While she was pregnant with her son Camden Jack Cutler, 25-year-old Kristin Cavallari noticed an odd occurrence in her bathroom sink: “Every time I floss, my sink looks like I murdered somebody!” the actress and reality-TV personality exclaimed. Should we be concerned that something wicked is going on with the star of Laguna Beach and The Hills?

Before you call in the authorities, ask a periodontist: He or she will tell you that there's actually no mystery here. What Cavallari noticed is, in fact, a fairly common symptom of “pregnancy gingivitis,” a condition that affects many expectant moms in the second to eighth month of pregnancy. But why does it occur at this time?

First — just the facts: You may already know that gingivitis is the medical name for an early stage of gum disease. Its symptoms may include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. Fundamentally, gum disease is caused by the buildup of harmful bacteria, or plaque, on the teeth at the gum line — but it's important to remember that, while hundreds of types of bacteria live in the mouth, only a few are harmful. A change in the environment inside the mouth — like inadequate oral hygiene, to use one example — can cause the harmful types to flourish.

But in this case, the culprit isn't necessarily poor hygiene — instead, blame it on the natural hormonal changes that take place in expectant moms. As levels of some female hormones (estrogen and/or progesterone) rise during pregnancy, changes occur in the blood vessels in the gums, which cause them to be more susceptible to the effects of bacterial toxins. The bacteria produce toxic chemicals, which in turn bring on the symptoms of gingivitis — including painful and inflamed gums that may bleed heavily when flossed.

Is pregnancy gingivits a cause for concern? Perhaps — but the condition is generally quite treatable. If you've noticed symptoms like Kristen's, the first thing you should do it consult our office. We can advise you on a variety of treatments designed to relieve the inflammation in your gums and prevent the harmful bacteria from proliferating. Of course, your oral health (and your overall health) are prime concerns during pregnancy — so don't hesitate to seek medical help if it's needed!

How did things work out with Kristen? She maintained an effective oral hygiene routine, delivered a healthy baby — and recently appeared on the cover of Dear Doctor magazine, as the winner of the “Best Celebrity Smile” contest for 2012. And looking at her smile, it's no mystery why she won.

If you would like more information about pregnancy gingivitis, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Expectant Mothers” and “Kristen Cavallari.”

CAMBRA — Caries Management By Risk Assessment

Worried about tooth decay? Dental Decay is one of the most common and infectious diseases known to man, but it is also very preventable. Today, it is even possible to determine your risk for getting tooth decay. There are disease indicators and risk indicators that can be assessed and used to determine your chances of getting tooth decay. And more importantly, they can be used to prevent and reverse early decay.

Essentially, the difference between healthy teeth and tooth decay is a matter of balance and keeping the balance tipped toward health. That means controlling the factors that tip it toward health and away from disease. Here's a little about how it works:

Disease indicators, as the name implies, are indicators of disease. For example, the presence of white spots on the enamel of your teeth, early signs of decay, which can be detected by your dentist, your past experience of cavities, and whether you currently have tooth decay.

Today, with a “simple saliva sample,” we can test the bacteria in your mouth to determine your decay risk with a simple meter reading.

There are also certain risk factors for tooth decay that you can change by modifying what you do. The ways in which you can help yourself include:

• Reduce the amount of bacterial plaque (biofilm) build-up on your teeth. If plaque is actually visible on your teeth with the naked eye, it means there is a large amount that needs to be removed professionally. High levels of bacteria leave teeth more susceptible to attack from acid-producing bacteria that cause decay.
• Stop snacking on foods containing sugar between meals. Reducing the number of times your teeth are exposed to sugary snacks, and those that contain high amounts of refined carbohydrates, will help lower your risk of tooth decay. Stop feeding the bacteria sugar, which is turned into acid.
• Use fluoride toothpaste. This toothpaste will help strengthen your teeth, making them more resistant to acid attack. Deep grooves in the biting surfaces of your teeth, which we call pits and fissures, increase the likelihood of tooth decay making it impossible to reach with just a toothbrush. However, sealing these areas with “sealants” will prevent these areas from decaying.
• Always ask your doctors about the potential side effects of all medications. Certain drugs reduce the production of saliva and lead to dry mouth, which is one of the main contributors to tooth decay. Saliva has important buffering properties, neutralizing acids in the mouth, helping to reduce risk of decay.
• If you have an eating disorder, get professional help. People suffering from both bulimia and anorexia frequently vomit after meals, which creates a highly acidic condition in the mouth. Getting control over these conditions can help you also gain control over your risk for tooth decay.

We can further help assess your risk for tooth decay by using low dosage x-rays, microscopes, innovative laser technology, and other modern means. Call our office today to schedule a screening. To learn more about the diagnosis and prognosis of tooth decay, read the exclusive Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”

Tongue and lip piercing is a growing popular trend for some young people and adults; however, did you know that they could wreak havoc on oral health? In fact, some people soon discover that before they can even enjoy their new piercing they are faced with issues ranging from bleeding and infection to nerve damage. Tongues and lips are highly vascular — that means they have lots of blood vessels that can bleed easily and are not always easy to stop once they start bleeding. Many tongue and lip bolts can initiate problems such as tooth sensitivity, gum disease and recession, chipped teeth and more. In addition, not all tattoo parlors and tattooists are properly licensed to do piercings. Therefore, sterile techniques are not always guaranteed if they do not come under the scrutiny government agencies. Unfortunately, these potential concerns are rarely discussed prior to receiving a piercing.

So what can be done if you already have a tongue or lip piercing?

If you already have piercings, it is critical that they are closely monitored by your health professionals to make sure they are not doing damage. It is also important that you have routine dental exams to ensure that you do not have any silent problems causing issues that you haven't noticed. However, your best option is to consider removing these oral piercings. The good news is that most often the hole in your tongue or lip may heal itself; otherwise, a minor corrective surgery may be required.

A note of warning: Before you contemplate a piercing, get as much information as you can about them and the person who will do them. This includes asking about their risks, benefits and better alternatives. And then think twice to make sure they will not become permanent and negative reminders of temporary emotions!

According to the Centers for Disease Control and Prevention (CDC), community water fluoridation has been a safe and healthy way to prevent tooth decay effectively for over 65 years now. In fact, the CDC has recognized water fluoridation as one of the 10 great public health achievements of the 20th century.

It all began back in the 1930's when it was discovered that fluoride had oral health benefits. However, community water fluoridation did not begin until January 25, 1945, when Grand Rapids, Michigan became the first city to add fluoride to its municipal water system. Before it was officially rolled out in other cities, Grand Rapids was compared to other cities or “controlled groups” that had not added fluoride to their water so that scientific research could assess the relationship between tooth decay and fluoride. Well, you can guess the results — it was proven that fluoride helped reduce tooth decay when added to ordinary tap water. On November 29, 1951, the National Academy of Sciences’ National Research Council (NRC) declared water fluoridation safe, effective, and beneficial based upon the results of their findings and the fact that there was a dramatic decline in tooth decay in the children of Grand Rapids.

Ever since, fluoride has continued to play a critical role as a simple, safe, effective way to provide improved oral health by helping reduce tooth decay in the United States. This reality is still being demonstrated with each new generation benefiting from better oral health than the previous generation.

As for identifying when the time is right to introduce fluoride to your children's oral health program, ask us. Most children get the right amount of fluoride to help prevent cavities if they drink water that contains fluoride. And if by chance you live in an area where your tap water is not fluoridated, brush your children's teeth with no more than a pea-sized amount of fluoride toothpaste twice a day and ask your dentist about fluoride supplements and treatment.

Learn more on this topic by reading the Dear Doctor article, “Fluoride And Fluoridation In Dentistry.”

Did you know that recent research has shown diabetes is a risk factor for increased severity of periodontal (gum) disease and that periodontitis is a risk factor for worsening blood glucose (sugar) control in people with diabetes? Periodontitis can even increase the risk of diabetic complications for people diagnosed with diabetes. When you combine these facts with the following, you will clearly see how important it is to understand and manage these two diseases.

• Over 23 million people in the United States currently have diabetes and over 170 million worldwide.
• 14+ million Americans have a condition called pre-diabetes.
• Another estimated 6 million people in the US have diabetes but are unaware and thus not diagnosed.
• Periodontal disease is the second most common disease known to man, only surpassed by tooth decay.
• Diabetic individuals with periodontal disease have a greater risk for cardiovascular and kidney complications than those diabetics not having periodontal disease.

What You Can Do

One of the most important steps you can take if you have either of these conditions or suspect that you might have one or both is to make an appointment with your physician or with our office for a thorough examination. You should schedule an appointment with your physician for an exam and blood work so that your general health and well-being are monitored. Be certain to share your medical information and any family history of diabetes with our office, as it tends to occur in families.

Learn More

Learn the risks and how to take care of types 1 and 2 diabetes, as well as the stages of periodontal disease (with detailed full-color illustrations) when you read the Dear Doctor article, “Diabetes & Periodontal Disease.” Or if you want to schedule an appointment to discuss your questions, contact us today.