Periodontal disease or “gum disease” is typically caused by a build-up of plaque beneath the gum line. The bacteria in the plaque ignite the body’s inflammatory response, and the gums become red, swollen, and even bloody. While the main cause of periodontal disease is inflammation as a result of bacteria, other habits or environmental conditions, referred to as risk factors, can increase the likelihood that an individual will develop gum disease.
Common risk factors of periodontal disease include: Age: Recent data from the Centers for Disease Control and Prevention (CDC) found that almost half of Americans over the age of 30 have some form of periodontal disease. In adults 65 and older, prevalence rates increase to 70.1 percent.
Smoking/tobacco use: Studies have shown tobacco use to be one of the most significant
risk factors in the development and progression of periodontal disease.
Genetics: Research has found that a family history of periodontal disease may increase a
person’s susceptibility to gum disease. Genetic testing can be conducted to identify if you are
predisposed to periodontal disease.
Stress: Stress can make it more difficult for the body to fight off infection, including
periodontal disease.
Medication: Some drugs like oral contraceptives, anti-depressants, and certain heart medicines can affect your periodontal health. Poor nutrition and obesity: A diet low in nutrients can make it harder for the body to
fight off infection. Research has also found obesity may increase the risk of periodontal
disease. Poor oral hygiene: Ignoring teeth and gums allows plaque to build up along the gum line. Not routinely brushing and flossing can easily lead to gingivitis, the first stage of periodontal disease. Other systemic diseases: Recent studies have linked diabetes, cardiovascular disease, rheumatoid arthritis and erectile dysfunction to periodontal disease. These and other systemic diseases could interfere with the body’s inflammatory system and may worsen the condition of the gums.
It is recommended that you see a periodontist or dentist once a year for a comprehensive periodontal evaluation to assess gum health. If you are experiencing any of the risk factors mentioned, inform
your periodontist, dentist, or hygienist so he or she can look for early signs of periodontal
disease.
Considering risk factors as part of the treatment planning process allows for proactive management of an individual’s periodontal health and can potentially reduce the need for more complex
periodontal procedures in the future.
How do dental professionals assess risk for periodontal disease?
Your periodontist, dentist, or dental hygienist will assess your risk factors for periodontal disease as part of the comprehensive periodontal evaluation. This will help better predict the likelihood that you will develop periodontal disease or that your condition will worsen. It will assist your periodontist or dentist in determining the best personalized course of treatment for you.
Are Cruciferous Vegetables Healthier Than Other Ones?Are
Since we know that periodontal disease is
associated with many inflammatory systemic diseases and the evidence is incontrovertible
that nutrition is a factor in prevention of disease; good nutrition is a
benefit to your overall well-being. We thought we'd share this article about
health and vegetables. Every day there are more articles published about
nutrition and how it affects our health. So, let us introduce you to the world
of cruciferous vegetables!
Are Cruciferous Vegetables Healthier Than Other Ones?
Discover the truth about arugula, broccoli, cauliflower, and yes, kale
By Rachel Meltzer Warren January 16, 2017
Trying to name the healthiest vegetable is like trying to choose a favorite child. They're all wonderful. But cruciferous vegetables do have some healthful compounds not plentiful in other produce.
Thanks to the ubiquitous kale salad, this leafy green may be the cruciferous vegetable you're most familiar with. But you have many other options, including arugula, bok choy, broccoli, brussels sprouts, cauliflower, cabbage, and watercress. And these rival kale in their healthfulness.
“Cruciferous vegetables are among the most nutritious because they are rich in several vitamins and minerals, plus they contain unique disease-fighting compounds,” says Maxine Siegel, R.D., who heads Consumer Reports’ food-testing department.
What's Special About Cruciferous Vegetables
Cruciferous vegetables are the most common dietary sources of glucosinolates. These are natural chemicals that give the veggies their pungent flavor and break down into cancer-protecting compounds.
A study in the Annals of Oncology found that having just one serving of cruciferous vegetables per week over a two-year period lowered the risk of breast, colon, and oral cancer by 17 percent; esophageal cancer by 28 percent; and kidney cancer by 32 percent. Each type of vegetable has different anticancer compounds, so it’s best to eat a variety.
This vegetable family also stands out for its rich bounty of vision-protecting carotenoids as well as fiber, folate, potassium, and vitamins C, E, and K.
Some of these nutrients may contribute to that cancer-fighting ability, but they may also be part of the reason crucifers help control inflammation and protect against heart disease. In an analysis of 134,796 people, researchers in China found that those who ate about 6 ounces per day reduced their risk of heart disease by about 20 percent compared with those who ate an ounce or less.
Cooking and Serving Tips
Steam or stir-fry. These methods preserve the most glucosinolates. Aim for an al dente texture. Overcooking not only turns these vegetables an unappetizing color but also makes them mushy, gives them a stronger flavor than you might like, and diminishes the nutrient content.
Try brussel sprout chips. Remove the leaves from the base. Toss with olive oil and bake at 350 degrees F for about 20 minutes or until crispy, turning every 5 minutes.
Make a slaw. Season thinly sliced raw cabbage with rice-wine vinegar and olive oil. Use as a topping for fish tacos. Test-tube studies suggest that cabbage’s sulfur compounds make the selenium in fish a more potent cancer fighter.
"Rice" some cauliflower. Grate cauliflower florets or pulse them in a food processor to make rice-sized granules. Or you can buy already riced cauliflower fresh or frozen in many supermarkets. It makes for a lower-carb, lower-calorie replacement for couscous, rice, and potatoes.
Use watercress for more than a garnish. Mix it with milder greens like baby spinach and pair with sweet and creamy flavors like lemon juice, avocado, and apple slices to balance out the strong flavor.
Editor's Note: This article also appeared in the February 2017 issue of Consumer Reports on Health.
Rachel Meltzer Warren
Rachel Meltzer Warren, M.S., R.D., is a New York-area based nutrition writer, educator, and counselor
.
Youngsters should think twice before getting their tongue or lips pierced
Researchers at Tel Aviv University (TAU) have found that oral tissue piercings fracture teeth and increase dental complications in early adulthood.
Dr. Liran Levin, a dentist from the Department of Oral Rehabilitation, School of Dental Medicine at Tel Aviv University said that about 15 to 20 percent of teens with oral piercings are at high risk for both tooth fractures and gum disease. This may result in tooth fractures as well as periodontal problems, which in turn may lead to anterior (front) tooth loss later in life.
Tooth fracture from piercing
Levin also stated that high rates of fractures due to piercings are not found in other age groups, and cases of severe periodontal damage in teens without oral piercings are similarly rare.
Their earlier research was carried out on 400 young adults aged 18-19, but in their new study captures a larger area detailing the risks and complications of oral piercings, drawing on research from multiple centers in America and across the world.
Levin said that 10 percent of all New York teenagers have some kind of oral piercings, compared to about 20 percent in Israel and 3.4 percent in Finland. He also warned the kids to think twice before getting an oral piercing, as it can lead to easily preventable health complications and, in some (rare) cases, even death.
“There are short-term complications to piercings in low percentages of teens, and in rare cases a piercing to the oral cavity can cause death. Swelling and inflammation of the area can cause edema, which disturbs the respiratory tract,” he said.
In fact, he also cautioned that the most common concerns like tooth fracture and periodontal complications are long-term
.
Gum recession caused by lip piercing
“There is a repeated trauma to the area of the gum. You can see these young men and women playing with the piercing on their tongue or lip. This act prolongs the trauma to the mouth and in many cases is a precursor to anterior tooth loss,” said Levin.
In their Israel-based study, the researchers examined teens both with piercings and without, asking them a number of questions about their oral health, their knowledge of the risk factors associated with piercings, and about their piercing history, before conducting the clinical oral exams.
However, he noted that those youngsters who opted for oral piercing were very concerned about body image, but seemed to be unaware of the future risks such piercings can cause.
Bottom line, the best advice for teens is to “try and avoid getting your mouth pierced,” said co-investigator Dr. Yehuda Zadik.
The study was published in the American Dental Journal. (ANI)
It’s bad enough that expertise is under attack these days from populist political movements that dismiss specialist opinion as just another establishment ruse. But lately expertise is being criticized from another direction, too — from would-be defenders of science.
Consider the recent controversy over flossing. In August, a widely read Associated Press report suggested that, contrary to the advice of dentists everywhere, flossing didn’t necessarily foster good oral health. The report looked at 25 studies that had generally compared toothbrushing and flossing with toothbrushing alone and concluded that the evidence for the benefits of flossing was weak.
In response, the Department of Health and Human services, the American Dental Association and the Academy of General Dentistry reaffirmed the importance of interdental cleaning. But confusion persists: A lot of people now mistakenly think that “science” doesn’t support flossing.
What explains this confusion? Misconceptions about the relation between scientific research, evidence and expertise.
In the case of flossing’s benefits, the supposedly weak evidence cited by The Associated Press was the absence of support in the form of definitive randomized controlled trials, the so-called gold standard for scientific research. Why was there so little of this support? Because the kind of long-term randomized controlled trial needed to properly evaluate flossing is hardly, if ever, conducted — because such studies are hard to implement. For one thing, it’s unlikely that an Institutional Review Board would approve as ethical a trial in which, for example, people don’t floss for three years. It’s considered unethical to run randomized controlled trials without genuine uncertainty among experts regarding what works.And dentists know from a range of evidence, including clinical experience, that interdental cleaning is critical to oral health and that flossing, properly done, works. Yet the notion has taken hold that such expertise is fatally subjective and that only randomized controlled trials provide real knowledge.
The opposition between randomized controlled trials and expert opinion was fueled by the rise in the 1990s of the evidence-based medicine movement, which placed such trials atop a hierarchy of scientific methods, with expert opinion situated at the bottom. The doctor David Sackett, a father of the movement, once wrote that “progress towards the truth is impaired in the presence of an expert.”
But while all doctors agree about the importance of gauging the quality of evidence, many feel that a hierarchy of methods is simplistic. As the doctor Mark Tonelli has argued, distinct forms of knowledge can’t be judged by the same standards: what a patient prefers on the basis of personal experience; what a doctor thinks on the basis of clinical experience; and what clinical research has discovered — each of these is valuable in its own way. While scientists concur that randomized trials are ideal for evaluating the average effects of treatments, such precision isn’t necessary when the benefits are obvious or clear from other data.
Clinical expertise and rigorous evaluation also differ in their utility at different stages of scientific inquiry. For discovery and explanation, as the clinical epidemiologist Jan Vandenbroucke has argued, practitioners’ instincts, observations and case studies are most useful, whereas randomized controlled trials are least useful. Expertise and systematic evaluation are partners, not rivals.
Distrusting expertise makes it easy to confuse an absence of randomized evaluations with an absence of knowledge. And this leads to the false belief that knowledge of what works in social policy, education or fighting terrorism can come only from randomized evaluations. But by that logic (as a spoof scientific article claimed), we don’t know if parachutes really work because we have no randomized controlled trials of them.
Antagonism toward expertise can also waste time and effort by spurring researchers to test the efficacy of things we already know work. In the field of international development, for example, a recent study investigated the relationship between prescription glasses and school performance. A randomly selected group of Chinese children with poor eyesight were given glasses … and subsequently got better grades. Imagine: Kids who could see did better in school!
The cult of randomized controlled trials also neglects a rich body of potential hypotheses. In the field of talk therapy, for example, many psychologists believe that dismissing a century of clinical observation and knowledge as anecdotal, as research-driven schools like cognitive behavioral therapy have sometimes done, has weakened the bonds between clinical discovery and scholarly evaluation. The psychiatrist Drew Westen says the field is too often testing “uninformed hunches,” rather than ideas that therapists have developed over years of actual practice.
Experiments, of course, are invaluable and have, in the past, shown the consensus opinion of experts to be wrong. But those who fetishize this methodology, as the flossing example shows, can also impair progress toward the truth. A strong demand for evidence is a good thing. But nurturing a more nuanced view of expertise should be part of that demand.
Shorter life spans. Greater risk for heart attacks. Higher rates of cancer. As if men don’t
have it tough enough, studies report that periodontal disease is more prevalent and severe in males
than in females. In fact, the January, 1999 Journal of Periodontology reports that at the very least,
34 percent of the U.S. male population age 30 to 54 has periodontitis, compared to 23 percent of females.
Part of the reason for this is attributed to poorer oral hygiene among males than females. Further
reasoning for the gender difference remains unclear, but may have something to do with a protective
effect of female hormones.
So why should men be concerned? First of all, periodontal disease is a major cause of tooth loss in adults. After age 65, almost 25 percent of men have no remaining natural teeth. However, don’t think tooth loss is a problem you won’t face until old age. Tooth loss due to periodontal disease can strike people in their 30's and younger.
And maybe more importantly, the pool of research linking periodontal disease to far more serious health threats, such as heart disease, respiratory disease and diabetes, continues to grow.
One study found that people with advanced periodontal disease are 4.5 times more likely to have a chronic respiratory disease. Another study found that people with periodontal disease may have nearly twice the risk of having a fatal heart attack as those without periodontal disease. While periodontal disease cannot always be avoided, proper oral hygiene is the best means of prevention.
Daily flossing breaks up the bacterial colonies between teeth, and proper brushing prevents plaque buildup.
Professional cleanings at least twice a year are necessary to remove calculus from places your toothbrush and floss may have missed.
And, because there are often no symptoms of the disease in its early stages, a trip to a periodontist can determine if you have periodontal disease
Just for men
Face your fears According to a 1999 AAP online poll, 47 percent of periodontists say that their male patients are more often fearful of periodontal treatment, while only 11 percent find their female patients to be the more fearful gender. Share your anxiety with your dentist, periodontist and their staffs. They are prepared to help. The survey also revealed that the top origins of dental fear are family and friends or a personal bad experience more than 10 years ago. Realize that advances in the ability to treat periodontal conditions in a comfortable way have come a long way in recent years.
Chew on this
Smokeless tobacco products such as snuff and chewing tobacco increase your risk for oral
cancer. In fact, oral mucosal lesions are found in 50 to 60 percent of smokeless tobacco users.
And, smokeless tobacco use has been associated with more severe and rapidly progressing periodontal disease.
Don’t skip the trip
Dental care utilization rates are lower among men than women. According to a 1997 American
Dental Association/Gallup phone survey, one in four men reported they hadn’t visited a dentist in the
past year. In addition, a study in the June, 1999 Journal of Periodontology found that well over half
of males under age 40 who have undergone nonsurgical periodontal treatment are likely to drop out
of periodontal maintenance therapy. Periodontal diseases are chronic diseases, and without this
careful, ongoing treatment, disease can and often does recur.
Make it a mate ritual
One study, which examined 58 elderly couples, found that long-married partners had strikingly similar tooth-care habits. So men may want to begin flossing with their significant others before bed as part of their evening ritual. Good oral care will help ward off periodontal disease and tooth loss.
Election Day has come and gone, and after one of the most divisive campaigns in memory, “healing” seems to be the word of the hour. What better time to begin than Thanksgiving, which Benjamin Franklin called a day of “public Felicity” to give thanks for our “full enjoyment of Liberty, civil and religious.” Thanksgiving, our nation’s oldest tradition, is a moment to focus on our blessings as Americans, on what unites us, not on what divides us.
Such was the case in 1863, when Abraham Lincoln called for a national Thanksgiving celebration. He did so at the urging of a farsighted magazine editor who believed that a Thanksgiving celebration would have a “deep moral influence” on the American character, helping to bring together the country, which was divided over the issue of slavery. Lincoln’s 1863 proclamation was the first in the unbroken string of annual Thanksgiving proclamations by every subsequent president. It is regarded as the beginning of our modern Thanksgiving holiday.
Lincoln’s call for a national Thanksgiving was different from the thanksgivings he orJefferson Davis, the president of the Confederacy, had called in the early years of the Civil War to express gratitude to God for specific Union or Confederate military victories. Rather, in 1863 Lincoln asked Americans to give thanks for the nation’s general blessings. It was the first time since George Washington led the country that a president proclaimed a day of general Thanksgiving.
The opening sentence of Lincoln’s proclamation set the tone: “The year that is drawing toward its close has been filled with the blessings of fruitful fields and healthful skies,” he wrote. This was an astonishing way to characterize the year 1863, when death, suffering and grief were ever present. At the Battle of Gettysburg, which had taken place in July, the Union lost 27% of its fighting men and the Confederacy lost 37%. Yet amid this human suffering, Lincoln cataloged the blessings for which Americans could be grateful. Even “in the midst of a civil war of unequaled magnitude and severity,” he wrote, the nation remained at peace with foreign countries, its borders were expanding, its population was growing, and its farms, industries and mines were producing.
Lincoln spoke not as commander in chief of the Union forces but as president of the entire nation, North and South. He made no reference to victories or losses or rebels or enemies. Instead, the president spoke of “the whole American people.” He called on every American to celebrate Thanksgiving “with one heart and one voice.”
To understand how Lincoln came to believe in the healing power of a national Thanksgiving, it is necessary to examine the remarkable life of the woman who made it happen. She used her position as editor of the most popular magazine of the pre-Civil War era to conduct a decadeslong campaign for a countrywide Thanksgiving holiday. She is often called the godmother of Thanksgiving. Her name was Sarah Josepha Hale.
Hale’s story is a classic American saga of how one enterprising, hardworking individual with a good idea can have an impact in an open, democratic society. In this case, a penniless young widow from New Hampshire—subject to all the limitations attached to such a station in life in the early 19th century—rose to become the editor of the most widely circulated magazine of her era, Godey’s Lady’s Book.
As editor—or “editress,” as she preferred to be addressed—Hale set out to publish American authors writing on American themes. This approach contrasted with that of other magazines of the day, which typically reprinted articles pirated from English publications. Hale lined up American writers such as Harriet Beecher Stowe, Nathaniel Hawthorne, Washington Irving and Edgar Allan Poe. Her interest in culture extended to everyday aspects of American life—food, fashion, manners, child rearing and running a household.
Thanksgiving Day, a homegrown holiday, fit into Hale’s mission of focusing on Americana. She saw it as a patriotic occasion along with the Fourth of July and Washington’s Birthday. Thanks in part to Hale’s campaign, by the time the Civil War began nearly every state marked its own Thanksgiving Day on dates ranging from September to December. Her goal was to have it established as a national holiday and observed on a uniform date throughout the country. George Washington had selected the last Thursday in November as the date of the first national Thanksgiving in 1789, so that was the date she chose.
Hale helped consolidate popular support for a national Thanksgiving by publishing editorials making the case for the holiday, fiction and poems set around Thanksgiving Day, and recipes for traditional Thanksgiving dishes such as roast turkey and pumpkin pie. Her hope wasn’t simply to see Americans feast on the same foods on the same day, but she was shrewd enough to realize that the culinary appeal of Thanksgiving was another selling point for her vision of a shared celebration.
Meanwhile, she conducted a letter-writing campaign, soliciting support for her project from presidents, governors, congressmen and other influential Americans. On Sept. 28, 1863, Hale sent a letter to Lincoln. The subject she wished to lay out before the president, she wrote, “is to have the day of our annual Thanksgiving made a National and fixed Union Festival.” The editor asked the president to “appeal to the Governors of all the States” to follow suit. “Thus the great Union Festival of America would be established.” The result, as we know, was Lincoln’s decision to declare a national day of Thanksgiving.
In his 1863 proclamation, Lincoln reminded Americans that the Civil War would eventually end. He asked them to look beyond the current horrors to a better day, when the country “is permitted to expect continuance of years with large increase of freedom.”
Lincoln’s Thanksgiving proclamation was profoundly hopeful, reminding the American people of the nation’s capacity for renewal. It’s a message that resonates today.
Ms. Kirkpatrick is the Journal’s acting editorial features editor. This essay is adapted from her book, “Thanksgiving: The Holiday at the Heart of the American Experience,” just out from Encounter Books.
Brushing Up on Oral Health: Never Too Early to Start
As the American Academy of Pediatrics (AAP) and other children's organizations report, tooth decay(also called early childhood caries, or ECC) is the most common chronic children's disease in the country. As a result, it is very important that parents work with their pediatrician to establish good oral health care from the first weeks of their baby's life. Although most of us think of dental care in relation to our own dentists, parents will be working closely with their pediatrician even earlier than with a dentist.
Since pediatricians see young infants and children frequently for preventive health care visits, they are in an excellent position to identify children at risk for dental health problems, coordinate appropriate care and parent education, and refer affected and high-risk children to pediatric dentists.
The Centers for Disease Control and Prevention (CDC) has stated that dental caries is five times more common than asthma and seven times more common than hay fever in children. More than 40 percent of children have tooth decay by the time they reach kindergarten. Children with dental caries in their baby teeth are at much greater risk for cavities in their adult teeth.
Health care professionals know that tooth decay is a disease that is, by and large, preventable. Because of how it is caused and when it begins, however, steps to prevent it ideally should begin prenatally with pregnant women and continue with the mother and young child, beginning when the infant is approximately 6 months of age. Pediatricians have become increasingly aware that their own proactive efforts to provide education and good oral health screenings can help prevent needless tooth decay in infants.
For parents who wish to establish good dental health for their infants, the following general guidelines may be of help:
Fluoride and Your Child: Fluoride is a naturally occurring mineral that is found in many foods, and it also is added to the drinking water in some cities and towns. It can benefit dental health by strengthening the tooth enamel, making it more resistant to acid attacks that can cause tooth decay. It also reduces the ability of plaque bacteria to produce acid. Check with your local water utility agency to find out if your water has fluoride in it. If it doesn't, ask your doctor if you should get a prescription for fluoride drops or chewable tablets for your child.
Check and Clean Your Baby's Teeth:
Healthy teeth should be all one color. If you see spots or stains on the teeth, take your baby to your dentist. As soon as your child has a tooth begin to use a smear (size of a grain of rice) of fluoride toothpaste. Clean the teeth at least twice a day. It's best to clean them right after breakfast and before bedtime. Once your child turns 3 you can begin to use a pea-sized amount of fluoride toothpaste. When your child is able, teach him to spit out the excess toothpaste, but don't rinse with water. As your child gets older let her use her own toothbrush. It is best if you put the toothpaste on the toothbrush until your child is about age 6. Until children are 7 or 8 years old, you will need to help them brush. Try brushing their teeth first and then letting them finish.
Feed Your Baby Healthy Food: Choose drinks and foods that do not have a lot of sugar in them. Give your child fruits and vegetables instead of candy and cookies. Be careful with dried fruits, such as raisins, since they easily stick to the grooves of the teeth and can cause cavities if not thoroughly brushed off the teeth.
Prevent Tooth Decay: Do not put your baby to bed with a bottle at night or at naptime. (If you do put your baby to bed with a bottle, fill it only with water). Milk, formula, juices and other sweet drinks, such as soda, all have sugar in them. Sucking on a bottle filled with liquids that have sugar in them can cause tooth decay. During the day, do not give your baby a bottle filled with sweet drinks to use like a pacifier. If your baby uses a pacifier, do not dip it in anything sweet like sugar or honey. Near his first birthday, you should teach your child to drink from a cup instead of a bottle.
Talk With Your Pediatrician About Making a Dental Home: Since your pediatrician will be seeing your baby from the first days and weeks of life, plan to discuss when and how you should later develop a "dental home"—a dentist who can give consistent, high-quality, professional care—just as you have a "medical home" with your pediatrician. Usually, your dentist will want to see a child by his first birthday or within six months of the first tooth's emergence. At this first visit, your dentist can easily check your child's teeth and determine the frequency of future dental checkups.
Last Updated
10/3/2014
Source
Adapted from Healthy Children Magazine, Winter 2007
The information contained on this post should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
