It is not uncommon for dental offices to use an image of a tooth in their signs or promotional materials. What you rarely see is an image of the gums. Yet gum health is an essential part of overall dental care. Nico Geurs, DDS, MS, Weatherford/Palcanis Endowed Professor and Chair in the Department of Periodontology at the UAB School of Dentistry, talks about the importance of not being dumb when it comes to the gums.
Dr. Nico GeursQ: While most people are knowledgeable about what’s needed to take care of their teeth, the health and care of their gums often is overlooked. Why is that?
Geurs: Gum disease – or periodontal disease – tends to not be associated with overt signs that are alarming to the patient. Pain is not associated with periodontal disease, and the signs that it does have are often minimized. For instance, if your gums bleed when you brush, that is a sign of an inflammatory disease around your teeth that needs to be evaluated and possibly treated. But many people will tell me that nothing is wrong with their mouth, and then casually mention, “Oh yeah, my gums bleed every once in a while.” Well, if they’re bleeding, then there’s generally an issue that needs to be corrected. This is a disease that requires treatment, and you need to go see your dentist to be evaluated. If people wait for pain to send them to the dentist, then generally that is at the very terminal stages of the tooth.
Q: What are the dangers of periodontal disease?
Geurs: It’s important just from the perspective of keeping the tooth. There’s an aspect of having inflammation around your tooth that leads not just to gum loss but also to bone loss. It creates these deeper pockets and pouches around your teeth. That disease affects probably around 50 to maybe 60 percent of the population. Once you’ve had that, you get these deeper pockets and pouches, and the potential increases that the inflammation plus the bacteria will affect your overall health. Because there are correlations between oral inflammatory burden and oral microbial burden with an established impact on the progression of cardiovascular disease.
Q: In addition, haven’t studies linked periodontal disease in pregnant women to preterm birth and low birth weight?
Geurs: Yes, it was established that if you have periodontitis during pregnancy, your odds for delivering preterm goes up. For patients with mild disease, it’s about three to fourfold, and with severe disease it’s up to sevenfold. We’ve done some studies with this where we’ve looked at health care disparities in underserved areas, and many of those women were not exposed to professional dental care during their pregnancy. We found that it’s feasible to improve oral health if the patient just knows they have to do this and are given the tools so they can learn to do it. We have used a model that incorporates nurses as oral health educators, and we found that it can make a difference.
Q: What is the best preventive treatment?
Geurs: The basic treatment is for patients to keep their teeth plaque-free, and that’s done at your home. This hasn’t changed. What we do in the dental office is merely supportive of those efforts. There is always great interest from patients asking, “Can I rinse with something and prevent this from happening?” But as of now, the only way to treat this disease is by preventing bacteria from being on your teeth by performing oral hygiene. Even though patients like the thought of not having to brush and floss regularly, there’s really no alternative to good oral hygiene at this point. Many of our efforts in research are designed to make patient compliance less important. But without their compliance, we still can’t be very successful in treatment. They have to treat their disease. We’re merely there to understand the issues, and guide and help them. But if they don’t treat it, then our efforts are going to almost be in vain.
Q: Finally, tell us about the UAB Dentistry Wellness Clinic, which combines regular oral exams with general health screenings.
Geurs: We’re a dental clinic, so obviously we’re going to take care of teeth. But we also want to look at a patient’s overall health at the same time. So we check their blood pressure, follow their weight. We’re also looking for signs and symptoms of things like diabetes and skin diseases. If we see any particularly overt signs, we can institute a referral with their doctor. Most people see their dentist to get their teeth cleaned twice a year, giving us a chance to look at smaller changes that might take place more than the once-a-year visit to the physician’s office. We’re trying to be a partner with patients not just in their oral health, but also to look at the aspects that intersect between oral health and overall health. Because the mouth is often a mirror for the rest of the body to help screen for diseases that patients may not know they have.
For more on Dr. Nico Geurs and our other experts, visit UAB News Experts in Dentistry.