Dr Gatti's Blog a Lawrence Dentist Reflections

Brushing and flossing may help you have better overall health, not just in your mouth. Inflammation of the gums caused by the accumulation of plaque and bacteria above the gumline is called gingivitis. This is an early phase of gum disease and, if left untreated, it can progress to periodontitis, a more serious and damaging stage of infection and inflammation. An association between periodontitis and certain systemic diseases has been shown in recent studies. These diseases include stroke, diabetes, low birth weight and heart disease, Did you know heart disease is the leading cause of death in both men and women? Indeed, heart disease has been shown to be four times more prevalent in people who also have periodontitis! More research is needed and is underway to better understand the correlation and impact serious gum disease may have on these and other systemic conditions.

Removing oral bacteria and fighting gum inflammation associated with gingivitis and periodontitis is a simple step that people can incorporate into their daily routines to help keep their mouths healthy and to have a positive effect on their overall health. Please let us know if you would like more specific information on this association between your mouth and the rest of your body or if you would like us to help you with techniques to better remove the oral bacteria from your mouth.

A cancer sore (aphthous stomatitis) is an open sore in the mouth. They are typically white and surrounded by a bright red area. These lesions are benign (not cancer) and occur on the moveable tissue inside the mouth or on the tongue. They do not appear on the outside of the lips. The exact cause of canker sores is unknown. Stress or tissue injury will often cause these sores to appear.

For those individuals who get these lesions frequently, we have found that one of the main causes is the presence of sodium lauryl sulfate in toothpaste. Sodium lauryl sulfate is a detergent added to toothpaste to produce foaming and to break down oils. In doing this it also causes drying of the oral tissues. Some people are more sensitive to sodium lauryl sulfate than others and suffer from weekly to daily problems with canker sores.

If you frequently get canker sores, one of the simplest remedies is to switch to toothpaste without this foaming agent. Depending on your specific need we can help guide you as to which toothpaste might work best for your individual situation.

Here is a list of some of the most popular toothpastes without sodium lauryl sulfate:

• Sensodyne PRONAMEL
• Tooth and Gums Paste (an herbal paste available at the Studio)
• Biotene
• Rembrant for Canker Sore Sufferers
• Tom’s of Maine SLS Free
• Squigle Enamel Saver Toothpaste
• Prevident for Dry Mouth (available by prescription or at the Studio)

Medications you take for osteoporosis can have an impact on your dental health

Recent news reports have alarmed and confused dentists, as well as people who take bisphosphonates (bis-fos-fo-nates). That is because a condition known as osteonecrosis (os-tee-oh-ne-kro-sis) of the jaw (also know as OJN) has been reported in some patients who have taken these medications. Bisphosphonate associated osteonecrosis of the jaw, or BON, is a rare but serious condition that can cause severe damage to the jawbones.

Since there is so much confusion on the subject I wanted to give you a brief overview of the current recommendations and suggestions of what to consider.

First, this is a real event. However, the overwhelming majority of people (94%) diagnosed with BON are cancer patients who are receiving or did receive repeated high doses of bisphosphonates through intravenous (IV) infusion. The other 6% of people with BON were taking oral bisphosphonates for treatment of their osteoporosis.

Given this information there are practical matters to consider. First, osteoporosis and broken bones are serious. The statistics around hip fractures and mortality in people over 50 are somewhat frightening. Studies indicate that in many people, bisphosphonate medication can help reduce the chance of broken bones by increasing bone density. Some reports indicate that these medications may reduce the chance of hip fracture by 50% in people with osteoporosis.

So, like everything in life, there are risks and rewards. In the instance of osteoporosis, the benefits of these medications greatly outweigh the low risk of developing BON. Bottom line, if you are taking bisphosphonate medication, don’t go off your meds unless you have had a serious conversation with your physician. Practically speaking, if systemic conditions permit, initiation of bisphosphonate therapy should be delayed until dental health is optimized. It is imperative that the decision is made in conjunction with your treating physician and oncologist.

Once again, regular dental visits and excellent oral hygiene practices may be the best way to reduce your risk.