New York City is a great place to live, work, and play. As a leading dentist in one of the world’s busiest cities, I know all too well the stress that my patients undergo. If stress is allowed to plague the body long enough it can cause severe damage to an individual’s physical and mental health. As a society, the dangers that stress poses to the body are fairly well known. Unfortunately, not many people are aware of the effects that chronic stress has on oral health.
Chronic stress can have many significant effects on oral health. For instance, emotional stress is believed to be related to the practice of tooth grinding, also known as bruxism, jaw and facial pain, and headaches. Increased tension in the muscles of the face are a major side effect of stress. This tension can cause an individual to inadvertently grind upper and lower teeth during their sleep or even while awake. This can lead to sensitive teeth, cracked or chipped teeth, or a change in their bite. Bruxism is usually treated with a mouth guard that is worn at night to stop grinding, however, when brought on as a result of stress, patients are encouraged to treat this symptom by focusing on reducing stressful triggers and relaxation.
Stress is also known to significantly affect the immune system, leaving the victim more susceptible to infections. Oral health suffers greatly, as the risk of periodontal disease almost doubles. The gum tissue cannot fight off the ever-present bacteria lurking within the mouth and is also more vulnerable to mouth sores, dry mouth, burning mouth syndrome, and TMJ disorder.
Finally, its has been found that someone under a great deal of emotional stress is more likely to develop certain coping habits to help reduce anxiety, but in the end have negative effects on oral health. Such habits include ignoring proper oral hygiene practices, engaging in desctructive behaviors such as smoking and alcohol abuse, and eating foods full of sugar.
If you are experiencing any of the following and lead a stressful lifestyle, you may be diagnosed with chronic stress:
Upset Stomach
Headaches
Backaches
Insomnia
Anxiety
Depression
Anger
If you feel you have chronic stress, it is very important to speak with your dentist about ways you can avoid causing harm to your oral health. Your dentist will likely advise a variety of methods to control chronic stress, including exercise, healthy eating habits, stress management and relaxation techniques, adequate rest, and relaxing hobbies.
Daniell Mishaan, D.M.D. is a Cosmetic and Restorative dentist in the Garment District in midtown Manhattan. He serves patients from all over New York City and is open Sundays for all patients including emergencies.
Dentists have warned for years that keeping your teeth brushed and flossed can drastically cut down on gum disease, as well as reduce the risk of heart attack and stroke. Now, researchers at West Virginia University have found a clean mouth may also help preserve memory.
The National Institutes of Health (NIH) has awarded a $1.3 million grant over four years to further build on studies linking gum disease and mild to moderate memory loss.
“Older people might want to know there’s more reason to keep their mouths clean — to brush and floss — than ever,” said Richard Crout, D.M.D., Ph.D., an expert on gum disease and associate dean for research in the WVU School of Dentistry. “You’ll not only be more likely to keep your teeth, but you’ll also reduce your risk of heart attack, stroke and memory loss.”
Crout will share the grant with gerontologist Bei Wu, Ph.D., formerly of WVU and now a researcher at the University of North Carolina; Brenda L. Plassman, Ph.D., of Duke University, a nationally recognized scientist in the field of memory research; and Jersey Liang, Ph.D., a professor at the University of Michigan. Wu is the principal investigator.
The team will look at health records over many years of several thousand Americans.
“This could have great implications for health of our aging populations,” Crout said. “With rates of Alzheimer’s skyrocketing, imagine the benefits of knowing that keeping the mouth free of infection could cut down on cases of dementia.”
The research builds on an ongoing study of West Virginians aged 70 and older. Working with the WVU School of Medicine, School of Dentistry researchers have given oral exams and memory tests to 270 elderly people in more than a dozen West Virginia counties.
Funded by a $419,000 two-year grant, they’ve discovered that about 23 percent of the group suffers from mild to moderate memory loss.
A blood draw is also part of the study for research subjects who agree.
“If you have a gum infection, you’ll have an increased level of inflammatory byproducts,” Crout explained. “We’re looking for markers in the blood that show inflammation to see if there is a link to memory problems. We’d like to go full circle and do an intervention — to clean up some of the problems in the mouth and then see if the inflammatory markers go down.”
Researchers don’t yet understand whether microorganisms in the mouth create health problems or whether the body’s inflammatory response is to blame. It may be a combination of both. Researchers also don’t know much about mild to moderate memory loss, even though the connection between severe dementia and gum disease is well-known, Crout said.
In the future, dentists may routinely administer memory tests to their older patients, he said.
“A dentist may see a longtime, older patient with an area of the mouth that’s showing signs of inflammation because of not being properly cleaned daily,” Crout said. “Many times we as clinicians, however, don’t think of this as due to a memory problem. The patient may not be flossing or brushing properly as we have instructed they should. But this research indicates that the problem may be due to memory loss as opposed to noncompliance.”
Daniell Mishaan, D.M.D. is a dentist in the Garment District in midtown Manhattan. He serves patients from all over New York City and is open Sundays for all patients including emergencies.
Source: West Virginia University Health Sciences Center
A few simple changes to your diet can help keep your teeth healthy for life.
You brush, you floss, you see your dentist, but do you eat with your oral health in mind? And it’s not just the usual suspects like sugar that may be harmful. Some surprising–even healthy–foods can cause cavities, while others can help protect you from decay, gum disease, and even bad breath. Here, how to tailor your diet for optimal dental health.
Eat carbs at mealtimes
A handful of potato chips or even a whole wheat roll can be just as damaging to your teeth and gums as a chocolate chip cookie. All carbohydrates break down into simple sugars, which are ultimately converted by bacteria in the mouth into plaque, a sticky residue that is the primary cause of gum disease and cavities. Carb-based foods such as breads and crackers tend to have “a chewy, adhesive texture,” making it easier for them to get caught between teeth or under the gum line, where bacteria can then accumulate, says Christine Gerbstadt, MD, RD, a spokesperson for the American Dietetic Association. Have carbs at mealtimes rather than as a snack: When you eat a larger amount of food, you produce more saliva, which helps wash food particles away.
Drink Tea
Black and green teas contain polyphenols, antioxidant plant compounds that prevent plaque from adhering to your teeth and help reduce your chances of developing cavities and gum disease. “Tea also has potential for reducing bad breath because it inhibits the growth of the bacteria that cause the odor,” explains Christine D. Wu, PhD, associate dean for research at the University of Illinois at Chicago College of Dentistry, who has conducted several studies on tea and oral health. Many teas also contain fluoride (from the leaves and the water it’s steeped in), which helps protect tooth enamel from decay.
Sip with a straw
Most sodas, sports drinks, and juices contain acids, such as citric and phosphoric, that can erode dental enamel–even if they’re diet or sugar-free versions. Sipping acidic drinks through a straw positioned toward the back of your mouth limits their contact with your teeth and helps preserve the enamel, says a study in the British Dental Journal.
Increase your C intake
“Vitamin C is the cement that holds all of your cells together, so just as it’s vital for your skin, it’s important for the health of your gum tissue,” says Jones. People who consumed less than 60 mg per day of C (8 ounces of orange juice or one orange contains more than 80 mg) were 25% more likely to have gum disease than people who took in 180 mg or more, according to a study of over 12,000 US adults conducted at the State University of New York University at Buffalo.
Eat 800 mg of calcium a day
People who do are less likely to develop severe gum disease, says a recent study by the Buffalo researchers. The reason: About 99% of the calcium in your body is in your bones and teeth. Dietary calcium–available in foods like cheese, milk, and yogurt–strengthens the alveolar bone in the jaw, which helps hold your teeth in place. The recommended amount is 1,000 mg per day for women younger than 50 and 1,200 mg for those older.
Dr. Daniell Mishaan, is a dentist in Midtown, New York City. For more information about what kind of preventive measures you can take to protect your teeth- please click here.
Learn more about the link between nutrition and dental health, here.
The American Academy of Pediatric Dentistry (AAPD), the recognized leader in pediatric oral health, announced new oral health guidelines for expectant mothers and infants. The guidelines call for all pregnant women to receive counseling and oral healthcare during pregnancy, and also that infants receive an oral health risk assessment and oral care by their first birthday. These steps will contribute to optimal oral health for both mom and baby.
“There is evidence associating periodontal disease and increased risk of preterm birth and low-birth weight,” said AAPD’s Immediate Past-President Dr. Beverly Largent. A recently published study found significant differences between women treated for periodontal disease and those who were not treated. The findings suggest that incorporating periodontal care may result in improved pregnancy outcomes.
“Because premature births have become the number one obstetric problem in the United States, we felt the need to provide more guidance about necessary oral care for expectant moms, in addition to promoting oral health as a key part of pregnant women’s overall health,” said Dr. Largent.
The guidelines are based on studies that suggest that proper dental care during the perinatal period may help prevent preterm and low-birth weight babies and is an important aspect of overall health for pregnant women – allowing them to enter delivery in optimal health. Many women, however, are unaware of the implications poor oral health can have on themselves and their babies and often don’t seek oral care during pregnancy.
Additionally, mothers with poor oral health may be at greater risk of infecting their children with the bacteria that causes cavities, increasing their children’s caries risk at an early age. Because cavities in infants are preventable, determining which mothers are at the highest risk improves opportunities for preventive intervention.
“Every expectant mother should receive a comprehensive oral health evaluation and risk assessment,” said Dr. Largent. “Dental treatment is safe throughout pregnancy, and this is a time when expectant mothers need to be screened for oral risks, counseled on proper oral hygiene and receive necessary dental treatment.”
The updated guidelines also address proper oral care for infants and toddlers, the age group most susceptible to early childhood caries (ECC), which is an infectious but preventable disease that causes tooth decay and potentially more serious health issues. When left untreated, ECC can affect speech and communication, eating and dietary nutrition, sleeping, learning, playing, and quality of life – even into adulthood. The guidelines outline how simple changes in a mother’s oral hygiene, diet, use of topical fluoride and sharing of eating utensils can significantly reduce a child’s risk for ECC.
Overview of the new AAPD Oral Health Guidelines for expectant mothers and infants:
Oral Hygiene: Tooth brushing and flossing on a daily basis are important for the parent to reduce bacterial plaque, which research has linked to preterm, low-birth weight babies.
Diet: Dietary education for the parents, including the potential effect of foods and beverages on their oral health, helps maintain good dental care.
Fluoride: Using a fluoridated toothpaste approved by the American Dental Association and rinsing every night with an alcohol-free, over-the-counter mouth rinse containing 0.05% sodium fluoride have been suggested to help reduce plaque levels.
Caries removal: Routine professional dental care for the parents can help keep their oral health in optimal condition.
Delay of colonization: Education of the parents, especially mothers, on sharing utensils, food and cups can help prevent the transmission of cavity-causing bacteria.
Xylitol gum: Recent evidence suggests the use of xylitol chewing gum (four pieces per day by the mother) can decrease a child’s caries rate.
Fluoride is the name given to a group of compounds that are composed of the naturally occurring element fluorine and one or more other elements. Fluorides are present naturally in waterand soil.
2. What is fluoridated water?
Virtually all water contains some amount of fluoride. Water fluoridation is the process of adding fluoride to the water supply so that the level reaches approximately 1 part fluoride per million parts water (ppm) or 1 milligram fluoride per liter of water (mg/L); this is the optimal level for preventing tooth decay (1).
3. Why fluoridate water?
In the early 1940s, scientists discovered that people who lived where drinking water supplies had naturally occurring fluoride levels of approximately 1.0 ppm had fewer dental caries (cavities). Many more recent studies have supported this finding. Fluoride can prevent and even reverse tooth decay by enhancing remineralization, the process by which fluoride “rebuilds” tooth enamel that is beginning to decay.
4. When did water fluoridation begin in the U.S.?
In 1945, Grand Rapids, Michigan, adjusted the fluoride content of its water supply to 1.0 ppm and thus became the first city to implement community water fluoridation. By 1992, more than 60 percent of the U.S. population served by public water systems had access to water fluoridated at approximately 1.0 ppm, the optimal level to prevent tooth decay. The Centers for Disease Control and Prevention (CDC) considers fluoridation of water one of the greatest achievements in public health in the 20th century.
5. Can fluoridated water cause cancer?
The possible relationship between fluoridated water and cancer has been debated at length. The debate resurfaced in 1990 when a study by the National Toxicology Program, part of the National Institute of Environmental Health Sciences, showed an increased number of osteosarcomas (bone tumors) in male rats given water high in fluoride for 2 years. However, other studies in humans and in animals have not shown an association between fluoridated water and cancer. In a February 1991 Public Health Service (PHS) report, the agency said it found no evidence of an association between fluoride and cancer in humans. The report, based on a review of more than 50 human epidemiological (population) studies produced over the past 40 years, concluded that optimal fluoridation of drinking water “does not pose a detectable cancer risk to humans” as evidenced by extensive human epidemiological data reported to date. In one of the studies reviewed for the PHS report, scientists at the National Cancer Institute evaluated the relationship between the fluoridation of drinking water and the number of deaths due to cancer in the United States during a 36-year period, and the relationship between water fluoridation and number of new cases of cancer during a 15-year period. After examining more than 2.2 million cancer death records and 125,000 cancer case records in counties using fluoridated water, the researchers found no indication of increased cancer risk associated with fluoridated drinking water. In 1993, the Subcommittee on Health Effects of Ingested Fluoride of the National Research Council, part of the National Academy of Sciences, conducted an extensive literature review concerning the association between fluoridated drinking water and increased cancer risk. The review included data from more than 50 human epidemiological studies and six animal studies. The Subcommittee concluded that none of the data demonstrated an association between fluoridated drinking water and cancer. A 1999 report by the CDC supported these findings. The report concluded that studies to date have produced “no credible evidence” of an association between fluoridated drinking water and an increased risk for cancer.
6. Where can people find additional information on fluoridated water?
The Environmental Protection Agency (EPA) Web site has more information about drinking water and health. It includes information about drinking water quality and standards. This Web site is located at on the Internet.
7. Key Points
Fluoride prevents and can even reverse tooth decay (see Question 3).
More than 60 percent of the U.S. population on public water supply systems has access to water fluoridated at approximately 1 part fluoride per million parts water—the optimal level for preventing tooth decay (see Question 4).
Many studies, in both humans and animals, have shown no association between fluoridated water and risk for cancer (see Question 5).
1. What is fluoride?