Saturday, November 11, 2017

Tobacco & Oral Health

Tobacco use in smoked and smokeless forms has countless negative impacts on oral health.  Smoking and smokeless tobacco have been associated with periodontal disease, caries, tooth loss, oral soft tissue changes, dental implant failure, peri-implant disease, and oropharyngeal cancer.  Studies have shown that smokers are three to six times more likely to suffer from advanced gum disease than non-smokers.  Tobacco use also causes oral infection, cracked or chipped teeth.
Tobacco is a Threat to Oral Health
Tobacco’s greatest threat to your oral health may be its association with oral cancer.  The American Cancer Society reports the followings:
·       About 90% of people with oral cancer and some types of throat cancer have used tobacco.
·       Smokers are 6 times more likely than non-smokers to develop oral cancer.
·       About 37% of people who continue to smoke after cancer treatment will develop second cancers of the mouth, throat or larynx.
·       Smokeless tobacco has been linked to cancers of the cheeks, gums and inner surface of the lips.  Smokeless tobacco increases the risk of these cancers by nearly 50 times.

The negative impacts of (smoking/smokeless) tobacco on Oral Health
·       Smoking and Tooth Loss-studies from the American College of Prosthodontists have reported correlations with smoking and tooth loss.  Smokers have greater risk of tooth loss.
·       Smoking and Periodontal Disease-“studies have found that tobacco use may be one of the biggest risk factors in the development of periodontal disease,” says David Albert, D.D.S., an associate professor at the Columbia University College of Dental Medicine.

-smokers have more calculus (tartar) than nonsmokers.  This may be the result of decreased flow of saliva.
-smokers have more severe bone loss and deep pockets between their teeth and gums than nonsmokers.
-smokers are 3 to 6 times more likely to have gum destruction than nonsmokers.
·       Smoking and Oral soft tissue changes
-leukoplakia is a white or gray patch that develops on the tongue, the inside of the cheek, or on the floor of the mouth.
-chronic smoking may be a cause of leukoplakia
-leukoplakia is potentially premalignant.  Patient should be referred for appropriate medical care for possible oral cancer.
·       Smoking, Dental Implant Failure and Peri-implant Disease (inflammation of soft tissues surrounding the implant)
-smoking compromises healing time after oral surgery.
-smoking increases the risk of implant failure and post-operative infections. Tobacco reduces the body’s ability to fight oral infection.
-studies from the American College of Prosthodontists reported correlations with smoking and peri-implant disease (peri-implantitis).
·       Smokeless tobacco causes gum recession and cavities
-tobacco irritates gum tissue and causes gum recessions. 
-gum tissue recedes and root of the teeth is exposed and increases the risk for tooth decay.
-sugar is added to smokeless tobacco and enhances its flavor; sugar increases the risk for tooth decay.
·       Smoking and Oral Cancer is usually found on the floor of the mouth, the ventrolateral surface of the tongue and the soft palate. Heavy tobacco users have a 5 to 25 times greater risk of oral cavity and oropharynx cancer.

Tobacco use increases the risk of oral cancer
According to the American Dental Association (ADA), these are some of the signs & symptoms of     oral cancer:
·       A sore or tenderness in the mouth that does not heal or get better
·       Pain, tenderness, or numbness in the mouth or on the lips
·       A lump or leathery patch inside your mouth, or color changes in your oral tissues (gray, red, or white patches)
·       Difficulty chewing, swallowing, or speaking
·       Changes in the way your teeth fit together

Tobacco use increases the risk of Periodontal Disease
Here are some of the signs and symptoms of Periodontal Disease:
·       Red, swollen, or tender gums
·       Gums that easily bleed
·       Gums pulling away from the teeth
·       Teeth are loose or separating
·       Chronic bad breath

Smoking causes Dental and Oral Health problems
·       Bad breath
·       Tooth discoloration/Stained teeth
·       Inflammation of the salivary gland openings on the roof of the mouth
·       Increases buildup of plaque and calculus (tartar) on the teeth
·       Increases loss of bone with the jaw
·       Increases risk of leukoplakia, white patches inside the mouth
·       Increases risk of developing gum disease and leading to tooth loss
·       Delays healing process following tooth extraction, periodontal treatment, and oral surgery
·       Lowers success rate of dental implant procedures
·       Increases risk of developing oral cancer

Here are some quitting tips from the American Cancer Society (ACS):
·       Set a quit date.  Make a quitting plan.
·       Get support and turn to family, friends and coworkers for support.
·       Join a support group. Call ACS AT 800-227-2345 for a list of support groups.
·       Join a stop-smoking program. 

Smoking and smokeless tobacco elevate risks for oral cancer, dental and oral health problems. If you notice any of the signs and symptoms of periodontal disease and oral cancer, schedule a dental consultation with Dr. Anna Lee for a thorough evaluation. Contact us at 626-335-5114 or email at

Monday, November 6, 2017

How Do I Treat My Periodontitis Dental Health

Periodontitis is gum disease.  It is an infection that affects the dental health of gum tissues and bone that support the teeth.  Periodontitis is often painless and sneaky, patients may not be aware that they have dental health problem until the gum tissues and the supporting bone are seriously damaged.   

The early stage of gum disease is gingivitis and it is reversible with professional cleanings at the dentist’s office and regular brushing and flossing.  If gingivitis is left untreated, it may progress into a more serious dental health condition called periodontitis and it may require more complex treatment to prevent bone loss and tooth loss.

Periodontitis is caused by plaque, a sticky film of bacteria that forms on the teeth.  Plaque produces harmful toxins that can irritate and inflame the gums.  Inflamed gums pull away from the teeth and form spaces called pockets and they trap plaque which cannot be removed with regular brushing.  Gingivitis is the early stage of periodontitis and it is reversible. Periodontitis is the advance gum disease with bone loss.

Periodontitis is diagnosed by the dentist during a routine, dental checkup.  The dentist uses an instrument called periodontal probe to measure the depth of the spaces between the teeth and gum tissues. Periodontal pockets measured at 3mm (millimeters) or less is considered healthy.  Periodontal pockets measured greater than 3mm (millimeters) can be an indication of periodontal disease is present.
·       Early stage of gum disease
·       Gum tissues are red, appear swollen, bleed easily
·       No damage has been done to the bone (no bone loss)
·       Reversible to healthy gums
·       Professional cleanings at the dentist’s office
·       Regular brushing and flossing daily

·       Gum infection caused by plaque, a sticky film of bacteria
·       Plaque causes destruction of gum tissues & supporting bone of the teeth
·       Diagnosed by the dentist
·       X-rays show bone loss
     A July 2015 study in the Journal of the American Dental Association (ADA) finds that 47.2% of adults over 30 is affected by Chronic periodontitis in US
·       Signs & symptoms:
-gums that bleed easily
-red, swollen, tender gums
-gums pulled away from the teeth and form pockets depths more than 3mm
-persistent bad breath or bad taste
-any change in the way the teeth fit together (bite/occlusion)
-visible pus surrounding the teeth and gums
-loose/separating teeth
Treatment of Periodontitis

Treatment methods depend on the type and severity of the disease
1.      Non-surgical treatment:  Scaling & Root Planing (deep cleaning)
·       scaling removes plaque and tartar above and below the gumline
·       root planing smoothes the tooth root and helps the gums reattach to the tooth
·       may take several visits to be completed
·       may require anesthetics
·       may experience pain for several days, teeth may be sensitive for up to a week
·       gums may be swollen and feel tender and bleed for a few days
·       medications  placed directly in the periodontal pocket after the scaling & root planing to help control infection and pain, or to aid healing
·       patient is scheduled to come back within a few weeks to measure the pocket depths and check how the gums have healed. 
·       More frequent dental checkups and cleanings to ensure there is improvement of your dental health
·       periodontal maintenance is recommended every 3 month
2.      Surgical treatment
·       Pocket Reduction Procedure/flap surgery-the dentist or periodontist can remove the infectious bacteria and smooth the areas of damaged bone, allowing the gum tissues to reattach to healthy bone
·       Gum Grafts-the dentist or periodontist can take gum tissues from the palate or from other parts of the mouth and graft over the exposed root of the tooth due to gum recession.
·       Bone Grafts-the dentist or periodontist can use natural or synthetic bone to graft over the area of bone loss. This procedure helps to regrow bone and gum tissues.

Recommendations to prevent gum disease:
·       Proper brushing 2 times per day and flossing daily
·       Use antibacterial toothpaste and mouth wash to kill bacteria
·       Visit your dentist at least 2 times per year or more for cleanings and checkups

According to the American Dental Association (ADA), these are some factors that may increase the risk of developing gum disease:
·       Poor dental health, poor oral hygiene
·       Smoking or chewing tobacco
·       Genetics
·       Crooked teeth that are hard to keep clean
·       Pregnancy
·       Diabetes
·       Medications: steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, oral contraceptives

If you notice any signs and symptoms of gingivitis or periodontal disease, please contact Glendora Dentist, Dr. Anna Lee for a dental checkup.  You don’t have to lose teeth to periodontal disease. Dr. Anna Lee can help to save your teeth.                                Good dental health is achievable!  Call and schedule a dental visit with Dr. Anna Lee at 626-335-5114 or email