When Your Breath Is Cutting into Your Social Life | Alhambra Dentist

Many patients inquire about their foul breath when it begins to affect all aspects of their lives: work environment, social interactions, and feeling good about oneself. The main questions? What is the bad breath coming from and how do you fix it?

A few of the factors that affect your breath are the diet you maintain (the food you ingest), the condition of your teeth (if cavities are present or not), as well as the bacteria in your mouth. A variety of foods can cause different scents, but the factor that plays the largest role is the bacteria in the mouth.  Every mouth has bacteria, some of which are good, and some which aren’t. Removing the bacteria is essential to keeping good overall health, as well as reducing the possibility of halitosis (bad breath).

It is necessary to brush and floss your teeth at least twice a day, but ideally after every meal. When brushing, it is essential to also brush your tongue. It is also critical to see your dentist and hygienist on a regular basis so they can take x-rays, and measure your gum pockets to determine the extent of the bacteria in your mouth, as well as remove the bacteria from above the gums. Occasionally, it is noted that bacteria may be able to get inside the gums and cause gum infections (gum disease) and tooth loss. This is the leading cause of bad breath, and removal of the bacteria is essential. Generally, when this is noted, a deep cleaning might be recommended to remove the bacteria causing the problems. This can be done with lasers and small cameras that show where the bacteria are. Removing these bacteria also removes the bad breath.

Once it has been determined you have gum disease, it is recommended to have cleanings done every three months to maintain the health of the gums. Generally, gum measurements are made to determine how well the gums are responding to treatment and cleaning, and to ensure the continued improvement of the bacteria removal. It is necessary to always brush and floss as often as possible throughout the day.

If you would like more information about bad breath prevention, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Diabetes Leads to Gum Disease; Gum Disease leads to Diabetes | Alhambra Dentist

Poorly controlled diabetic patients are at risk for numerous oral complications, such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing.

Diabetes mellitus (diabetes) is a common chronic disease of abnormal carbohydrate, fat, and protein metabolism that affects an estimated 20 million people in the United States, of whom about one third are undiagnosed. There are two major forms recognized, type-1 and type-2. Both are characterized by inappropriately high blood sugar levels (hyperglycemia). In type-1 diabetes, the patient cannot produce the hormone insulin, while in type-2 diabetes the patient produces insulin, but it is not used properly. An estimated 90% of diabetic patients suffer from type-2 disease. The causes of diabetes are multiple and both genetic and environmental factors contribute to its development. The genetic predisposition for type-2 diabetes is very strong and numerous environmental factors such as diet, lack of exercise, and being overweight are known to also increase one’s risk for diabetes. Diabetes is a dangerous disease which affects the entire body and diabetic patients are at increased risk for heart disease, hypertension, stroke, kidney failure, blindness, neuropathy, and infection when compared to nondiabetic patients. Diabetic patients also have impaired healing when compared to healthy individuals. This is in part due to the dysfunction of certain white blood cells that fight infection.

The most common test used to diagnose diabetes is the fasting blood glucose. This test measures the glucose levels at a specific moment in time (normal is 80-110 mg/dl). In managing diabetes, the goal is to normalize blood glucose levels. It is generally accepted that by maintaining normalized blood glucose levels, one may delay or even prevent some of the complications associated with diabetes. Measures to manage diabetes include behavioral modification (proper diet, exercise) and drug therapies (oral hypoglycemic, insulin replacement). The choice of therapy prescribed takes into consideration the type and severity of the disease present and patient compliance. The physician may request the patient to keep a log of their daily blood glucose measurements to better assess therapeutic success. Another commonly obtained test is the hemoglobin A1c (HbA1c), which is a surrogate marker used to assess blood glucose levels over an extended period (2-3 months). This test provides the physician with a good picture of the patient’s glucose levels over time.

Oral changes are evident in poorly managed diabetics. These patients are at risk for numerous oral complications, such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing. None of these complications are unique to diabetes. However, their presence may serve as an early clue to the possible presence of diabetes, prompting your dentist to perform or request further testing.

Periodontal disease is a commonly observed dental problem for patients with diabetes. It is similar to the periodontal disease encountered among nondiabetic patients. However, as a consequence of the impaired immunity and healing associated with diabetes, it may be more severe and progress more rapidly. The potential for these changes points to the need for periodic professional evaluation and treatment.

In conclusion, we can summarize the above by citing the American Dental Association, which states that those with diabetes are more at risk for getting periodontal disease; and those with periodontal disease are more likely to contract diabetes. Good hygiene and regular visits to the dentist will lower our risk for gum disease, as well as diabetes and other diseases. Keeping your blood sugar level within the normal range by proper diet and exercise will keep your body healthy and lower the risk of gum disease.

(This column is partly based on statements of the American Academy of Oral Medicine.)

If you would like more information about diabetes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Maintaining Good Health by Taking Care of Your Toothbrush | Alhambra Dentist

Most dentists agree you should change your toothbrush at least every two to three months. According to a recent report, “20 Things You Should Throw Away For Better Health” by TIME (1/30, Jones), a toothbrush is one of these things. The American Dental Association (ADA) spokesman, Ruchi Sohota, was quoted to say, “Toothbrush bristles start to fray after two months and should be replaced by three months”.

After daily wear, a toothbrush can get worn and become less effective in cleaning teeth and gums. Bacteria, germs and fungus can flourish in between the bristles. Putting a wet toothbrush in an enclosed case can cause mold to grow on it. Let your toothbrush dry before putting it a case.

It is very important to change your toothbrush after you have had a cold, flu, mouth infections, cold sores, and sore throat. This will help you from re-infecting yourself and others. Even if you are not sick, bacteria and fungus can still grow on your toothbrush.

Always rinse, shake any excess moisture, and air dry your toothbrush after you brush your teeth. Also try to keep your toothbrush away from any flushing commode because of germs that may travel with any aerosols.

Taking care of your tooth brush can help you have a healthier 2018!

If you would like more information about toothbrushes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Abscessed Teeth Increases Risk of Heart Attacks | Alhambra Dentist

In a study carried out at the University of Helsinki, in cooperation with the Heart and Lung Centre of the university and published in the Journal of Dental Research, a dental abscess (infection at the root tip of a tooth) increases the risk of coronary artery disease, even if there no pain. The study states, “Acute coronary syndrome (heart attack) is 2.7 times more common among patients with untreated teeth in need of root canal treatment than among patients without this issue.” In short, this study suggests a substantially higher risk of heart attacks among those with untreated abscessed (dead) teeth.

A dental abscess is a reaction of the body to microbial infection of the dental pulp, the nerve and blood vessels in the canals of the root. Dental caries (cavities) is the most common cause of abscesses.

Gum infections have been found to be associated with many common chronic diseases. Low grade inflammation generated by oral infections is postulated to be an independent risk factor for coronary artery disease and diabetes. This is the first study to link a need for root canal treatment to heart disease.

In this study of 508 Finnish patients with a mean age of 62 years who were experiencing heart symptoms, 58 percent were found to be suffering from one or more dental abscesses. Furthermore, these dental abscesses were connected with a high level of serum antibodies related to common bacteria. Thus, a dental abscess, whether painful or not, can affect other parts of the body as well.

Cardiovascular diseases cause more than 30 percent of deaths globally. They can be prevented by a healthy diet, weight control, exercise and not smoking. With regard to the health of the heart, measures should be taken to prevent or treat oral infections, as they are very common and often asymptomatic. Root canal treatment of an infected tooth may eliminate an unnecessary risk of heart disease. In other words, root canal treatment can save lives.

If you would like more information about cardiovascular disease, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

7 Reasons Sugar Is Bad for You | Alhambra Dentist

Refined sugar or added sugar is said to be the most harmful ingredient in the Standard American Diet (SAD). Its harmful effects on metabolism may be traceable to many other diseases. Below are 7 of the reasons for you go sugar-free for 2018:

Sugar. Sugar, as we all know, is bad for your teeth. What you may not know is that it is also bad for your gums. Bacteria, which cause gum disease and loose teeth, can metabolize sugar in its pure form in the mouth, leading to an increase in the growth of these germs. Therefore, sugar can cause cavities and loose teeth.

Sugar and liver disease. Overloading your diet with sugar can cause the liver to overwork to convert sugar into glycogen. When the saturation is reached, liver is forced to covert glycogen into fat, which in turn, has deleterious effects on the body. In more extreme cases of heavy sugar intake, the liver itself can be damaged, leading to Fatty-Liver-Disease.

Sugar and diabetes. Excessive intake of sugar can cause insulin resistance. Insulin is necessary for glucose to enter the cells and be used for energy. Excessive glucose can cause the cells to become “insulin resistant”. Becoming insulin-resistant can be the cause of diabetes II, metabolic syndrome, obesity, cardiovascular diseases, etc.

Sugar and cancer. Cancer is characterized by uncontrolled growth and multiplication of cells. Insulin plays a key role in regulating cell growth. Elevated insulin levels because of an abnormally high intake of sugar can contribute to cancer, according to leading experts. Additionally, high blood glucose is associated with high levels of inflammation, which also contributes to higher risk of cancer.

Sugar and addiction. Sugar stimulate the production of dopamine from the “feel-good” center of the brain. Those who have susceptibility to addiction may become addicted to sugar and junk foods.

Sugar and obesity. Strong links have been found between sugar and obesity – that is no surprise.  But obesity in children has been found to be associated with sugar-sweetened beverages. There is a 60% chance of obesity in children who consume high amounts of these beverages.

Sugar and heart disease. Strong links have been shown between sugar and heart disease. High intake of sugar can lead to rise in triglycerides, LDL, high blood glucose and abdominal obesity, all of which are risk factors for heart disease.

So, cutting down or cutting out refined/added sugar in your diet can not only save your teeth, but can save your life. See your dentist regularly. Make your goal for 2018 to cut down or cut out added sugar altogether. Do it now! You won’t regret it.

If you would like more information about sugar effects, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

10 Fun Facts About Toothbrushes | Alhambra Dentist

1. When selecting your toothbrush, look for the ADA seal.

The ADA Seal of Acceptance is the gold standard for toothbrush quality. It’s how you’ll know an independent body of scientific experts, the ADA Council on Scientific Affairs, has evaluated your toothbrush to make sure bristles won’t fall out with normal use, the handle will stay strong and the toothbrush will help reduce your risk for cavities and gum disease.

2. The toothbrush is 5,000 years old.

In various forms, that is. Ancient civilizations used a “chew stick,” a thin twig with a frayed end, to remove food from their teeth. Over time, toothbrushes evolved and were made from bone, wood or ivory handles and stiff bristles of hogs, boar or other animals. The modern nylon-bristled toothbrush we use today was invented in 1938.

3. The first mass-produced toothbrush was invented in prison.

In 1770, an Englishman named William Addis was jailed for inciting a riot. He saw fellow prisoners using a rag covered in soot or salt to clean their teeth. Addis saved an animal bone from dinner and received bristles from a guard. Accounts state he bored tiny holes into the bone, inserted the bristles and sealed them with glue. After his release, he modified his prototype, started a company and manufactured his toothbrush. That company, Wisdom Toothbrushes, still exists in the United Kingdom today.

4. Manual or powered? Your teeth don’t care, if you do it right.

In the manual and powered toothbrush debate, it’s a wash. You just need to brush twice a day for two minutes with a fluoride toothpaste. Both types of toothbrushes can effectively and thoroughly clean your teeth. It all depends on which one you prefer. People who find it difficult to use a manual toothbrush may find a powered toothbrush more comfortable. Talk to your dentist about which kind is best for you. If you do decide to use a powered toothbrush, you must hold it with your fingers, like how you would hold a flute. Don’t hold it in the palm of your hand. Palming your power toothbrush is likely to cause excessive pressure on your teeth and gums.

5. There is no “correct” order for brushing and flossing.

Brushing before flossing, flossing before brushing – it doesn’t matter to your teeth, as long as you do both. However, be very careful not to cut your gums when you floss. Over-zealous flossing can cause spaces (dark triangles) to form between your teeth as well as gum recession.

6. Toothbrushes like to be left out in the open.

Cleaning your toothbrush is easy: rinse it with tap water to remove any remaining toothpaste and debris. Store it upright and allow it to air dry. If you store your toothbrush with other toothbrushes, make sure they are separated to prevent cross contamination. And do not routinely cover toothbrushes or store them in closed containers. A moist environment such as a closed container is more conducive to the growth of unwanted bacteria than the open air.

7. Lifespan = 3-4 Months

Make sure to replace your toothbrush every three to four months, or sooner if the bristles are frayed. A worn toothbrush won’t do as good of a job cleaning your teeth.

8. When it comes to choosing a brush, go soft.

Whether you use a manual or powered toothbrush, choose a soft-bristled brush. Firm or even medium-strength bristles may cause damage to your gums and enamel. When brushing your teeth, don’t scrub vigorously – only brush hard enough to clean the film off your teeth.

9. Remember: 2 minutes, 2 times a day.

Four minutes a day goes a long way for your dental health. Put the time in each day to keep your smile healthy and keep up this twice-a-day habit.

10. Sharing is caring, but not for toothbrushes.

Sharing a toothbrush can mean you’re also sharing germs and bacteria. This could be a particular concern if you have a cold or flu to spread, or you have a condition that leaves your immune system compromised.

If you would like more information about toothbrushes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Gum Treatment Reduces Pain of Rheumatoid Arthritis | Alhambra Dentist

“After gum treatment my arthritis pain is at least 65% better.” Mary, age 36, has been suffering from rheumatoid arthritis (RA) for five years. Her suffering has been particularly from pain and swelling in the joints of the wrists, hands and toes. Because of the severity of the symptoms, her rheumatologist insisted that she see the dentist for treatment of noticeable oral infections. Her rheumatologist told her that removing sources of infection from the oral cavity may very well lessen the severity of her condition. Having been a reader of my columns for many years, she chose to come to this office for treatment. After uneventful non-surgical gum treatment, she was thrilled that pain had subsided by so much. Mary also said that she felt more energetic and definitely more enthusiastic about life. Even her complexion cleared up. Although we cannot predict the exact effect of gum treatment in every case involving rheumatoid arthritis, Mary’s experience is not uncommon in my practice. We have seen many cases just like Mary’s. In fact, this association between rheumatoid arthritis and gum treatment has been reported in various medical and dental journals for at least the past ten years. But what is the science behind this improvement?

A recent study published by the American Rheumatism Association compared the dental health of 44 patients with rheumatoid arthritis (RA) with 44 healthy patients. With 95% confidence level, the study concluded that RA patients are more at risk for gum disease (periodontitis), thus being more susceptible to gum disease. It came as no surprise, since a previous study also showed that patients with rheumatoid arthritis may have a higher risk for gum disease (periodontitis). In an article published in January 2008 in the Journal of Rheumatoid Arthritis, called Association of Periodontal Disease and Tooth Loss with Rheumatoid Arthritis in the US Population it was concluded that “RA (rheumatoid arthritis) may be associated with tooth loss and periodontitis”. This study involved 4,461 patients.

What is interesting is that a third study published June 2009 in an issue of the Journal of Periodontology titled Periodontal Therapy Reduces the Severity of Active Rheumatoid Arthritis in Patients Treated with or without Tumor Necrosis Factor Inhibitors showed that non-surgical treatment of gum disease “had a beneficial effect on signs and symptoms of RA”. The latter study was a collaborative project between the Division of Rheumatology, University Hospital Case Medical Center in Cleveland, Ohio and the Department of Periodontology, School of Dentistry of Case Western Reserve University. This study involved forty rheumatoid arthritis patients who also had been diagnosed for moderate or severe gum disease. Twenty received non-surgical gum treatment and the other twenty received no gum treatment. Six weeks of objective observation by rheumatologists and blood tests were done.

The story that these three studies tell is that RA patients tend to get periodontitis which if treated, may likely reduce symptoms of RA.

How are these two disorders related?  According to the summary of the literature, as reported in this article, rheumatoid arthritis and periodontitis (gum disease) share some common characteristics. Rheumatoid arthritis is an inflammatory disease wherein the autoimmune system attacks the hard and soft tissue of the joints. Periodontitis is a bacterially-incited inflammatory disease wherein the autoimmune system attacks and hard (bony) and soft (gum) tissue around the teeth. Bacteria that cause gum disease have been found in the joints of patients with rheumatoid arthritis. Patients with rheumatoid arthritis have been shown to have more antibodies against bacteria that cause gum disease than those patients without rheumatoid arthritis. Artificially-induced rheumatoid arthritis has been associated with development of gum disease in some laboratory experiments.

Hence it appears that studies reported in both medical and dental journals acknowledge the association between rheumatoid arthritis and periodontitis. Although there is no scientific basis to definitively conclude that there is a “causal” relationship as yet, there is no downside risk in having one’s gum disease treated, no matter whether you have rheumatoid arthritis or not. Furthermore, there is no dispute that removing infection from the gums and the mouth will not only save teeth, but also certainly improve one’s general health. In conclusion, for the rheumatoid arthritis patient who has gum disease or without, only good can come out of seeing the dentist. See your dentist regularly. You can’t lose.

If you would like more information about gum treatment, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Oral Bacteria Linked to Alzheimer Disease | Alhambra Dentist

The sixth leading cause of death in the US is Alzheimer Disease (AD) and it is more prevalent as people age. According to an article published in the Journal of Oral Microbiology, one of the causes of AD may be traceable to oral infection.

AD is characterized by inflammation of the brain. This article reported on 200 studies examining the link between infections in the mouth and inflammation of the brain. These studies point to “germs” in the mouth as a possible cause of AD. Various groups of bacteria, including fungus and viruses from the oral cavity, can find their way into the bloodstream and penetrate the blood-brain barrier. Their action in the brain can instigate brain inflammation. Microbes from gum disease are particularly suspected of being likely causes of brain inflammation.

These articles pointed out that oral infections, especially fungal infections, among the elderly have dramatically increased in the last thirty years. Fungi can be found in gum pockets, root canals and under dentures. Protein DNA and protein have been found in the brain tissue of AD patients. Although oral infection is one of many factors in the development of AD, this article raises the possibility that oral infection increases systemic inflammation, which in turn may predict the onset of dementia.

Thus it is important for people of all ages to maintain good oral health. Oral bacteria may play a role in the onset of AD, even decades before the symptoms of AD develop. It is recommended that everyone develop good dental hygiene habits and receive dental care, especially gum care, on a regular basis.

If you would like more information about Alzheimer Disease, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Acetaminophen (Tylenol) and Ibuprofen (Advil) in Combination Better than One or the Other | Alhambra Dentist

For mild to moderate pain after surgery, patients are asked to take over-the-counter (OTC) pills. There are basically two kinds of OTC pills – one is represented by pain pills such as Tylenol and is called acetaminophen, the other is represented by Advil and is called ibuprofen.

For quite some time now many doctors have advised their patients to take both acetaminophen and ibuprofen together, in the belief that taken together brings about more relief from pain than just taking one kind. However, it has not been strongly established that this is true. An article reviewing various studies involving a total of 1909 patients published in the September issue of the Journal of the American Dental Association has concluded that taking acetaminophen (e.g., Tylenol) in combination with ibuprofen (Motrin or Advil) would be better for dental post-operative pain than taking only one or the other. In other words, if you take a Tylenol at the same time you taken an Advil, you would have better relief from pain from dental surgery than if you took just Tylenol or just Advil.

According to the author, Ferne Kraglund, D.D.S., these two kinds of over-the-counter pain pills “are widely available and inexpensive, with a well-established reputation for safety and efficacy” (effectiveness). This review of a number of very strident scientific studies, called randomized clinical trials, involving these 1909 patients showed that the combination of these two drugs effectively lowers pain intensity and decreases the need for higher dosage or the addition of other supplementary drugs.

Of course, you should only use these over-the-counter drugs at the direction of your dentist to make sure that it is safe and effective. Just as importantly, you need to be instructed by your dentist as to how much and under what circumstances you should take or not take these drugs.

The FDA recommends certain limits as to strength and daily dosage of these drugs. For example, each tablet of acetaminophen should contain no more than 325 milligrams, and the maximum dosage should not exceed 4000 mg per day. It is critical you follow your dentist’s instruction and contact them with any unusual reactions.

 

Too Much Sugar: Diabetes and Gum Disease | Alhambra Dentist

We know too much sugar can cause cavities. So, it is not surprising that too much glucose, also called sugar in your blood from diabetes, can cause pain, infection, and other problems in your mouth, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Glucose is present in your saliva—the fluid in your mouth that makes it wet. When diabetes is not controlled, high glucose levels in your saliva help harmful bacteria grow. These bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease and bad breath.  Therefore, diabetics who are not careful in controlling sugar intake are more prone to cavities, as well as gum disease.

Emerging research also suggests that the relationship between serious gum disease and diabetes is two-way, according to the American Diabetic Association.  Not only are people with diabetes more susceptible to serious gum disease, especially when blood glucose is high, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes. Research suggests that people with diabetes are at higher risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease). People with diabetes are at an increased risk for serious gum disease because they are generally more susceptible to bacterial infection and have a decreased ability to fight bacteria that invade the gums.

It can be said that overconsumption of sugar may be a major cause of two of the most prevalent diseases in the world, i.e., gum disease and diabetes.

National surveys have found that the average American consumes around 85 grams of sugar every day. According to the new USDA guidelines, we should really be eating a fraction of that amount. The recommended sugar intake for adult women is 22 grams of sugar per day, for adult men, 36 grams daily, and for children, 12 grams a day.

Over time, consistently taking in more sugar will lead to insulin disease, otherwise known as diabetes. What’s alarming is that many people do not realize they are on the road to diabetes. This epidemic of “on the way to diabetes” is called prediabetes. Type 2 diabetes doesn’t appear suddenly and the slow, long and invisible road there is “prediabetes,” which is where blood sugar levels are consistently higher than normal over a long time, slowly affecting insulin signaling.

So, overconsumption of sugar leads not only to cavities and gum disease, but also can predispose you to prediabetes and even diabetes. In summary, cut down on the sugar intake. Be consistent in your home dental care, as well as your visits to your dentist.

If you would like more information about diabetes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.