Continuation of our discussion about Nutrition & Oral Health

Nutrition plays an important role in overall wellness, including oral health. Eating well and maintaining a healthy diet can help reduce the risk of developing problems in your mouth, including
periodontal disease. In fact, including certain foods as part of a nutritious diet has actually been shown to play a role in the prevention of  periodontal disease.

Lactic Acid & Calcium

Most people know that dairy products can help build strong bones. What some may not know is that consuming dairy products may also reduce your risk for developing periodontal
disease. A recent study determined that individuals who regularly consume 55 or more grams of foods containing lactic acid, commonly found in dairy products such as yogurt, have a lower instance of gum disease. Dairy products are also a good source of
calcium which has been shown to lower the risk of severe periodontal disease. The American Dietetic Association advises that adults should consume at least three servings of calcium each day to help keep your jaw bone strong and your teeth in place.

Vitamin C

When a cold is coming on, many people reach for the vitamin C. But this vitamin may do more than just fend off the sniffles; it may reduce the risk of periodontal disease. According to a study, consuming less than 60 mg of vitamin C each day can put you at slightly higher risk for developing certain types of periodontal disease. And this isn’t recent news! In fact, in the late 18th century, sailors away at sea would eat limes to prevent their gums
from bleeding! According to the Institute of Medicine, the recommended dietary allowance for vitamin C is 60 mg per day – or about 1 orange.

Vitamin D

Sometimes known as the “sunshine vitamin”, vitamin D can help lessen inflammation associated with periodontal disease. Research shows that foods fortified with vitamin D such as milk, eggs, sardines, and tuna fish, as well as moderate exposure to sunlight, can provide you with the amount of vitamin D required to stay healthy.

Healthy Diet

There may be more reasons to watch what you eat other than maintaining a healthy weight. Studies indicate that obesity may be linked to periodontal disease. Obesity can be the
result of an unbalanced diet, which may lack the nutrients known to help prevent gum disease. Also, excessive consumption of sugary drinks such as soft drinks and foods high in sugars, trans-fats, and sodium are often associated with increased tooth decay and can have a negative impact on periodontal health. Without the proper nutrients from a healthy diet, the body can have a  hard time fighting off infections such as periodontal diseases. And routinely including such things as lactic acid, calcium, and vitamins C and D in your diet have been shown to possibly reduce the occurrence of gum disease. So next time you go to the grocery store or sit down for a meal, remember: eat right to smile bright!

Eat Well and Brush Well

While nutrients such as lactic acid, calcium, and vitamins C

and D have been shown to have a possible effect on periodontal

diseases, patients should  be aware that a well-balanced

diet alone is not a substitute for periodontal care. It is important

to follow up every healthy meal with proper brushing and flossing!

Read to post to LEARN MORE about how your DIET/NUTRITION can affect your ORAL HEALTH!!!!

NUTRITION AND ORAL HEALTH

Milk does a mouth good

Adults who consume at least three servings of calcium each day have another reason to smile. A new study published in the July, 2000 issue of the Journal of  Periodontology found that people who get enough calcium have significantly lower rates of periodontal disease, a leading cause of tooth loss.

Researchers found that men and women who had calcium intakes of fewer than 500 milligrams, or about half the recommended dietary allowance, were almost twice as likely to have periodontal disease, as measured by the loss of attachment of the gums from the teeth. The association was particularly evident for young adults in their 20s and 30s.

The relationship between calcium intake and periodontal disease is likely due to calcium’s role in building density in the alveolar bone that supports the teeth. Periodontal disease is an infection caused by bacteria that accumulate in pockets between the teeth and gums. Eventually, the infection can break down and destroy the tissues and bone that support the teeth. But, if the jaw bone is kept strong with enough calcium, it may be better able to withstand the bacterial onslaught.

Calcium is necessary for healthy bones, teeth, muscle contractions and other body functions. However, according to the American Dietetic Association, about three out of four people do not meet their daily need. Good sources of calcium include dairy foods such as milk, yogurt and cheese, dark green veggies, fortified orange juice, as well as rice and beans.

A relationship between calcium intake and periodontal disease makes sense in light of other new
research linking osteoporosis with tooth loss. However, people need to keep in mind that several other important risk factors exist for periodontal disease, including tobacco use, oral hygiene habits, genetics, diabetes, certain medications and stress. In addition to drinking milk, ask your dentist or periodontist about the state of your periodontal health to help prevent tooth loss. He or she can help you identify and control the risk factors for periodontal disease

Nourish your smile

A diet low in important nutrients can make it harder for the body’s immune system to fight
off infection. Because periodontal disease is an infection, a well-balanced diet benefits your
oral health.

In addition to calcium, research has shown that not getting enough vitamin C may put
you at increased risk for periodontal disease, especially if you smoke. Good sources of
vitamin C include dark colored fruits and vegetables, such as oranges, green and red peppers, broccoli and strawberries.

Here’s some other nutritional recommendations to help keep you smiling:

• Keep your mouth moist by drinking lots of water. Saliva is important in warding off tooth decay and periodontal disease because it washes away food and neutralizes plaque. If you have dry mouth, your dentist or periodontist can recommend various methods to restore moisture, including sugarless gum, oral rinses or artificial saliva products. 
• Foods that are sticky, such as raisins, fruit rolls and candy, can cling to the teeth and promote tooth decay. Brush and floss after eating sticky foods. 
• Good nutrition plays an important role in protecting the oral health of diabetics. Research shows increased serum triglyceride levels in uncontrolled diabetics seems to be related to greater attachment loss and probing depths, measures of periodontal disease. Reducing cholesterol and serum triglyceride levels, preferably through diet and exercise, may be the most important change that diabetics can make to improve their quality of life, as well as their oral health.
• Research shows that a diet high in wide variety of plant based foods helps to provide the antioxidants needed to fight diseases that are caused by high levels of free radicals (metabolic toxins) in the blood stream. 

Dr. Duello will be Lecturing at the American Dental Association & the American Academy of Periodontology this November

Dr. Duello at the ADA

Dr. Duello returned to his practice on Monday, November 9, 2015 after attending the American Dental Association 2015 Annual Meeting in Washington, DC. Approximately 21,000 dentist and staff were in attendance at this meeting.   This is one of the largest dental meetings in the world.   After many years of lecturing, Dr. Duello was honored to be invited to speak for the first time at the ADA Annual Meeting.  Despite some rain on Saturday, it was a very pleasant experience for Dr. Duello.

He gave two lectures over the weekend while in attendance. The first lecture was in cooperation with the American Academy of Periodontology on "Implant Treatment in the Esthetic Zone" .                                                                                                                                                                                                                                                                  Photo was taken just before the lecture began          




The second program was a panel discussion involving 5 specialties entitled " Myth vs. Realities: Dental Implant vs Root Canal Therapy.  Both programs were well attended and excellent audience participation occurred.   Dr. Duello was especially pleased with the caliber of presenters at the round table discussion.

In addition to Dr. Duello, panelists for this course were:
Dr. Michael Glick, professor and William M. Feagans Chair, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY; editor of The Journal of the American Dental Association; and a diplomate of the American Board of Oral Medicine.
Dr. Stuart Lieblich, clinical professor at the University of Connecticut; in private practice of oral and maxillofacial surgery; and a co-principal investigator on a national study on the use of antibiotics for oral surgical procedures.
Dr. David Little, adjunct clinical professor at the University of Texas Health Science Center at San Antonio Dental School; maintains a private dental practice in San Antonio, Texas.
Dr. Jaime Lozada, professor and director of the Advanced Education Program in Implant Dentistry at Loma Linda University; past president of the American Academy of Implant Dentistry; and a member of the editorial board of the Journal of Oral Implantology.
Dr. Daniel Meyer, an endodontist and the ADA chief science officer.
Dr. Alan Gluskin, a course panelist and professor and co-chair of the department of endodontics at the University of the Pacific.

 Dr. Duello and the other panelists took a moment to pose for a photo op.

Following his lecture, Dr. Duello was able to take in some of the famous sites in Washington, DC.  After lecturing on Saturday morning, he visited the Smithsonian Aerospace Museum, the National Gallery, and the News Museum.   To complete his visit, Dr. Duello viewed the White House from the South Lawn and the front of the White House from the North View.   

Dr. Duello at AAP

Dr. Duello will be presenting two lectures at the American Academy of Periodontology's (AAP) international meeting in Orlando FL November 13-16, 2015. He will be presenting on implant treatment. The first presentation is entitled" Transitioning the Full Arch Terminal Dentition to a Fixed Implant Solution". His second presentation will be a live hands on demonstration titled "Surgical & Restorative Procedures for the Edentulous Patient Using the All-on-4 treatment concept.More to follow when Dr. Duello returns.....

this post regarding MEDICATIONS AND ORAL HEALTH is a MUST READ, if your are among the millions of Americans on Rx Meds

That pill might be making your mouth ill

Your medicine cabinet may hold the answer to some of your oral  health problems. Drugs that improve the health of one part of your body may have a detrimental affect on your mouth.
     
For example, over 400 medications produce dry mouth or xerostomia, which can be damaging to the gum tissue. Other drugs may cause gingival enlargement, which means the gums become swollen and “grow over” the teeth. Medications with sugar as a main ingredient, such as over-the-counter
cough drops and syrups, may increase plaque as well as enhance the ability of plaque to be more adherent to your teeth. In addition, medications which have a depressant effect may make people  negligent with their oral hygiene habits.

Drugs that induce dry mouth include those for high blood pressure, spastic bladder syndrome,
pain relief, anxiety and allergies. People with dry mouth have a tendency to accumulate more plaque
and experience changes in their gum tissue that can make them more susceptible to periodontal disease and tooth decay. Your dental professional can recommend various methods to restore moisture, including sugarless gum, oral rinses or artificial saliva products.

A number of medications also may cause gingival enlargement or overgrowth, such as
calcium channel blockers, phenytoin used for seizure prevention and cyclosporine, which
is widely used following organ transplants to control rejection. Gingivitis may act as a predisposing factor to this condition, so meticulous oral care and routine dental visits are very important for people who use these medications.

Many liquid or chewable medications, especially children’s medications, are made palatable by the
addition of sucrose, glucose or fructose as sweeteners. These may significantly alter plaque and increase the risk of cavities and possibly periodontal disease. When purchasing lozenges, chewable tablets and syrups, look for those that are sugar-free.

Just as you tell your physician about the drugs your taking, be sure to tell your periodontist about all
the medications that your are taking, including herbal remedies and over-the-counter medications.
Your dental professional can talk to you about what effects, if any, these may be having on your
periodontal health. Your dental professionals can work with you and your physician to minimize negative effects.

Dental care may ward off gingival overgrowth

If you use a calcium channel blocker, you can add another important reason to go to the dentist to the list. These drugs commonly cause gingival overgrowth. And, nifedipine a commonly prescribed medication for high blood pressure, is the calcium channel
blocker most frequently associated with this condition.

However, a recent study in the Journal of Periodontology suggests that frequent dental visits
following initial periodontal treatment may significantly reduce gingival overgrowth in patients taking nifedipine. This is good news for the 20 to 40 percent of patients taking nifedipine who experience discomfort from recurring gingival overgrowth and rely on nifedipine to control their high blood pressure. Swollen gums can be painful, unsightly and interfere with speech, eating, and everyday brushing and flossing.

The study found that gingival overgrowth recurrence was eliminated in more than half of patients with a combination of initial periodontal therapy, including surgical and non-surgical treatments, followed by more frequent dental visits (every three months). This regimen
appeared to affect recurrence more than previously known risk factors, such as gender, drug type, and duration of drug therapy.

Overgrown gums make it easierfor bacteria to accumulate and attack supporting structures of the teeth, which can lead to severe periodontal infection. These study findings are a significant advancement to earlier research, which concluded that the development and recurrence of gingival overgrowth could be minimized, but not prevented, with periodontal
therapy and frequent dental visits.

Some people also may be able to substitute the calcium channel blocker they take with a different type if it is causing oral problems. Talk with your physician and periodontist.,

Bad Breath, Gum Disease & Oral Bacteria

Bacteria are the culprit in periodontal disease

Imagine you’re in a jungle. It’s warm and moist and there is plenty of food to feed on.  It is also crawling with hundreds of diverse species of living beings. Many are harmless and some are even beneficial to the environment. However, one group can be described as predators, attacking their immediate environment and wreaking havoc far and wide. To stop the wild beasts, you need weapons. What should you grab? A toothbrush and floss. Okay, we’re not talking about the Amazon Rain Forest, we’re talking about your mouth, but it really is a jungle in there. 

More than 500 species of microorganisms have been identified in the mouth. Approximately 15 of these bacterial species have been implicated for playing a role in periodontal disease. Whether or not you get periodontal disease depends on the bacterial makeup, your response mechanism and environmental factors, such as smoking. Your saliva includes proteins and anti-fungal agents, which help get rid of oral bacteria. 

The bacteria in plaque cause the gums to become red and swollen and to bleed easily. Eventually, gums separate from the teeth forming pockets. The pockets fill with even more plaque and infection and eventually deepen. Over time, tissue and bone are destroyed and the teeth loosen.

To stop this process, it is necessary to eliminate the infection-causing bacteria that accumulate below the gumline, dental professionals often use simple procedures such as scaling and root planing. These are nonsurgical procedures to remove plaque and tartar from below the gum line. Tooth root surfaces are cleaned and smoothed as the rough surfaces of tartar make it easier for bacteria to get a foothold. 

In addition, your periodontist may recommend antibiotic treatments to enhance traditional
therapies. These are designed to kill a wide variety of oral bacteria. 

Someday, researchers may discover a vaccine to eliminate harmful bacteria from the mouth. Until then, arm yourself with a toothbrush, floss and regular dental visits.

Don't be a yuck mouth, tame that beastly breath

With all the bacteria proliferating in the human mouth, it is no wonder that about one in four
people believe they have halitosis. Bad breath originates from certain oral bacteria producing an abundance of volatile sulfur compounds. Bad breath can be caused by several things, including certain foods, periodontal disease, dry mouth, tobacco use or a medical disorder. Here are some breath freshening tips:

• First, determine if you have bad breath. One method is to take a piece of unwaxed, unflavored dental floss and floss between your upper and lower back molars. Or, use a dry cloth and wipe it across the back part of your tongue for about five seconds. Wait about a half a minute and then smell it. Asking a friend or family member works too.
• Mouthwashes, breath sprays and mints mask the problem temporarily. In fact, mouthwashes with alcohol may further the problem as, over time, they can dry out the mouth. If you have chronic bad breath, you will want to get to the source of the problem. 
• Be aware of foods that trigger bad breath such as garlic, onions and coffee. And, brush your teeth after consuming milk products, fish and meat. 
• Keep your mouth moist by drinking plenty of fluids, chewing sugar free gum or sucking on sugarless candy. 
• Floss, and brush your teeth, gums and tongue daily. Do not forget to clean behind the back teeth in each row. 
• Denture wearers need to avoid plaque buildup under the dentures. Thoroughly clean dentures daily and remove dentures at night to avoid bacterial growth. Denture wearers should continue to see a dental professional regularly. 
• Talk with your dentist or periodontist about oral problems that may be the cause. Your dental professional can also tell you about the latest techniques to treat bad breath. 
• If you determine that chronic bad breath is not from an oral source, see your physician. 

View this blog post for information about Aging & Tooth Loss

A Lifetime of Healthy Teeth and Gums

People are now living longer and healthier lives, and older adults are more likely than ever before to keep their teeth for a lifetime. However, research has shown that older people also have the highest rates of periodontal disease. In fact, at least half of people over age 55 have some form of periodontal disease, and almost one out of four people over 65 have lost all their teeth.

No matter what your age, it is important to keep your teeth and gums healthy. If you’ve
succeeded in avoiding periodontal disease as you age, it is especially important to continue
to maintain your oral care routine. Be sure to brush and floss daily, and see a dental
professional, such as a periodontist, regularly. You should also receive a comprehensive 
periodontal exam each year. This will ensure that your oral health (and possibly even your overall health) stays at its best. If you have dexterity problems or a physical disability and are finding it difficult to properly brush or floss your teeth, your dentist or periodontist can suggest options such as an electric toothbrush or floss holder. 

Research has shown that periodontal disease is a chronic inflammatory disease that may put you at a higher risk for other diseases including cardiovascular disease, diabetes, and Alzheimer’s disease. During your regular visits with your dentist or periodontist, be sure to let him or her know if you have any of  these medical conditions or if you have a family history of disease. Likewise, if you have been diagnosed with periodontal disease, it’s a good idea to share this information with your physician to ensure that you’re receiving appropriate care. 

You should also tell your dentist or periodontist about any medications you are taking, because many medications can impact your oral health and therefore affect your dental treatment. Hundreds of common medications - including antihistamines and high blood pressure medications - can cause side effects such as soft tissue changes, taste changes, and gum overgrowth. Another possible side effect of some medications is dry mouth, a condition that leaves the mouth without enough saliva to wash away food from your teeth. This may leave you more susceptible to tooth decay and periodontal disease, and can cause sore throat, problems with speaking, and difficulty swallowing. 

Maintaining your oral health should be a priority at any age. As you get older, be sure to continue to take care of your teeth and gums to ensure that they’ll stay healthy and strong for life.

Special Concerns For Women

Women who are menopausal or post-menopausal may experience changes in their mouth including
dry mouth, pain or burning sensations in the gum tissue, and altered taste due to hormonal
changes. Additionally, menopausal women should be concerned about osteoporosis, which can
lead to tooth loss if the density of the bone that supports the teeth has decreased. Talk to your doctor
about hormone replacement therapy or estrogen supplements, which may help symptoms of
menopause.

DENTAL FEAR & ANXIETY

Don'’t let your fear keep you out of the chair

If your palms start sweating and your heart starts pounding at the thought of visiting the
dentist, you are not alone. The vast majority of individuals experience some anxiety toward
dentistry. However, about 10 to 15 percent of the population suffers from high dental anxiety,
which has been associated with avoidance behaviors and adverse outcomes to dental health. It’s important to find ways to “unlearn” this dental fear because when dental professionals can catch a
problem in your mouth early, it minimizes expense, time and discomfort.

Here are some ideas:

• The first step is to identify where your fear came from. According to a recent AAP survey,periodontists report that the two most common origins for patient fear are family and friends or personal bad experience more than 10 years ago. Discuss your fear with family members, friends and your dental professionals. In many cases, the fears are no                       longer realistic because of advances in dentistry. 
• Next, find ways to feel more in control of your experience. Ask your periodontist                     to explain any procedures being considered. Knowledge can be empowering. Your periodontist can also explain your options for techniques to control pain and stress, such as medications, anesthesia, sedation and relaxation techniques that can make your treatment virtually painfree. And, you and your periodontist can agree on a signal, such as a raised hand, that will stop the procedure and allow you the opportunity to deal with your anxiety. 
• Choose times for your appointments when you won’t be rushed or stressed by other issues. If you feel tense when you get into the dental chair, try relaxation techniques such as rhythmic breathing or visualizing calming scenarios, such as relaxing on a beach. Or, distract yourself with a Walkman or by focusing on something in the room. 
•  Once the dental visit is over, congratulate yourself for your courage and treat yourself to a special reward.   
• Most importantly, remember that your dental professionals are your allies. Enlist their help in overcoming your fear by not being embarrassed to talk with them about it and by asking any questions you may have.

Many periodontal procedures can be pain-free

        It’s been “drilled” into our minds by family members and friends and experiences from

long ago: our fear of dental treatments. However, according to a recent online poll of periodontists conducted by the AAP, many more patients indicate they have a fear about receiving periodontal treatment prior to treatment than say they felt extreme discomfort or pain following treatment.

       Of the 164 periodontists polled, almost half said that more than 50 percent of their patients indicate they are fearful about receiving periodontal treatment. However, more than three-quarters said less than 10 percent of their patients say periodontal treatments actually cause them any extreme discomfort or pain. Many respondents said establishing trust with patients goes a long way in alleviating fear. 

       Periodontists report that it’s men and middle-aged adults who are most likely to fear periodontal procedures. While 47 percent of those surveyed said that male patients

are more often fearful, only 11 percent find their female patients to be the more fearful gender. And, more than half chose adults in their 40s and 50s as the most fearful age group, compared to younger and older age groups. Specifically, they said their patients are most likely to be afraid of feeling pain and needles. 

        The survey also revealed that the top origins of fear are family and friends or a personal bad experience more than 10 years ago. 

        The vast majority (84 percent) of respondents said that they have implemented specific procedures to help patients deal with their fear during treatment, and 59 percent said they’d implemented procedures in the past three years that actually make periodontal treatment more comfortable. In addition, some periodontists mentioned that improvements in local anesthesia, pain and anxiety medications, and in some cases, conscious sedation, have made many procedures performed at the periodontist's office virtually painfree.