CHICAGO – June 10, 1999 – Poor oral hygiene may pose a bigger threat to Austin Powers, the secret agent with the hideous mouth whose movie sequel hits theaters this month, than his nemesis, Dr. Evil.

Neglecting the mouth is just as dangerous for the rest of us, according to the American Academy of Periodontology (AAP), which cites studies linking periodontal (gum) disease to heart and respiratory disease.

“When bacterial plaque is allowed to build up on your teeth, you put yourself at high risk for periodontal disease,” says Dr. Robert Schoor, president of the AAP. “And the bacteria associated with periodontal disease can travel into the blood stream to other parts of the body, jeopardizing your health.”

The impact of periodontal disease, one of the most common infections, is far more widespread than the mouth. One study found that people with advanced periodontal disease are 4.5 times more likely to have a chronic respiratory disease. Another study found that people with periodontal disease may have nearly twice the risk of having a fatal heart attack as those without periodontal disease.

While periodontal disease cannot always be avoided, proper oral hygiene is the best means of prevention.

• Daily flossing breaks up the bacterial colonies between teeth.
• Proper brushing prevents plaque buildup.
• Professional cleanings at least twice a year are necessary to remove calculus from places your toothbrush and floss may have missed.
• And, because there are often no symptoms of the disease in its early stages, a trip to a periodontist can determine if you have it.

The January 1999 Journal of Periodontology reports that at the very least, nearly 30 percent of people in this country age 30 to 54 have periodontitis – an advanced state of periodontal disease in which there is bone loss around the teeth. Study Abstract *

In addition to heart disease and respiratory disease, periodontal disease has been linked to diabetes and premature, underweight births.

A referral to a periodontist in your area and free brochure samples including one titled Ask Your Periodontist About Periodontal Disease & Heart Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – August 17, 1999 – The image of grandpa going to bed with his teeth in a glass in the bathroom is quickly becoming outdated. Instead, many of today’s grandparents use electric toothbrushes and go to bed with their dental bleaching trays.

Edentulism (toothlessness) has been declining in the United States since the 1950s. According to the Centers for Disease Control and Prevention, not quite 25 percent of the current population over age 65 is toothless. And, because edentulism rates are often dependent upon sociological and technological factors, toothlessness should continue to decline as baby boomers age.

“My older patients are becoming increasingly concerned about their oral health and the aesthetics of their smile,” said Dr. Robert Schoor, president of the American Academy of Periodontology (AAP). “They want to keep their teeth, but when that’s not a possibility, many are opting for the next best thing – dental implants.”

A 1998 survey sponsored by the American Dental Association and Oral-B Laboratories found that almost two-thirds of respondents 65 and older said their teeth are better than their parents at their age. And, more than half said a smile is the first thing they notice about other people.

However, maintaining a healthy mouth is not just a matter of a pretty smile and being able to eat corn on the cob. A study in the January 1999 issue of the Journal of Periodontology reports that at the very least, half of people over age 55 have periodontitits (an advanced form of periodontal disease). Recent research has advanced the idea that periodontal diseases – a primary cause of tooth loss – are linked to a number of major health concerns, such as heart disease, stroke, respiratory disease, osteoporosis and diabetes.

“To help prevent periodontal diseases, improve overall health and maintain a nice smile, we need to take note of the changes taking place in our mouths as we age and discuss these changes with our dental professionals,” said Schoor. “The goal is to make adjustments in oral care before these changes result in full-blown problems in the mouth that could jeopardize overall health.”

Older adults are one of the highest risk age groups for cavities and periodontal disease. Reasons include:

• Dry mouth (xerostomia), which may be caused by medical disorders or hundreds of medications (such as high blood pressure drugs, diuretics and antidepressants), can leave mouths without enough saliva to wash away food and neutralize plaque, leaving the mouth more susceptible to tooth decay and periodontal disease. In addition, calcium channel blockers can cause gingival enlargement or overgrowth.
• Receding gums leave the roots of the teeth exposed, making them vulnerable to plaque’s cavity causing acids and periodontal disease.
• Medical conditions associated with aging, such as diabetes, can increase the risk of periodontal disease. In addition, memory problems may lead to lessened oral hygiene. And, arthritis can make brushing and flossing more difficult.
• Women who are menopausal or post-menopausal may experience discomfort in the mouth, including pain and burning sensations in the gum tissue, altered taste and dry mouth. These changes, attributed to hormonal fluctuations, can lead to periodontal disease.
• Lack of preventative dental care and infrequent visits to the dentist also place older adults at increased risk for oral health problems. At dental visits, patients should discuss with their dentists or periodontists their health histories and any medications (including over-the-counter and herbal remedies) they are taking. For those people already missing teeth, ask if dental implants are a viable option.

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – September 13, 1999 – Prepare the guest list . . . Choose the wedding dress . . . Schedule the photographer . . . Visit the periodontist . . ? Yes, brides-to-be may want to consider adding a visit to the periodontist to their wedding timelines to ensure a beautiful and healthy wedding-day smile.

Periodontists offer a variety of cosmetic periodontal procedures for brides insecure about smiling in front of the camera.

Emerging research in esthetic and regenerative periodontal procedures enables periodontists to provide patients with treatment alternatives for imperfections such as “gummy” smiles and missing teeth that are functional and esthetically pleasing.

Before Treatment	After Treatment
Click for enlarged photos.

“Long gums can create a gummy smile,” said Dr. Robert Schoor, president of the American Academy of Periodontology (AAP). “To correct this, the periodontist simply reshapes the gum tissue, exposing the rest of the tooth.”

Stress and hormonal fluctuations during wedding planning can affect many tissues, including gum tissue, and increase susceptibility to periodontal disease. “Stress can make it more difficult for the body to fight off infection, including periodontal disease,” said Schoor.

In addition, oral contraceptives and pregnancy cause hormonal changes, which can negatively impact oral health. Women who are planning to become pregnant need to know that their periodontal health can affect their babies. “Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small,” said Schoor.

A referral to a periodontist in your area and free brochure samples including one titled Something To Smile About: Periodontal Cosmetic Procedures to Enhance Your Smile are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – October 22, 1999 – “All I Want For Christmas Is My Two Front Teeth” is an amusing song heard during the holiday season, but for anyone who has lost a tooth due to trauma, injury or periodontal disease, new teeth may actually be at the top of their wish list. The good news is, dental implants are a solution to tooth loss that offers comfort and confidence.

“Dental implants are a unique gift idea because they look and feel like real teeth and will be appreciated for years,” said Dr. Jack Caton, president of the American Academy of Periodontology. “Dental implants are permanent tooth replacements that look and feel so much like natural teeth, patients usually forget they’re not.”

A dental implant is an artificial tooth root placed into the jaw to hold a replacement tooth or bridge in place. Since the dental implant integrates into the structure of the bone, it prevents the bone loss and gum recession that often accompanies bridgework and dentures. While high-tech in nature, dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support.

“Dental implants not only create a winning smile, but more importantly have significant functional benefits to overall good health,” said Caton. “People with dentures or loose and missing teeth have restricted diets since biting into fresh fruits and vegetables is often not only difficult, but also painful. Dental implants are so secure that the patient will never give a second thought when biting into a crisp apple.”

Periodontal disease is a major cause of tooth loss for Americans. Periodontal disease is a bacterial gum infection that destroys the attachment fibers and supporting bone that hold the teeth. If left untreated, periodontal disease can lead to tooth loss. Periodontal disease can be a silent disease, but oftentimes it does come with warning signs.

Warning signs of periodontal disease may include:

• persistent bad breath
• gums that bleed when you brush your teeth
• red, swollen and bleeding gums
• gums that have pulled away from the teeth
• loose or separating teeth
• pus between the gum and tooth
• a change in the way your teeth fit together when you bite

Dental implants will require the same type of care as your own teeth. It is important to keep the dental implant clean with at-home oral care and regular dental visits. “After treatment, the periodontist will work closely with the patient and dentist to develop the best care plan for the patient’s treatment goals,” says Caton.

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – October 11, 2000 – Periodontists say that many of their patients should be doing more to protect their periodontal health, according to a recent online poll of periodontists conducted by the American Academy of Periodontology (AAP).

Are the majority of your patients adequately concerned about the health of their gums?

Periodontal disease is a major cause of tooth loss in adults. Nearly 90 percent of the 201 periodontists polled reported that flossing frequency is one of the areas of oral care that patients are most lax in, and about 61 percent reported that their patients’ flossing technique could use improvement, two essential components of an effective oral care regimen.

According to the poll, the biggest offenders are overwhelmingly male patients. Ninety-seven percent of those surveyed reported that their female patients practice better oral hygiene habits than males.

Not only is it important for patients to establish a regular routine for oral care, it is also important that they use proper techniques so that they don’t damage their gums. In the survey, hard bristled toothbrushes beat out popcorn seeds and candy as the item having done the most damage to patients’ periodontal health. And several periodontists wrote in that they’d also seen improperly used oral rinses, toothpicks and floss holders cause damage.

Unsatisfactory home care seems to persist despite the fact that nearly all the periodontists surveyed reported that they or a staff member review and ask patients to demonstrate oral home care techniques either every visit or on those visits when it seems necessary. When trying to motivate and educate patients, periodontists report that mirrors, X-rays, and drawings or photos depicting periodontal disease are helpful. “I like to have the patient and spouse in the exam room and show both, with a hand mirror, the difference between healthy gums and disease. I point out plaque and pocket depths,” said Steven Uretsky, D.M.D., a private practitioner in Pittsburgh. Patients should not be afraid to ask their periodontists to help them improve their oral care techniques or to use visuals to help them understand what’s happening in their mouth, said survey participants.

And, when it comes to motivating factors to accept treatment, nearly 71 percent of periodontists reported their patients are most motivated by a fear of loosing teeth. However, other important reasons cited for seeking periodontal treatment included aesthetic reasons such as improving the look of the gum line or getting rid of bad breath, improving functional problems such as difficulty chewing, and lowering the risk of heart disease, respiratory disease, preterm births or diabetes.

While patients often cite lack of time and dexterity problems as reasons for not flossing, many periodontists report having heard some rather unique excuses, including: I used all of my floss tying up my tomato plants; I gag when I see what comes out when I floss; and, my kids use it to tie up their siblings, so we can’t keep it in the house. Excuses aside, as many periodontists like to point out, it’s only important to floss the teeth you want to keep.

A referral to a periodontist in your area and free brochure samples including one titled How to Brush and Floss are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – November 17, 2000 – Periodontists are placing more implants than they did five years ago, and the vast majority of their patients are very satisfied with the results, according to a recent online poll of periodontists conducted by the American Academy of Periodontology (AAP).

A dental implant is an artificial tooth root placed into the jaw to hold a replacement tooth or bridge in place. Nearly 88 percent of the 295 periodontists polled reported that they perform implant surgery. Many of these respondents wrote in that their patients with implants often tell them that they forget the implants are not their natural teeth.

The survey showed that people from all age groups are opting for implants. However, 43 percent of the periodontists polled said half or more of the implants they place are for people ages 55 to 79, while 31 percent reported that half or more of the implants that they place are for the baby boomers – people ages 35 to 54. The top reasons for tooth loss leading to implant placement were periodontal disease, tooth decay and accidents, violence or injuries.

Dental implants have proven to be the answer for many people with missing or damaged teeth – from the 21-year-old woman who had trained herself not to smile or laugh for fear of exposing her damaged front teeth to the public speaker who had experienced losing his teeth during a speech. “I’ve been told by my patients that getting implants changed their whole life and made them look and feel younger,” said Ira Port, D.M.D., a periodontist in Toms River, N.J., echoing a sentiment expressed by many of the periodontists surveyed.

Periodontists say the biggest deterrent for patients who decide against dental implants is cost. The average charge for a single implant placed by a periodontist is between $1,000 and $2,000, according to the survey. Implants are usually not covered by dental insurance. However, periodontists point out that implants, while expensive in the short term, are long-lasting and more tooth-saving than traditional bridgework since they do not rely on neighboring teeth for support. “You can’t put a price tag on some of the esthetic and health benefits of dental implants,” said Michael McGuire, D.D.S., president of AAP. “Dental implants integrate with the jawbone to help prevent the loss of bone that accompanies conventional dentures or bridges. Loss of bone can lead to visible defects for people missing a single tooth or collapsed smiles for people who have lost all of their teeth. In addition, implants allow most people to return to a regular diet, including apples and corn on the cob.”

Another deterrent cited by about 10 percent of the periodontists was the time commitment involved in getting implants. The survey found that on average placing a single implant takes between five-and-a-half and seven-and-a-half months. After the implant is placed, it usually takes about two to six months for it to bond with the bone to form an anchor for the artificial tooth. During this time a temporary tooth replacement option can be worn. Often, a second step is then necessary to uncover the implant and attach an extension, which completes the foundation for the new tooth. The gums are allowed healing time following this step.

About 73 percent of periodontists described the level of pain or discomfort that the majority of patients experience in the process of getting implants as very little to none. Another 23 percent said getting implants is only somewhat painful or uncomfortable during limited periods of time. Many periodontists wrote in that their patients have commented after getting implants that they were surprised by the lack of pain.

Not everyone is a candidate for dental implants. Adequate bone in your jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease. People who have missing or damaged teeth should ask their periodontists if they are a candidate and about the process and cost involved for them.

A referral to a periodontist in your area and free brochure samples including one titled Dental Implants: Teeth that Look and Feel Just Like Your Own are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – November 30, 2000 – A case report released today in the November issue of the Journal of Periodontology found that piercing the tongue, lip or cheek could cause localized gingival recession. This can lead not only to an unattractive defect, but also leaves the tooth root more vulnerable to decay and periodontal disease. Case Report Abstract *

Researchers analyzed the case of a 26-year-old female who had localized gingival recession around the area of her lip piercing. The patient noticed soon after getting the oral barbell that her gums started to progressively recede in the area of the piercing. The barbell had direct contact with the area where the gums were receding. Since the patient’s gingival recession was present only in the area of the oral metal device, the piercing was considered to be the cause of the gingival recession.

Click for enlarged photo.

“Oral piercing has become a popular trend, and most people do not seek advice from a dental or medical professional prior to the piercing,” said Michael McGuire, D.D.S, president of the American Academy of Periodontology (AAP). “Another important concern is hygienic maintenance of the pierced oral area. The mouth contains millions of bacteria, and infection is a common complication of oral piercing.”

Other consequences of oral piercing may include swelling, increased flow of saliva, pain, fractured teeth, interference with speech and metal hypersensitivity. “Many people with oral piercing do not think about the harmful effects it can have on their oral and overall health,” explained McGuire. “In this particular case, the doctors were surprised that the patient had a history of mitral valve prolapse, and she was unaware of the consequences of piercing on her medical status. In fact, a case of infective endocarditits following nasal piercing has been reported.”

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – February 8, 2001 – Daily brushing and flossing using the proper technique is fundamental to good oral health. But beyond that, the rules aren’t hard and fast.

For example, nearly 39 percent of periodontists believe it is best to floss before brushing your teeth, while about 35 percent say after is better, according to an online survey of 195 periodontists conducted recently by the American Academy of Periodontology (AAP). In addition, about half of those surveyed said people should spend about two minutes brushing. However, another 43 percent recommend about three minutes or more.

“Patients often ask how long they should spend brushing,” said Ravi Smith, D.D.S., a periodontist in San Francisco. “I do not recommend a timed regimen. Rather, I tell them however long it takes for them to properly brush all surfaces of their teeth.”

As for oral care products that promote fresh breath, nearly 44 percent of respondents said using a tongue scraper is an important part of an oral care routine while about 56 percent said it’s not. In addition, about 63 percent recommend mouthwash to patients concerned about fresh breath, while nearly 37 percent do not. For a quick breath refresher, 43 percent say sugarless gum is the best option; about 28 percent said a breath mint; and nearly 18 percent said breath spray.

More agreement exists on how many times a day brushing and flossing is necessary. About 82 percent of periodontists said they recommend brushing two or three times a day, and nearly 74 percent recommend flossing once per day. About 82 percent of periodontists say they personally floss daily, a much larger percentage than in the general population.

“The answer to many of the common questions dental professionals hear from their patients is that really it depends on the individual,” said Michael McGuire, D.D.S., president of the AAP. “Therefore, I advise people to ask their dental professional to talk with them about oral care products and to teach them how to properly brush and floss.”

Many periodontitsts wrote in that teaching patients about proper oral care regimens can have dramatic effects. “I recently had a 65-year-old patient who said he had only flossed once in his life,” wrote one periodontist. I explained to him the importance of cleaning between his teeth. He came back for an evaluation two months after treatment and said he was now flossing five days a week. Needless to say, his periodontal health has improved significantly.”

A referral to a periodontist in your area and free brochure samples including one titled Who Is a Periodontist and Why Do I Need One? are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

The American Academy of Periodontology is a 7,900-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.

For more information, contact the AAP Public Affairs Department at 312/573-3243 or 312/573-3242.

Find Out More

• Detailed Survey Results

CHICAGO – June 8, 2001, – About one out of four people say their smile’s biggest flaw is either that it is too gummy or their teeth appear too long, according to a poll conducted recently on the American Academy of Periodontology’s (AAP) consumer Web site. Yet, only 26 percent of the 307 respondents said that they know about periodontal procedures that can reshape the gum line to correct these complaints.

• Detailed Results of Consumer Survey

These procedures remain a beauty secret, even while 67 percent of periodontists report that they are doing more cosmetic periodontal procedures than they were five years ago.

“Cosmetic periodontal procedures can dramatically improve a smile’s appearance, often making a bigger change than more well-known smile enhancements such as tooth whitening,” said Michael McGuire, D.D.S., president of the AAP.

For gummy smiles, crown lengthening recontours excess gum and bone to expose more of the natural tooth. Conversely, when teeth appear too long, soft tissue grafts cover exposed roots with gum tissue from another source. Most of the time, periodontists perform crown lengthening and soft tissue grafts for functional rather than esthetic reasons. Crown lengthening is often done to prepare a tooth that is to be fitted with a crown, and soft tissue grafts protect exposed roots from decay and can reduce further recession and bone loss.

However, when these procedures have major esthetic benefits, periodontists agree it is rewarding for them and can be life changing for their patients.

“A young woman visited my office for an evaluation of her gummy smile,” relates David Lamberts, DDS, a periodontist in Grand Rapids, MI. “She would not smile very wide, even though she had beautiful teeth. We did crown lengthening on her six upper front teeth. Now she confidently displays a gorgeous wide smile.”

Before Treatment	After Crown Lengthening
Click for enlarged photos Photos by David Lamberts, DDS

A referral to a periodontist in your area and free brochure samples including one titled Something to Smile About: Periodontal Cosmetic Procedures to Enhance Your Smile are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – March 22, 2002 – A new study published in the March Journal of Periodontology found that extended wear of tongue jewelry (barbell-type) could increase your chance of gum recession and tooth chipping. Study Abstract *

Researchers from Loma Linda University School of Dentistry and Ohio State University College of Dentistry examined and surveyed 52 young adults with pierced tongues. They found gum recession in 35 percent of subjects with pierced tongues for four or more years, and in 50 percent wearing long-stemmed barbells for two or more years.

“During tongue movement, long-stem barbells are more likely to reach and damage the gums than short barbells,” said Dr. Dimitris Tatakis, professor of periodontology at the Ohio State University College of Dentistry and coauthor of the study. “Over time, this damage may cause the gums to recede, which can lead to more serious dental/oral complications.”

Additionally, 47 percent of young adults wearing either type of barbell for four or more years had chipped teeth. The prevalence of tooth chipping was significantly greater in those wearing short-stemmed barbells (1/4 inch – 5/8 inch) for four or more years.

Researchers believe tooth chipping is a result of habitual biting of the barbell. “A short barbell is possibly easier to position between teeth, which could be one reason why we are seeing more chipped teeth in this group,” said Tatakis. “Another factor that was not investigated could be the size or material type of the screw caps attached to the barbell.”

Dr. Timothy Roberts from the University of Rochester School of Medicine in New York presented study results on 4,500 adolescents aged 12 to 21 and found that teens with body piercings are more likely to smoke cigarettes, use drugs and exhibit other types of unhealthy behavior. Study findings were presented at the Society of Adolescent Medicine’s annual meeting in Boston.

“Mouth piercings and smoking combined could cause a mouthful of trouble,” said Dr. Kenneth Bueltmann, president of the American Academy of Periodontology. “As a smoker, you are more likely than nonsmokers to have calculus on your teeth, deep pockets between your teeth and gums and loss of the bone and tissue that support your teeth. Combine these problems with gum recession from tongue piercing and you are on your way to having a serious infection called periodontal disease and not to mention a not so cool looking mouth.”

“Given this new information, I strongly recommend discussing potential risk factors with your dentist before mouth piercing,” said Bueltmann. “Additionally, anyone with a pierced mouth should receive a thorough oral examination of their gums and teeth to identify problem areas. Taking precautions now will increase your chance of keeping your teeth for a lifetime instead of needing dentures like many of your grandparents.”

In addition to periodontal diseases (serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth) tongue piercing may cause other complications such as t ongue swelling, difficulties with chewing, swallowing and speech, increase of saliva flow, localized tissue overgrowth and metal hypersensitivity.

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – August 20, 2002 – Answer: A toothbrush. As summer comes to an end, many Americans are rushing to their favorite vacation spot to enjoy the final days of summer. The American Academy of Periodontology (AAP) surveyed 71 periodontists to offer oral health tips and ensure consumers stick with their oral hygiene regimen while on vacation.

“Most consumers naturally spend more time thinking about which outfits they are going to pack for their vacation than their oral health needs,” said Kenneth Bueltmann, D.D.S., president of the American Academy of Periodontology. “This is unfortunate because there are several things to take into consideration regarding your oral health especially if you are traveling abroad.”

For example, 59 percent of periodontists surveyed recommend storing toothbrushes in containers with air holes that allow bristles to completely dry, killing oral bacteria, and keep other family members’ toothbrushes from touching. Ninety-seven percent recommend cleaning these travel containers before and after travel. Yet more than one-third of all patient respondents indicated that they never thought to clean their containers.

In order to avoid bacterial growth when traveling or at home, some periodontists recommended that patients wash their toothbrushes periodically in the dishwasher, store it in the refrigerator or place it in a cup with mouthwash.

“It is important to disinfect your toothbrush and storage container frequently to kill potentially harmful bacteria that could cause periodontal disease, a serious bacterial infection that destroys the attachment fibers and supporting bone that holds teeth in the mouth,” said Bueltmann. “In addition, allow your toothbrush to dry completely in an opened-air environment after each brushing. The bacteria, most harmful to the gums, are anaerobic, which means they will die if they are exposed to oxygen.”

For those traveling out of the country, 74 percent of periodontists suggest using bottled water to brush teeth to avoid the possibility of becoming ill due to the various microorganisms sometimes found in foreign water supplies. Other respondents recommended boiling water if bottled water is not available. The majority of periodontists indicated that toothbrushes should be kept a safe distance away (2-5 feet) from the sink and toilet to avoid water contamination.

Putting It in a Nutshell:

• Pack extra oral hygiene accessories, as they may not be available in remote areas.
• Disinfect your toothbrush before and after your trip.
• Keep oral hygiene instruments dry and clean.
• Store your toothbrush in a container that has air holes when traveling.
• Keep toothbrushes safely away (approx. 2-5 feet) from the sink and toilet to avoid water contamination.
• Wash your hands thoroughly before flossing and brushing.
• Use bottled water to brush teeth when you are traveling abroad.
• Floss and use mouthwash if you forget your toothbrush and are unable to purchase a new one.
• When purchasing a toothbrush while traveling abroad, make sure you select a soft-bristled brush.
• If you run out of toothpaste, brush with water. As long as your technique is correct, plaque will still be removed.
• Do not share toothbrushes. Oral bacteria can be passed to other family members and can potentially spread periodontal diseases.

The good news is that more than 91 percent of patients surveyed continue their normal oral care routine while on vacation. The bad news is that only 27.5 percent of patient respondents brush their teeth two minutes or longer, while more than double the percentage of periodontist respondents (67.6 percent) recommend this regimen. Moreover, more than one-third of patient respondents don’t feel either they’re using the proper brushing technique or are not certain if they are.

Dr. Bueltmann explains that technique is everything. “If you don’t have the proper technique when brushing and flossing teeth, you won’t be cleaning as well as you could and you possibly might be harming your teeth and gums.”

Periodontal diseases are silently making their way into millions of Americans’ mouths and may represent a far more serious threat to their health than previously realized.

Approximately 15 percent of adults between 21 and 50 years old and 30 percent of adults over 50 have periodontal disease. Recent research has revealed that periodontal infections may contribute to the development of heart disease, increase the risk of premature, underweight babies and pose a serious threat to people whose health is already compromised due to diabetes and respiratory disease.

In September, the AAP is hosting its Annual Meeting in New Orleans to discuss periodontal diseases and their systemic links and new treatment techniques that periodontists can use to combat the disease.

A referral to a periodontist in your area and free brochure samples including one titled How to Brush and Floss are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – February 27, 2003 – If you lose one tooth or many teeth due to an accident or trauma, you know that you’ve also lost the ability to smile and eat with ease. Replacing the teeth with dentures or partial teeth may not give you the same confidence that the real teeth did. A dental implant, on the other hand, does look and feel like a real tooth. A dental implant is an artificial tooth root that is placed into the jaw, and holds the replacement tooth, teeth or bridge.

Recent case studies published in the Journal of Periodontology found that placing implants immediately after tooth extraction resulted in a high percentage of clinical success, and that using a temporary fixed crown restoration may provide a better opportunity to meet patient needs. In the first study, ten patients received a total of 15 implants placed immediately after removal of 15 single-rooted teeth. Case Study Abstract *

In the second case, a temporary fixed crown restoration was placed immediately after the bone reconstruction, and the final crown was permanently placed 6 weeks after surgery. Case Study Abstract *

“This is exciting news because in the past, dental implants weren’t placed until two to nine months after the tooth was extracted,” explained Antonio Barone, D.D.S. and lead researcher of one of the studies. “We observed no complications during the healing period, and found that implants placed immediately after tooth extractions have advantages such as prevention of jawbone deterioration, reduced number of surgical procedures and reduction of treatment time.”

“Implant dentistry has improved dramatically in the last 20 years,” said Gordon Douglass D.D.S., president of the American Academy of Periodontology. “Although more research needs to be conducted, the concept of placing an implant and in some cases a crown immediately after tooth extraction provides a better opportunity to meet patient needs. An implant is the ultimate in tooth replacement enhancing the smile and preventing bone loss due to the loss of the tooth or teeth.”

A referral to a periodontist in your area and free brochure samples including one titled Dental Implants: Teeth that Look and Feel Just Like Your Own are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO–June 2, 2003–A case report published in this month’s Journal of Periodontology reported that minocycline, a commonly prescribed antibiotic in the treatment of acne and rheumatoid arthritis, can cause the teeth and bone to discolor, which may make gum tissue to appear blackish-blue in color. Patients who take this drug or healthcare professionals who prescribe it should be made aware of the possibility of oral discoloration. Case Report Abstract *

Mayo Clinic researchers were presented with a 29-year old white female patient referred to the periodontics department by her dermatologist for an evaluation of the dramatic blue appearance of the gum tissue and bone surrounding her teeth. A review of her medical history indicated that she had been taking 50 mg of minocycline four times a day for the past 17 months.

“We informed the patient that in addition to the bone discoloration, her permanent teeth could also become discolored with continued use of minocycline. And, unlike the periodontal bone, teeth discoloration from minocycline does not always resolve after discontinuation of the therapy,” said Phillip J. Sheridan, D.D.S., Mayo Clinic, Periodontics, Department of Dental Specialties. “In this patient’s case, the dermatologist elected to change antibiotics to treat her acne.”

“This case definitely ‘drives home’ the importance of collaboration between medical and dental professionals,” said Gordon Douglass, D.D.S. and president of the American Academy of Periodontology. “Periodontists have known for awhile that medical drugs can affect a person’s oral health, and this is a reminder for patients to inform their dental professionals of all medications they are taking.”

For example, over 400 medications produce dry mouth, which can be damaging to the gum tissue, including periodontal disease and tooth decay. Other drugs like calcium channel blockers, phenytoin (used for treating seizures) and cyclosporine (used following organ transplants) may also cause gingival overgrowth.

According to this case report, approximately three to six percent of long-term users of minocycline will develop dental staining. This discoloration does not harm the teeth, bone or gum tissue, but is the reason behind the blackish-blue appearance of the gums. The periodontal bone can become discolored from minocycline therapy and show through the gum tissue, causing it to appear discolored as well.

“Like acne, periodontal disease can take away a person’s confidence and smile,” said Douglass. “Also like acne, periodontal disease is a chronic bacterial infection. Whereas acne inflames the walls of the hair follicles causing the walls to inflame and break, periodontal disease destroys attachment fibers and supporting bone that hold the teeth into the mouth.”

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.

For more information, contact the AAP Public Affairs Department at 312/573-3243 or 312/573-3242.

CHICAGO – September 18, 2003 – Reality television has become a popular form of primetime entertainment. The latest topic helps people enhance their features from head-to-toe through plastic surgery. However, if a patient already has a bacterial infection in the body or mouth, the surgical procedure may have to be postponed.

On one episode, the patient was unable to proceed with breast augmentation because of a bacterial infection in her mouth known as periodontal disease. The periodontist and plastic surgeon were concerned that the bacteria in the patient’s mouth may affect the outcome of her plastic surgery.

“Periodontitis is a bacterial infection of the gums, bone and periodontal ligament. The bacteria from periodontitis can enter the blood stream and cause systemic complications,” said Gordon Douglass, D.D.S., and president of the American Academy of Periodontology (AAP). “The bacteria in the bloodstream can compromise recovery from any surgery, but is particularly problematic for patients receiving implants, transplants or replacements of body parts since it may cause these procedures to fail. Before undergoing surgery, patients should have a periodontal examination to ensure that they don’t have bacteria in their mouth that may affect their recovery.”

In addition to treating the periodontal infection, the patient’s smile may also improve. This is important because a smile is often one of the first things people notice about another person. “When watching people on television receive a total makeover, it’s obvious that the appearance of the person’s smile can greatly affect their self-esteem. I see this in my practice everyday,” said Douglass.

Now that Americans are living longer, cosmetic surgery has become more popular. Oral plastic surgery has also felt this trend as it has experienced a significant shift toward cosmetic-related surgery to help improve the smile.

Excessive gum tissue can create a “gummy” smile, but the periodontist can perform a crown lengthening procedure to remove excess gum tissue and expose an ideal smile. Conversely, a person’s teeth may appear too long if their gums have receded or shrunk. This can often be corrected with soft tissue graft procedures. Dental implants, an artificial tooth root placed into the jaw to hold a replacement tooth or bridge, can be used to replace missing teeth.

“These procedures improve the smile, and are functional as well,” said Douglass. “A soft tissue graft can reduce further recession and bone loss, and in some cases reduce tooth sensitivity. Crown lengthening uncovers the tooth or teeth and improves its function. After the procedure, my patients can’t stop smiling, and it’s very rewarding when a patient says that periodontal plastic surgery changed their life by making them look and feel younger.”

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – February 13, 2004 – Appearing on a recent episode of reality TV, periodontist and member of the American Academy of Periodontology (AAP), Jeff Ganeles, DMD, showed how immediate loading dental implants transformed a patient’s smile in just a few visits. This event gave Americans a look at the future of implant dentistry, making the thought of dentures primitive and traditional dental implants routine technology.

“Today, patients’ expectations are much higher because of advances in technology and medicine,” explains Ganeles. “They want treatment methods that not only eliminate disease but also replace defective parts and make them feel whole again. Removable solutions such as dentures and partials used to be generally accepted, but increasingly my patients insist on more instantly gratifying, permanent options such as immediate loading dental implants.”

A dental implant, which looks like a small post or cylinder, is an artificial tooth root placed into the jaw to hold a replacement tooth, bridge, or denture in place. Using traditional dental implant methods and procedures, it typically takes two to six months for the bone and implant to bond together to form anchors (osseointegration). During this time, patients can wear a removable temporary tooth replacement option over the implant sites.

Improved technology affords some patients the luxury of immediate loading dental implants, whereby a periodontist places the implant immediately following tooth extraction and attaches a temporary fixed tooth replacement. “Although more research needs to be conducted, I have observed no complications during the healing period, and found that immediate loading implants can have notable advantages such as prevention of jawbone deterioration, reduced number of surgical procedures, reduction of treatment time, and better patient acceptance,” states Ganeles.

“We’ve come a long way with tooth replacement technology,” notes Michael P. Rethman, DDS, MS, and president of the AAP. “Today, the optimal solution for most patients is dental implants, and in some cases immediately loading implants.”

This is good news for patients who experience sadness, depression and embarrassment with tooth loss because they have lost the comfort and confidence of a natural smile. “Many also find that dentures, bridges and other dental appliances come with problems of their own,” Ganeles comments. “I’ve been told by my patients that getting implants changed their lives, making them look and feel younger and healthier.”

Consequently, it’s not just the “maturing” population that is electing implants to repair their smiles and restore their facial structure. In an online poll of periodontists, thirty-one percent report that half or more of the implants they place are for baby boomers – people ages 35 to 54, while forty-three percent state that more than half of the implants they place are for individuals between the ages 55 to 79. According to the poll, the top reasons for tooth loss leading to implant placement were periodontal diseases, tooth decay and accidents, violence or injuries.

Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the experts who specialize in precisely these areas, they are ideal members of the dental implant team. Periodontists not only have experience working with other dental professionals: they also have special knowledge, training, innovation, and facilities that patients need to attain the natural looking and feeling smiles the want.

A referral to a periodontist in your area and free brochure samples including one titled Dental Implants: Teeth that Look and Feel Just Like Your Own are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – April 7, 2004 – Many Americans are spending their tax refunds on periodontal plastic surgery, according to an online poll of consumers conducted recently on the American Academy of Periodontology’s (AAP) Web site.

“This patient survey confirms what periodontists see in their practices,” said Michael P. Rethman, DDS, MS, and president of the AAP. “One out of 4 periodontists polled said they perform most periodontal plastic surgery procedures during ‘tax time’ – the months of April through June.”

Click for Detailed Survey Results

Cosmetic surgery has become so popular in the United States that it is the hottest topic for reality television. Periodontal plastic surgery has also felt this trend as it has experienced a significant shift toward cosmetic-related surgery to help improve the smile.

“I elected to have periodontal plastic surgery, because I hated my gummy smile,” explained Denise Riddle. “I’m thrilled with the results, and every day someone compliments me on my smile.”

Excessive gum tissue can create a “gummy” smile, but the periodontist can perform a crown lengthening procedure to remove the excess gum tissue and expose an ideal smile. Conversely, a person’s teeth may appear too long if their gums have receded or shrunk. This can often be corrected with soft tissue graft procedures.

If patients have missing or damaged teeth, a dental implant is an artificial tooth root placed into the jaw to hold a replacement tooth or bridge. Implants also prevent bone loss that often accompanies dentures, and look and feel like the original tooth.

“The results are rewarding for the periodontist, restorative dentist and the patient,” said Jonathan Cole, D.M.D., private practitioner in DuBois, Pennsylvania. “Prior to surgery, patients tell me they hate smiling because they don’t want people to see their teeth. After surgery, they smile with ease and confidence. Patients have even told me they can’t believe this change makes them look so much younger and instills much more confidence in their personality.”

“The periodontist plays an integral part in the appearance and health of the smile,” said Kevin Moore, D.M.D., restorative dentist in Clarion, Pennsylvania. “The patient cannot achieve a winning smile without the periodontist and dentist working together to reshape the gumline or remove the gum infection.”

“Periodontal plastic surgery improves the smile, and is functional as well,” said Rethman. “A soft tissue graft can reduce further recession and bone loss, and in some cases reduce tooth sensitivity. Crown lengthening uncovers the tooth or teeth and improves its function since the patient can once again feel the tooth.”

The AAP online survey found that almost a third of those surveyed will use their tax refunds for periodontal plastic surgery.

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Surgery: What Can I Expect are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO—March 19, 2008—A smile is one of the most universally recognizable facial expressions, helping to depict an individual’s happiness, confidence, attractiveness, sociability and sincerity. And now, according to a recent study published in the Journal of Periodontology (JOP), the official publication of the American Academy of Periodontology (AAP), a smile may also help convey healthy teeth and gums. Researchers found evidence that periodontal, or gum, disease may negatively affect an individual’s smiling patterns and deter someone from displaying positive emotions through a smile. Study Abstract *

The study, conducted at the University of Michigan, evaluated the smiling patterns of 21 periodontal patients while viewing a segment of a comedy program. At predetermined measurement points throughout the segment, the researchers assessed three dimensions of each patient’s smile: the horizontal width of the mouth in millimeters, the open width of the mouth in millimeters, and the number of teeth shown. In addition, the researchers also noted the number of times the patient covered his or her mouth while watching the segment. Individual perceptions of how the patient’s quality of life is affected by oral health were also considered. The data were then evaluated along with a clinical exam of the patient’s periodontal health.

“Since periodontal disease is prevalent in such a large number of adults, we sought to investigate if the disease affects a person’s smiling behavior,” said study author Dr. Marita R. Inglehart. “Smiling plays a significant and essential role in overall well-being. Previous findings suggest that smiling can affect social interactions, self-confidence and can influence how people perceive one another.”

The study findings indicated that periodontal disease can certainly impact how a person smiles. The more symptoms of gum disease found in a patient’s mouth, such as periodontal pockets between four to six millimeters deep or loose, moving teeth, the more likely the patient was to cover his or her mouth when smiling or to limit how widely the mouth opened during the smile. In addition, the more gum recession seen in the patient, the fewer teeth he or she showed when smiling. The way patients perceived their quality of life as a result of their oral health was also significantly correlated with the number of teeth affected by periodontal disease.

“It is already widely known that periodontal disease is connected to systemic health,” said Dr. Susan Karabin, DDS, President of the AAP. “These results help demonstrate that periodontal disease may affect more than just overall health. It can also impact actual quality of life, making caring for one’s teeth and gums all the more important.”

Find out if you are at risk for periodontal diseases by taking the Academy’s risk assessment test. A referral to a periodontist in your area and free brochure samples are available by visiting the AAP’s Web site at www.perio.org. or by calling 800-FLOSS-EM.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for