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The American Academy of Periodontology stresses the importance of good oral health since gum disease may be linked to heart disease and stroke. Thus far, no cause-and-effect relationship has been established, but there are multiple theories to explain the link between heart disease and periodontal disease. One theory suggests that oral bacteria may affect heart health when it enters the blood and attaches to the fatty plaque in the heart's blood vessels. This can cause the formation of blood clots. Another theory suggests the possibility that inflammation could be a contributing link between periodontal disease and heart disease. Gum disease increases plaque buildup, and inflamed gums may also contribute to the development of swollen or inflamed coronary arteries.

What is coronary artery disease?

Coronary artery disease is caused in part by the buildup of fatty proteins on the walls of the coronary arteries. Blood clots cut off blood flow, preventing oxygen and nutrients from getting to the heart. Both blood clots and the buildup of fatty proteins (also called plaque) on the walls of the coronary arteries may lead to a heart attack. Moreover, periodontal disease nearly doubles the likelihood that someone will suffer from coronary artery disease. Periodontal disease can also worsen existing heart conditions, so many patients who suffer from heart disease need to take antibiotics before any dental procedures. This is especially true of patients who are at greatest risk for contracting infective endocarditis (inflammation of the inner layer of the heart). The fact that more than 2,400 people die from heart disease each day makes it a major public health issue. It is also the leading killer of both men and women in the United States today.

What is periodontal disease?

Periodontal disease is a chronic inflammatory disease that destroys the bone and gum tissues around the teeth, reducing or potentially eradicating the system that supports your teeth. It affects roughly 75 percent of Americans, and is the leading cause of adult tooth loss. People who suffer from periodontal disease may notice that their gums swell and/or bleed when they brush their teeth.

Although there is no definitive proof to support the theory that oral bacteria affects the heart, it is widely acknowledged better oral health contributes to overall better health. When people take good care of their teeth, get thorough exams, and a professional cleaning twice a year, the buildup of plaque on the teeth is lessened. A healthy, well-balanced diet will also contribute to better oral and heart health. There is a lot of truth to the saying "you are what you eat." If you have any questions about you periodontal disease and your overall health, give our Millburn office a call!

A root canal entails the removal of the nerve supply from a tooth. If you know the purpose of a root canal, the process may seem a little less intimidating.

Dr. Barker will explain the steps in person before your scheduled root canal. Here are some reasons why you may need one and how it will be done when you visit our Millburn office for your appointment.

Let’s look at the parts of a tooth. Teeth are made up of layers. The outside is the enamel you see, which is composed of minerals. The middle layer is called dentin. It is less dense and made of calcified tissues.

The center of the tooth, also known as the pulp, holds the nerves and blood vessels. When a tooth has decayed or been infected all the way down to the pulp, a root canal is used to remove and replace the root with a filling.

A cavity, sudden trauma, severe cracks, or other events that may cause nerve damage can start an infection of the root of your tooth. You may notice an infection if you experience abnormal pain, swelling, sensitivity, or change in tooth appearance.

Don’t hesitate to contact our Millburn office to schedule an examination if you notice these symptoms. We may need to take X-rays of the problem tooth to find out if a root canal is necessary.

Once an appointment is scheduled for a root canal and we’re ready to begin the procedure, you’ll be given anesthesia to keep you comfortable. The problem tooth will be isolated and sterilized. We work to remove all the infected area after that.

The treatment will include getting rid of nerve tissue and blood vessels, then filling in the spot where the nerve used to be. A crown is placed over the area to secure enamel from breaking down in the future and prevent the potential loss of the tooth. The root canal can block the possibility of having your tooth extracted due to decay or infection.

If you have further questions about root canals or notice any new issues in your mouth, please don’t hesitate to call our office and speak with a member of our staff. We’d be happy to answer your questions and schedule an appointment for you to come and get your problem tooth checked out.

Don’t forget: You can avoid having to undergo a root canal if we catch the problem early on!

Why does gum disease develop? Our mouths are home to bacteria, which form a film called plaque. Plaque sticks to the surfaces of our teeth, at the gumline, and can even grow below the gumline. And this bacterial growth leads to inflammation and gum disease.

When the disease progresses, the gums gradually pull away from the teeth leaving pockets which can be home to infection. Toxins can attack the bone structures and connective tissue, which support our teeth. Left untreated, periodontal disease can lead to serious infection and even tooth loss.

Because we are dealing with bacteria, it makes sense that antibiotics are one way to combat gum disease. Depending on the condition of your gums, we might suggest one of the following treatments:

• Mouthwashes—there are mouthwashes available with a prescription that are stronger than over-the-counter antibiotic formulas, and can be used after brushing and flossing.
• Topical Ointments—These ointments or gels are applied directly to the gums, most often used for mild forms of the disease.
• Time-release Treatments—If there is severe inflammation in a pocket, we might place a biodegradable powder, chip, or gel containing antibiotics directly in the affected area. These minute methods release antibiotics over a period of time as they dissolve.
• Pills and Capsules—For more serious periodontal disease, you could be prescribed an oral antibiotic. Take in pill or capsule form as recommended, and always finish the entire prescription.

Talk to Dr. Barker at our Millburn office before beginning a course of antibiotics. It’s important to know if you have any allergies to medications, what to look for if you might have an allergy you didn’t know about, if you are pregnant or breast-feeding, or if you have any health concerns that would prohibit antibiotic use. Talk to us about possible side effects and how to use the medication most successfully. With proper treatment, we can treat gum disease as quickly and effectively as possible, and provide advice on maintaining a periodontal routine that will keep your gums and teeth healthy for years to come.

Women using medication to treat a variety of medical conditions are often unaware of the potential side effects. One common side effect of medications such as blood pressure medication, birth control pills, antidepressants, and cancer treatments is dry mouth. The technical term for dry mouth is xerostomia.

Xerostomia can lead to undesirable effects in the oral cavity including periodontal disease and a high rate of decay. Many women who have not had a cavity in years will return for their routine exam and suddenly be plagued with a multitude of cavities around crowns and at the gum line, or have active periodontal disease. The only thing that the patient may have changed in the past six months is starting a new medication.

Saliva washes away bacteria and cleans the oral cavity, and when saliva flow is diminished harmful bacteria can flourish in the mouth leading to decay and gum disease. Many medications can reduce the flow of saliva without the patient realizing the side effect. Birth control pills can also lead to a higher risk of inflammation and bleeding gums. Patients undergoing cancer treatments, especially radiation to the head and neck region, are at a greatly heightened risk of oral complications due to the possibility of damage to the saliva glands.

There are many over the counter saliva substitutes and products to temporarily increase saliva production and help manage xerostomia. One great option for a woman with severe dry mouth or high decay rate is home fluoride treatments. These work in a number of ways, including custom fluoride trays that are worn for a short period of time daily at home, a prescription strength fluoride toothpaste, or an over the counter fluoride rinse. If you have more questions on fluoride treatments, make sure to ask Dr. Barker at your next visit to our office.

The benefits of many of the medications on the market outweigh the risks associated with xerostomia, however, with regular exams you can manage the risk and prevent many oral consequences of medications.