What does November make you think of? Pumpkins? Turkeys? Dry leaves and frosty mornings? How about cigarette butts?

If you’re wondering about the last item, remember that November 15 is the date of the Great American Smokeout—a day set aside for those who want to take the first steps toward quitting the tobacco habit. While the percentage of smokers in the U.S. has dropped to less than 16% in recent years, according to the American Cancer Society there are still some 38 million Americans who smoke cigarettes. Smoking causes over 480,000 deaths every year, and is the leading preventable cause of death in the U.S.

Even if it doesn’t kill you, the effects of tobacco use can be devastating to your entire body—including your mouth. Whether you smoke cigarettes or use chewing tobacco, your risk of oral cancer is greatly increased, as is your chance of developing periodontal (gum) disease. What’s more, smoking can mask the symptoms of gum disease, so your condition is actually worse than it appears. Severe gum disease is one reason why smokers tend to lose more teeth than non-smokers.

In addition, because smoking interferes with the natural healing process, smokers have a much greater chance of dental implant failure. Tobacco use also can lead to increased amounts of plaque, which results in tooth decay and other oral health problems. It also stains your teeth, reduces your senses of smell and taste, and gives you bad breath.

Ready to quit yet? If so, there are lots of resources to help you on the road to a healthier life. The American Cancer Society, sponsor of the Smokeout, can help you make a plan to quit tobacco—and stay off it. It’s not easy, but over a million Americans do it every year. See their website for more information, plans and tips on quitting. Your health care professionals are also a great source of information and help when it’s time to get off the tobacco habit. Feel free to ask us any questions you may have.

And here’s the good news: The moment you quit, your body begins to recover from the effects of tobacco use. In just one year, you’ll have cut your risk of heart attack and stroke in half. After 5 to 15 years, your risk of stroke, coronary heart disease, and several other conditions is the same as someone who has never smoked.

If you have questions about smoking and oral health, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Dental Implants and Smoking.”

Not coincidentally, GERD Awareness Week overlaps with the Thanksgiving holiday. Many people get acid indigestion from time to time, especially during this month of major feasting, but if you suffer from more than occasional acid reflux, you may be among the 20 percent of U.S. adults with gastroesophageal reflux disease, or GERD. For many individuals, painful heartburn often accompanies acid reflux; however, for others there are few or no symptoms. In the latter situation, dentists may be the first to suspect GERD based on what we see during a regular dental exam.

With GERD, acid washes up from the stomach into the esophagus or throat, and even into the mouth. If the condition is not treated, the repeated contact with acid can lead to ulcers and cause pre-cancerous cell changes along the esophagus lining. In addition, the acids can eat away at tooth enamel and harm the soft tissues of the mouth, which may result in severely eroded teeth and chronic gum disease. Unfortunately for those who have relatively minor symptoms, GERD may go undetected until serious damage has been done. For this reason, diagnosis and treatment of GERD is very important.

You can play a big role in managing your GERD symptoms. Besides taking any over-the-counter or prescription medication your doctor recommends, you can help control acid reflux by eating smaller meals, avoiding foods and beverages that trigger heartburn, refraining from eating within three hours of bedtime, and resisting the urge to recline right after eating. Also, quitting smoking and taking off extra weight can help greatly.

Further, it is important to take steps to protect your teeth if you suffer from GERD. Here are some tips:

• Neutralize acid by chewing on an antacid tablet or rinsing your mouth with half a teaspoon of baking soda mixed into a cup of water.
• Don't brush your teeth immediately after an episode of acid reflux, as this could damage the weakened tooth enamel. Instead, rinse your mouth with water to dilute the acid and wait an hour before you brush to allow your saliva to rebuild the minerals on the surface of your teeth.
• Schedule regular dental visits to monitor the health of your teeth and gums. Depending on your specific situation, we may recommend a particular treatment to help strengthen your teeth.

Our goal is to help you preserve your teeth for life, so be sure to tell us if you have been diagnosed with GERD or any other medical condition. If you have questions, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “GERD and Oral Health” and “Tooth Decay: How to Assess Your Risk.”

While your chances of losing teeth increase as you age, it's not a given. With proper hygiene and care your teeth could last a lifetime.

But brushing and flossing can become more difficult in later years. Arthritis or strength issues in the fingers and hands make holding a toothbrush an arduous chore and flossing next to impossible.

But you can accommodate these physical changes. Many seniors find using a powered toothbrush much easier to handle and effective for removing disease-causing plaque. A tennis ball or bike handle grip attached to a manual toothbrush can also make it easier to handle. As to flossing, older people may find it easier to use floss threaders or a water irrigator, which removes plaque from between teeth with a pressurized water spray.

You may also find changes in the mouth that increase your risk for dental disease. One such issue is xerostomia, dry mouth. As you age you don't produce as much saliva, which neutralizes acid and restores minerals to enamel, as when you were younger. Dry mouth can also be a side effect of certain medications. Older people are also more likely to suffer from gastric reflux, which can introduce stomach acid into the mouth.

With these dry, acidic conditions, you're more susceptible to both tooth decay and periodontal (gum) disease. You can help offset it by increasing water consumption, taking a saliva stimulator, changing to alternative medications if available, and relieving gastric reflux.

Another area of concern in aging is the higher risk for inflammatory diseases like diabetes or cardiovascular diseases (CVD), which could also increase your risk of periodontal (gum) disease. Seeking treatment for gum disease and other similar systemic diseases may help ease the effects of each one.

Taking care of your mouth can be challenging as you grow older. But tooth loss and other unpleasant results aren't inevitable. Invest in your teeth and gums today and you're more likely to have a healthy life and smile all through your golden years.

If you would like more information on caring for your teeth and gums as you age, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Aging & Dental Health.”

Nearly half of all Americans have some form of periodontal (gum) disease. Without proper daily hygiene and treatment, this aggressive disease can ultimately cause tooth loss. It also appears the effects of gum disease reach beyond the mouth, as researchers have found relationships between it and other systemic diseases.

Inflammation, the body’s response to infection, is at the center of these relationships. In the case of gum disease, periodontal tissues become inflamed as the body attempts to isolate and fight the infection. If the inflammation becomes chronic, however, it will begin to damage gum tissues.

Inflammation is also a major feature of diabetes, a condition in which the pancreas doesn’t produce enough insulin. Without enough of this hormone that transforms sugar into usable energy for the body, the sugar accumulates in the blood stream; as a result, the patient becomes more susceptible to an exaggerated inflammatory response when the body encounters an infection. This is especially true for periodontal infections: the resulting inflammation can be greater and harder to control in diabetic patients. What’s more, uncontrolled gum disease may worsen their blood sugar levels.

Although not as prominent as with diabetes, cardiovascular disease also seems to share a connection with gum disease. This collection of chronic conditions like high blood pressure or restricted blood vessel flow raises the risk of heart attack or stroke. Like gum disease, inflammation is a major component in the progression of cardiovascular disease — in fact, both diseases leave similar chemical “markers” in the blood that indicate their early development.

Ongoing research has also produced some promising treatment findings for both gum disease and inflammatory diseases, which also include osteoporosis, respiratory disease and rheumatoid arthritis. We’re now finding in many cases that treating one side of the disease connection can have positive effects on the other side. For example, diabetics who receive professional treatment for gum disease may see better blood sugar control.

With this in mind, the best approach is to practice effective, daily oral hygiene to reduce the risk of gum disease, coupled with regular office cleanings and checkups. Not only will this help you maintain optimum oral health, it may also contribute to better management of other conditions you may have.

If you would like more information on the relationship between periodontal (gum) disease and other diseases, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”

If you’re pregnant, you may find yourself pondering decisions you didn’t have to think about before. Should you have that glass of wine… or skip it, because of the alcohol; go for the sushi… or avoid uncooked foods; take the pain reliever… or live with the headache. And if you have a toothache — or even if you’re overdue for a checkup and a cleaning — you may also be wondering whether having dental treatment (especially treatment that might involve local anesthetics) is safe for you and your developing baby.

Fortunately, a study that recently appeared in the Journal of the American Dental Association (JADA) should let expectant moms breathe a little easier. The research concludes that it’s safe for pregnant women to undergo dental treatment, including procedures that use local anesthetics.

And that’s good news indeed, because while maintaining good oral health during pregnancy is critical for the developing baby, many expectant moms experience problems during this period.  Some common issues include a higher risk of tooth decay due to increased carbohydrate consumption, and sore or bleeding gums from a condition called pregnancy gingivitis.

According to the study’s lead author, Aharon Hagai, D.M.D., "[Pregnancy] is a crucial period of time in a woman’s life, and maintaining oral health is directly related to good overall health." Yet, as Dr. Hagai notes, pregnant women sometimes avoid the dentist even if they have a problem. So his team set out to determine whether having dental treatment with anesthesia affected the outcome of pregnancies. They compared a total of 1,004 women, some of whom had dental treatment with local anesthesia, and some who did not.

The research showed there was no significant difference between the two groups. This applied in terms of both major medical problems (such as cleft palate, heart defects or cerebral palsy) and other issues, including low birth weight and preterm delivery. Dr. Hagai summed it up this way: "We aimed to determine if there was a significant risk associated with dental treatment with anesthesia and pregnancy outcomes. We did not find any."

So if you’re pregnant, there’s one less thing to worry about. Go ahead and schedule your routine dental check up — and remember that it is particularly important to have cleanings during pregnancy.  If you experience changes in your oral health, don’t hesitate to come in for an office visit and cleaning; that way, you can make sure your hormonal changes are not playing havoc with your gums. There is an old saying in some cultures that for every child a woman has, she loses a tooth. Don’t let that happen to you.

If you have questions about oral health and pregnancy, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine article “Expectant Mothers: Dental facts you need to know” and “Pregnancy and Oral Health.”