Back when my father and grandfather were both general dentists, they taught me that the goal of dentistry was to keep the teeth for life. That is a goal that has now broadened to include controlling tooth and gum disease to prevent complications all over the body. My grandfather spent most of his career extracting teeth beyond repair and putting in dentures, while my father did beautiful crown and bridge restoration. Today, the bottom line is to get rid of the disease before it takes your teeth or sets you up for heart attack, stroke, diabetes or other diseases.

Each year, cardiovascular disease kills more Americans than cancer. While most people are aware that lifestyle choices such as eating right, getting enough exercise and quitting smoking can help prevent cardiovascular disease, they may not know that by just brushing and flossing daily they might also be avoiding this potentially lethal threat - regular flossing can add 6 ½ years to your life. In fact, along with other serious variables as high cholesterol and hypertension, periodontal disease is now considered a risk factor for cardiovascular disease.

Since the mouth is a pathway to the body, people with chronic gum disease are at as much as ten times higher risk for heart attack and stroke, says the Academy of General Dentistry. Even more sobering is that gum disease affects 80 percent of American adults. Signs of gum disease include bleeding or swollen gums, bad breath, sores in the mouth and receding gums.

An article published in the Journal of Periodontology in December 2007 explains diabetics are more likely to have periodontal disease than non-diabetics, as diabetes patients are more susceptible to contracting infections. The Journal found that poorly managed Type II diabetics are more likely to develop periodontal disease than well controlled patients. Moreover, diabetics with uncontrolled gum disease have a much harder time than other diabetics at controlling their blood sugar levels.

It is believed that oral bacteria affect the heart when they enter the bloodstream, attaching to fatty plaques and contributing to clot formation. Clots restrict flow of oxygen and nutrients for the heart to function, leading to a heart attack.

Another theory suggests that inflammation caused by periodontal disease increases plaque build up and can swell the arteries. Decay and inflammation start by common bacteria accumulating around the neck of the tooth. If it sits there for 24 hours or longer, it releases enzymes causing the gum to separate from the bone and tooth. If the pocket gets to be three millimeters, you cannot clean the bottom of the pocket and toxins released by the bacteria enter the bloodstream. By the time five millimeter pockets form, the bone is starting to be lost, or cratered out. A scaling (either with hand instruments or ultrasonic) by the dentist or hygienist will reduce the inflammation (infection) and therefore reduce the pocket depth. A second scaling and/or evaluation should be done to measure the pockets to ensure they are all areas of less than three millimeters. If not, something more definitive needs to be done.

If the bone is cratered out, periodontal surgery may be needed. At this point, no amount of scaling will correct the bone. There are several appropriate procedures. One is guided tissue regeneration to regrow lost bone and attachment.

Another involves gum flap surgery where the exposed tooth root is cleaned of all infection. If a person already has advanced gum disease, we can save teeth with 80-90 percent bone loss. Beyond that, we can replace a lost tooth with titanium implants that fuse to the bone and are treated like natural teeth. The New England Journal of Medicine suggests that periodontal treatment may actually reverse atherosclerosis by improving elasticity of arteries or endothelial function. With a healthy foundation, we can protect your teeth, gums and your heart.

Here is how you can prevent tooth decay and gum disease:

• Eat a balanced diet; limit snacking, especially of sticky or high-sugar foods
• Replace your toothbrush every 1-3 months
• Do not smoke
• Limit alcohol to one to two drinks a day
• Brush teeth twice a day
• Floss daily to remove bacteria and food particles between teeth and under the gum line
• Go to a dentist every 2-4 months for oral exams and cleanings. Everyone misses some plaque deposits within two months.

Kitsie Hendrix, D.D.S. - Kitsie Hendrix, D.D.S. graduated from Emory University School of Dentistry, subsequently earning certification in periodontology from the University of Pennsylvania. A periodontist,  Hendrix specializes in gum and dental implant surgery and has practiced for over 27 years.  Passionate about people, Hendrix has traveled worldwide providing free dental care through mission work.