News & Events

What You Don’t Know Can Hurt You

The Oral-Systemic Disease Connection

A statistical association between oral disease, such as periodontal (gum) disease, and systemic diseases, such as cardiovascular disease, stroke, diabetes, kidney diseases, pregnancy complications, respiratory (lung) diseases, has been confirmed. Dentists and physicians have long suspected a causal relationship between dental infection and Subacute Bacterial Endocarditis (SBE). That’s why people with history of Rheumatic Heart Disease, Scarlet Fever, Heart Valve replacement or Mitral Valve Prolapse take antibiotics before dental visits that are likely to cause bleeding. But now, the list of systemic diseases that are at least statistically associated with oral diseases is growing and includes failure of orthopedic prostheses such as knees and hips. It only stands to reason that infectious and inflammatory byproducts from dental diseases can enter the blood stream through bleeding gums and cause inflammation or infection elsewhere in the body. But it has only been over the course of the last 15 years that research has been able to explain why and how this association exists and to what degree. Now we are able to:

  • test for chemicals in the blood known as “markers” for immune responses signifying the presence of inflammation or infection
  • quantify the amount of the markers signifying the severity and extent of the infection or inflammation in the body and determining risk (odds ratio) of developing further disease
  • monitor the inflammatory markers during treatment to assess the impact of treatment and confirm the physical location of the source of inflammation or infection in the body.

Pertinent conclusions from research of the oral-systemic disease link are:

  • 75% of the adult population has some degree of gum disease with 20-30% exhibiting more severe forms.
  • People with oral infections were 30% more likely to have a heart attack than people with no oral infections.
  • The likelihood of Coronary Heart Disease increases with increasing severity of gum disease. Men less than 50 years old with gum disease were 72% more likely to develop Coronary Heart Disease compared to those with healthy gums.
  • The surgeon general in 2000 declared that “Oral health is integral to general health.”
  • Actual gum disease causing bacteria have been detected in atherosclerotic blood vessels.
  • Gum Disease treatment has been shown to lower the concentration of inflammatory markers in the blood and the actual risk of developing further systemic disease.

The healthcare industry, including the health insurance industry, has taken a serious stance on identifying risk factors, such as gum disease and other oral diseases, for systemic diseases and including management of those risk factors in treatment protocols. Dr. Dunavant has lectured on this subject at international interdisciplinary medical meetings. He and the staff at Comprehensive Dentistry of Orange Beach examine and diagnose gum disease, test for the risk of associated systemic diseases, consult with and refer to the proper medical doctor if necessary and monitor the impact on treatment of dental risk factors.

Take this survey to see if you are a candidate for testing. Place a checkmark beside the score for each question answered “yes”.

Survey Questions: Score
Do you have swelling OR pus drainage in or around your gums? 6 points
Do your gums bleed when brushing and flossing your teeth? 5 points
Do you have pain in your teeth or gums? 4 points
Are some or all of your teeth loose? 3 points
Do you have receding gums, sensitive teeth or persistent bad breath? 2 points
Have any of these conditions been present for over a year? 1 points
Add up the points for all the questions for which you answered “yes”. __ total points

A total score of 7 or greater warrants blood testing for systemic inflammatory markers as well as a comprehensive dental examination.


Get the Most from Your Teeth Whitening Efforts

Comprehensive Dentistry of Orange Beach frequently hears from patients that their past teeth whitening experiences were disappointing. Either their teeth didn’t get as white as they had expected or the process took too long, was inconvenient or uncomfortable. We want to help you to get the best result you possibly can with no surprises, so we are glad to publish what we explain to all of our whitening patients and what our patients tell us they don’t hear from their previous teeth whitening consultants, whether dental offices, spas or manufacturer mail orders.

First of all, only natural tooth structure will whiten with these chemical agents. Porcelain veneers and crowns and composite fillings and bondings will not whiten. Since veneers only cover the front side of teeth, the un-veneered natural portion of those teeth will whiten unless covered with bonding agent, so it may help some to whiten veneered teeth. Chemical whitening agents can be toxic to the gums and inflammatory to teeth. Particular agents and concentrations should be prescribed in timely fashion to avoid potential tissue damage. We personally don’t recommend laser whitening but we get a noticeably improved result with light-enhanced whitening verses tray whitening alone. Your dentist is best able to discern what will or won’t whiten and the condition of your teeth and gums to get the best results without damage.

Any whitening agents will only work when applied to clean teeth and in constant undiluted contact with the teeth for the active duration of the chemical. You should get a professional prophylaxis (teeth cleaning) immediately before beginning whitening and keep your teeth clean with proper brushing and flossing immediately before each daily application. Different products have different chemical stability, viscosity, molecules, concentration which affect the duration of activity and effectiveness. The more potent chemicals are only available under dentist’s prescription and supervision. We use only researched products, which obviously cost more than the mail order ones. The design and fit of the application trays (mouthpieces) is extremely important in success and comfort. It must fit tightly at the interface of the tooth and gums, to prevent leakage of the agent and contamination by saliva, with just the right amount of reservoir for the chemical agent to bathe the teeth and stiffness to resist deflection of the agent, which causes splotchy or incomplete whitening. Never wear the tray in your sleep… you have no control over things such as biting on the trays, flexing your lips or squeezing with your tongue during swallowing or rolling over onto your face, all of which can squeeze the whitening agent right out of your trays or loosen the trays allowing saliva contamination or deflection of the agent in the reservoirs causing splotching. You should wear the trays in the evening after eating, brushing and flossing and socializing, before you go to bed when you can refrain from talking. Maybe read a book or watch TV for about 2-3 hours. When loading your trays, add enough that, from experience, you have a little overflow all around –front and back. Do not push on your trays after they are seated or when wiping excess agent at the gum line. Protect your trays from thermal or physical distortion by avoiding heat and storing in container when not in use.

The whitening agents work by soaking into the pores in tooth enamel (and root) and effervescing thus loosening trapped stains.You must remember that while you are in the process of whitening, your teeth are much more susceptible to staining than before because your enamel pores are now wide open and it takes time for your saliva to chemically seal those pores, which actually never completely happens. Our rule for food and drink avoidance is “avoid anything that will stain a white shirt when spilled on it.” This leads to one of the most neglected and disappointing aspects of teeth whitening. You must seal up those open enamel pores when your process is finished. Otherwise, your teeth will restain quickly.

We have new patients and vacationers ask for “touch-up” agent. When we ask them how often they “touch-up,” they say they continuously whiten. When we then ask them if they had their enamel sealed after whitening, they usually say they were never told they needed to. We don’t recommend “continuous whitening.” It is dangerous to your teeth and gums and is ineffective. You should only need to “touch-up” every 2-3 years if your teeth are sealed properly. Now go and whiten your teeth in confidence.