Treating Pregnant Patients

Dental professionals have long worried about treating pregnant patients because the effects of oral health care on fetuses are not well understood. In 2006, the Obstetrics and Periodontal Therapy Trial was conducted through funding from the National Institute of Dental and Craniofacial Research. This study determined that providing dental and periodontal care to pregnant patients did not cause an increase in preterm births or any other significant complications. A new study followed up on the study participants and their children. Researchers administered cognitive and language tests to the children of 411 inital study participants. Study authors found that the children of mothers who received dental care during pregnancy were at the same neurodevelopmental level as the children of control group mothers, demonstrating that dental treatment of pregnant women does not result in any negative effects on their children.

The opposite effect can be true, with the increase of pre-term births and low birth weight babies among women who have periodontal disease. Therfore, it is so important to have good oral care while pregnant - so go out there and make that dental appointment to get your teeth clened.

Diet, Exercise, and Immune Function Among People with Obesity

Scientist at the Boston University Goldman School of Dental Medicine concluded that a healthy diet and moderate daily exercise may reverse immune system problems , which make it more difficult to fight infection, that are common among people with obesity. The study included four groups of mice, lean mice on a standard diet, obese mice on a high-fat diet, obese mice on a high-fat diet that performed moderate daily exercise for 1 month, and obese mice that performed moderate daily exercise and a standard diet for 1 month. The mice who exercised daily and consumed a standard diet experienced significantly restored immune function. Their cytokines were repaired and their ability to fight gingivitis (measured by bone loss) improved. Researchers emphasized the need to address both diet and exercise in order to improve immune function among people with obesity

Periodontal Risk Assessment

Periodontal Risk Assessment is a necessary part of the periodontal paradigm. The American Academy of Periodontology, AAR) asserts that risk assessment should be a part of every comprehensive dental and periodontal examination. Risk assessment goes beyond identification of the existence of disease and severity, and considers factors that may influence future disease progression. These risk factors include:

*Cigarette smoking,

*Diabetes,

*Poor oral hygiene,

*Periodontal pockets,

*Vertical bone loss,

*Furcation involvement,

*Subgingival calculus

*Restorations with subgingival margins

The Link bewteen Oral Inflammation and Systemic Health

The role that oral inflammation plays as a pathway to the rest of the body is becoming much better understood, making the control and prevention of gingivitis and periodontitis a critical part of optimal patient care.

The oral cavity is the portal to the rest of the body. Within the past decade, an emerging body of evidence has linked oral infections, primarily chronic inflammatory periodontitis to systemic conditions including atherosclerosis, diabetes mellitus, Alzheimer's disease, kidney disease, bacterial pneumonia and obesity. All of these systemic issues may have an inflammatory, infectious, and/or bacterial component in common with periodontitis.

The dental hygienist plays an important role in the total systemic health treatment of patients with periodontal infections. A complete evaluation can assess the patient's risk of the future development, progression or recurrence of inflammatory periodontal diseases. This is especially important if the patient has one or more systemic risk factors, such as smoking, hyperglycemia, high cholesterol, or a familial history of hyperlipidemia. Genetic factors may play a significant role in 50% of patients with periodontal diseases.

Instead of merely treating the patient to stop the initiation of progression of periodontitis, today we want to control periodontal infection and inflammation that may affect other regions of the body. The focus of periodontal treatment is to attack the chronic inflammation. Essentially, periodontal disease should be treated as oral inflammation that must be controlled for better oral and overall health. Dealing with the inflammatory response to the bacteria is a main paradigm shift in the treatment of the periodontal patient.

Obesity, Physical Fitness and Periodontitis

A new research study performed at the Fukuoka Health Promotion Center in Japan, investigated the relationship between obesity, physical fitness and periodontitis. The study looked at 1,160 participants. The body mass index and percentage of body fat were used as indicators of obesity. Maximal oxygen consumption was used as an indicator of physical finess. Participants with a Community Periodontal Index code of 3 or 4 were defined as having severe periodontitis. Researchers found that the subjects who were phyically fit and at a healthy weight had the lowest risk of severe periodontitis.

Gum Disease Found to be Significant Public Health Concern

The prevalence of periodontal disease in the United States may be significantly higher than originally estimated. Research published in the Journal of Dental Research from the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) suggests that the prevalence of periodontal disease may have been underestimated by as much as 50%. The implication is that more American adults may suffer from moderate to severe gum disease that previously thought.

In a National Health and Nutrtion Examination Survey (NHANES) pilot study, funded by the CDC's Division of Oral Health, a full mouth , comprehensive periodontal examination was conducted on over 450 adults over the age of 35. Periodontal disease was classified according to definitions determined by the CDC in collaboration with the AAP. The prevalence rates were then compared against the results of previous NHANES studies which used a partial-mouth periodontal examination. Historically,NHANES has served as the main source for determining prevalence of periodontal disease in US adults. The pilot study finds that the original partial-mouth study methodology may have underestimated true disease prevalence by up to 50%.

Periodontal disease is a chronic inflammatory disease that affects the gum tissue and other structures supporting the teeth. If left untreated, it can lead to tooth loss, and may also interfer with other systems of the body. Several research studies have associated gum disease with other chronic inflamatory diseases such as diabetes, cardiovascular disease and rheumatoid arthritis.

This study shows that periodontal disease is a bigger problem than we all thought. It is a call to action for anyone who cares about his or her oral health. Given what we know about the relationship between gum disease and other diseases, taking care of your health isn't just about a pretty smile. It has bigger implications for overall health, and is therefore a more significant public health problem.

Increased prevalence of periodontal disease makes it essential to maintain healthy teeth and gums. Not only should you take good care of your periodontal health with daily tooth brushing and dental flossing, you should expect to get a comprehensive preiodontal evaluation every year. A dental professional will diagnose, treat and help you prevent gum disease, and will conduct the comprehensive exam to access your periodontal disease status.

This study suggests we have likely underestimated the prevalence of periodontal disease in the adult US population. We are currently utilizing a full-mouth periodontal examination to better understand the characteristics of periodontal disease in our adult population. Research suggests a connection between periodontal health and systemic health. In light of these findings, understanding the relationships between periodontal disease and other systemic diseases in the adult population is more crucial than ever.