Keep Calm and Floss On

On August 2nd, this New York Times article was published and caused quite a bit of controversy in both the dental community and with the general public. While it is not conclusive in its findings, the overarching claim is that flossing may not be as beneficial as once thought. As dental professionals, we take very seriously the responsibility we have ensuring our patients receive the best possible education and care regarding the health of General - Titletheir smiles. For this reason, we feel compelled to express our disagreement with the suggestion that flossing may be overrated, and why that’s a harmful position to propagate.

Let’s first look at the article, which uses a lot of language such as:

  • “…flossing may be
  • “…most of the current evidence fell short…”
  • “That flossing has the same benefit is a hunch that has never been proved.”
  • “…there is some mediocre evidence that flossing does reduce bloody gums and inflammation known asgingivitis.”

There is a stark difference between something ‘not having been proved’ and something being ‘disproved’. Please know that there is no evidence remotely close to suggesting the latter. In fact whether the evidence is “mediocre” or not, the only evidence the article does mention (quoted above) is in favor of flossing. A lack of ability to prove something is not cause to discourage an entire population from participating in a highly beneficial component of their health care. This is particularly true because evidence is acquired by conducting large-scale studies, which are extremely costly. It would hardly be economical to spend the research funding to prove something we already have no doubt offers a variety of benefit for your oral and overall health.

We do not agree with the article’s brash call to action, or more accurately, call to inaction, and we fear how this may increase the number of people inflicted with preventable damage to their smile. Looking again at the line “…there is some mediocre evidence that flossing does reduce bloody gums and inflammation known as gingivitis.” Gingivitis is the first stage in periodontal disease – the very condition flossing aims to combat. To reduce gingivitis is to reduce your chances of progressing into advanced gum disease, a condition more than half of Americans already suffer from (CDC).

It is unfortunate the scale of damage this article has the potential to incite; too many readers will take this “lack of evidence” as being evidence to the contrary, and feel it gives them permission to neglect a very essential part of their oral health care.

We can only do our best to keep our patients like you educated and on the path to a lifelong happy and healthy smile – a path that certainly includes consistent flossing.

CDC: “Periodontal Disease.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 10 Mar. 2015. Web.

Dr. Carl Trubschenck

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Deep Cleaning: What it means to you.

You’re a good person – you pay your taxes, pick up litter, and make it to the dentist every 6 months. Now you’re being told you may need a deep cleaning…but don’t you clean your teeth every day? And isn’t a deep cleaning what the dentist always does? Not quite, although we know it can sometimes feel that way.

A regular dental cleaning is what you are accustomed to receiving every 6 months. The intention of this visit to the dentist is to maintain your healthy gums and give your teeth a little extra attention when it comes to matters of plaque and tartar, which can be difficult to remove fully with a toothbrush and floss alone. The odds are that if you are brushing and flossing every day, and taking any other steps recommended by your doctor, a regular dental cleaning is the perfect addition to your regular care that will keep your smile happy and healthy.

Deep cleaning, a necessity?

A deep cleaning, on the other hand, is what becomes necessary when the health of your teeth and gums become jeopardized by gum disease (or ‘periodontitis’).  To put it in perspective, your gums are supposed to have tight and healthy seals around your teeth to protect them and keep them firmly in place. A standard part of your regular cleaning is your doctor using a diagnostic tool called a ‘periodontal probe’ to ensure this is the case; the probe is used to measure the depth of the space between your gums and teeth. Typically 1-3mm is considered normal, and there should be very little or no bleeding at all. Upwards of 4mm is a sign that you are developing ‘pockets’, which are a space between the teeth and gums that becomes prime breeding ground for bacteria and tartar buildup. Plaque that is not brushed and flossed away left on the teeth for more than 24 hours can become tartar, which only your dentist can remove. Left unattended, these pockets can deepen and compromise the tooth and the surrounding bone structure. If the dentist uses the probe and measures 4mm or more, and/or there is significant bleeding and signs of inflammation, then a deep cleaning will be scheduled to help you get your smile back on track.

Deep cleaning is not a scary process.

Oftentimes, your dentist will break the cleaning into two separate visits to most effectively treat your mouth, this is especially important if your entire mouth needs attention so that you’ll be numbed in only smaller sections of your mouth each time, making for a completely comfortable process and quick recovery. The most common forms of treatment are ‘scaling’ and ‘root planing’. The process of scaling involves using a professional tool to remove plaque and tartar from both the surface of the teeth, and the pocket area that has been created between your teeth and gums. A scaling instrument, on the other hand, removes plaque and tartar from the surface of the root of your teeth, which is below the gum line and not visible. These tools are the only thing that can removed built up plaque, as even floss cannot reach far into deepened pockets. The good news is they do a wonderful job of cleaning up any tartar that has built up beneath the visible surface.

Periodontitis is a progressive disease, and left unattended can turn into a much more serious problem. Fortunately, the treatment is typically straight forward and as long as you follow the doctor’s aftercare instructions, the bacteria should be reduced to manageable levels and your gums should return to normal and lose any signs of redness. If you are feeling pain or sensitivity in your teeth, have red and/or puffy gums, or are experiencing bleeding during normal brushing and flossing – call us. The sooner periodontitis is identified the easier it is to treat and the less expensive it is for you, if you have any concerns about your oral health just remember that a professional evaluation is never harmful and may offer you some great information.

Dr. Carl Trubschenck

8035 Madison Ave., Suite E2
Citrus Heights, CA 95610
USA

 

Phone: (916) 961-1610

 

Gum Disease and Heart Disease

It’s your dentist’s job to tell you about the health of your mouth, and we know that can get a little dry. But did you realize your oral health may actually affect your heart health?? Although researchers are still establishing exactly how this connection works, there is a lot of evidence to suggest those with gum disease, an advanced form of gingivitis, can Featured Image-Gum Diseaseactually lead to an increased chance of heart attack or stroke. Although we may not know exactly why gum disease can lead to heart problems, we want our patients to know how to avoid serious health complications (spoiler alert: it has a lot to do with regular brushing and flossing!).

Given the complexity of the human body, it’s an incredibly difficult task to identify and explain direct processes of cause-and-effect; as such, we have been unsuccessful at explaining precisely why and how gum disease and heart disease are linked, but we are aware there is a connection and that it’s in the interest of our health and yours to be familiar with the long-term risks poor dental health can have on the body. Succinctly put, there are tremendous amounts of data that have demonstrated those with compromised oral health and long-term periodontal inflammation are at a significantly higher risk to develop heart disease and increase the likelihood of the individual to suffer from a heart attack or stroke.

At present, the culprits most suspected of triggering this chain reaction are bacteria and inflammation. Some researchers have suggested that due to the vascular nature of the gums, infection and bacteria below the gum line can become dislodged and enter the blood stream with disruption, which can: trigger inflammation through the body, damage blood vessels, or possibly form clots. Your blood stream is a direct line to your heart, and the bacteria associated with gum disease can easily find its way into your heart and then cause significant damage. Inflammation, on the other hand, leads to hardened arteries and makes it more difficult for blood flow to reach your heart; this additional strain can easily trigger a heart attack, particularly if you were already susceptible in the first place. Gum disease comes with a handful of standard symptoms, and inflammation is one of the most common. Left untreated, it isn’t too far a stretch to suggest the long-term implications can move beyond your oral health and affect the rest of your body’s systems.

Ultimately the relationship between gum disease and heart disease is primarily based off long-standing conditions; that is to say, if you are diagnosed with gingivitis and visit your dentist to resolve the issue, there isn’t reason to worry about suffering a heart attack. It’s when problems are allowed to progress and fester that there is cause for concern in regards to the long-term damage that may be happening in the body without receiving proper treatment and care. A study titled Prevalence of Periodontitis in Adults in the United States estimated that 47.2 percent of American adults have mild, moderate or severe periodontitis. In adults 65 and older, prevalence rates increase to 70.1 percent. It’s an easy thing to miss by yourself, and your dentist can always give you more information about your health. If you are following proper home care treatment, visiting the dentist every 6 months, and have not been informed of any serious issues by the doctor, then there is little cause for concern. As always, if you have absolutely any worries at all about the health of your gums or overall oral health, then call our office for an appointment. It’s always easier and more affordable to treat the problem before it is allowed to take hold. Keep brushing and flossing!

Dr. Carl Trubschenck

8035 Madison Ave., Suite E2
Citrus Heights, CA 95610

Phone: (916) 961-1610