Studies have shown that gum disease, missing teeth and other signs of poor oral health, as well as poor brushing habits and lack of plaque removal, increase stroke risk. According to the American Stroke Association, stroke is the number 5 cause of death and a leading cause of disability in the United States. Previous research has also found that gum disease and other oral health concerns are linked to heart disease risk factors and other conditions like high blood pressure.

“What hasn’t been clear is whether poor oral health affected brain health, meaning the functional status of a person’s brain, which we are now able to understand better using neuroimaging tools such as magnetic resonance imaging or MRI,” said study author Cyprien Rivier, M.D., M.S., a postdoctoral fellow in neurology at the Yale School of Medicine in New Haven, Connecticut. “Studying oral health is especially important because poor oral health happens frequently and is an easily modifiable risk factor – everyone can effectively improve their oral health with minimal time and financial investment.”

Just as healthy lifestyle choices impact the risk of heart disease and stroke, they also affect brain health, which includes one’s ability to remember things, think clearly and function in life. Three in five people in the U.S. will develop brain disease in their lifetime, according to latest estimates from the American Stroke Association, a division of the American Heart Association.

Between 2014 and 2021, researchers in this study analyzed the potential link between oral health and brain health among about 40,000 adults (46% men, average age 57 years) without a history of stroke enrolled in the U.K. Biobank. Participants were screened for 105 genetic variants known to predispose persons to have cavities, dentures and missing teeth later in life, and the relationship between the burden of these genetic risk factors for poor oral health and brain health was evaluated.

Signs of poor brain health were screened via MRI images of the participants’ brains: white matter hyperintensities, defined as accumulated damage in the brain’s white matter, which may impair memory, balance and mobility; and microstructural damage, which is the degree to which the fine architecture of the brain has changed in comparison to images for a normal brain scan of a healthy adult of similar age.

The analysis found:

• People who were genetically prone to cavities, missing teeth or needing dentures had a higher burden of silent cerebrovascular disease, as represented by a 24% increase in the amount of white matter hyperintensities visible on the MRI images.
• Those with overall genetically poor oral health had increased damage to the fine architecture of the brain, as represented by a 43% change in microstructural damage scores visible on the MRI scans. Microstructural damage scores are whole-brain summaries of the damage sustained by the fine architecture of each brain region.

“Poor oral health may cause declines in brain health, so we need to be extra careful with our oral hygiene because it has implications far beyond the mouth,” Rivier said. “However, this study is preliminary, and more evidence needs to be gathered – ideally through clinical trials – to confirm improving oral health in the population will lead to brain health benefits.”

The analysis was limited by the fact that the UK Biobank includes only people who reside in the U.K., and they are predominantly of European ancestry (94% of the U.K. Biobank participants reported their race as white vs. 6% reported as mixed, Black British, Asian British or other). In addition, more research among people from diverse racial and ethnic backgrounds is needed.

American Stroke Association, a division of the American Heart Association, Stroke Council member and volunteer expert Joseph P. Broderick, M.D., FAHA, a professor at the University of Cincinnati Department of Neurology and Rehabilitation Medicine and director of the University of Cincinnati Gardner Neuroscience Institute in Cincinnati, Ohio, said while the study results don’t demonstrate that dental hygiene improves brain health, the findings are “intriguing” and should prompt more research.

“Environmental factors such as smoking and health conditions such as diabetes are much stronger risk factors for poor oral health than any genetic marker – except for rare genetic conditions associated with poor oral health, such as defective or missing enamel,” Broderick said. “It is still good advice to pay attention to oral hygiene and health. However, since people with poor brain health are likely to be less attentive to good oral health compared to those with normal brain health, it is impossible to prove cause and effect. Also, genetic profiles for increased risk of oral health may overlap with genetic risk factors for other chronic health conditions like diabetes, hypertension, stroke, infections, etc. that are known to be related to brain imaging markers.“ Broderick was not involved in this study.

Co-authors are Daniela Renedo, M.D.; Adam H. de Havenon, M.D., M.S.C.I.; Sam Pyabvash, M.D.; Kevin N. Sheth, M.D.; and Guido J. Falcone, M.D., Sc.D., M.P.H. Authors’ disclosures are listed in the abstract.

The study was funded by the American Heart Association through the Bugher Center for Hemorrhagic Stroke Research Network (AHA grant #817874). U.K. Biobank data were accessed using project application 58743.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.

Because of their age, older adults are more likely to develop dental diseases, and their health complications may make access to dental services more difficult. As a result, maintaining good oral health is critical, and this article will show you how. Let us investigate.

1. Educate Older Adults About Risk Factors for Poor Oral Health

Advancing age puts many seniors at risk for several oral health problems, such as:

Periodontal Disease

Periodontal disease refers to the infectious disease that damages your gum and can permanently destroy your jawbone. The most common risk factors for periodontal disease are smoking and poor oral hygiene. In the early stages of the disease, it’s called gingivitis, and it can make your gums swollen red which may further lead to bleeding. Some of the warning signs that you must notice for Periodontal disease are listed below:

• Swollen Gums
• Bleeding Gums
• Loose and Sensitive teeth
• Bad breath
• Change the fit of your dentures
• Change in the way your teeth react while eating food
• Painful chewing

Tooth Decay

Tooth decay happens when plaque starts building on your teeth due to bacteria and harms your enamel, along with causing cavities in your mouth. Many people with tooth decay notice changes in their teeth’ color, and in some places, they can see a black spot. Tooth decay is caused in seniors due to poor dental hygiene and a dry mouth that is usually seen because of the side effects of some medicines. You should also remember that certain spots can be difficult to brush when you have overlapping teeth. You’ll require Adult Braces to correct the overlaps.

Heart Disease 

Gum disease usually causes inflammation, and that’s known to increase the risk for heart diseases. A study also proves that Gum Diseases can also make your heart condition worse, increasing the risk of a stroke.

Dry Mouth

Dry Mouth refers to the condition in which a person has a reduced saliva flow, and the glands in your body don’t make enough saliva to keep your mouth wet. Dry mouth is usually caused by cancer treatments, diseases, and medication side effects in older adults.

Orofacial Pain

Orofacial Pain refers to the pain that is felt in your mouth, jaws and the face. When a person has orofacial pain, his ability to chew and eat food gets poorly affected. Such pain is usually caused due to trigeminal neuralgia, postherpetic neuralgia, headache, and arthritis.

Oral cancer

Older adults who smoke cigarettes and cigars, chew tobacco and consume alcohol are at a higher risk of developing oral cancer. Going for a regular dental checkup can help you to detect the problem in its early stages.

Oral Thrush 

Diseases and medications that affect your immune system result in the overgrowth of the fungus Candida albicans in the mouth, and when that happens in the mouth, it leads to oral thrush in men.

2. Encourage Elderly Dental Care

It is even more important as you get older to take care of your teeth and dental health. As a result, here’s a list of dos and don’ts for maintaining good oral health.

 DOs:

• Brush your teeth with fluoride toothpaste every day.
• If you have symptoms of dry mouth, try to see your dentist and chew xylitol-containing gum to increase your saliva production.
• Regularly floss your teeth.
• Visit your dentist for a dental cleaning. Make an appointment with your dentist at least twice a year.
• If you suspect you have gum disease, consult your dentist about using a chlorhexidine-containing mouthwash.
• If you have trouble brushing your teeth, use an electric toothbrush.

DON’Ts:

• Don’t start smoking or chewing tobacco.
• Make certain that you have control over your alcohol consumption.
• Request that your doctor recommends medications that do not reduce saliva production.
• Consume no foods with a high sugar content, particularly candies.

3. Dentist Might Ask Some Questions If you Are An Older Adult

 If you are an elder adult who is going for a dental exam, then your dentist might ask you the following questions:

• Details about your last dental visit along with its reasons.
• If you have noticed any pain or discomfort in your mouth.
• If you have any sensitive or loose teeth
• If you had difficulty eating some foods

Once your dentist knows the answers to these questions, he will examine your face, mouth, and jaw to check for problems. If you wear dentures, your dentist may also ask you about their overall fit to check if they require any work. Lastly, they will look for any irritation or discomfort problems that you have in your mouth.Conclusion:Elders need to get proper dental care, especially when they notice changes in their oral health, including bleeding, pain, loose teeth, or soft-tissue lesions that aren’t healed and are easily noticeable. It would be best to refer the patient to a dental specialist in situations like this. Routine dental monitoring may help reduce the incidence of many systemic conditions, including cardiovascular disease, diabetes, and pneumonia.

Author Bio:

Dr. Satish Pai is an orthodontist and Ivy League trained dentist who has served as a faculty at Columbia University. He believes a perfect smile not only makes a person look great but feel great. As the founder of Putnam Orthodontics and a Partner at Brite Orthodontics, he is dedicated to providing the best orthodontic treatments to his patients. He also writes to educate people about everything orthodontics and the importance of correctly aligned teeth along with good oral health. In his free time, you can find him golfing, doing yoga or surfing, and spending time with his family.

Smoking conventional cigarettes is a known risk factor for the development of gum disease, or periodontitis. Part of this risk is driven by changes in the bacterial communities that normally live in the mouth, called the oral microbiome. But whether e-cigarettes induce similar changes hasn’t been well understood.

According to an NIH news release written by Sharon Reynolds, a team led by Drs. Deepak Saxena and Xin Li from New York University examined 84 volunteers over a six-month period: 27 people who smoked conventional cigarettes, 28 who used only e-cigarettes, and 29 nonsmokers. All participants had at least mild gum disease at the start of the study. To reduce other factors that could affect the oral microbiome, the release says, none had their teeth cleaned during the study period.

At the beginning and end of the study, Reynolds writes, the team compared the types of bacteria found where the gums meet the teeth at the beginning and end of the six-month study. They also compared markers of inflammation and immune cell activity.

The study was funded in part by NIH’s National Institute of Dental and Craniofacial Research (NIDCR). Results appeared on February 22, 2022, in mBio.

The number of unique bacterial species—a measure called alpha diversity—living in and around the gums increased for all participants during the study. This can be a sign of gum disease getting worse.

The specific types of microbes found in the oral microbiomes differed substantially between the three groups. There was a core set of species common among the groups, the NIH says, but each also had unique features. They were so distinct that a machine-learning program could use the oral microbiome to predict which group people were in with 74% accuracy.

However, the program was least accurate at picking out e-cigarette users. The patterns of their oral microbes shared characteristics with both smokers and nonsmokers, with slightly more similarities to smokers. Unique traits among e-cigarette users included enrichment with Fusobacterium and Bacteroidales species. Both of these are linked with gum disease.

Several markers of inflammation and immune response were also higher in smokers and e-cigarette users than in nonsmokers. But again, these patterns differed between smokers and e-cigarette users.

“We are now beginning to understand how e-cigarettes and the chemicals they contain are changing the oral microbiome and disrupting the balance of bacteria,” Saxena says.

More work will be needed to better understand how e-cigarette use alters the oral microbiome and potentially affects gum health and disease.

Clearly, these are all good reasons to exercise consistent oral care, yet many people do not for a variety of reasons.

It’s not just teeth and gums; your whole body can be at risk if you let your dental health go. But too often adults, and especially parents, have put themselves last, including in regard to their own dental care, which they might see as cosmetic and not an immediate necessity.

As they age and neglect their teeth and gums more, their oral health worsens and it can definitely correlate with overall health issues. We’ve got to get more people learning how to take care of their teeth as they would their bodies.

Here’s how to get to the root of the self-oral care problem:

Prioritize your oral care.

That starts with recognizing behaviors that undermine self-care, or in effect, people putting themselves last. Parents just get caught up in their daily family life. When it isn’t family, it’s work. Self-care takes a back seat to everything else. Sometimes, this self-neglect stems from negative behavior patterns that began in childhood due to how they were raised. Perhaps a parent abandoned them, they were deprived emotionally, or they felt like a failure. Understanding and correcting those behaviors can help make dental care an important part of one’s improved self-image.

Regular brushing and flossing.

People with good oral hygiene spend less on health care overall. While brushing and flossing well should be obvious, people would be amazed at how much better their teeth and gums would be if they simply adhered to a daily oral-hygiene regimen. Proper brushing and flossing can turn back the clock on gum disease. Oral hygiene has a direct impact on the mouth’s microbiome, which is the balance of organisms that keep decay at bay. Without good oral hygiene, the mouth is at risk for developing periodontal disease — the leading cause of tooth loss in adults.

Commit to a healthier diet.

Excess sugar is one of the primary culprits of plaque, a sticky deposit on the teeth in which bacteria proliferate. Bad bacteria in the mouth feed off sugar and are the primary drivers of oral problems. Without eating healthier foods and having good levels of vitamins and minerals in the body, good bacteria turn to harmful, which leads to tooth decay.

Stick with the program.

Dental treatment alone offers no guarantees for the long term. The patient is the key person in the whole process. Successful outcomes rely on the patient to be a member of the care team. That means being open to being educated and following through with the dentist, and also it means what they’re doing outside the dentist office is just as important.

Your teeth are meant to be with you for life. And how you take care of them, and your gums, could go a long way toward dictating how long, and with what kind of quality, you live.

Dr. R. Craig Miller (https://drrcraigmiller.com), author of Get Back Your Smile, Take Back Your Life, is a dentist who offers general, cosmetic, restorative, and surgical services. He is on staff at Saint Barnabas Hospital in Livingston, N.J., and at Newark Beth Israel Hospital in Newark, N.J., where he teaches dental residents restorative, implant, and advanced cosmetic dentistry, along with dental sleep medicine. He earned his Doctor of Dental Medicine degree (DMD) from The University of Medicine and Dentistry of New Jersey, now known as the Rutgers School of Dental Medicine.

That point was established according  to a presentation at the American College of Cardiology Middle East Conference 2019 together with the 10th Emirates Cardiac Society Congress. The conference was early in October in Dubai, United Arab Emirates.

Cardiovascular disease is the No. 1 cause of death of men and women in the United States, and previous studies have linked cardiovascular disease with oral disease. Oral disease is an inflammatory disease that frequently causes tooth loss due to the breakdown of periodontal tissue.

The causal association between oral disease and cardiovascular disease is not well known, so researchers in this study conducted a secondary analysis of the 2014 Behavior Risk Factor Surveillance System that looked at tooth loss not caused by trauma, as well as cardiovascular disease, including heart attack, angina and/or stroke.

Clinicians should recommend that people older than 40 receive adequate dental care.

The study included 316,588 participants from the United States and territories between the ages of 40-79. Overall 8 percent were edentulous (had no teeth) and 13 percent had cardiovascular disease. The percentage of people who had cardiovascular disease and were edentulous was 28 percent, compared to only 7 percent who had cardiovascular disease but did not have missing teeth.

In addition to edentulous participants, those who reported having one to five missing teeth or six or more, but not all, missing teeth were also more likely to develop cardiovascular disease, even after adjusting for other factors such as body mass index, age, race, alcohol consumption, smoking, diabetes and dental visits.

“Our results support that there is a relationship between dental health and cardiovascular health,” said Hamad Mohammed Qabha, MBBS, lead author of the study and Chief Medical and Surgical Intern at Imam Muhammad Ibn Saud Islamic University. “If a person’s teeth fall out, there may be other underlying health concerns. Clinicians should be recommending that people in this age group receive adequate oral health care to prevent the diseases that lead to tooth loss in the first place and as potentially another way of reducing risk of future cardiovascular disease.”

Yet while orthodontists say there’s plenty of hope for adults to get their teeth straightened by braces, having a lot of other dental work done in advance — and spending a lot of money in the process — may be a big mistake in some cases.

If you are an adult about to invest in major dental work, you should definitely consider seeing an orthodontist for a consultation first. Certain kinds of major dental procedures, which the patient thinks will clear the way for braces, may actually reduce the effectiveness of them.

Here are some examples of dental work that may be best to wait on until after orthodontic treatment:

• Bridges and implants 

  If you have unfortunately lost one or more of your permanent teeth and are now in need of prosthetic replacements such as dental bridges and implants, please know that these cannot be moved by braces. Before you get an implant or bridge, take a good look in the mirror and ask yourself if you will ever want to get your teeth straightened or fixed. Once your implant is in, you may not be able to correct your bite orthodontically since the immobility of even one implant or bridge can seriously limit the movement of the surrounding natural teeth. Additionally, if it hasn’t been long since you lost your tooth, there may be a chance that the space left from the missing tooth could be closed with braces, allowing you to avoid the implant or bridge altogether.

• Crowns

  Because a crown changes the entire shape of your tooth, it is best if a crown is done after completion of your orthodontic treatment. When a crown is made, it’s shaped so that it fits well with the surrounding teeth as well as with the teeth on the opposing jaw. But if your bite is not good, that means when you get braces later, your crown may not fit with the opposing teeth in the new, corrected bite. The crown was shaped to fit your old bite, not your new bite. Depending on the situation, you may be able to get either a large filling or temporary crown on your tooth to hold you over until your orthodontic treatment is complete.

• Teeth-whitening

  Stained teeth can make patients feel insecure about their smile, and that is one reason why teeth-whitening is such a popular procedure. While there is nothing wrong with whitening your teeth without orthodontic treatment, you will definitely get a better result if your teeth are nice and straight first. Crooked or crowded teeth are often overlapping each other. Thus, the whitening agent will not be able to reach the areas of your teeth that are covered by other teeth. This results in uneven whitening and a less than optimal result.

It is never too late to get a beautiful smile, and more and more adults are discovering this each year. However, adult orthodontic treatment is different from that of children. It is important to understand what factors can affect your orthodontic treatment and your smile.

Dr. Ana Castilla is an orthodontist and the author of the book Smile of Your Life: Everything You Need to Know for Your Orthodontic Journey (castillaortho.com). Dr. Castilla is a Diplomate of the American Board of Orthodontics and is dedicated to both education and research in the field of orthodontics. Her research on indirect-bonding techniques has been published in the Angle Orthodontist journal. Dr. Castilla was born in Ecuador and grew up in the United States.

Digital dentistry allows for a wide variety of advanced techniques to be used to not only make the patient experience better, but it also allows the dentist to utilize quicker, easier and less expensive techniques. Dental dentistry advancements will continue to revolutionize many different aspects of the dental profession.

Digital dentistry incorporates computer-controlled components to carry out dental procedures rather than using mechanical or tools, or plaster tooth models. More dentists are embracing the technology because it improves efficiency, accuracy and potentially produces more predictable outcomes than non-digital techniques.electrical

Not all dentists are embracing the technology due to the significant investment required, a steep learning curve for both doctors and technicians, and a natural resistance to change, especially for those nearing retirement.

The benefits, however, are worth it, says Dr. Depew. He says the following areas are where digital dentistry is making a difference:

• Computerized patient rooms.

  The first area that most dentists start with in digital dentistry is putting computers into each patient room. This allows for a variety of state-of-the-art techniques as well as enhanced patient education.

• Digital patient education.

  This includes technologies already available in other industries, such as voice-activated and/or touch-screen computer and software instruction, live video and rapid recall of photos and educational components.

• Digital Radiography.

  X-rays no longer require film or chemicals. “The main advantages include lower radiation, significant time reduction, ease of storage and organization, and image enhancements for quick and improved viewing.

• Cone Beam CT.

  This is being quickly adopted by most specialties and becoming the proposed standard for diagnosing of a myriad of conditions; and for planning surgical procedures, including implant placement, third-molar removal, and endodontics. “Future advances and changes will see improved software diagnostic capabilities to automatically take measurements and propose implant positions, and algorithms that automatically look for problems.

  

• Intra-oral Scanning.  

  Instead of the gooey impressions, the dentist puts a wand in your mouth that makes a three-dimensional reproduction of your teeth. “Scanning teeth and preparations is becoming increasingly easier and faster.

• Digital Design.

  Using special CAD/CAM software the doctor and laboratory use the data from the methods mentioned above to design aligners for tooth movement, crowns, and other oral appliances.

• 3D Printers.

  Designing software, tooth models and even appliances can be printed instead of using outdated plaster models.

• Lasers.

  Diode lasers allow for advantages in simplifying surgical procedures, and an expanding use in many dental procedures make this area of digital dentistry highly desirable. The current trend is small, portable, cordless, low-cost diode lasers.

Combining these technologies, our treatments can be faster, more economical, predictable, consistent, and even more accurate. I believe digital dentistry is already changing the dental profession and that it will lead to even more remarkable technological advances in the future.

Dr. Doug Depew (https://www.depewsmiles.com) has maintained a thriving orthodontic practice in Kennesaw, Georgia since 1990. He graduated Magna Cum Laude from the University of Georgia and received his dental degree from the Medical College of Georgia where he graduated at the top of his class. His certificate in orthodontics and his master’s degree was earned from Baylor College of Dentistry at Baylor University. Dr. Depew is also the founder and Academic Director of Trapezio, which provides formal training for orthodontic staff members. This innovative program is endorsed by the American Association of Orthodontists and is recognized internationally as the standard for training and certification of orthodontic staff members. He is an active member in of the American Association of Orthodontists, the Southern Association of Orthodontists, and the Georgia Association of Orthodontists, the American Lingual Orthodontic Association, the Spear Dental Study Club, and the Elite Lingual Orthodontic Society.  Dr. Depew and his wife, Vicki, have three children and four grandchildren.

When it comes to our teeth, though, we aren’t always as conscientious about following maintenance schedules – and our oral health suffers as a result.

Every child and every adult should be given an operator’s manual for dental care. Too many people have no idea how to maintain good dental health.

It makes a significant difference when they do For example, parents who have a history of good dental care usually pass that knowledge on to their children.  But unfortunately, Barakat says, parents with little or no knowledge of the proper way to care for their teeth and gums don’t have good habits to pass on – so the cycle repeats generation after generation.

WHAT AN OWNER’S MANUAL FOR DENTAL CARE SHOULD INCLUDE

If there were an owner’s manual for dental care, here are a few things Barakat believes it should include:

• Basic routine maintenance Everybody has heard about brushing and flossing, but not enough people actually floss or know the proper way to do it.  The four most common flossing mistakes are flossing too often, moving too quickly, missing both sides of the tooth and quitting at the sign of bleeding gums.
• It’s not just the mouth Too many people think dentists worry only about cavities and the smile.  In reality, the mouth can be linked to back injuries, neck injuries, headaches and a host of other issues.
• Easy fixes Just as keeping tires properly inflated is an easy fix that will prevent big problems , dentists have a few of those too.  Easy, quick and comparatively cheap fixes are available for chipped teeth, cavities, sensitive teeth care and gingivitis.
• How prevention is cheaper than correction Good dental health is frequently a pocketbook issue.  A comprehensive and frank discussion with your dentist about what your dental-health-insurance coverage is, what you can afford and what you cannot will enable you to plan for your future.

We are doing a poor job of educating the general public about good dental health and what dentists can do to improve dental health. People need to understand that preventative care works just as well in dentistry as it does in automobile care.

Dr. Ami Barakat, author of of Perfecting Smiles, Changing Lives (www.villanovadental.com), is a general dentist who has trained extensively in orthodontics.  He has received several prestigious awards in recognition of his talent, achievements and passion for dentistry.  He graduated from the University of Toronto Faculty of Dentistry with honors and served a one-year residency at the Royal Victoria Hospital in Montreal.  

The findings of the analysis, based on a review of medical and dental exam records of more than 3,600 people with high blood pressure, revealed that those with healthier gums have lower blood pressure and responded better to blood pressure-lowering medications, compared with individuals who have gum disease, a condition known as periodontitis. Specifically, people with periodontal disease were 20 percent less likely to reach healthy blood pressure ranges, compared with patients in good oral health.

Considering the findings, the researchers say patients with periodontal disease may warrant closer blood pressure monitoring, while those diagnosed with hypertension, or persistently elevated blood pressure, might benefit from a referral to a dentist.

“Physicians should pay close attention to patients’ oral health, particularly those receiving treatment for hypertension, and urge those with signs of periodontal disease to seek dental care. Likewise, dental health professionals should be aware that oral health is indispensable to overall physiological health, including cardiovascular status,” said study lead investigator Davide Pietropaoli, D.D.S., Ph.D., of the University of L’Aquila in Italy.

The target blood pressure range for people with hypertension is less than 130/80 mmHg according to the latest recommendations from the American Heart Association/American College of Cardiology. In the study, patients with severe periodontitis had systolic pressure that was, on average, 3 mmHg higher than those with good oral health. Systolic pressure, the upper number in a blood pressure reading, indicates the pressure of blood against the walls of the arteries. While seemingly small, the 3mmHg difference is similar to the reduction in blood pressure that can be achieved by reducing salt intake by 6 grams per day (equal to a teaspoon of salt, or 2.4 grams of sodium), the researchers said.

The presence of periodontal disease widened the gap even farther, up to 7 mmHg, among people with untreated hypertension, the study found. Blood-pressure medication narrowed the gap, down to 3 mmHg, but did not completely eliminate it, suggesting that periodontal disease may interfere with the effectiveness of blood pressure therapy.

“Patients with high blood pressure and the clinicians who care for them should be aware that good oral health may be just as important in controlling the condition as are several lifestyle interventions known to help control blood pressure, such as a low-salt diet, regular exercise and weight control,” Pietropaoli said.

While the study was not designed to clarify exactly how periodontal disease interferes with blood pressure treatment, the researchers say their results are consistent with previous research that links low-grade oral inflammation with blood vessel damage and cardiovascular risk.

###

Hypertension is estimated to affect up to 40 percent of people over age 25 worldwide.

Untreated or poorly controlled hypertension can lead to heart attacks, strokes and heart failure, as well as kidney disease. Hypertension is estimated to claim 7.5 million lives worldwide.

Red, swollen, tender gums or gums that bleed with brushing and flossing are tell-tale signs of inflammation and periodontal disease. So are teeth that look longer than before, a sign of receding gums, and teeth that are loose or separating from the gum line.

Co-authors on the research included Rita Del Pinto, M.D., PhD candidate; Claudio Ferri, M.D.; Mario Giannoni, M.D., D.D.S.; Eleonora Ortu, D.D.S., Ph.D.; and Annalisa Moaco, D.D.S., M.Sc., of the University of L’Aquila, Italy; and Jackson Wright Jr., M.D., Ph.D., of Case Western Reserve University.

Respect and common courtesy go a long way on both ends of the dentist-patient relationship. Establishing a solid relationship with your dentist opens up more lines of communication.

A healthy dentist-patient relationship comes with a variety of advantages and makes dental visits less stressful. Developing a relationship with the family dentist as not only a professional but a caring human being has a many benefits and will result in less stress, he says.

I offer these suggestions:

• Be punctual. For the patient and the dentist, the best way to start a relationship is with the common courtesy of punctuality. The patient needs to arrive on time and the dentist needs to see the patient on time. Sometimes delays cannot be helped, but an effort should be made by both parties to be on time.
• Be honest. For the patient, be honest about your expectations, your dental history (including being honest when the dentist asks if you floss regularly) and any dental issues you have had in the past that your dentist may be unaware of. The dentist needs to be honest about all the potential outcomes of the procedure.
• Be prepared. Let the dentist know what your issues and concerns are. Make sure he or she has your most up-to-date dental records and let him know if you have seen a different dentist recently.
• Express gratitude. A simple thank you can go a long way in building a relationship for both the dentist and the patient.

• When warranted, offer sincere praise. Everybody likes to hear about it when they have done a good job, even dentists.

Dentists are trained on how to work with patients, but a little mutual respect will go a long way toward making the visit to the dentist a little more enjoyable for everybody.”

Dr. Ami Barakat, author of Perfecting Smiles, Changing Lives (www.villanovadental.com), is a general dentist who has trained extensively in orthodontics.  He has received several prestigious awards in recognition of his talent, achievements and passion for dentistry.  He graduated from the University of Toronto Faculty of Dentistry with honors and served a one-year residency at the Royal Victoria Hospital in Montreal.