Passionate Artistry

Systemic Connection

gum disease progressionNumerous scientific and clinical studies prove there is a direct relationship between periodontal disease and heart disease. Those individuals with periodontal disease are twice as likely to have coronary artery disease. Individuals with periodontal disease and heart valve defects usually die earlier than those without periodontal disease. A higher incidence of stroke is associated with poor gum health. Diabetics are at increased risk from their disease if they also have periodontal disease. Respiratory ailments increase with periodontal disease.

In other words, if you have periodontal disease you had better learn how to control it or you will be shortening your time with the rest of us. We would like your company, so why not learn to control this insidious disease? To do so, it’s important to understand a little bit about the disease.

For years we have focused on elimination of periodontal disease as a way to keep your teeth for the rest of your life. By controlling the disease you will reduce your risk for gum abscesses, extractions, costly replacement bridgework and the emotional and physical problems associated with dentures. You are also likely to live longer with reduced medical expenses.

The same bacteria present in periodontal disease affect your heart. The main route for many bacteria to enter your blood stream is through the blood vessels that line the pockets around your teeth. You may further research how this may evolve into additional diseases by visiting the American Academy of Periodontology’s website.

Periodontal disease is caused by the presence of a combination of disease-causing bacteria that flourish in the pockets between your gum and your teeth. In order to flourish, they must be consistently present. If all disease-causing bacteria (pathogens) are removed (for instance, during a dental cleaning), the disease takes many months to re-establish. If pockets remain, however, the disease is sure to re-establish itself completely within two to three months. If the pockets are eliminated, the disease will take much longer to reestablish itself, however, patients who have had the disease are prone to re-infection. These facts are responsible for the theory behind any treatment of periodontal disease.

Periodontal disease may be treated by some or all of these:

  1. Removing all materials from the tooth that enable the pathogenic bacteria to survive. This is done with root planing and scaling.
  2. Medicating the pockets with anti-bacterial solutions. This is done by injecting solution under the gum immediately following dental treatment, with home mouthwashes, and with placement of timed-release antibiotic fibers in the pocket spaces.
  3. Disinfection or sterilizing the base of pockets with a low energy laser. This generally requires no anesthesia.
  4. Meticulous home care, including brushing, flossing and use of other implements recommended by your dentist or dental hygienist.
  5. Removal and replacement of any dental restorations that do not have a perfect fit with the tooth.
  6. Surgical reduction of any pocket depths that cannot be maintained in health.
  7. Elimination or reduction of risk factors, including smoking (especially in combination with alcohol), chewing tobacco and stress.
  8. Regular visits for periodontal dental hygiene care…effective maintenance usually requires visits at three-month intervals or less. The recommended intervals may be increased when disease is controlled with excellent home care.

Although periodontal disease can be frustrating, there are effective ways to treat this disease. Patients who did not respond to treatment in decades past are much more likely to succeed today. It is reassuring to know that help is possible. There is a pattern to the failures. Experienced dentists understand these patterns and can help assure your success in combating the disease.

Dentists certainly contribute to the problem, patients contribute to the problem and insurance companies contribute to the problem. Together, these groups contribute to INCOMPLETE TREATMENT. If we address each of these contributions, you may see how you can avoid being the victim. You can have a healthier mouth with stronger teeth, fresher breath, and healthier heart that will help you live longer.

Poor Oral Health – The Dentist’s Contribution

Most dentists recognize periodontal disease, but many do not treat the problem well. Dentists may fail to provide complete recommendations and treatment.

  1. Dentists are rewarded with a “job-well-done” feeling when they restore teeth. Eliminating periodontal disease is a long-term proposition…there are no instant cures.
  2. Some dentists may not enjoy or many not want to take the time to go through the educational process with their patients.
  3. Some dentists are accustomed to going along with insurance benefits, even when these benefits are not in the interest of the patient’s best health.
  4. Some dentists are not competent in treating all aspects of periodontal disease or they may be uncomfortable with referring to a specialist.
  5. Some dentists may want to provide higher fee generating services first.

Poor Oral Health – The Patient’s Contribution

Patients are unaccustomed to periodontal disease and many do not understand the nature of the disease and its affect on their overall health. Some patients may have a hard time trusting the dangers of a disease they cannot see or feel. Additionally, many patients may be dental-phobic, having fear of treatment itself, the immediate costs associated with treatment, or sensitivity following treatment.

Poor Oral Health – The Insurance Company’s Contribution

By limiting benefits to “twice a year” and not covering some of the newer techniques, insurance companies control their own expenses at the cost of the insured’s overall health. This is starting to change as insurance companies recognize that they will have higher health care costs later if oral health isn’t addressed now.

Many health care professionals now recognize that we don’t strive for healthy gums just for the sake of your mouth and smile. There are increased risks of coronary artery disease, diabetes, pre-mature childbirth and other systemic diseases in those patients with periodontal disease. Your dentist and dental insurance companies are starting to take pro-active steps to recognize, treat and provide coverage to assist you in eliminating this risk to your systemic health. You can expect some dentists to work in conjunction with your physician to assess your risk. This may include tests, such as a C-reactive protein screening, which is one of the best tests to determine the degree of inflammatory disease associated with your circulatory system. Look for a professional who will help you achieve complete health.

By reading this article, you are taking a most important step in getting your own disease under control. You can take these specific actions to ensure your periodontal and general health:


  1. Ask your dentist or hygienist if they have any other materials for you to read regarding periodontal disease. Education is great medicine.
  2. Insist on instruction and review regarding your own dental care. Being told to “brush and floss” is not enough.
  3. Tell your dentist and his staff that you want to be treated for health, not just to receive your insurance benefits. Plan on and be willing to pay the little extra out of your pocket to stay periodontally healthy. This is your best insurance.
  4. Always remember that the ill effects of periodontal disease are not reversible. We cannot grow gums back or fix your damaged heart valves. Prevention and early interceptive treatment are the best medicine.
  5. If you are fearful or concerned about after-treatment sensitivity or appearance, talk to your dentist about your concerns. There are new and effective ways to manage these issues.

If you would like to learn more about the dental procedures and treatments performed by cosmetic dentists Dr. Rob Strain, DDS  and Dr. Laura Wittenauer, DDS please call us at 760.568.9494 or click here. Serving new patients in Rancho Mirage, Palm Springs, Palm Desert and surrounding areas.

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