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Periodontal Disease: Did The Romans Really Have Less Gum Disease Than Us?

Gum Disease: Why Romans had teeth to smile about

A recent article in The Times newspaper claims the Romans suffered from  less periodontal disease than we do today. Really? We know they didn’t have access to the same modern dentistry and mouth-care techniques back then, so what was their secret? Was it really all down to not smoking and less sugar in the  diet, or are there other factors at play? Dr Galgut challenges some of the views proffered by Professor Frances Hughes and suggests some other reasons for the lowered incidence of periodontal disease found in our ancient forebears.
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Preventative Dentistry: Everything You Need To Know About Dental Plaque

Dental plaque is not just about the build-up of film on your teeth caused by bacteria or bad brushing. It is the first line in a whole array of oral problems, including gum disease and periodontal disease, which left untreated, can cause other more serious illness throughout the body. Preventative dentistry is about just that: preventing oral problems from developing in the first place, rather than just treating the symptoms as they appear. Nothing in the body is isolated. In terms of “good health”, it is important to remember the whole body functions as one unit. Each process is inter-connected to another in some way, shape, or form. That means if you want a healthy body, you can’t ignore your teeth!
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Why Do I Need A Gum Disease Expert? What’s Wrong With My Regular Dentist?

Gum disease is a common problem that can indicate the presence of a serious infection. Amazingly, even after all of the advances in modern medicine, over half of all adults in the UK will suffer from gum problems at some time. However, far more worrying is the fact that if you are suffering from gum disease, or periodontal disease as it is also known, it’s not just your teeth that are at risk. Although gum disease can be something people fear more from a cosmetic point of view than a medical point of view due to its unsightly disfigurement of the teeth and gums, this is a very misguided viewpoint. Latest studies have linked this disease to other serious health concerns such as stroke, diabetes, heart disease and degenerative ailments. Therefore, quickly identifying the signs of gum disease is the best way to prevent the condition worsening and causing serious lasting damage. Read More

Is It Possible to Reverse Periodontal Disease?

Yes, it is possible to reverse periodontal disease. However, before you know how to treat this oral health condition, you must first know what you are facing.  The first thing to know is that there are two types of gum disease: gingivitis and periodontitis.

Gingivitis is the swelling of the gums that is caused by the accumulation of bacteria along the gum line. If the gingivitis is left untreated, it leads to periodontitis. Symptoms of periodontal disease include receding gums, inflammation along the gum line, pain, and sensitivity to changes in temperature. Read More

Is There a Cure for Aggressive Periodontitis?

Is There a Cure for Aggressive Periodontitis?

Aggressive periodontitis is more common than a lot of people think, nevertheless many people are unaware of the symptoms and occurrence of this disease. The most obvious features of the disease include hasty attachment loss and bone obliteration and genetic aggregation of the teeth. This can result in very early tooth loss if not tackled in a timely and efficient manner. The diagnosis of the disease is similar for all patients, but the treatment can vary from person to person due to their different characteristics and the intensity of the disease. It is definitely curable and should be treated as early as possible in order to avoid any kind of severe loss of the teeth. Unfortunately, once it has reached the very advanced stages, the patient  would usually have a lot of bone loss and once the bone has gone it cannot be regenerated. This does not however mean that the disease cannot be successfully treated and managed, often without the need for surgery.

It is possible to graft bone into the areas around the teeth by taking it from somewhere else in your body such as your hip or your ribs, but the problem with aggressive periodontitis is that the bone erodes away because of an exaggerated destructive response of your gums, and this excessive destructive process usually affects the grafted bone so it melts away as well.

However, as I said, even in extreme cases, all is not lost. Textbooks state that if you lose more than a 3rd of the bone around your teeth the teeth have a hopeless prognosis and need to be extracted.  That is very often what a dentist will tell their patient because this is what they have been taught. And from a ‘text book’ point of view, he/she is right.  This is where the services of a periodontal expert can reap dividends. As a periodontal specialist in North London, I have been treating very advanced cases of periodontal disease with bone loss for many years and in most cases the condition can be managed and treated in different ways and in some cases very successfully without any tooth loss at all!

Scaling and Root Planing Treatments

Aggressive periodontitis is a disease much like the high blood pressure and diabetes which, whilst unfortunately cannot be completely cured, can be controlled and managed exceptionally well with medical treatment and specialist after care. Depending on the time of diagnosis and the intensity of the disease, the treatment will vary accordingly. If the disease is diagnosed at an early stage, then your periodontal specialist will  have several options for treatment – one of which is Scaling and Root Planing. This works by removing plaque and calculus in all the areas around the teeth and gums and also flattening the surface of the root. Scaling and Root Planing treatment helps significantly in getting rid of the mouth bacteria which is mostly just along the gum line of the teeth. This kind of treatment works best where there is early stage detection of the disease or for cases which have not developed viciously. If the situation is severe and it is not timely diagnosed, then many periodontal specialists go for other complex treatments where periodontal surgery is highly likely to be the treatment proposed.

Gum graft surgery

This is the preferred surgical treatment for Aggressive periodontitis as suggested by many periodontal experts. The surgery repairs the loss and also prevents any further damage or loss of the gum bones. Gum graft surgery is done to cover roots and encourage development of new gum tissues on the gum line where there is a shortage excessive gingival recession. In graft surgery for gums, the surgeon takes the gum tissues from any relevant part of your body (for example your hip or rib) or any other donor’s source to fill the exposed root of the teeth. This filling is done tooth by tooth. It can be done either for one tooth or several teeth as per the requirement and condition of the root under each tooth until the gum line is completely recovered, and the sensitivity is reduced.  As stated above, however, the problem with aggressive periodontitis is that the bone erodes away because of an exaggerated destructive response of your gums, and this excessive destructive process usually affects the grafted bone so it melts away as well. This is why I always propose looking at non-surgical and far less invasive treatments where at all possible. I have developed a practice over 20 years specializing in exactly that, and now lecture extensively on the subject of non-surgical treatment of periodontal disease, including aggressive periodontitis. Read more about my published work.

In conclusion, Aggressive periodontitis can be a serious condition with a fairly grim prognosis if it is not caught and treated in a timely fashion. An early diagnosis of the disease involves far simpler treatment processes. Nevertheless, even severe or chronic conditions can sometimes be treated without the need for surgery.
Of course, your periodontal specialist is the one to consult for an individual diagnosis and prognosis of your condition.
I offer both telephone and face-to-face consultations and can work together with your own dentist to provide the best treatment plan for you. You can contact me here for further advice on periodontal treatment.
Take heart, even in severe cases of aggressive periodontitis, all is not lost 🙂
Take care and I hope to hear from you soon.

How to Reverse Periodontal Disease Without Surgery

Our teeth play an important role in personal image and therefore, it’s our responsibility to make sure that proper practices that promote dental health and hygiene are upheld. However, teeth are also susceptible to many infections that can cause great discomfort and even the loss of teeth. Periodontal disease is a common disease that affects the gums and is experienced by many people in today’s society. This disease is detected by common symptoms such as bleeding gums, receding gum line, bad breath and losing some teeth. If left unchecked, periodontal disease can cause other serious complications and it’s therefore good to immediately get information on how to reverse periodontal disease before it causes more damage to your teeth.
For many people, the common question is: What causes periodontal disease and how can it be treated? An accumulation of plaque on the surface of your teeth for extended periods of time is the main cause of periodontal disease. When plaque stays on the tooth surface for long, the body responds naturally by inflaming the gums that eventually leads to the creation of spaces between the gum and teeth commonly known as “pocketing”.
This complication makes it difficult for you to effectively clean your teeth because of the breakdown of body’s collagen and structure of the bone. When you are unable to clean these spaces, the area becomes fertile for the development of bacteria that is responsible for further bone structure breakdown. At this point, it is important to visit a dentist to be advised on how to reverse periodontal disease because more bacterial accumulation means further damage to your teeth.

Approaches on How to Reverse Periodontal Disease

Your periodontist will advise you on the best approach  for you to treat the symptoms and cure this disease. One approach is to perform root planning or deep scaling. It is important to use a qualified and reputable periodontal expert who clearly understands the process of how to reverse periodontal disease. When performing this procedure, a patient should be sedated while the dentist performs a thorough mouth cleaning process. However, it is usually advised that a quarter of the mouth is cleaned at a time especially for serious cases of periodontal disease. Some patients are also prescribed drugs that consist of tetracycline whose main aim is to reduce further inflammation by shrinking pockets in the gums and prevent them from widening.

How Many Appointments Are Required?

Once the initial cleaning has been done, a good periodontist always schedules regular appointments with their patients to ensure that the process of how to reverse periodontal disease is highly successful, and in case an infection recurs, it can be quickly handled. The first step to successfully start the process of how to reverse periodontal disease is to get in touch with Periodontal Services by calling in to schedule an appointment.
My periodontal practice is in North London and I am happy to schedule an initial appointment with you where we can discuss your symptoms and the best periodontal treatment and aftercare for you in more depth.
You can contact me here: Get in touch with Dr Peter Galgut

Best Way to Brush Your Teeth to Prevent Gum Disease?

Recently, The Times ran an article suggesting that dentists are confused over the best way to brush your teeth. Really? Could it really be true that “in reality dentists have no real idea of the best way to brush your teeth” to prevent gum disease, periodontal disease and other nasties? Or, worse, that the advice your parents gave you to brush twice a day is “based on habit rather than solid research”. Could it really be that the reason why nearly half of all adults in the UK suffer from some kind of gum disease is because dentists have been advising their patients wrongly?

Below is  a copy of the article ‘Dentist’s divided over best way to brush’ as it was run in Times, on Saturday 9th August, together with my comments, and my advice, based on over 25 years of research and clinical practice, on how best to brush your teeth to prevent gum disease and periodontits.

Dentists divided over best way to brush

Chris Smyth Health Correspondent

“Some demand a circular motion, others call a 45-degree angle, and there are still partisans of the horizontal scrub. Yet in reality dentists have no real idea of the best way to brush your teeth, researchers have concluded.
A range of contradictory advice is offered by dentists, governments and the makers of toothbrushes, yet there is little evidence to support any of it, scientists have said. Even the advice to brush twice a day for two minutes is based on habit rather than solid research, according to scientists who surveyed dozens of studies for an article in the British Dental Journal.
The senior author of the research, Professor Aubrey Sheiham, of University College London, said: “If people hear one thing from a dental association, another from a toothbrush company and something else from their dentist, no wonder they are confused about how to brush. In this study we found an unacceptably inconsistent array of advice from different sources.” He added: “There is no evidence to suggest that complicated techniques are any better than a simple, gentle scrub.”
Professor Sheiham said that brushing after eating sweet or sugary drinks made little difference to tooth decay, and John Wainwright, who carried out the study, said ensuring toothpaste contained fluoride was more important than any brushing technique.
“I advise my patients to focus their brushing on areas where plaque is most likely to collect – the biting surfaces and where the teeth and gums meet – and to use a gentle scrubbing motion,” Dr Wainwright said, adding that holding the toothbrush in a pencil grip might help to stop gums being damaged by overzealous brushing.
He conceded: “We can give these kinds of rationale, but the evidence that’s available doesn’t score highly. The current situation, where not just individuals dentists but different dental organizations worldwide, are all issuing different brushing guidelines isn’t just confusing, it’s undermining faith and trust in the profession as a whole. For something most people do twice a day, you would expect dentists to send a clearer message to their patients on how to brush their teeth.”
Professor Damien Walmsley, a scientific adviser to the British Dental Association, said: “No technique is superior to the other but a dental professional will check what the patient does and tweak the technique accordingly.
“Take two minutes to brush all surfaces of the teeth in a systematic manner, using fluoridated toothpaste; brush at least twice a day; and spit, don’t rinse the mouth after brushing [to avoid washing away the fluoride].”
Nigel Carter, the chief executive of the British Dental Health Foundation, said: “There’s no real evidence on which is the best way of tooth-brushing. They will all have benefits and drawbacks.”
Although people in Britain are told advised to brush twice a day, Dr Carter said there was no international agreement. “Virtually the whole of South America says one minute, three times a day,” he said. “It’s based on habit and there’s no robust research.”
He said that it was probably not necessary for children to brush for two minutes but establishing that habit during supervised brushing up to the age of seven ensured that it would be carried on into later life.”

[The Times, Saturday 9th August 2014]

So, are we dentists really confused about the best way to brush your teeth – Of course we’re not!

In my opinion, the study by Professor Aubrey Sheiham is yet another example of academics sitting in their ivory towers spending lots of money and resources on totally irrelevant clinical research.  Anyone in the real world of clinical dentistry as opposed to academia knows that people are different, their levels of manual dexterity is different, their mouths the different, and even different parts of their mouths of different.  Not only that, but there are many different toothbrushes and other oral hygiene aids and there are many different ways of achieving a nice clean mouth only an academic, divorced from the reality of clinical practice could dream up the preposterous idea that there is some universal tooth brushing technique that is the best for everyone.

There is no such thing as the best way to clean your teeth, any more than there is a best motorcar or a best T-shirt, or even the best dentist!  The idea that one tooth brushing technique is good for everyone is simply stupid.  People who suffer from gum recession need to brush their teeth in a different way to those who do not, and the secret of achieving good oral hygiene is not a matter of the best toothbrush, or the best dental floss, or the best technique, but rather it is the best combination of technique and oral hygiene aids for you which might be different to everybody else.

In my own practice I recommend different techniques and different toothbrushes and different oral hygiene aids because I believe everybody is an individual and therefore need individual attention that is tailored to their needs specifically rather than assuming that what is good for Professor Aubrey Sheiham is good for the rest of us!

The general advice, as suggested in the article:

•    Brush for two minutes, twice a day
•    Brush all the surfaces in a systematic manner
•    Use fluoridated toothpaste
•    After brushing, spit. Don’t rinse the fluoride away
[Source: Damien Walmsley]

is of course true, however, if you are suffering from any unusual symptoms or are worried about gum disease, periodontitis or are suffering from bleeding, itchy gums, why not not take advantage of my ‘Ask a dentist online‘ service?

Alternatively, I offer a telephone support service, where I can discuss with your dentist, the best treatment pan for you. Please contact me for details.

I look forward to answering your questions, and giving you an individual service and care plan 🙂

What Causes Periodontal Disease?

Causes

Periodontitis begins with plaque. This invisible, sticky film forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Although you remove plaque every time you brush your teeth, it re-forms quickly, usually within 24 hours.

Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus), a white substance that makes plaque more difficult to remove and that acts as a reservoir for bacteria. Unfortunately, brushing and flossing can’t eliminate tartar — only a professional cleaning can remove it.

The longer plaque and tartar remain on your teeth, the more damage they can do. Initially, they may simply irritate and inflame the gingiva, the part of your gum around the base of your teeth. This is gingivitis, the mildest form of periodontal disease. But ongoing inflammation eventually causes pockets to develop between your gums and teeth that fill with plaque, tartar and bacteria. In time, the pockets become deeper and more bacteria accumulate, eventually advancing under your gum tissue. These deep infections cause a loss of tissue and bone. If too much bone is destroyed, you may lose one or more teeth.

Although the destructive cycle that starts with the accumulation of plaque is the most common cause of periodontal disease, a number of other factors can contribute to or aggravate the condition. These include:

  • Tobacco use. Smoking is the most significant risk factor for periodontal disease. Chewing tobacco also contributes to periodontal disease. Tobacco use in any form damages your immune system, putting you at greater risk of periodontal infection. It also creates a favorable environment for harmful bacteria and interferes with the normal mechanisms for limiting bacterial growth in your mouth. Even exposure to secondhand smoke appears to contribute to periodontal disease. And because smoking impairs healing, smokers are less likely to respond to treatment than nonsmokers are.
  • Heredity. Sometimes you may do everything right and still develop periodontal disease. In that case, you — along with close to one-third of the population — may have inherited a predisposition to gum problems.
  • Drugs. Hundreds of prescription and over-the-counter antidepressants, cold remedies and antihistamines contain ingredients that decrease your body’s production of saliva. Because saliva has a cleansing effect on your teeth and helps inhibit bacterial growth, this means that plaque and tartar can build up more easily. Other drugs, especially anti-seizure medications, calcium channel blockers and drugs that suppress your immune system, sometimes cause an overgrowth of gum tissue (gingival hyperplasia), making plaque much tougher to remove.
  • Diabetes. A number of health problems can take a toll on your gums. One of the most significant of these is diabetes, which makes you more prone to many infections, including gum infections. But the relationship between diabetes and periodontal disease doesn’t end there. Gingivitis and periodontitis impair your body’s ability to utilize insulin, making diabetes harder to control. And because diabetes and periodontal disease may make you more susceptible to heart attack and stroke, having both conditions increases your risk of cardiovascular disease.
  • Hormonal changes. Changes in hormone levels that occur during pregnancy, menopause or even menstruation can make your gums more susceptible to periodontal disease.
  • Nutritional deficiencies. A poor diet, especially one deficient in calcium, vitamin C and B vitamins, can contribute to periodontal disease. Calcium is important because it helps maintain the strength of your bones, including the bones that support your teeth. Vitamin C helps maintain the integrity of connective tissue. It’s also a powerful antioxidant that counters the tissue-destroying effects of free radicals — substances produced when oxygen is metabolized by your body.

When to seek medical advice

Healthy gums are firm and pale pink. If your gums are puffy, dusky red and bleed easily, see your dentist. The sooner you seek care, the better your chances of reversing damage and preventing more serious problems.

For more advice, why not seek a consultation – you can contact me here: http://periodontal.co.uk/new-contact/

What Age Do Most Adults Start Losing Their Teeth?

What age are most adults when they start losing their teeth? Well, it may surprise you to learn, adult teeth don’t ‘die’, which means they don’t fall out from natural causes (unless you call falling head-first off your bike or being punched in the face a natural cause!)  Disease or trauma are the main culprits for adult teeth dying.
Most people assume losing teeth is a natural consequence of the aging process. Not so. All too often, just like most things in life, if you lose your teeth and end up with false teeth, you’re probably the cause.
Baby teeth fall out on their own to be replaced with adult permanent teeth. However, adult teeth don’t fall out from natural causes.

So that’s the good (and the bad) news. You don’t have to lose your teeth, but if you do, don’t blame nature, in most cases the cause can be found a little closer to home.

What Are The 3 Causes of Adults Starting to Lose Their Teeth?

1) Trauma –
Obviously, a severe blow or knock to the head can cause your teeth to be instantly knocked out. Even if this doesn’t instantly knock them out, it may cause them to be damaged beyond repair and eventually you lose them.
Other less obvious forms of trauma include using your teeth to open bottles, tear open bags or hold things. Your teeth weren’t designed to be used as a Swiss army knife!
Finally, is you are a chronic jaw clencher or tooth grinder, beware. Did you know clenching and grinding the teeth can put more than 800 pounds of pressure on your teeth? …Clearly, this can lead to fractures and tooth loss.

2) Serious Illness –
Besides gum disease, chronic illness such as diabetes, cancer, osteomyelitis, and autoimmune diseases, can result in adults losing their teeth at an early age.

3) Periodontitis (Gum Disease)
Periodontal or gum disease is known as the ‘Silent Disease’ because it doesn’t start as a full-blown disease causing serious damage to your mouth. It can sneak up on you. Before you know it, the signs you ignored destroy bone resulting in tooth loss.

Now we know that, what can we do to stop our teeth from falling out?

As you can see, in all the reasons for adults losing their teeth mentioned above, not once have we mentioned old age. No matter your age, your teeth can be healthy. The flip side of that is, if you don’t look after them,  you could lose your teeth at any age.
So age is really does not a determining factor as to when we start to lose our teeth. Like so many things, lifestyle, diet and good health practices, in this case good oral health practices, are far more important in keeping teeth healthy and determining what age our teeth will start to fall out.
Of all the causes mentioned above, studies reveal gum disease is far and away the main cause of adults starting to lose their teeth. And in most instances, gum disease is the result of not taking good care of your mouth with regular, daily brushing and flossing.
So the best answer to keep teeth healthy and stop them from falling out is to give them a good ‘workout’ everyday combined with  regular check ups and proper home oral hygiene. Remember the “Two by Two Rule” Just two minutes, twice a day, especially at bedtime.

So, in a nutshell, the best way to stop your teeth from falling out is to make sure you give your teeth a good ‘workout’ everyday. Unlike going to the gym though, keeping your teeth healthy and in tip-top condition is a far less arduous task than keeping your body in shape. Just two minutes of cleaning, flossing and mouth-washing everyday, backed up with regular trips to the dentist and hygienist  will have your teeth fit for a lifetime!

In fact, this quote sums it up perfectly:“You don’t have to clean all your teeth every day – just the ones you want to keep.”

If you are worried about bleeding gums, bad breath or worried you may have gum disease, why not contact me for some advice?
You can reach me here: http://periodontal.co.uk/ask-a-periodontist/