Treating gum disease to prevent heart disease: the evidence is unclear

Heart diseaseGum disease is a common chronic or persisting condition that can get worse over time. It involves inflammation of the gums, which surround and support the teeth, causing swollen and painful gums and in severe cases loss of the bone (alveolar) that supports the teeth. Clinical investigations have shown that there might be a link or association between chronic, ongoing gum disease and heart and blood vessel disease (cardiovascular disease). Some investigators believe that the treatment for gum disease, which gets rid of bacteria and infection and controls inflammation, might prevent the occurrence or recurrence.

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Chlorhexidine mouthrinse reduces plaque and can improve gum health in people with low levels of gingivitis

Chlorhexidine mouthrinse_croppedGingivitis is a reversible condition when gums become red, swollen and can bleed easily. Gingivitis is also very common – studies suggest that as many as 50% to 90% of adults in the UK and USA suffer from it. In susceptible people gingivitis may lead to periodontitis, which is not reversible. In periodontitis inflammation is accompanied by loss of ligaments and bone supporting the teeth. If untreated it may eventually lead to tooth loss. Severe periodontitis is the sixth most widespread disease globally.

It is recognised that maintaining a high standard of oral hygiene is important for the prevention and treatment of gingivitis. Toothbrushing is the main method for maintaining good oral hygiene. Other cleaning methods commonly used include dental floss, interdental brushes and scaling and polishing carried out by a dental professional. Some people have difficulty controlling plaque build-up and preventing gingivitis using only conventional tooth cleaning. Therefore people sometimes use mouthrinses containing chlorhexidine in addition to conventional tooth cleaning. These mouthrinses are readily available over the counter; prescriptions generally not being required outside the USA. Continue reading

Treating gum disease: can it help diabetics control their blood sugar levels?

iStock_000013589042_SmallGum disease treatment is used to reduce swelling and infection from gum disease. Keeping blood sugar levels under control is a key issue for people with diabetes, and some clinical research suggests a relationship exists between gum disease treatment and glycaemic control. As a result, it is important to discover if gum disease treatment does improve glycaemic control to encourage better use of clinical resources.

There is a broad range of gum disease treatments available for treating patients with diabetes. This review considered:

1. Does gum disease treatment improve blood sugar control in people with diabetes?
2. Does one type of gum disease treatment have a bigger effect than another in improving blood sugar control?

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Treating all teeth within 24 hours for chronic gum disease

FMSGum disease or periodontitis is a chronic inflammatory disease that causes damage to the soft tissue and bone around the teeth. Mild periodontitis is common in adults with severe periodontitis occurring in up to 20% of the population. Non-surgical treatments based on the mechanical removal of bacteria from infected root surfaces are used in order to arrest and control the loss of the bone and tissue that support the tooth in adults suffering from chronic gum disease. These treatments can be carried out in a different area of the mouth in separate sessions over a period of several weeks (SRP), which is the conventional method, or alternatively, can be done within 24 hours in one or two sessions, which is termed ‘full-mouth scaling’ (FMS). When an antiseptic agent (such as chlorhexidine for example) is added to the full-mouth scaling the intervention is called ‘full-mouth disinfection’ (FMD). The rationale for full-mouth approaches is that they may reduce the likelihood of re-infection in already treated sites. This review is an update of one originally published in 2008, and considers the effectiveness of full mouth treatments. Continue reading

Treating chronic gum disease – can it help to prevent heart disease?

Heart diseaseGum disease (periodontitis) is a common chronic or persistent condition that can get worse over time. It involves inflammation of the gums, which surround and support the teeth, causing swollen and painful gums and in severe cases loss of the bone that supports the teeth. Clinical investigations have shown that there might be a link between chronic, ongoing gum disease and heart and blood vessel disease (cardiovascular disease). Some investigators believe that the treatment for gum disease, which gets rid of bacteria and infection and controls inflammation, might prevent the occurrence or recurrence of heart disease. Continue reading

Do electric toothbrushes remove more plaque and lead to better oral health?

electic toothbrush_

Photo copyright Pau Artigas, under Creative Commons Licence

Removing plaque through effective toothbrushing has an important role in the prevention of gum disease and tooth decay. Dental plaque is the primary cause of gum inflammation, and this can lead to more serious oral conditions. The build up of plaque can also lead to tooth decay. There are different kinds of powered or electric toothbrushes available to the public, at a range of prices. Powered toothbrushes work in different ways – some move from side to side, and some in a circular motion. Are these kind of toothbrushes better to use than a manual toothbrush? Does their use lead to less inflammation in the gums? Continue reading

Interdental brushes – do they prevent and control tooth decay and gum disease?

D:DCIM100MEDIAIMG_0007.JPGGum disease and tooth decay are the main reasons for tooth loss. Unless brushed away, plaque (a sticky film containing bacteria) can build up on the teeth, which can lead to gum inflammation. Plaque is also a key factor in the development of tooth decay. Interdental brushes are designed to clean between the teeth, to remove the plaque in harder to reach areas. They are small headed toothbrushes, available in a range of different widths to match the space between the teeth. They can be cone-shaped or cylindrical. Together with dental floss, interdental brushes are one of the most commonly recommended, advertised and available aids for cleaning between the teeth. But is there evidence that they really work to control tooth decay and reduce gum disease? Continue reading