periodontal disease

Greenbelt and Millersville Maryland Dental Hygienists at McCarl Dental Group

At McCarl Dental Group we recommend that all patients see one of our registered dental hygienists for routine prophylactic cleaning appointments at least every 6 months. For patients with gum disease we may recommend visits every 3-4 months. Our hygienists work with each one of our patients to ensure that they maintain optimum gum health, which means keeping their teeth healthier for years to come. With extensive training in the removal of tartar and plaque from the tooth surfaces and below the gums, dental hygienists play an active role in fighting periodontal disease.

Many people believe that if they do not have problems with their teeth, they do not need to have their teeth cleaned by a hygienist and examined by a dentist. This can mean a couple of years quickly turns into 5, 10, or even 15 before some people have another dental exam. Unfortunately, for most of these people, waiting longer between visits means unhealthy gums and sometimes very rampant tooth decay.

When plaque is missed from irregular flossing, it hardens and becomes tartar under the gumline. This contributes significantly to the destruction of gum and bone attachment levels around your teeth. Eventually this uncontrolled gum disease, correctly known as periodontal disease, can lead to tooth loss.  Through routine cleaning appointments and screenings, patients can help prevent conditions including periodontal disease and advanced tooth decay.

The hygienists at McCarl Dental Group work with each individual patient to help them create an oral hygiene regimen that will work best for their own needs. Fifty percent of tooth and gum health comes from what you’re doing at home. Because every person’s mouth is different, so are his or her home care needs. What works for one person may not work for the next.

Hygienists don’t just clean teeth or check for suspicious areas of decay. They also screen for oral cancer and precancerous lesions of the mouth, head and neck.  Many medical conditions and diseases of the human body first manifest themselves as symptoms that are seen in the mouth. Because people are more likely to see their hygienists for routine cleanings as opposed to annual physical exams with their doctor, many conditions are first found in the dental office. Many Dental Hygienists also offer nutritional counseling because of the vital connection between overall health and oral health.

McCarl Dental Group hygienists help promote and safeguard your overall health and wellness. If you’re behind on your dental hygienist visits, it’s better to be late than never. Contact us today to schedule your biannual cleaning appointment. You can reach our Millersville, Maryland dental office at (410) 987- 8800 or our Greenbelt, Maryland dental office at (310) 474-4144. You may also request an appointment online at www.McCarlDental.com.

Advances in Dental Hygiene

We have seven very talented dental hygienists who work at our dental offices in Greenbelt and Millersville Maryland.

Greenbelt and Millersville Maryland Dental Hygienists at McCarl Dental Group

Recent years have shown tremendous strides in the advancement of technology in the area of dental hygiene. The Dental Hygienists at McCarl Dental Group stay current with the latest advancements so they are able to deliver the highest quality dental hygiene care.  Several of our hygienists have worked at McCarl Dental Group for more than 20 years! Our patients always give fabulous reviews of their dental hygiene care. Because prevention and early intervention is key at your professional dental cleanings with the hygienists at McCarl Dental Group, we want to take a moment to share some of the technological steps that preventative dentistry is making.

• Desensitization

For patients who suffer from tooth sensitivity that does not require restorative dental treatment, desensitizing agents are now more effective than ever.  McCarl Dental Hygienists can apply topical gels that make your teeth “pain free.” Fluoride varnish helps block the pain receptors of the hypersensitive tooth surface. Our dentists can also provide prescription strength fluoride toothpaste for everyday use. This allows patients to eat and drink without associated tooth sensitivity and helps ensure dental comfort between dental appointments.

• Digital Radiography

In the beginning of dental radiography, x-ray films had to be dip processed in 3 separate tanks with chemicals that allowed the films to be viewed. This development process took 20 minutes. Electric processors shortened this time dramatically, usually developing an x-ray within 5-7 minutes after being placed in the machine. In the 21^st century with digital radiography, the images are ready for viewing in an instant. McCarl Dental Group uses digital radiography machines for several types of x-rays. This shortens the time it takes to view x-rays and decreases radiation exposure to our patients. While the exposure levels with traditional films were already safe, digital radiography lowers exposure even more. The detail and resolution of digital radiographs is of extremely high quality, and the files can be sent electronically to other dental professionals or insurance companies.

• Local and Systemic Delivered Medications

For patients who suffer from periodontal disease, in addition to procedures such as Scaling and Root Planing, local delivery of medication to areas with advanced bone loss can improve healing as well as encourage tissue attachment and bone regeneration. (1) These medications are placed below the gum surface into the infected pocket area, and are delivered through fibers, gels, chips, ointments and microspheres.

Recent studies also show that Statin drugs, commonly used to control blood cholesterol, are suggested to improve tissue attachment on the root surfaces of teeth, and encourage bone growth. (2) Azithromycin, another orally delivered medication, has also been shown to improve the success in Scaling and Root Planing therapy. (3)

At McCarl Dental Group  we strive to provide state of the art, quality preventative, restorative and cosmetic dental care to each of our patients. To find out more about the advanced dental care we offer in Millersville, MD and Greenbelt, MD, please call us at (410) 987-8800 or (301) 474-4144.

References:

1. Pradeep, A., Thorat, M.: Clinical Effect of Subgingivally Delivered Simvastatin in the Treatment of Patients with Chronic Periodontitis: A Randomized Clinical Trial. J Perio 81: 214- 222, 2010.

2. Fajardo, M., Rocha, M., Sanchez-Marin, F., Espinosa-Chavez, E.: Effect of Atorvastatin on Chronic Periodontitis: A Randomized Pilot Study. J Clin Perio 37: 1016-1022, 2010

3. Rotundo, R., Nieri, M., Francesco, D., Mervelt, J., Bonaccini, D., Esposito, M., Pini-Prato, G.: Lack of Adjunctive Benefit of Er:YAG Laser in Non-Surgical Periodontal Treatment: A Randomized Split-Mouth Clinical Trial. J Clin Perio. 37: 526-533, 2010

Each year about 800,000 new cases of diabetes are diagnosed.  Even more frightening- the Center for Disease Control reported a 70% increase in diabetes diagnosed in 30-39 year olds from 1990-1998.  In diabetics, the blood glucose level is higher than normal due to a lack of insulin.  Insulin is a hormone produced by the pancreas, the organ that breaks down sugar in our bodies.  Diabetics are typically unable to produce enough insulin or use the body’s natural insulin.  Heart disease, blindness, organ failure, and poor circulation are medical concerns associated with high glucose levels.  However, diabetes also increases the risk of gum disease, which can affect your overall health.

The first stage of gum disease is gingivitis.  Gingivitis occurs when normal bacteria in the mouth are not removed adequately. This causes the gums to become inflamed or swollen. Bacteria grow in plaque, a sticky film that everyone can remove with proper brushing and flossing.  If the plaque is not removed, it hardens into tartar (also known as calculus).  When teeth are not cleaned properly, gums start to bleed while brushing and flossing, a sign of gingivitis. Only a professional cleaning by your dental hygienist or dentist and can remove tartar or calculus.  The dentists and dental hygienists at McCarl Dental Group emphasize preventive oral hygiene. Every patient has unique oral health needs. Some people are more prone to plaque accumulation and need to have their teeth cleaned professionally by a dental hygienist more often than the usually recommended time interval of every six months.

If gingivitis is ignored, more severe gum disease called periodontitis may develop.  Periodontitis causes pockets to form between your teeth and gums.  The gums pull away from your teeth allowing more germs to enter.  The resulting infection may cause bone loss around your teeth which often leads to loose teeth and ultimately results in losing teeth. Missing teeth cause additional health problems.

Research indicates a strong correlation between gum disease and diabetes. Diabetics are more prone to bacterial infections and cannot fight bacterial infections as well as a patient with normal glucose levels.  Common symptoms of oral infections include swelling, pus, pain while chewing or general pain in the mouth, oral sensitivity to temperature and sweetness, and white or red patches within the mouth.

New, studies emphasize the importance of oral health and suggest that gum disease may actually contribute to diabetes.  Serious oral infections like periodontitis can cause unbalanced glucose levels which increase the risk factors for diabetes.

Preventing oral health problems in diabetics is first controlled by regulating diabetes.  Keep a healthy glucose level.  Secondly, brush and floss your teeth properly at least twice daily.  Finally, maintain regular check-ups with your dentist.  Make sure to keep your dentist and hygienist updated on your health condition, medications, and glucose levels.  Dental procedures are best performed when blood sugar is carefully controlled.  Diabetics are typically slower healers, so regulating diabetes allows for a faster healing time.  Remember to eat before heading to the dental office and stick to your normal meal plans afterwards in order to maintain regular blood sugar levels.  If you cannot chew well after the visit, plan an alternative way to sustain your calorie intake.  If you have any concerns about how your diabetes will affect your upcoming dental visit, please contact McCarl Dental Group serving Anne Arundel County and Prince Georges County Maryland to plan your strategy for a healthy smile.

How much do you know about Periodontal Disease?

1.  What systemic diseases are related to periodontal disease?
a)    heart disease
b)    diabetes
c)    premature birth
d)    rheumatoid arthritis
e)    dementia
f)    all of the above

2. Flossing and gum health have been linked to longer healthier lives. True or False

3. What percentage of Americans over the age of 35 has some form of periodontal disease?
a) 25%
b) 50%
c) 100%
d) 75%

4. Patients who want to maintain a healthy smile should…
a) visit their dentist at least twice a year
b) brush with fluoride toothpaste twice daily
c) floss teeth daily
d) all of the above

5. Match the dental term with the correct definition
a) gingivitis _____
b) periodontal disease _____
c) plaque _____

1) chronic bacterial infection that causes gum tissue to pull away from the teeth forming pockets and
resulting in damage to the bone supporting the teeth and ultimately the loss of teeth
2) sticky film with bacteria that constantly forms on your teeth and gums
3) mild inflammation of the gums often characterized by red, swollen and bleeding gums which can
be prevented by regularly brushing and flossing teeth

Contest Rules
1) Must be a Facebook Fan of www.Facebook.com/McCarlDental (Just click “LIKE”)
2) Submit quiz answers to McCarl Dental Group via email to mccarldentalgroup@gmail.com
3) The winner will be selected randomly from Facebook Fans with correct answers.
4) Employees are not eligible for prize money but their families are!
5) Winner must pick up the check from our Millersville or Greenbelt Dental Office.
6) Drawing will be held on July 1, 2010.

Answers are in our Taste of the Bay Cover Story!

Cheryl Pruitt was surprised when the surgeon replacing her knee required a complete dental work up prior to surgery. “It was a real wake up call,” she says. “I had no idea I would need to go to the dentist before getting knee surgery.” Pruitt, a corporate human resources specialist from Millersville, needed her dentist to verify that she didn’t have any bacterial infections, such as nerve abscesses, gum disease or plaque build up on her teeth….

…click here to download full article PDF

Retired dentist and Heritage Harbour Annapolis resident Dr. Walter Smith summarized the recent dental presentation by McCarl Dentists by saying there has never been a better time for dentistry. The newest technological changes have made dentistry more comfortable for dental patients than ever. When Dr. Smith retired in the 1980s, dental implants were in their infancy. Dentists could not have imagined a digital scanner taking pictures of teeth prepared for dental restorations with images sent via high speed internet for fabrication of perfect dental crowns and bridges. Neither could dentists imagine computer morphology that would allow clear aligner trays to straighten teeth. Today’s dentistry is remarkable!

Dr. James McCarl interviewing retired dentist Dr. Walter Smith.

Drs. Clayton and Jay McCarl discussed four of the newest procedures and technologies in dentistry at Heritage Harbour in Annapolis Maryland last week. The four topics they presented were dental implants, Invisalign orthodontics, digital scanning for dental impressions and healthy mouth – healthy body: the relationship between oral and overall health.

Door prizes are always fun! Dr. Walter Smith won a professional custom in-home teeth whitening, Lillian Gill won a dental exam, cleaning and necessary x-rays. Sheri Reagor won a Sonicare Electric toothbrush.

Dental Implants
Dental implants can improve your quality of life if you are missing teeth! Dental implants have improved dramatically since the 1980s and have continued to improve during the last few years. They are small titanium posts that are inserted into the jaw bone and function like the root of a tooth. Implants are an effective and reliable anchor for dental crowns, removable bridges and dentures. The jaw bone fuses to the titanium implant and withstands forces from chewing food. Mini dental implants, known as minimally invasive implants, are thinner in diameter and the procedure for placing them is less invasive than traditional dental implants. Case selection is instrumental in a successful dental implant case. The dentists at McCarl Dental Group are certified in traditional and mini dental implants and understand what is best for each individual patient.

Invisalign Orthodontics
Crooked teeth contribute to gum disease. Invisalign orthodontics are less expensive, more esthetic and can also be faster than metal braces. Adults of all ages are straightening their teeth in record numbers. These dental patients improve the health and appearance of their smiles. McCarl dentists are preferred providers of Invisalign orthodontics.

Digital Scanning for Dental Impressions
Digital scanning for dental impressions is the future! McCarl Dentists and LVI Dentists use the Cadent iTero 3D Intraoral Scanner. The iTero has a camera on a wand that takes digital pictures of teeth that have been prepared for a dental crown or bridge. These pictures are sent over high speed internet to fabricate dental restorations. This method provides the most accurate impression of teeth available today. The crowns and bridges fabricated using digital scanning for impressions require very little or no adjustment – they fit perfectly! Digital imaging will replace conventional dental impressions in our lifetime.

Healthy Mouth-Healthy Body
Diseases in the mouth affect your entire body. Prior to joint replacement surgery it is essential to have a dental exam to check for infection in your mouth. Oral infections range from gum disease or periodontal disease to tooth abscesses. Germs in your mouth can get into your bloodstream and affect other parts of your body. Are you planning a knee or hip replacement? See your dentist first! Are you about to start chemotherapy? Have your dentist check your gums and teeth for potential sources of infection before taking immunosuppressant drugs including chemotherapy. When teeth are healthy it enhances nutrition. McCarl Dentists help our patients enjoy smiling and eating. A healthy smile contributes to your overall health and well being. Visit our YouTube Channel to see videos of the presentation. McCarl Dentists discuss Healthy Mouth Healthy Body

Your oral health is connected to many other health conditions beyond your mouth. Sometimes the first sign of a disease shows up in your mouth. In other cases, infections in your mouth, such as gum disease, can cause problems in other areas of your body. Periodontal disease is a chronic bacterial infection of the gums, and the byproducts of oral bacteria can enter the bloodstream. When oral bacteria escapes into the bloodstream it increases inflammation throughout the body and can injure major organs. Chronic inflammation is recognized as a significant factor in aging and disease. Research links inflammatory periodontal diseases to systemic conditions.

Over 75 percent of Americans over the age of 35 have some form of gingivitis or gum disease.

Inflammation from periodontal disease is associated with a number of serious health problems including:
•    Heart disease
•    Diabetes
•    Dementia
•    Rheumatoid arthritis
•    Premature birth

Do you notice any of these signs of gum disease – bleeding gums (even when you brush); red, swollen or tender gums; loose teeth; persistent bad breath; or receding gums? Sometimes there are NO obvious signs of gum disease.

Dental plaque is a sticky film with bacteria that constantly forms on your teeth and gums. When plaque isn’t removed by daily brushing/flossing and routine dental hygiene cleanings, it not only causes tooth decay, but also leads to gum or periodontal disease. Gum disease ranges from simple gum inflammation, called gingivitis, to a more serious disease, called periodontitis, that causes gum tissue to pull away from the teeth and form pockets that are infected. Periodontitis can result in damage to the underlying bone supporting the teeth. The American Dental Association recommends prevention by proper diet, brushing, flossing and dental visits. If you have symptoms of gum disease, please call our Millersville Dental Office at 410-987-8800 or Greenbelt Office at 301-474-4144 to schedule an appointment!

Drs. Clayton, Jay and David McCarl of McCarl Dental Group, www.mccarldental.com, are third-generation dentists with two dental offices in Greenbelt, Maryland and Shipley’s Choice Medical Park in Millersville adjacent to Severna Park fifteen minutes from  Annapolis. They are graduates of the University of Maryland Dental School and participate regularly in continuing education programs. Drs. McCarl are listed in America’s Top Dentists selected by the Consumers Research Council of America, Top Dentists as voted by Dental Specialists and Best Dentist in the Capital Reader’s Choice 2010 Poll.

For more information on the latest news in dentistry or the McCarl Dental Group, visit www.McCarlDental.com.

Every day we hear lots of creative (and sometimes lame) excuses for not flossing.

“The cat unraveled my floss.”

“I used it to hang my pictures.”

“I couldn’t find white thread and needed it to reattach a button.”

“Went fishing and used floss as fishing line.”

“Emergency shoe lace.”

“Ponytail holder.” Yada, yada, yada…

The excuse we hear most often is, “My gums bleed when I floss – it must be bad for me.”

If this is your excuse, we have great news! Gums only bleed for a day or two when you start flossing daily. The reason for bleeding is that the gums are inflamed from food and plaque trapped between your teeth and gums. Once the plaque is removed, your gums will no longer be inflamed and will stop bleeding.  To keep your gums healthy, you must maintain regular brushing, flossing and routine professional cleaning to prevent build up of bacteria-harboring plaque and tartar.

At McCarl Dental Group, we give floss to every patient after their dental hygiene visits. If you have your teeth cleaned regularly according to your dentists’ recommendations, and run out of floss between visits, please come see us. We are happy to give you more floss!

According to Dr. Steven Offenbacher, professor of periodontology at UNC’s School of Dentistry and Dental Research, “Poor dental health is so prevalent that the number of lives saved by eliminating gum disease worldwide would definitely be in the hundreds of thousands.” The first sign of gum disease or gingivitis is red or swollen gums that bleed easily. If gingivitis progresses to periodontitis, the gums recede and pockets form between the gums and teeth, potentially leading to tooth loss.

A substance produced in the body called high-sensitivity C-reactive-protein or hs-CRP is suspected to play a role in the link between gum disease and heart disease. Inflammation from acute gum disease increases the amount of hs-CRP. The American Heart Association says hs-CRP is linked to an increased risk for heart attacks.

Here are a few pointers – just in case you have forgotten how to floss.
•    Hold an 18-inch piece of floss tightly between the thumbs and forefingers.

•    Guide the floss between the teeth, gently hugging the side of each tooth.

•    When the floss reaches the gum line, curve it into a C shape against the side of the tooth and slide it in between the gum and the tooth.

•    Move the floss away from the gum with up and down motions and repeat this method between all of your teeth. Don’t forget the back of your last tooth!

Good oral hygiene means much more than bright white teeth. The condition of your teeth and gums is associated with a growing list of diseases that affect your overall health. Here are 9 ways to keep a healthy smile for a lifetime.

1) Quit Smoking
Everyone has heard about the cardiovascular and cancer risks associated with tobacco use and smoking. Smokers are also two to three times more likely to get periodontal disease and do not heal as well after periodontal treatment for gum infections.

2) Eat for a Healthy Body and Healthy Teeth
Eat a balanced variety of healthy foods from the five major food groups. Recent dental research indicates that a diet high in fruits and vegetables may help prevent oral cancer. A healthy diet with enough calcium and vitamin D will help you maintain strong teeth and bones. If you have osteoporosis or periodontal disease, you are at higher risk of losing teeth. If you do lose a tooth, get a dental implant to prevent resorption and shrinking of your jaw bone.

Limit sugary snacks and decrease soft drink consumption – even diet soda! Tooth decay and dental cavities are caused by bacteria that are normally present in your mouth. Every time you eat, bits of food become lodged in and around your teeth. This food provides fuel for the bacteria in plaque. Oral bacteria produce acid. Each time you consume food or beverages containing sugars your teeth are exposed to these acids for 20 minutes or more. Even diet-sodas are very acidic and increase risk of tooth decay and cavities. Brush your teeth after eating. Careful brushing and flossing help keep normal bacteria under control.

3) Brush and Floss Properly
Bleeding gums can be serious. Seventy five percent of Americans over the age of 35 have some form of gingivitis or gum disease. Gum disease and gingivitis are associated with heart disease, diabetes, stroke, arthritis, and pregnancy complications.

Brush your teeth at least twice daily and floss daily. Use a soft brush in gentle circular motions at a 45-degree angle to your gum line. You may also use an electric toothbrush to help with areas that are difficult to reach. Electric toothbrushes are automatically set for two minutes which is the recommended brushing time. Floss gently but firmly, hugging the side of each tooth and make sure to floss gently into the gum line along the tooth to remove any plaque or food that has lodged between your teeth or between a tooth and your gum.  We recommend a professional dental hygiene visit at least twice a year.

4) Use Fluoride Products
Fluoride helps prevent tooth decay and strengthen tooth enamel in children and adults. In addition to the fluoride treatment that you receive after your teeth are cleaned by a dental hygienist during a routine dental exam, toothpastes and fluoride rinses are good sources of fluoride. Your dentist may recommend a stronger concentration of fluoride in a gel, toothpaste or rinse.

5) Know the Warning Signs of Oral Cancer
Have you ever noticed a small white or red patch in your mouth or a sore that takes longer than two weeks to heal? These symptoms could potentially be a sign of oral cancer. Other potential signs of oral cancer include: a sore that doesn’t heal or bleeds easily; a lump, thickening, ulceration, or color change of the gums and tissue in the mouth; chronic sore throats and a change in tonsil size. Dental journals are filled with articles about human papillomavirus (HPV) and an associated increase in oral cancer, with reports that 30 to 50 percent of head and neck cancer diagnoses are HPV related. Other risk factors include alcohol and tobacco use, sun exposure (lip cancer), and age.

6) Keep Your Dental Work Current
Old fillings can wear out or chip around the edges creating an opportunity for bacteria to enter the tooth and cause decay. Your dentist will evaluate the seal of all dental work during routine exams. You should visit your dentist if you are experiencing tooth sensitivity or discomfort.  Also, don’t use your teeth as tools.

7) Reduce Stress
Grinding or clenching your teeth can cause excessive wear on the chewing surfaces of teeth and can even lead to cracked and chipped teeth. Our teeth normally wear down with age – clenching and grinding accelerates the process. Dental mouth guards, NTI appliances and stress-management techniques can also help reduce clenching.

Pregnant? See your OB … AND DDS
Pregnancy hormones can increase propensity toward swollen and bleeding gums that are more vulnerable to bacterial infection.  Inflammation of the gums during pregnancy is called “pregnancy gingivitis.” Flossing is especially important because it reduces the risk of gingivitis and periodontitis, a serious gum infection that can travel from your mouth to your body. Periodontal disease has been associated with preterm and low-birth-weight babies.

You may have heard the old wives’ tale about pregnancy,” Gain a child, lose a tooth.” The origin of this phrase is that pregnancy interferes with calcium absorption and increases hormones that affect oral health. Studies have indeed found a link between pregnancy and dental problems. It is important to have excellent oral hygiene during pregnancy and continue with routine dental exams and hygiene visits for teeth cleaning.

9) Prevention is the best strategy for keeping our teeth and bodies healthy!