

Shortly after I began working in a dental office in the early 1970s, I discovered that my father had advanced periodontal disease. He was seeing a dentist whose only advice was “I am going to have to make you dentures in six more months.” The dentist I worked for at the time believed in prevention to his core, and it was from him that I first learned about proper home care. When I next visited my father, I taught him everything I had learned. The results were astounding, and even his dentist couldn’t believe the improvement. My father, of course, found a new dentist who also shared a preventive philosophy. And since that time, he has only lost two more teeth. One was lost because of decay on the roots (stayed tuned for more on that), and the other had tipped severely from losing the tooth in front of it due to his periodontal disease years ago.

I continue to be surprised by the number of new patients I meet who haven’t been properly taught to care for their teeth. They may have been told to brush and floss, but these are skills that must be learned and practiced. Telling simply isn’t enough. This month we have posted a brushing and flossing resource article specifically designed to teach you these skills. Even if you have been brushing and flossing regularly for years, I urge you to review this article. I cannot tell you how many people brush and floss regularly with the best of intentions, only to discover that their efforts are ineffective because of improper technique.

Obviously, the home care techniques we recommend are designed to aid in the prevention of decay and periodontal disease. But we continue to learn that controlling oral bacteria may play a role in the prevention of so much more. Recently, I read an article in the Journal of Periodontology that details research which demonstrates that many respiratory diseases may have their beginnings in the aspiration of oral bacteria and other organisms into the lower respiratory tract. Pneumonia can originate from the mouth and inflammation in the mouth seems to exacerbate COPD.

The research messages are becoming clear: To stay healthier, you must reduce the bacterial load in the mouth as much as you can. And flossing and brushing are the best first defense in this effort to control bacterial growth. You owe it to yourself to take the time every day to thoroughly clean your mouth.

Martha (Signature)