GUM DISEASE AND WOMEN

A woman's periodontal health may be impacted by a variety of factors.

PUBERTY

During puberty, an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum's sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red and feel tender.

MENSTRUATION

Occasionally, some women experience menstruation gingivitis. Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman's period and clears up once her period has started.

PREGNANCY

Some studies have suggested the possibility of an additional risk factor – periodontal disease. Pregnant women who have periodontal disease may be more likely to have a baby that is born too early and too small. However, more research is needed to confirm how periodontal disease may affect pregnancy outcomes.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. The Academy recommends that women considering pregnancy have a periodontal evaluation.

MENOPAUSE AND POST-MENOPAUSE

Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.

In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition. Most women find that estrogen supplements help to relieve these symptoms.  perio.org

GUM DISEASE RISK FACTORS

The main cause of periodontal (gum) disease is plaque, but other factors affect the health of your gums.

AGE

Studies indicate that older people have the highest rates of periodontal disease. Data from the Centers for Disease Control and Prevention indicates that over 70% of Americans 65 and older have periodontitis.

SMOKING/TOBACCO USE

Tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

GENETICS

Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early intervention treatment may help them keep their teeth for a lifetime.

STRESS

Stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. Stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

MEDICATIONS

Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

CLENCHING OR GRINDING YOUR TEETH

Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

OTHER SYSTEMIC DISEASES

Other systemic diseases that interfere with the body's inflammatory system may worsen the condition of the gums. These include cardiovascular disease, diabetes, and rheumatoid arthritis.

POOR NUTRITION AND OBESITY

A diet low in important nutrients can compromise the body's immune system and make it harder for the body to fight off infection. Because periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums. In addition, research has shown that obesity may increase the risk of periodontal disease

Tooth Enamel May Be Damaged By Early Exposure To Bisphenol A

Are teeth the latest victims of bisphenol A? Yes, according to the conclusions of work carried out by the research team led by Ariane Berdal of the Universite Paris-Diderot and Sylvie Babajko, Research Director at Inserm Unit 872 "Centre des Cordeliers". The researchers have shown that the teeth of rats treated with low daily doses of BPA could be damaged by this. Analysis of the damage shows numerous characteristics that are common with a recently identified pathology of tooth enamel that affects roughly 18% of children between the ages of 6 and 8.

These results have been published in the American Journal of Pathology.

Bisphenol A (BPA) is a chemical compound used in the composition of plastics and resins. It is used for example to manufacture food containers such as bottles or babies' bottles. It is also used for the protective films inside drinks cans and food tins, or as developers on sales receipts. Significant amounts of BPA have also been found in human blood, urine, amniotic liquid and placentas. Recent studies have shown that this industrial compound has adverse effects on the reproduction, development and metabolism of laboratory animals. It is strongly suspected of having the same effects on humans.

As a precautionary measure, the manufacture and commercialisation of babies' bottles containing bisphenol A were prohibited in Europe in January 2011. The prohibition will be extended to all food containers in France as from July 2015.

So this study shows that teeth are the latest in an already long list of victims of BPA.

The Inserm researchers have shown that the incisors of rats treated with low daily doses of BPA (5 microgrammes/kg/day) could be damaged by this. This effect has also been observed within a development window of no more than 30 days post-birth in rats, thus demonstrating a range of sensitivity to exposure.

Analysis of these teeth showed numerous characteristics that are common with a tooth enamel pathology known as MIH (Molar Incisor Hypomineralisation) that selectively affects first molars and permanent incisors. This enamel pathology is found in roughly 18% of children between the ages of 6 and 8. Children affected by this pathology present with teeth that are hypersensitive to pain and liable to cavities. It is interesting to note that the period during which these teeth are formed (the first years of life) correspond to the period during which humans are most sensitive to bisphenol A.

Amongst the earliest observations made was the appearance of "white marks" on the incisors of rats treated with endocrine disruptors, one of which was bisphenol A (BPA). The researchers decided to define the characteristics of incisors of rats treated with low doses of BPA and to compare these with the characteristics of teeth in humans suffering from MIH

Macroscopic observation of marks on both series of teeth showed similarities, in particular fragile and brittle enamel.

Microscope observation of the enamel showed a significant reduction of the Ca/P and the Ca/C ratios in affected teeth. This leads to mineral depletion, making the teeth more fragile and more liable to cavities.

Finally, analysis of the proteins present in the tooth matrix of rats showed an increased quantity of enamelin, a key protein for enamel formation, and a buildup of albumin leading to hypomineralisation. Analysis of the expression of key enamel genes highlighted two BPA target genes: enamelin and kallicrein 4.

According to Sylvie Babajko, the latest author of this article, "Insofar as BPA has the same mechanism of action in rats as in men, it could also be a causal agent of MIH. Therefore, teeth could be used as early markers of exposure to endocrine disruptors acting in the same way as BPA and so could help in early detection of serious pathologies that would otherwise have occurred several years later". 

medicalnewstoday.com

Gum Disease and Heart Disease

Heart Disease

Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.
Scientists believe that inflammation caused by periodontal disease may be responsible for the association.
Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Stroke

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.  perio.org

Diabetes and Periodontal Disease

Diabetic patients are more likely to develop periodontal disease, which in turn can increase blood sugar and diabetic complications.

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don't have their diabetes under control are especially at risk.
Research has suggested that the relationship between diabetes and periodontal disease goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.
Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications. perio.org

Overall Oral Health There's a growing trend within general dentistry that stresses the importance of overall oral health – not only health of teeth and gums, but of all the soft tissues in the oral cavity and oropharynx. Growing numbers of clinical practitioners now incorporate routine intra- and extra-oral head and neck exams into their hygiene appointments to screen for dysplasia, oral cancer and a host of other oral diseases. Oral CancerApproximately 36,540 Americans will be diagnosed with cancer of the oral cavity and pharynx in 2010. During the same time period 7,880 Americans will die of oral cancer.* One of the VELscope system's most important tasks is to help identify areas that might, if not identified and treated, progress to oral cancer. The statistics below, from the National Cancer Institute's SEER Database, 1999-2006, are a compelling argument for regular VELscope exams: Found early, while still Localized (confined to the primary site), oral cancer's five-year survival rate is good: about 83%. Only 33% of all oral cancer discoveries fall into this category. Found while Regional (progressed to regional lymph nodes) the five-year survival rate drops significantly, to about 55%. Approximately 46% of all oral cancer discoveries are Regional. Found late, oral cancer's five-year survival rate is poor: approximately 32%. This accounts for approximately 14% of all oral cancer findings. Clearly, finding oral cancer in its early stages is key to survival. Routine VELscope examinations can improve the morbidity and mortality of oral-cancer, because the VELscope system assists in early detection, potentially saving lives through less invasive, more effective treatment. HPV — Changing the Demographics of Oral Cancer An increasing body of evidence points to a strong link between particular strains of the human papilloma virus (HPV, most notably strain 16) and a certain type of oral cancer that occurs in the oropharynx. HPV 16 is the same strain associated with almost all cervical cancer. Many experts now recommend that all adult patients over the age of 18 receive a thorough intra- and extra-oral head and neck exam annually. For more information on oral cancer, please visit the Oral Cancer Foundation. * All statistics from the National Cancer Institute's SEER Database.

Alan Ferguson, D.D.S., P.L.C.
1222 E. Missouri Avenue, Suite 201
Phoenix, AZ  85014
Office: (602) 242-5445

April 23, 2013

To All Current & Future Patients,

Dr. Ferguson and his team would like you to be aware of the news coverage involving the investigation of an Oklahoma oral surgeon and now a dentist in Tucson for poor infection control practices.  We are committed to an expert level of infection control practices and patient protection.  In our office we utilize the best possible protective equipment and sterilization techniques in order to ensure the safety of our patients and our dental team.  Please be assured that your safety and quality of care is our number one concern.  You can rest easy as you enter our practice.

Our steam autoclaves are tested weekly on site for accuracy and also sent weekly to a biological testing facility for spore testing, again ensuring that our instruments and equipment are sterilized effectively.  The water for our dental units is always distilled water and the lines are cleaned and maintained weekly: as well as sending water samples to a biological monitoring facility weekly.


Dr. Ferguson and his team of dental professionals are routinely attending continuing education for OSHA and infection control seminars in order to maintain the most up to date infection control protocols.  Please do not hesitate to call if you have any questions in regards to this extremely important subject. We would love to speak with you.

Thank you,

Alan Ferguson, D.D.S., P.L.C.

Cindy, Valorie, Stephanie, Maria, Suzy, Shelly and Sheryl

Press Release

For Immediate Release

Phoenix Dentist Using Salivary DNA Tests

to Fight Periodontal Infections

Phoenix, AZ – April, 17, 2013 –  Phoenix dentist, Dr. L. Alan Ferguson, whose practice is located at 1222 E. Missouri Avenue, #201, is administering two molecular tests that provide supplemental information about a patient’s periodontal disease. This information can be used to develop patient-specific treatment plans for periodontal disease therapy and to help establish the therapy endpoint.

The two salivary diagnostic tests, named MyPerioPath^® and MyPerioID^® PST^®, are offered by OralDNA^® Labs Inc., a subsidiary of Quest Diagnostics.

Specifically, the MyPerioPath test provides semi-quantitative levels of 11 different species of bacteria known to trigger periodontal disease. In addition to identifying the bacterial pathogens, the test provides a bacterial-related risk of disease progression and suggestions for suitable antibiotic therapy. The MyPerioID PST test detects genetic changes (DNA polymorphisms) that have been associated with increased incidence and/or progression of chronic periodontal disease in some studies.

According to Dr. Ferguson, “We are very pleased to be one of the first dental practices in the area to utilize the MyPerioPath and MyPerioID PST salivary diagnostic tests, enhancing our ability to provide the best possible care.”

Periodontal disease is a chronic inflammatory disease that affects the gum tissue and other structures supporting the teeth. If left untreated, it can lead to tooth loss. Besides helping with tooth retention, successful periodontal treatment can help patients with diabetes to better control their disease.^1,2 About 50% of Americans have gingival bleeding, the more common but less severe form of periodontal disease.³ Prevalence of more severe disease is more difficult to ascertain.

Several research studies have associated gum disease with other chronic inflammatory

diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis.^4,5

For more information regarding the MyPerioPath^® and MyPerioID^® PST^® salivary diagnostic tests, or to schedule an appointment, call Dr. Ferguson at (602) 242-5445 or visit http://www.drfergusonaz.com.

About OralDNA Labs Inc. (www.OralDNA.com)

OralDNA Labs Inc., a subsidiary of Quest Diagnostics Incorporated (NYSE: DGX), is a specialty diagnostics company created to advance clinical testing in the dental community. The company’s goal is to help the dental profession achieve better clinical outcomes by providing reliable, definitive, and cost-effective clinical tests that drive the detection and prognosis of disease at an earlier, more treatable stage.

References:

1.      Swedish (Sweden) Koromantzos PA, Makrilakis K, Dereka X, et al. A randomized, controlled trial on the effect of non-surgical periodontal therapy in patients with type 2 diabetes. Part I: effect on periodontal status and glycaemic control. J Clin Periodontol. 2011;38:142-147.  

2.      Simpson TC, Needleman I, Wild SH, et al. Treatment of periodontal disease for glycaemic control in people with diabetes (Review). Cochrane Database Syst Rev. 2010;(5):CD004714.

3.      Albandar JM, Kingman A. Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994. J Periodontol. 1999;70:30-43.

Services Provided

X-rays

X-rays allow us to see in between the teeth and under existing fillings to help us detect tooth decay. X-rays can also help us check the health of the bone supporting the teeth.

Diagnostic Impressions

Diagnostic impressions are taken to ensure the fit of any crown, bridge, or denture. The exact shape of your teeth and gums is molded in a flexible vinyl mixture that sets quickly. The vinyl mold is then used to create a replica of your mouth with plaster or plastic.

Comprehensive Oral Exams

The first step in any dental care plan is to determine your existing health conditions. If you are a first-time patient, we will perform a comprehensive examination; including recording of your medical history, taking full x-rays, screening for oral cancer, examining periodontal (gum) condition, checking each tooth for cavities, and examining your jaw and bite.

Periodic Oral Exams

As an established patient with a preventive dental care plan, you will come to the office on a regular recall schedule for a cleaning and check-up. Periodic exams are important for maintaining your healthy smile.

Consultation and Treatment Planning

Oral health is a lifelong concern. We will help you understand any conditions that need treatment and devise a plan for correcting them. We will also discuss the options for any cosmetic treatments you may be interested in. Furthermore, we will outline a regular course of preventive care.

Cracked Tooth Syndrome

Cracked tooth syndrome, as the name suggests, is the development of cracks and fissures in teeth over time. These cracks may be invisible to the naked eye but extend deep into the tooth. We examine your teeth for cracks so that we can take preventive action before the tooth suffers severe damage.

Gum Disease Diagnosis

Gum disease is much more common than people think. We will examine your gums for disease and make recommendations based on your specific dental healthcare needs. Regular, careful brushing and flossing are essential to gum health.

Oral Cancer Screening

Currently oral cancer is on the rise in a much younger population; all individuals are at risk for developing oral cancer.  What used to be related to smoking and chewing tobacco is now being linked to very common viruses, making oral cancer a much greater concern for a larger population.  We pride ourselves that each and every patient seen in our practice is given a visual oral cancer screening and we have additional technology called the Velscope® which allows us to catch even the earliest of lesions.

Alan Ferguson, D.D.S., P.C.

Chief Dentist

Dr. Ferguson is originally from Omaha, Nebraska. In 1975, Alan earned a Bachelor of Science degree in Zoology from Iowa State University and in 1979 graduated from the Virginia Commonwealth University Dental School.

Dr. Ferguson was in private practice in Richmond, Virginia before moving to Arizona to practice in 1994. Dr. Ferguson has taken many hundreds of hours of continuing education with an emphasis on restorative and functional cosmetic dentistry. Dr. Ferguson is a member of the American Dental Association, Arizona Dental Association and Central Arizona Dental Society as well as the American Academy of Sleep Medicine, American Academy of Dental Sleep Medicine and the Sleep Apnea Dental Institute. Dr. Ferguson is also a member of one of Arizona’s finest implant study clubs.

One thing you will notice about Dr. Ferguson is that he likes to have the practice resemble a home atmosphere, so every patient is treated like part of our dental family.