Deaf Health Talks Periodontal Disease and Heart Health Presenter: Christopher Lehfeldt, DDS Elmwood Dental Group March 15, 2012 Many thanks to DHCC, community partner of NCDHR working with RRCD’s R.E.A.P. Thursday, March 15, 12
charterstowers.e-village.com.au
Brushing and flossing may actually save your life! Thursday, March 15, 12
1. What is periodontal disease? •
Caused by harmful bacteria in the mouth
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Harmful bacteria grow inside a ‘sticky film’ on the tooth surface
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This sticky film is called “dental plaque” www.implantperio.com
• Thursday, March 15, 12
The bacteria infect the gums around the teeth
1. What is periodontal disease? (cont’d.) • •
Infected gums swell up
•
This happens when someone does not brush or use floss to remove this dental plaque every day
The infection destroys the supporting tissue and bone around one or more teeth
www.fiestadentalcare.com/
Thursday, March 15, 12
I ask you: an ASL sign for “periodontal disease”?
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Sign “letter P” at corner of mouth, then the sign for “disease” at forehead and abdomen?
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2. How common is periodontal disease? • Mild and moderate periodontal disease is found in 30 to 50% of adults
• Severe periodontal disease affects from 5% to 15% of adults in the United States
(American Academy of Periodontology. Epidemiology of periodontal diseases (position paper). J Periodontol 2005;76:1406-1419.) Thursday, March 15, 12
3. What does periodontal disease look like? • • • •
Swollen gums
• •
Teeth appear “long” due to receding gums
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Discolored gums Tender gums Bleeding gums (spontaneous or after brushing or flossing) Increased spaces between teeth
3. What does periodontal disease look like? (cont’d.) • • • • • • •
Pus between teeth and gums Loose teeth Teeth feel strange when biting down Change in the fit of partial dentures Change in the way your teeth meet when biting Bad taste Bad breath www.perio.org/consumer/gum-disease-symptoms.htm
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4. How is periodontal disease diagnosed? •
The dentist will use a periodontal probe to examine gums
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X-rays are taken to show extent of bone loss around teeth
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rickwilsondmd.typepad.com
X-ray showing bone loss Thursday, March 15, 12
5. What is heart disease?
•
The medical name for heart disease is cardiovascular disease (CVD)
•
An American dies from CVD every 37 seconds.
(Lloyd-Jones D, Adams R, Carnethon M et al. Heart Disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee (published correction appears in Circulation 2009;119[3]e182.) Circulation 2009;119[3]:e21-e181.) Thursday, March 15, 12
I ask you: an ASL sign for “heart disease” or “CVD”?
Thursday, March 15, 12
Sign “letter C” “letter V” “letter D” at chest where heart is, on the left side?
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6. How does CVD happen? •
Animal fats from food are changed into fatty particles in the blood
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These fatty particles ‘stick’ to the walls of blood vessels
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This is called ‘artherosclerotic plaque’
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The blood vessels narrow
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The heart works harder to pump blood
Thursday, March 15, 12
www.medicinenet.com/heart_disease_pictures_slideshow
6. How does CVD happen? (cont’d.) •
Blood pressure increases
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Heart failure can happen
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Sometimes, a bit of the ‘sticky’ plaque peels off into the bloodstream
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This can cause a blood clot which gets stuck somewhere in the body www.medicinenet.com/heart_disease_pictures_slideshow
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6. How does CVD happen? (cont’d.) • Blood clot ending up in the brain causes a stroke
• Blood clot blocking a blood vessel of the heart causes a heart attack
www.heart.org Thursday, March 15, 12
7. What is dental plaque? • Dental plaque is a
‘sticky’ film on and around teeth
• Dental plaque
contains harmful bacteria which invade the blood vessels of the mouth
Thursday, March 15, 12
meadfamilydental.com
8. What is artherosclerotic plaque? •
Some types of mouth bacteria cause more fatty droplets in the blood
•
These bacteria increase the ‘sticky’ properties of the blood vessels in the body and heart, leading to growth of artherosclerotic plaque
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I ask you: sign or fingerspell “dental plaque”? “Artherosclerotic plaque”?
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Dental plaque IS NOT THE SAME as atherosclerotic plaque! (Arteriosclerosis, Thrombosis, and Vascular Biology. 2003; 23: 1309-1311)
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9. What do periodontists and cardiologists say? •
A periodontist is a dentist who has had advanced training in the treatment and prevention of periodontal disease
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A cardiologist is a physician who specializes in treating diseases of the heart
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9. What do they say? (cont’d.) •
“Inflammation is a major risk factor for heart disease, and periodontal disease may increase the inflammation level throughout the body. Since several studies have shown that patients with periodontal disease have an increased risk for cardiovascular disease, we felt it was important to develop clinical recommendations for our respective specialities.”
•
“Both periodontal disease and CVD are inflammatory diseases, and inflammation is the common mechanism that connects them.”
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“Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries (blood vessels).”
www.perio.org/consumer/perio_cardio.htm
Thursday, March 15, 12
9. What do they say? (cont’d.) •
This is why your cardiologist or physician examines your mouth!
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This is also why your dentist or periodontist asks questions about your heart health!
www.perio.org/consumer/perio_cardio.htm
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10. What is an example of new or recent research? • •
Published in the British Medical Journal, May 2010 “Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey”
(BMJ 2010;340:c2451 doi:10.1136/bmj.c2451) Thursday, March 15, 12
10. Example of new research? (cont’d.) • • • • •
11869 men and women
•
participants who never or rarely brushed had an increased risk of a CVD event (hazard risk 1.7)
mean age 50 oral hygiene assessed from self reported frequency of toothbrushing surveys were prospectively linked to clinical hospital records blood tests on subsample of participants (4830) for inflammatory markers and coagulation
(BMJ 2010;340:c2451 doi:10.1136/bmj.c2451) Thursday, March 15, 12
11. Am I at risk for periodontal disease? •
A self-test will help you see if you are at risk for having or developing periodontal
•
See your dentist to get your gums evaluated and treated for periodontal disease! www.perio.org/consumer/4a.html
Thursday, March 15, 12
11. What are risk factors for CVD or heart disease? • • • • • • • •
High cholesterol High blood pressure Diabetes Cigarette smoking Overweight and obese Poor diet Physical inactivity
www.medicinenet.com/heart_disease_pictures_slideshow
Alcohol use http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_disease.htm
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11. Risk factors for CVD or heart disease? (cont’d.) •
See your physician to get evaluated and treated for heart disease or CVD!
•
Your physician will listen to your heart, take your heart rate, check your blood pressure, perform a physical exam, recommend blood tests to check your cholesterol levels and blood markers that may indicate heart disease
http://www.webmd.com/heart-disease/guide/heart-disease-diagnosis Thursday, March 15, 12
12. What is treatment for periodontal disease? • • •
Different for each person
•
Periodontal surgery might be required to reduce periodontal pockets, to regenerate the gums, or to lengthen the crown (of the tooth), or to place a soft tissue graft
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Designed and performed by your dentist, periodontist or dental hygienist Non-surgical treatment such as root planing and scaling (a careful cleaning of the root surfaces to remove dental plaque and calculus (tartar) from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), usually with an antibiotic, either placed locally in the periodontal pocket or orally
13. What is treatment for heart disease? • •
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Different for each person Your physician or cardiologist develops treatment
14. Want more information? American Academy of Family Doctors: http://familydoctor.org/familydoctor/en.html American Dental Association: http://www.ada.org/365.aspx American Academy of Periodontology: http://www.perio.org American Heart Association: http://www.heart.org Centers for Disease Control and Prevention: http://www.cdc.gov/ Mayo Clinic: http://www.mayoclinic.com/ WebMD: http://www.webmd.com/heart-disease/default.htm
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15. Can I trust the healthcare information found on the Internet? HON recommendation to Internet users: Before consulting healthcare information, click on a website's HONcode certification seal.
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