Jul
27
2013

Flossing and Brushing Saves Your Heart

It was not until about the mid 1990’s when it became apparent that gum infections and severe tooth decay could cause inflammation in the blood measurable by using the CRP marker (C-reactive protein). As this link shows Dr. Joseph Muhlestein at the University of Utah demonstrated in 1996 that chronic gum infection could cause a heart attack. He isolated the bacterium Chlamydia pneumoniae in 79% of patients undergoing coronary bypass surgery, while samples from heart transplant patients isolated this bacterium in only about 5%. The new thinking was that bugs that multiply in diseased gums could migrate into the blood and cause platelets from the blood to clump together and block coronary arteries causing heart attacks. Harvard University researchers have confirmed this. In the past it was known that a bad tonsillitis with an aggressive bacterium, Streptococcus viridans, could cause subacute endocarditis, a dangerous infectious disease of the heart valves, which can be responsible for sudden death in younger persons. Neglected cavities in teeth can also harbor this bacterium. Another study in 2009 showed that two particular strains of bacteria in infected gums, Tannerella forsynthesis and Preventella intermedia, were associated with an increased risk for heart attacks; but it was more the overall burden of bacteria in the infected gums than the specific bacteria strains that mattered most.

Flossing and Brushing Saves Your Heart

Flossing and Brushing Saves Your Heart

 

Preventing heart disease by brushing and flossing

With this background it is easier to understand that we need to take good care of our teeth and gums, if we want to maintain good health. As a start most people should see their dental hygienist (who usually works in a dentist’s office) twice a year. The dental hygienist will probe the depth of gingival pockets with a periodontal probe. A normal depth measures up to and including 3 mm. Deeper pockets than that usually indicate that the patient did not floss regularly. One needs to floss at least once per day, better twice per day and it should not bleed after flossing (initially when a person flosses for the first time the gums tend to bleed a bit).

The hygienist will do scaling of plaques on the tooth enamel. Any cavity that is detected will be brought to the attention of the dentist. At the end of the scaling procedure fluoride is applied, which puts a coating on the tooth surfaces to prevent tooth decay.

When deeper pockets (6 mm or more) are detected a trial of subgingival root brushings has shown to have a very beneficial result within only 14 days.

Periodontal pockets were improved and bacterial counts of periodontal infections were shown to have improved as well.

Oral care and cavity prevention in the population

It has been accepted for quite some time that a combination of brushing and flossing are the best methods to control dental plaque, which is the precursor for cavities.

In order to test the knowledge of adults in families with small children these authors from the School of Public Health of the Maryland University investigated Maryland’s adult population knowledge regarding caries prevention. It turns out that there were deficiencies in knowledge about the prevention of dental caries and the importance of fluoride to create strong, decay resistant enamel.

A randomized, prospective study is planned in Hong Kong which will start teaching oral hygiene to kindergarten children aged 3 and will be reinforced several times later to instill good dental hygiene behaviors into these children’s health routine as outlined in this link. Not only is it important to teach brushing and flossing, but also food habits with cutting down on sugary and starchy snacks as these foods make the saliva acidy promoting caries producing bacteria in the plaque.

This English study shows that a primary school based caries prevention program reduced caries by 35% when sugar intake was limited in the interventional group and brushing of teeth was done twice per day along with flossing.

An addition to flossing for those with narrow tooth intervals or those with braces is a waterpik system. This can be used to clean food residues from the spaces between your teeth and from gum pockets. Flossing once or twice per day is still needed to remove plaque to avoid tartar build-up. Before bedtime it is advisable to floss first, then use a waterpik, then use your electric toothbrush with a fluoridated toothpaste. During the day use the waterpik after meals followed by brushing with an electric toothbrush with non-fluoridated toothpaste.  Water Picks are also called “water flossers”; they are easier on your gums.

Other measures helpful in preventing tooth decay

Xylitol is a natural sweetener originally derived from birch. Sugarless gum often is sweetened with Xylitol. This study has shown that chewing Xylitol containing gum can effectively reduce caries. This paper describes that the increased saliva production from chewing gum provides a slightly alkaline environment for teeth. This helps to clear out sugar faster from the oral cavity after a meal, inhibits bacterial growth, neutralizes the pH in plaque that is on the acidy side after sugar consumption. The authors concluded that chewing Xylitol gum is a useful addition to the other known preventative measures of dental decay prevention, such as brushing and flossing teeth.

The techniques the dentist is using to treat plaque and dental decay have been refined by a new technique describe in this Australian publication as a minimum intervention caries prevention program.

The four methods used in minimum intervention dentistry are described here.

1. Recognition: to recognize potential caries factors early through lifestyle factor analysis and saliva testing.

2. Reduction: alter the diet and lifestyles to increase the pH of the saliva, which will reduce the risk factors for caries.

3. Regeneration: to arrest and reverse minimum lesions at the earliest stage. Use agents such as fluorides and casein phosphopeptides-amorphous calcium phosphates to achieve this.

4. Repair: when a cavity is present, a technique of “conservative caries removal” involves using bioactive materials to allow healing of the dentine layer of the tooth.

Reduction of cariogenic bacteria

I already mentioned above that alkalization of saliva by chewing Xylitol gum could significantly help prevent tooth decay. It does so by raising the pH, while chewing on sugary foods or starchy foods lowers the pH (making it more acidy). Growth of caries producing bacteria, which are called “cariogenic bacteria” is stimulated by acidy saliva and inhibited by alkaline saliva. For this reason people whose diet consists of a lot of vegetables and greens will have more alkaline saliva and are less prone to develop cavities. The worst foods to get cavities are sugar in its many disguises and starchy products (candies, bread, rice, potatoes, pasta, bagels, cookies, cakes).

What can cause bacteria from the mouth to appear in the blood? One common condition is periodontitis, which is a chronic inflammatory condition of pockets of the gums around the teeth. This originates from neglecting your teeth and not flossing. Smokers are more afflicted by this as well. Dental procedures called scaling and root planing are often done for chronic periodontitis. This study from January 2013 shows that there is about the same amount of bacteria that leak into the blood following these procedures when compared to flossing.

Sometimes a dentist will recommend using a short-term antibiotic to reduce the leakage of bacteria into the blood, particularly with people who have heart valve problems or had porcine heart valve replacement in the past. This publication from 2009 also describes that dental flossing causes bacteria to be shed into the blood (bacteremia).

Conclusion

Dental self-care should be taught to children at an early age to educate them to brush their teeth twice a day and floss them at least once per day. At the same time they need education what causes cavities in terms of food intake and that fluoride can help make teeth more cavity resistant. They should avoid sugar in pop, candies and cookies etc. Parents best teach by example! Regular visits to the dentist’s office will safe money on the long term. Regular scaling by a dental hygienist every 6-month will remove plaque from which cavities develop when bacteria thrive in them and produce acids that affects the enamel. Minimum intervention dentistry discussed above (4 methods used) can prevent your teeth from decaying. Regular flossing will keep your gums healthy and reduce the colonization of the mouth with bad, cariogenic bacteria. With all this in place you likely will keep your teeth for a long time and not need dentures or tooth implants because of lost teeth. At the same time you will prevent your immune system being overwhelmed by mouth bacteria, which could have lead to a heart attack had you neglected your teeth. As mentioned in the beginning, a CRP blood test is a useful tool to rule out chronic infection.

More information on:

1. Tooth decay: http://www.nethealthbook.com/articles/dentistry.php#Tooth_Decay

2. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Reference: http://www.webmd.com/heart-disease/features/your-guide-gum-disease

Last edited Nov. 7, 2014

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Feb
19
2013

Forget The Glass Of Red Wine For Good Health

We have been hearing for over 10 years that 1 glass of red wine per day for women and 2 glasses of red wine per day for men would be recommended in order to prevent a heart attack or a stroke. Now we are confronted with new research from Boston showing that even small amounts of alcohol are bad for you as alcohol is a carcinogen (=cancer producing substance). Misinformation like this occurs when science concentrates only on one angle of health, such as cardiovascular disease prevention and the other part of the equation, the cancer producing (carcinogenic) effect of alcohol, is disregarded.

In 1996 this Australian study followed 1236 men and 1569 women 60 years and over for more than 5 years and studied their mortality rates as a function of alcoholic drink intake. The authors found that there was a short-term protective effect with regard to cardiovascular/stroke mortality. But due to the fact that mortality was the end point for both cardiovascular disease and for cancer, the study was mostly taken as evidence that alcoholic beverages would protect to a certain degree from strokes and heart attacks. The authors were aware that alcohol was cancer causing as they stated, “Those taking any alcohol exhibited an increased proportion of deaths due to cancer at the expense of a reduced proportion of CHD and stroke deaths”. But this part was not mentioned in the popular press or in future alcohol/cardio-protective recommendations. The authors also were aware that the observation time of 5 years was on the short side. We know from other studies that alcohol toxicity requires a longer observation time such as 15 to 20 years or longer to show significance in a multitude of cancers.

Forget The Glass Of Red Wine For Good Health

Forget The Glass Of Red Wine For Good Health

As already mentioned above, recently a new survey of alcohol-caused cancer was published and went through the popular press. Dr. Timothy S. Naimi from Boston University Medical Center was the main investigator of an international team of scientists. The study found that every year 18,200 to 21,300 cancer deaths in the US (that is 3.2% to 3.7% of all US cancer deaths) are directly caused from alcohol consumption. The authors of the study determined that every person who dies from alcohol related causes lost on average approximately 18 years of his/her life (scientists call this “years of potential life lost”).  51% of women developed breast cancer from alcohol exposure, 62% of men came down with upper airway and esophageal cancers. Less than 1.5 drinks per day caused between 26% and 35% of alcohol-related cancer deaths. There was no safe lower margin. The authors concluded, “Reducing alcohol consumption is an important and underemphasized cancer prevention strategy”.

Interestingly, in 2006 other research looked at alcohol caused cancer cases in the world based on WHO data and came to the conclusion that with the increased worldwide consumption, particularly in East Asia, preventative steps by eliminating or replacing alcoholic drinks would be wise.

A recent study in 2012 where cancer rates in the US were compared between Hispanics and Caucasians showed that Hispanics had higher rates of stomach cancer, liver cancer, uterine/cervix cancer and gallbladder cancer. The authors concluded that Hispanics need more screening done such as Pap tests and that effective vaccines (like Gardasil) should be used. In addition effective interventions should be applied to reduce obesity, curtail alcohol consumption and reduce tobacco use.

Studies have shown that there is no safe level of alcohol consumption, not even the famous 1 drink for women and 2 drinks for men (with regard to heart attack prevention), because cancer incidence increases with increasing alcohol consumption in a linear relationship.

What does alcohol do in the body that it is so dangerous to your cells? Many cancer researchers have researched this question in detail. Essentially, alcohol is by itself a toxin for your cells (the targets being sub particles in your cells called microsomes and mitochondria). Your liver metabolizes alcohol into acetaldehyde, your kidneys excrete it and your lungs exhale it (this is how a breathalyzer can detect how much you have been drinking). All of these chemical changes in your cells release free radicals, which in turn attack other cells. This sets up a chronic inflammatory process, which breaks down your immune system, leads to cell mutations and finally to cancer.

What protects you from cancer?  It is the antioxidants that stabilize the above-mentioned processes: vitamin C, glutathione, vitamin D 3, curcumin, multiple vitamins, magnesium, flavonoid foods, cruciferous foods (like broccoli), exercise and soluble fiber.

So, if you were serious about cancer prevention, you may want to stop any alcohol intake and take the above supplements instead. The heart attack and stroke protection will be achieved by flavonoid foods (perhaps specifically adding resveratrol 250 mg per day as well) and exercise.

If you were less conscientious about cancer prevention, at least reduce your alcohol consumption perhaps to the occasional glass of wine or beer, but avoid high percentage spirits and remember, the less the better! You may be toasting to ill health with that glass of wine. Say no to false advertising of the wine industry! Your body will thank you for it.

More information on alcoholism: http://nethealthbook.com/drug-addiction/alcoholism/

Here is another reference where you can read about the recent Boston study:

http://www.physbiztech.com/news/ceasing-alcohol-consumption-leading-way-prevent-cancer-death-study-finds

Last updated Nov. 6, 2014

Mar
01
2007

Olive Oil No Magic Elixir

Health trends come and go, and some myths need to be demystified, such as the notion that we need a lot of one beneficial food to achieve good health. The Mediterranean diet has become a buzz word in the public, and there is certainly nothing wrong with a diet that emphasizes the benefits of vegetables and fish with omega-3 fatty oil. These figure prominently in foods of the Mediterranean. Olive oil, which is one of the fat sources, has been also touted as a “miracle food”, and the benefits of the healthy fats to which it belongs have received a lot of attention.
Dr. James Kenney, who holds a PhD in nutrition at the at the Pritikin Longevity Centre, questions inflated health claims of olive oil. No matter, which way you look at it, olive oil remains a calorie-dense and nutrient-poor food. Pound for pound, like all refined oils, olive oil has more than 4000 calories, and 13% to 14% of the calories in olive oil come from saturated fat. The good news is that compared to lard (38% saturated fat) and butter (63% saturated fat) olive oil is the better choice. People who switch from butter to olive oil will see a reduction of cholesterol, reports Dr. Kenney. The reason is that they are eliminating a lot of saturated fat, trans fat and cholesterol that was in the butter. Olive oil itself does not lower cholesterol, as monounsaturated fatty acids do not raise or lower cholesterol. As a result it is not a good idea to freely pour olive oil into salads, over vegetables or to dip white bread into it, transforming it into an oil-dripping calorie bomb.

Olive Oil No Magic Elixir

Olive Oil No Magic Elixir

Olive oil can be compared to rocked fuel: it is a high calorie food, and if you plan to go on a long distance bike excursion across the country, you’ll clearly need more fuel than if you are working at a sedentary job in an office. Olive oil should be used like salt. It is a condiment, and choosing extra virgin olive oil in a spray pump gives us a boost of flavor. The real beneficial food sources in the Mediterranean diet are fruit, vegetables, beans, small amounts of whole grain and omega-3 rich fish. Flavonoids and antioxidants in the fruit and vegetables are some of the main players, but lifestyle and genetics may also play a role.

More about fats, the good, the bad and the ugly here: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/fat-good-bad-fatty-acids/

Reference: The Medical Post, February 2, 2007, page 17

Last edited November 2, 2014