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Plaque 102: What Happens When Plaque Happens
by Jan DeAndrea Lemoine
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Happy midweek!
I hope this finds you empowered, inspired and...flossing. Your health is, largely, in your own hands after all! On the other hand, if you are the sort who prefers to gather up all the information first, nodding silent "amens" after hearing familiar recommendations, intending (eventually) to implement them, read on anyway--you never know when that "teachable moment" is, after all!
We discussed plaque, in all its invisible glory. Just because you cannot see it, doesn't mean it isn't there. It is said that "what you don't know can't hurt you." May I suggest, instead, that what you don't know (or in this case, see), you may be unaware is hurting you... but the fact is, with regards to plaque (among other things), what you don't see or feel is likely gaining silent momentum, waiting in the wings (think camouflage) for the host (your body, your mouth) to lose resistance, then launching a full blown attack. Kind of makes you feel a bit paranoid, doesn't it? The enemy within. Do not fear: in many cases, your counterattack, especially with the guidance and assistance of your dental hygienist/dental team, catches the would be conquerers off guard, eradicating or lessening the ill effects of the unwelcome invaders by strengthening your immune response and lessening the bio-burden by breaking up the bacterial colonization in the dental hygiene chair (your hygienist KICKS BUTT!).
How it begins: In the early stages of gum (periodontal) disease, the foreign invaders (bacterial endotoxins) irritate the gingiva (gums), making them puffy and causing bleeding. This, the first stage, is usually completely reversible--so take bleeding gums as a warning; you, the host, have the power to send those unwanted houseguests packing, and in a hurry! Use a soft or extra soft toothbrush, brushing gently 3x/day, being sure to brush the gums as well as the teeth. Then get the floss out, whether it is "string" floss or those Y-shaped flossers from OralB (all flossers are not made alike; you need adequate tension and the proper angle). Flossing enables you to reach the tooth surfaces between adjacent teeth where the toothbrush cannot reach. As you floss, keep the tension on the teeth, curving it around and being sure to swipe the floss UP and DOWN the side of each tooth, rather than using a “sawing motion.” Keeping up with your care often means that they will get out--and STAY out!
Are you undergoing hormonal changes (or taking birth control pills)? Struggling with your blood sugar? Have a family predisposition to periodontal disease? No worries! Although these conditions can initiate or exacerbate gingivitis, they do not doom you to an unhealthy outcome. I'm not going to lie, though--you will, most probably, need to work a bit harder than those who do not have these factors. By now, you already know that "life isn't fair," so pull out your floss and JUST DO IT. Better to be safe than sorry.
Then again, if you so desire, you can look at your floss each night, saving enough of it up that you could become your dentist's supplier, but...what then?
Sometimes, nothing happens, at least not right away. If you are otherwise healthy, gingivitis may be the stage where the disease remains...for years...not a good place, to be sure, but certainly not the worst. After all, it is completely reversible while in this disease phase!
In most cases, though, those bad buggies, now given license to proliferate, colonize and populate the sulcus (that pouch-like area between the tooth and the gum), literally eating their way through the tissues, ligament and bone which hold your teeth in your head (where, in my opinion, they belong). This is periodontitis, characterized by the eating away of the bones and ligament which holds your teeth in your head. This loss is termed “periodontal pocketing,” which is measured in millimeters by your dentist or hygienist (not to be confused with areas of food entrapment)—when your dental team uses the word, “pocketing,” they are referring specifically to the vertical measurement of the loss of ligament and bone as a result of periodontal (gum) disease and/or clenching/grinding (another subject for another newsletter).
To recap, the destruction of dental structures results in bone loss, which can be seen on x-rays and is measured in millimeters with a periodontal probe Normally, we want to see no more than 3mm of bone loss (called periodontal pocketing). When pocketing exceeds four millimeters, it indicates progression from gingivitis to periodontitis. The sooner treatment is sought, the better.This phase is characterized by often irreversible bone loss. Your teeth are still in your head but—I will not lie—they are on borrowed time.
OK, OK…I KNOW I need to floss…I start out strong after each cleaning appointment…What now?
The last stage of periodontal disease finds your teeth loose, which affects your bite and will haunt your dreams…trust me, it is a sad, sad phase. Those of you who have been there/done that know this, having discovered it the hard way. Forgive yourself and do what you can to be healthy and happy. If it is not too late, trust me—it is worth the work to avoid losing teeth. There are some things better left unexperienced!
The ability of dental pathogens to colonize is not to be underestimated; periodontal disease can progress swiftly and without pain. It remains the leading cause of tooth loss. Smoking greatly increases the risk of periodontal disease, reducing the host resistance significantly...yet another reason to work on the arduous process of smoking cessation—no matter how many tries (it typically requires at least three before it “sticks”)!
We are not sharks; we only get two chances. Our baby teeth serve as training wheels, are succeeded by an adult dentition, and that's it--at least, without extensive and oft expensive intervention.
The good news is: you are in control! See your dental team and follow through with their advice. Eat good stuff; drink lots of water. Nourish your body so it can heal from the inside out and bask in the glory of keeping your teeth as you age (my almost-102 year old grandma has most of hers!). If you have already lost a few battles, use what you know now to maintain what you DO have-and encourage others. It takes a village to raise a child--let's all lend a hand!
Tune in next visit for practical tips to make flossing actually HAPPEN...and to hear about "Oil Pulling," which is all the rage (and well worth exploring).
Feel free to email me any questions you have; I will answer to the best of my ability.
Wishing you health and empowerment.
Love, peace and hugs,
Coach Jani
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