Congratulations! In a few months, you're expecting a new baby... but, in the mean time, your body is adjusting to nausea, weight gain, food cravings, and a hundred other changes. Is this really the time to worry about your teeth and gums?

Yes and no — don't worry, but do be aware of a few basic facts about your oral health and your pregnancy, and how they affect each other.

Being pregnant may make your teeth and gums more sensitive. It also puts you at greater risk for some periodontal diseases, like pregnancy gingivitis (“gingival” – gum tissue; “itis” – inflammation of) and benign growths on the gum called “pregnancy tumors.” You may think these problems are just uncomfortable, but you should really have them evaluated as soon as they develop. Why?

Once upon a time, it was believed that periodontal (gum) diseases just affected the mouth. Today, we think these diseases and their associated bacteria may be involved with the whole body, playing a role in cardiovascular ailments, heart attacks, strokes, diabetes, and other illnesses.

What's more, recent studies suggest that these oral bacteria may be able to cross the placenta, stimulating an inflammatory response that may lead to preterm delivery. Babies who are born pre-term often have low birth weight, and are at greater risk for a number of health complications. That's one reason why maintaining good oral health is so important to expectant moms.

So, what should you do? First of all, keep in mind that maintaining your own general and dental health is the best thing you can do for your developing baby. Eat a balanced diet, keep up healthy habits — like limiting sugary between-meal snacks and brushing regularly — and don't put off visiting your dentist to get your dental cleanings. Those cleanings and a thorough evaluation can set your mind at ease and give your baby the best chance at a healthy start.

If you would like more information about pregnancy and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Pregnancy and Oral Health,” and “Expectant Mothers.”

The increasing rates of obesity and diabetes in Americans have been getting a lot of attention lately. Most people know that the two are clearly linked. But did you know there's also strong evidence of a link between diabetes and gum disease?

Both diabetes and periodontal (gum) disease are chronic inflammatory conditions. That means they are disorders that develop over time (chronic), and are characterized by problems with a function of the immune system (inflammation). In diabetes, problems with the hormone insulin lead to abnormal levels of sugar in the blood. This can bring about a number of complications which, if not treated, may result in kidney failure, coma and even death. In many people, however, it's a condition that can be managed with drugs and lifestyle changes.

You may not think of gum disease (periodontitis) as a serious illness. But here's something you should know: If you have diabetes, having gum disease is a risk factor for worsening control of blood glucose levels, and may also increase the risk of complications. Likewise, having diabetes puts you at greater risk for developing more severe forms of periodontal disease.

What is gum disease? It's actually a group of diseases caused by many types of bacteria in the mouth, which affect the tissues around the teeth. Initially, it often causes swelling and redness of the gum tissue. Left untreated, it may result in bone loss, abscess formation, and ultimately the loss of teeth. But its ill effects aren't limited to your mouth.

Periodontal inflammation is associated with a higher systemic (whole-body) inflammatory state. That means it may increase your risk for cardiovascular diseases like heart attack and stroke, and adverse pregnancy outcomes — as well as complicating the management of blood-sugar levels in diabetics.

Now, here's the good news: Treatment of periodontal disease which reduces inflammation has a beneficial impact on the inflammatory status of the whole body. For people who have both diabetes and periodontal disease, that means that periodontal therapy can lead to improved blood sugar control.

How do you know if you have periodontal disease? Bleeding gums and bad breath are both possible symptoms, as are redness and soreness of the gum tissues. But these warning signs may be masked by any number of other factors — or may not be noticed at all.

The sure-fire way to diagnose and treat periodontal disease is by getting regular dental checkups, followed by specialized periodontal treatment when necessary. If you presently have diabetes, or may be at risk for developing the disease, those check-ups and treatments are even more important.

If you have concerns about diabetes and gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Diabetes & Periodontal Disease” and “Understanding Gum (Periodontal) Disease.”

Every pregnant woman knows that her body will go through a series of profound changes as it's making a new life. Along with the alterations in overall size and changes in eating and sleeping patterns, pregnancy also affects the teeth and gums. Here are some answers to common questions women may have about oral health during pregnancy.

1) What's the most important thing I can do for my baby's oral health?

Maintain your own dental and general health! Eat a healthy and balanced diet — it provides the nutrients, vitamins and minerals needed for proper development of your baby's teeth and bones. While food cravings and aversions are common, try to at least limit your intake of sugary snacks to mealtimes. Don't neglect the good habits of brushing, flossing, and seeing your dentist regularly. This will help minimize the possibility of tooth decay or gum disease.

2) Does pregnancy make me more susceptible to gum disease?

Yes. “Pregnancy gingivitis” (“gingival” – gum tissue; “it is” – inflammation of) may develop from the second to the eighth month. This is mostly due to elevated hormone levels. In the presence of gum disease, pregnancy hormones may stimulate the production of prostaglandins, which cause inflammation of gum tissues. Occasionally, benign growths called “pregnancy tumors” may also appear on the gums during the second trimester. If they don't resolve themselves, these may be surgically removed after the baby is born.

3) With all my other concerns right now, why is the health of my teeth and gums so important?

Several studies have shown a link between periodontal (gum) disease, pre-term delivery and low birth weight — conditions which put some newborns at greater risk for health complications. There's also a correlation between more severe periodontal disease and an increased rate of pre-eclampsia, a potentially serious condition. But treating periodontal disease decreases the level of inflammation-causing prostaglandins. That's one reason why you should come into our office for an evaluation as soon as you know you're expecting.

4) Is it safe to get dental treatments while I'm pregnant?

Dental examinations and routine treatment during pregnancy is generally safe for both mom and baby. If you need non-urgent dental care, it may be most comfortable in the first five months of pregnancy. Situations requiring urgent care are managed as they arise, to treat pain and infection and to reduce stress to the developing fetus. Under the watchful eye of your dentist, it's possible to have anesthesia, X-rays and dental medications (if needed) without undue risk. So don't let worries about dental treatments keep you from coming in for a check-up!

If you would like more information about pregnancy and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Pregnancy and Oral Health,” and “Expectant Mothers.”

Periodontal disease is the leading cause of tooth loss in adults. A recent survey by the Centers for Disease Control and Prevention showed that nearly half of Americans older than 30 had some signs of periodontal disease. That's more than 64 million people.

How much do you know about this potentially serious disease? Take our quiz and find out.

True or False: Gum Disease is caused by bacteria in the mouth

TRUE. Of the hundreds of types of bacteria that occur naturally in the mouth, only a small percentage are harmful. But when oral hygiene (brushing and flossing) is lacking, these can build up in a dental plaque, or biofilm. This often causes inflammation of the gums, the first step in the progression of gum disease.

True or False: Gum disease is more prevalent among younger people

FALSE. Gum disease is most often a chronic disease, meaning that it progresses over time. Statistics show that as we age, our chances of developing gum disease increase, as does the disease's severity. In fact, according to the study mentioned above, about 70% of adults 65 and over have mild, moderate or severe periodontitis, or gum disease.

True or False: Bleeding of the gums shows that you're brushing too hard

FALSE. You might be brushing too hard — but any bleeding of the gum tissue is abnormal. Gum sensitivity, redness and bleeding are typically the early warning signs of gum disease. Another is bad breath, which may be caused by the same harmful bacteria. If you notice these symptoms, it's time for a checkup.

True or False: Smokers are more likely to develop gum disease

TRUE. Not only are smokers more likely to develop gum disease, but in its later stages they typically show more rapid bone loss. Smoking also prevents the warning signs of gum diseaseâ??bleeding and swelling of the gum tissuesâ??from becoming apparent. Other risk factors for developing the disease include diabetes and pregnancy (due to hormonal changes). Genetics is also thought to play a role in who gets the disease — so if you have a family history of gum disease, you should be extra vigilant.

True or False: The effects of gum disease are limited to the mouth

FALSE. Numerous studies suggest that there is a relationship between periodontal health and overall health. Severe gum disease, a chronic inflammatory disease, is thought to increase the risk of cardiovascular diseases like heart attack and stroke. It may also lead to complications in pregnancy, and problems of blood-sugar control in diabetics.

So if you have any risk factors for gum disease, or if you notice possible symptoms, don't ignore it: let us have a look. We can quickly evaluate your condition and recommend the appropriate treatments if necessary. With proper management, and your help in prevention, we can control gum disease.

If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”

If you think you'd rather wrestle a pack of porcupines than go to the dentist for a root canal treatment — then maybe it's time to think again! This common procedure has been the butt of jokes for a long time. Let's set the record straight by answering some common questions about the much-maligned procedure.

Q: What is a root canal?

A: Coursing through the central part of each root is a hollow space or canal, which contains the pulp tissue. The pulp tissue contains the nerves which respond to temperature changes transmitted through the tooth. When the temperatures are extreme the nerves signal sensitivity and pain. It's also shorthand for the dental procedure that is performed when the pulp tissue that fills these canals develops a disease.

Q: Why do I need to get a root canal?

A: Because an infection or inflammation has developed deep inside one or more of your teeth. When the living pulp tissue — which contains nerves and blood vessels — becomes inflamed or infected, it can cause intense pain. It also releases bacterial toxins, which can lead to further problems.

Q: What happens if I don't get a root canal?

A: Your acute pain may temporarily go away, but the infection won't. It will eventually travel through the tooth's roots into the surrounding tissues. If left untreated, it may result in an abscess or even a systemic infection. That's why you need to take care of it now.

Q: Will it be painful?

A: Generally, a root canal procedure is no more painful than getting a filling. In fact, it starts the same way: An anesthetic is given to numb the tooth and the surrounding area. Then a small hole is made through the tooth's chewing surface and down into the canal. Diseased pulp tissue is removed through the hole via a set of tiny instruments. Finally, the root canal is cleaned, disinfected, filled with inert biocompatible material and sealed up.

Q: What happens after that?

A: Your tooth may be sensitive for a few days after the treatment, but the acute pain will be gone. Over-the-counter pain relievers generally work well for pain relief at this point. To restore your tooth to its fully-functioning state, a crown or other restoration is usually needed after root canal treatment. Properly done, the restored tooth can last as long as any of your natural teeth.

Q: Is there an alternative?

A: Yes. You can relieve the pain by having the tooth removed. But you don't want to go there. Tooth loss can lead to unwanted side effects, like migration of teeth, bone loss and eventually the inability to chew properly. It's far better to save your natural teeth when you can.

If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”