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What is Gum Disease?

1/27/2021

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So we know that gum disease is linked to COVID, but what exactly is gum disease?  Gum disease, or periodontitis, is a serious gum infection that destroys the tissue and bone around your teeth.  In addition, it can cause teeth to loosen or make your teeth fall out.  Scary, right?!?  However, periodontitis is largely preventable!  
Healthy gums should be firm, pale pink, and tight around the teeth.  Symptoms of infection, or periodontitis are swollen or puffy gums, bright red or purple gums, sore gums, gums that bleed, seeing pink or blood when you brush your teeth, bad breath, loose teeth, pain, and sometimes even puss.  
How does it start?  Gingivitis is the first stage of periodontal disease.  Gingivitis occurs when the bacteria in plaque build-up irritate the gums and cause them to become inflamed and bleed.  Gingivitis is completely reversible.  However, when left untreated by not getting regular dental cleanings, gingivitis can progress to periodontitis.  
Periodontitis occurs when the inner layer of the gum and bone pull away from the teeth and form pockets.  The pocket then collects debris and becomes infected.  This causes the body’s immune system spring to action.  So, now we have the toxins from the bacteria and plaque combined with the body’s immune system.  This combination starts to break down the jaw bone and ligaments that hold the teeth in place.  This creates a snowball effect where the pockets continue to get deeper and more and more bone is destroyed.  As more bone is lost, the teeth become loose.  This process is not reversible, but it is treatable.  
There are many contributing factors to periodontal disease such as poor oral hygiene, genetics, smoking, and illnesses that affect your immune system like diabetes.  Some medications are also risk factors for developing gum disease.  
Now the question becomes, how do we prevent it?  Early prevention is easy!  Brushing and flossing you teeth after meals and getting checked every 6 months at the dentist will help prevent periodontal disease.  If you already have periodontal disease though, that is another story.  Periodontal disease is irreversible, and once you have it, you’ll always have it.  The good news is that your dentist can help you keep it in remission and under control.  The only way to accomplish this is to get a deep cleaning followed by maintenance cleanings every three months called periodontal maintenance visits.  Research has shown that once the bacteria is completely cleaned out of the gum pockets by a deep cleaning, it takes approximately 90 days for the bacteria to get back down in the pocket and start breaking down the jaw bone and surrounding tissue again.  This is why we recommend 3 month periodontal maintenance visits.  We are trying to stay ahead of the jaw destruction, and research shows we need to clean the teeth and gums 90 days in order to have the highest chance for success.  
There have been many times where I have seen a patient and diagnosed gum disease and they have gotten the deep cleaning, and then they just disappear and fail to do maintenance cleanings afterwards.  After being in practice for a while, I started to see those patients turn back up.  They were confused as to why their gums were bleeding and inflamed again after they had gotten the deep cleaning done years ago.  The periodontal maintenance visits are as important as the original deep cleaning.  Without them, the disease cannot be kept in remission.  
I hope this helps you to understand!  In a quick rundown, gum problems start with reversible gingivitis and if left untreated progress to periodontal disease which is an irreversible disease that must be treated every 3 months to avoid future problems.  Now go brush and floss your teeth!  :)


Ariana Clayton, DMD
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Should I Risk A Trip To The Dentist?

1/13/2021

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I’m sure I’m not the only one this year who weighs my every action in life against the risk of getting COVID.  I feel like every decision I make is based on which is more likely to cause me to die, the activity I might miss, or the chance of me getting COVID.  Therefore, getting my yearly mammogram screening was a necessary evil and worth the risk of COVID.  But, I have not seen the inside of a salon since last March, hence my nails and hair are scary.  Everyone has their own pros and cons, but I thought I would share some research as to why the dentist should be on everyone’s necessary risk list.  It is particularly important for people over the age of 30!

One of the latest discoveries in this terrible disease is the effect of gum disease on COVID patients.  In a 3 month study, hospitalized COVID patients with high levels of IL-6, which is a protein produced by gum disease, were at significantly higher risk of suffering life threatening respiratory problems.  Since previous research has shown that IL6 is linked to other breathing problems such as pneumonia and chronic obstructive pulmonary disease, when researchers first began trying to figure out COVID, they looked to proteins that they already knew were linked to breathing problems. In Germany, they found that patients who were unable to breathe due to COVID tested positive for IL6.  The doctors were shocked that this tiny inflammatory protein could rob people of their ability to breathe.  Further research showed that patients with COVID and gum problems and hence higher IL6 levels, are 22 times more likely to suffer from acute respiratory problems and be placed on a ventilator.  Of the COVID patients placed on a ventilator, almost 80% have died.  

The researchers stress that their findings indicate a need for people who believe they may have gingivitis or more serious gum disease to get their teeth and gums checked and cleaned as soon as possible. Researchers are even urging doctors who screen COVID patients to take a moment with each patient and check them for gum disease, a diagnosis that would prompt them to be extra vigilant over watching the patient’s breathing.  Because, while we can’t stop COVID, we may now know something that can reduce its severity.  Since gum disease is the most under diagnosed problem in dentistry, the researchers are urging everyone who thinks it may even be a possibility to get tested and treated as soon as possible because its link to COVID is real and deadly.  

The CDC now predicts the virus will be the leading cause of death in the United States and since we have now confirmed that gum disease makes it even deadlier, it is imperative that if you’re worried that you may have any gum problems, your next trip to the dentist may actually change your life.  Since the CDC states that in the US, 47.2% of adults over the age of 30 have some form of gum disease, I know if I wasn’t already a dentist, a trip to the dentist would be the first thing on my list of, “definitely worth the risk.”  


Ariana Clayton, DMD


https://www.dentistrytoday.com/news/industrynews/item/6778-covid-19-patients-with-periodontitis-face-greater-risk-of-dying


https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html
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COVID and Your Teeth...Can COVID Make My Teeth Fall Out?

1/6/2021

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Can COVID Make My Teeth Fall Out?


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Throughout the last year, we have all faced the unknowns of COVID. However, as time has passed, experts are learning more and more about the long term effects of COVID. Since the CDC now estimates that more than 15% of Americans have had COVID, it is time to examine the long term affects that we all could face. The CDC is still trying to determine the number of people who have long term effects after facing COVID, and part of the reason is that COV|D can affect every system in the body. So, while one person’s long term effect could be cardiovascular, another’s may be dermatological, and still another’s neurological. As I write this, there are clinics being set up around the country solely to treat the long term symptoms and try to understand more about them.
Being a dentist, I can only really discuss the effects of COVID on the mouth. I have done quite a bit of research, and the result is astonishing. There are thousands of reports of COVID affecting people’s teeth. There are many cases of people’s teeth becoming loose during, as well as, months after COVID. Even teenagers have reported their adult teeth, “falling out.” Currently, research is being done to determine the cause of this, but there are several theories.
The American Academy of Periodontology(The Gum Specialists) has reported that the tongue and oral mucosa are among the body parts that have the highest level of ACE2 receptors which are highly linked to COVID. Research
indicates that these cells and their high level in the tongue, oral mucosa, and nasal mucosa are the basis for the loss of taste and smell being a common symptom of COVID. They are continuing research into these receptors to determine if tooth loss is a continuation of the virus. A study published in June 2020 by the National Institute of Health, already proved a connection between people suffering from severe cases of COVID and people with periodontal disease, but now the question is, in people who survive, does it reverse and cause more problems?
Another theory is that the cytokine storm or hyper- inflammatory reaction that we have heard so much about in regards to COVID can actually manifest in the mouth. We know that gum disease is very sensitive to hyper- inflammatory reactions, so the researchers are putting together the pieces of the puzzle that seem to show that people who already have even mild forms of gum disease can have significant worsening, or even more concerning, severe tooth issues, from the inflammatory response of the body to COVID.
We already know that 47% of people over the age of 30 have periodontal problems or gum disease. Therefore, physicians are now alerting the dental profession to be on the lookout for the long term effects of COVID. They are recommending that physicians and dentists work together with patients to really understand and, therefore, help patients with these long term and relatively unknown COVID effects. Our doctors are staying current on all the research so that we can help our patients in every way possible. Dr. Michaud, our board certified Periodontist (gum specialist) is available to help anyone who has been affected by this horrible disease. Please do not hesitate to reach out with any concerns or questions. We are all learning how to fight the COVID battle together and I know that together we will win.
Ariana Clayton, DMD

Viviana Pitones-Rubio, E.G. Chávez-Cortez, Angélica Hurtado-Camarena, Anna González-Rascón, and Nicolás Serafín-Higuera,Is periodontal disease a risk factor for severe COVID-19 illness? https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC7303044/, June 2020.
US Dept of Health and Human Services. Long Term Effects of Covid. http://www.cdc.gov, November 13, 2020.
BriannaAbbott, Morethan15%ofAmericansHaveHadCovid.https://www.wsj.com/livecoverage/covid-2020-11-27/ card/vNkshCuxwSGLw7zkSx4z. November 27, 2020.
Wudan Yan, Their Teeth Fell Out, Was it Another Covid-19 Consequence? https://www.nytimes.com/2020/11/26/ health/covid-teeth-falling-out.html, November 28, 2020.
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    Author

    Born in Saint Petersburg, Florida, Ariana displayed bright intelligence from an early age, eventually becoming salutatorian for her graduating class at Dixie-Hollins High School. She went on to earn a bachelor's degree in nutritional sciences from the University of Florida at Gainesville, and continued her education to earn her dental degree in 2004 from the University of Florida College of Dentistry. It's worth noting that the College of Dentistry is ranked seventh among all dental schools in the United States, and it has an international reputation for the caliber of its graduates. Through continuing education programs, Dr. Clayton maintains her training on the most up-to-date and successful dental treatment techniques, and she strives to incorporate the best of newly available techniques into her practice. Sunshine Smile Designs is proud to offer this high level of care at an affordable price to many patients. Beyond her daily practice, Dr. Clayton is a volunteer for Dentistry From the Heart, a program that provides dental services at no cost to the indigent in Florida. Likewise, she also regularly attends mission trips to provide free dental services to blind and deaf children in an impoverished area of Jamaica. Ariana enjoys spending time with her nine-year-old son and her husband, who is also a University of Florida–trained dentist. Her artistic side is fulfilled by playing (and teaching) piano and by photography. She also enjoys travel, and one of her life goals is to visit all fifty states by recreational vehicle!

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