Gum Disease: The Heart Health Predictor

Hello, welcome everybody to our webinar. Today, we are doing a webinar on gum disease, the heart health predictor. I'm Dr. Michelle Hucke with Jax Beaches Family dentistry. I'm blessed to practice with my partner, Dr. Elizabeth Alfuente and we practice complete health dentistry. And what that means is that we help people with the health of their teeth cause we're dentists, but we also are focused on people's complete health and we are concerned about your overall health. I'm excited about sharing this information today, just in general, because it's something I have passion for, but I'm also excited about sharing it in this COVID-19 crisis that we're in, because it's important that we all work together to live a healthier lifestyle. So we're going to begin our class today. And the exciting part about this class is that I'm sharing information that I'm passionate about Because I'm a dentist, but I'm also sharing information that has many, many detailed sources. And we are going to be citing lots of different articles and I'm going to be talking to you about lots of different statistics and resources. You are more than welcome at the end of the presentation. There will be a slide and my personal email is on there, and I'm always happy to share information with people. So please feel free to email me if you're interested in the sources.

So having gum disease increases the risk of your first heart attack by 28%, according to a study in 2016, and the verdict about that is, you know, your heart health is important and it's important to keep your mouth healthy so that those two things can both be healthy. And that study was done somewhere where they won the Nobel peace prize. So a super important study. And that's a study that we refer to all the time. The American periodontal association also says that periodontal disease is associated with heart disease. And it's proven because the inflammation caused by periodontal disease is responsible for that association heart disease. As we know, right, is one of the leading causes of death for people in the United States. And in fact, about 610,000 people die every year of heart disease. And it's responsible for one in every four deaths. That statistic surprised me. So it's the leading cause of death for men and women and coronary heart disease is the most common of those heart diseases. And it kills 370,000 annually. Every year, 735,000 people have a heart attack. And of these 525,000 are their first heart attack. So are you ready to learn some more about the relationship between oral health and heart disease and how to improve your health? Well, the good news about all of this is that because so much of this is related to gum disease and gum disease is in fact treatable and curable. We have some hope, you know, we have the hope that we can actually diminish this disease. So maintaining your oral health is super important. It's very important to maintain your gums, but it's also important not to lose teeth. And what I always tell people in my practice is gum disease is the leading cause of tooth loss. When you lose teeth, you are at a greater risk for cardiovascular events, cardiovascular death by 85%. And you're also at an increased risk of stroke. And I read a study not too long ago, that just in general when you lose teeth, it decreases the length of your life. And the study that I'm referring to and with these particular statistics today says that roughly 6% of your increased risk for cardiovascular disease is increased Every time you lose a tooth. So if you're in a situation where you're starting to lose teeth, the fewer teeth that you lose, the better in terms of the longevity of your life and the health of your life.

So do you feel like these statistics lead us to believe that the health of our mouth is improved when we improve our gums? And what is important for people to know is like, what puts you at risk for these things? So according to the Academy Association of Periodontology, which is an important Academy for all of us, you're at risk. If you notice that your gums are red and swollen, if your gums are bleeding, if you notice signs of infection, if you feel like your gums are pulling away from your teeth, or if you have bad breath, you know, you find yourself using mints more often, or you feel like you're uncomfortable to get close to people. All those things seem minor, but those are signs that you have gum disease and it didn't use to be something that we were worried about in terms of our overall health. So even if you're not that focused on the health of your mouth, because some people aren't I do think it's important to take a step back and realize that it can negatively impact your overall health. And the reason I'm passionate about it is that I'm a dentist, right? So I'm passionate about teeth, but I'm passionate about it because I had my own challenges with gum disease. So the before and after pictures that are in front of you right now are mine. So I decided it was important to share it because it's impacted me personally. My gums, even though I was getting my teeth cleaned every three months and I was flossing regularly, I was still really struggling with gum disease. My gums were swollen and bleeding. I often when I went and to see my hygienist and we did the probing. So those that's when they put the instrument in and they read out the numbers that were probably depths were chronically higher than they should be. And I was having bleeding. That's a sign of active disease. And you can see in my before and after pictures before I found perio protect, which is an amazing technology, it allows us to take hydrogen peroxide gel. And we all know now because of the COVID-19 crisis, how important peroxide is it takes that gel and it shoves it deep up under the gums to really treat that bleeding and get rid of the inflammation. So super happy that I was exposed to that. And it's something I'm very passionate about sharing.

So gum disease and I'm, you know, I'm happy to be living a healthier lifestyle as a result of it. Gum disease is important because it impacts your heart health and what a lot of people don't know, like what is gum disease? We hear about Gingivitis. We hear layman's terms about what it is. And Gingivitis is a term that I think is commonly used a lot of times on TV ads. That's the early stage of gum disease and it's completely reversible. So when your gums are inflamed and bleeding and you don't have any breakdown of the bone, we can treat that with standard traditional cleanings and other things to reverse that the problem becomes once that Gingivitis progresses to periodontal disease and the bone breaks down, that's when we really have concerns. Now, even when you have gum disease like I had, we have lots of different treatments, including those trays. I was talking about that. I just love scaling and root planning and lasers and all kinds of traditional therapy In addition to the trays to help you get healthy. So very important to come in. If you've ever been told that you had gum disease and you were hesitant to get it treated, you didn't like the way the treatment sounded. Now's the time to come back in and, you know, hear what new things are that aren't as invasive and aren't as scary sounding so that you can protect your heart health and protect your gums. So gum disease, like I said, is an erosion of the tissue. It's also an erosion of the bone and what happens and why would it be that you have when you have gum disease, gum disease, and vector in your mouth, how could that possibly impact your heart? Cause people think of their mouth and their heart is being completely separate. But once you have that bleeding, that gives that bacteria direct access to your bloodstream. And that's when those toxins and the bacteria can actually have direct communication with your heart. So the toxins create inflammation and then the bacteria actually can claw onto the walls of the arteries in your bloodstream and create problems in your heart and then also obviously in your brain. So the inflammation is bad, the bacteria is bad. The plaque building up is bad. And so are the toxins. So those are the reasons why it impacts your heart negatively. And so even if you're not as motivated right about the teeth themselves, we want to take a look at it and have everyone be motivated from an overall health standpoint.

The other thing that's really interesting is that there was a study done in 2016 about abscesses at the end of the roots of your teeth. And those can be even more deadly and that an abscess at the end of the root. Now that would be an abscess when you go to the dentist and they talked to you about having a root canal and that's when the nerve and the tooth dies and it makes an abscess at the end of the tooth. The reason that it's more deadly than periodontal disease is that a study shows that it increases the likelihood that you're going to have an acute coronary incident by 2.7 times. So you're 2.7 times more at risk for a coronary incident. If you have an abscess at the end of the root. So I know, you know, from being a dentist for 30 years, right, I've had a lot of experience where I'm telling people that they need a root canal and explaining that to them, that they have an abscess and they're delaying it or postponing it for whatever reason. And a lot of times, the timing's just not right, or I want to wait a couple of months or we are finding more and more that we can't agree to that because we know the increased risk of something as extreme as a coronary incident. So if you're listening to this and you know, have a loved one or you yourself have been told that you need a root canal, please keep in mind that it's just not okay anymore to put that off. It's important to make a decision about what you're going to do with the tooth. And if that means you're sacrificing and taking it out then you know, that's fine. You need to do whatever treatment is best for you, but it certainly isn't something that we feel comfortable anymore delaying.

So what is it that causes gum disease are all different things that cause it, but the main thing, you know, that we all know that causes it is the plaque or that bacteria it's building up on the teeth. And then the other thing that causes it, unfortunately, it's just having more birthdays, that thing that we call aging. And the reason that we know that is that when we do, when we look at statistics, 70% of Americans over the age of 65 have periodontitis, and that's a really big number. So that's something that as dentists, we're not particularly proud of, right? We hope that we can do things to that statistic that we don't like. We do have a lot of things. Like I said, if you were diagnosed or someone talked to you about gum disease in the past, we do have a lot more things in our arsenal to make the treatment more predictable and not as invasive. So the other thing that causes gum disease is smoking. I know that if you're out there and you're listening and you're a smoker, you've already been told at least 9,000 times that's not good for you. But another thing to add to the list is that if you use tobacco studies show that tobacco use is one of the most significant respecters in the development and progression of gum disease. So, you know, you can add that to that list of reasons to quit.

And the other thing I tell people, my smokers is it's really hard to quit. The good news in terms of the health of your mouth is even if, if you're smoking six cigarettes a day and you can get down to three cigarettes a day, even reducing the number of cigarettes makes a huge difference in the health of your gums. So I encourage you to cut back if nothing else. And genetics too. I talk to people about that in terms of gum disease, but we also talk about it in terms of tooth decay. There's definitely a genetic tendency, and there's a lot of research now about testing people for some genetic markers and using that information ahead of time, right? So that we can identify with people that are most at risk and help them keep their teeth for the rest of their life.

And then stress, right? Nobody, nobody knows about stress, especially right now, I'm sure. But stress, as everybody knows, right? It decreases your immunity and anything that decreases your immunity increases any kind of inflammation, especially if you have underlying gum issues. So, you know, easier said than done, but we all need to manage our stress. And also medications, especially when my patients are on multiple medications, the main thing I ask them to look out for is a reduced and reduced level or a change in their saliva. Saliva is a super important thing right in your mouth and in your body. That's what helps us fight gum disease and dental decay. So the more medications that you're on when you change a medication it's important even to, you know, call in and let us know that you have that change because in a six month period of time if your saliva shuts down, a lot of things can happen with your overall health and with the health of your gums. If you're clenching and grinding your teeth, that can progress gum disease, that's already in place. So if you have a certain amount of gum disease, you go through a stressful period, you're punching, grinding your teeth. You are likely to really rapidly accelerate that gum disease. So if you feel like you're clenching and grinding your teeth, do you feel like your jaw is tired, and feel like any of that is going on, that's another important thing to let your dentist know about.

And there are lots of other systemic diseases. There's a long list of them, including diabetes. Diabetes is a huge issue with gum disease. If you have diabetes and you're going through a period of time where your sugar isn't controlled, please reach out to your dentist and let them know so that they can coordinate with your physician about that issue. If your sugar is out of whack, it's going to affect the ability for your gum disease to stay under control. And then as the gum disease accelerates, your physician will have a really hard time getting your sugar under control. So it's important. That's a really important issue to cooperate with the physician.

Also, just in general, poor nutrition. I know we're all struggling with our nutrition during this difficult time because we've been holed up and limiting our access to the grocery store. So poor nutrition is a big indicator in terms of gum disease. There's been a couple of really interesting studies, one of them. And you know, we've been talking about obesity because obesity is a problem with COVID. Well, it's also participating and as an indicator of an increased risk of periodontal disease too, I read another study when I did my nutrition webinar last month, too, that if you're doing a certain diet and you're not getting enough protein, so we have to be careful, right of really restrictive diets. Protein is a super important thing when it comes to the health of your gums. So you want to make sure when you look at nutrients, you know, a lot of times we're tracking our nutrients. We want to make sure that your protein if you're concerned about your gums is high enough. Also, sleep apnea. Another one of my favorite topics, because we diagnose and treat sleep apnea in our office, but there is a huge component between interaction between sleep apnea and periodontal disease. Obstructive sleep apnea Patients are 60% more, 60% of patients diagnosed with periodontitis have sleep apnea. So they're definitely linked. And the inflammation that's caused by continuing to have sleep apnea causes extreme inflammation. And when we reduce or eliminate sleep apnea, it dramatically improves in a study. It dramatically improves periodontal disease.

So what do we do about all of this? Some of it's very basic. Again, it all sounds terrible. Some of the statistics are terrible, but the super good news is that gum disease is in fact preventable. It isn't fact curable, even when it's really stubborn like mine was. So seeing a dentist regularly is very important. Just like I was talking about earlier, too, really important to coordinate between the physician and the dentist. If your physician and your dentists, aren't talking and coordinating, and they're not sharing information about your medications check in with your dentist, make sure that you feel like they're taking a really complete medical history and that they're talking to you about who your physician is and what's going on with your health, certainly brushing your teeth every day. Twice a day for three minutes is awesome. Flossing eating a healthy diet as we talked about, avoiding cigarettes, which we also discussed, and limiting your alcohol intake. And then the other thing too, seeing your dentist immediately, I've been super focused on emergency care, because that's all we're allowed to do during this COVID crisis, but emergency care is really important. It's something that I really, you know, I'm proud of. we for the last, you know, 20 years, at least in my practice, but really as long as I can remember, I've always seen same day emergencies. We've always blocked out certain times during the day to see emergencies because sometimes even the smallest thing, even if you're slightly aware of a tooth, it can be a really tragic, important thing. Especially when we talk about, you know, an abscess at the end of a root triggering, a heart attack, even if you're mildly aware of a tooth or your gum is slightly swollen, whatever it is that's nagging at you, it's way better to come in and let us take a look at it then to let it pass, especially in light of, you know, what we were talking about earlier.

So we're available, especially if you live, you know, in Jacksonville each or kind of be addressed. But no matter where you live and no matter who your dentist is, you always want to reach out its way better to reach out and deal with the issue and get it diagnosed than to wait. The other thing that's important too is that in the early stages since many people have regular oral exams, you have to see your dentist more often than a physician. So we are able to as dentists diagnose things way before physician sometimes because we see you often, sometimes every three months. So the great thing about that is that we are able to, like I was talking about earlier, coordinate with physicians and help keep you healthier. 90% of all systemic illnesses show up in the mouth. Sometimes you knew you've already had it diagnosed with a physician and then we noticed changes in the mouth. But a lot of times it's the other way around. So things like diabetes, like we were talking about earlier, leukemia, different kinds of cancer and heart disease show up in the mouth first. So that's another really important reason to go to the dentist every three to six months, but also make sure when you go there that you actually see the dentist and get a really good exam. So there are signs like bad breath and bleeding gums and dryness of the mouth. That could be an indication of diabetes. A lot of times when we're taking down x-rays we notice things like bone loss that shows up in the mouth too, and any sort of sore and painful job can be, you know, it can be the sign of a heart attack coming on. So your oral health at the bottom line plays a crucial role in your overall health. And we as dentists have windows into other aspects of your health. So I'm just encouraging you, in general, to see your dentist regularly.

I want to thank you so much for your time and for coming to my class. I love sharing this topic with people. It's a huge passion of mine, partly because of the personal struggles that I've had with my health as I shared earlier. And it always makes me a little bit weepy, but I want to be around because I have beautiful twin 12-year-old girls and, you know, we all want to be around for somebody. So especially in this time of this global crisis, I think it's more important than ever that we strive and do all we can to be as healthy as possible. So if you live in Jacksonville or part of the beach area, please call or email me. Like I said before, I'm very accessible. This is a huge passion of mine. So even if you have a question or like I say, you're interested in some statistic or a piece of research that I quoted, and you want to hear more about that, I'm happy to do that. And if you have any further questions, please let me know. I'm always here to support you. Thank you so much again for coming and I appreciate you.

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