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Prevent periodontal disease to help avoid tooth loss.

According to the American Association of Oral and Maxillofacial Surgeons, 26 percent of adults age 74 and older have lost all of their permanent teeth--but practicing good oral hygiene can help protect your smile no matter what your age. In addition, taking care of your teeth and gums is also good for your overall health.

"The good news is that dental inflammation and infection generally can be treated with regular and routine dental care," says Andre H. Montazem, DMD, MD, an assistant professor and residency program director of oral and maxillofacial surgery at Mount Sinai School of Medicine. "Good tooth brushing and flossing habits will go a long way to maintaining dental health." A variety of mechanical aids, such as electric toothbrushes, are available for patients who have lost some of their manual dexterity. According to Dr. Montazem, people should visit their dentist at least twice a year, though. "Patients with more advanced forms of periodontal disease may require more frequent evaluations and cleanings," he says.

Good dental care appears to decrease the levels of C-reactive protein (CRP), an inflammatory marker in the bloodstream, and this may lower the risk of a variety of conditions such as heart disease and stroke. "Although the relationship is unclear at this time, it is certain that good dental care and health will help maintain the teeth and allow for better function, nutrition, and overall well-being," says Dr. Montazem.

How oral health affects overall health. "Maintenance of dental health is an important part of the overall medical care of patients," says Dr. Montazem. "When dental health is neglected, it can lead to dental problems and periodontal disease. This can cause pain and dysfunction which may lead to a variety of consequences. Severe infections, sometimes life-threatening, can occur and result in hospitalization and occasionally urgent surgeries to remove teeth and drain abscesses. More commonly, dental problems, periodontal disease, and infections can result in altered nutrition (i.e., the inability to eat a healthy diet) which can place certain patients at risk."

Research has linked cardiovascular disease and cerebrovascular disease to poor dental health. "It is clear that oral bacteria are a common cause of bacteremia (bacteria in the bloodstream) which allows bacteria to travel to distant organs, such as the heart," says Dr. Montazem. "Bacteria that are commonly found in areas of dental inflammation and infection have been isolated in the atherosclerotic plaques in the coronary arteries (blood vessels of the heart)." Although a direct-cause-and-effect relationship has not yet been determined, tooth and gum infections are associated with increased levels of heart disease and stroke.

Risk factors for gum disease. Poor oral hygiene caused by improper brushing techniques, or not brushing and flossing regularly, can encourage the development of gum disease, but there are other factors that can increase your risk as well:

Smoking Tobacco smoking has not only been linked to numerous medical problems including throat and lung cancer, but it also dramatically increases the risk of gum detachment, bleeding, and severe periodontal disease.

Medications Gum tissue is sensitive to estrogen, so medications that increase the estrogen levels in your body, such as hormone replacement therapy, can increase your risk of gum disease. In addition, some blood pressure medications, including calcium channel blockers, can cause an overgrowth of gum tissue and increase your risk of developing gum disease.

Unhealthy eating A healthy diet rich in antioxidants can decrease your risk of developing gum disease. In addition, try to avoid eating sugary foods and limit your alcohol intake to one drink per day for women and two for men.


* Brush inner, outer, and chewing surfaces at least twice daily with a soft-bristled brush held at a 45[degrees] angle.

* Floss at least once daily, gently guiding the floss between teeth. While holding floss taut and curved around each tooth, slide the floss up and down. If you find you don't have the strength or dexterity to use floss, try using a floss pick.

* Obtain professional dental cleaning every six months (more often if you are prone to plaque or gingivitis).

* Ask for an annual periodontal screening and assessment of the degree to which gum tissue has pulled away from teeth.
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Title Annotation:PREVENTION
Publication:Focus on Healthy Aging
Date:Dec 1, 2008
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