Medications and Oral Health

Many medications both those prescribed by your doctor and the ones you buy on your own affect your oral health.

A common side effect of medications is dry mouth. Saliva helps keep food from collecting around your teeth and neutralizes the acids produced by plaque. Those acids can damage the hard surfaces of your teeth. Dry mouth increases your risk for tooth decay. Your soft oral tissues, gums, cheek lining, tongue can be affected by medications as well. For example, people with breathing problems often use inhalers. Inhaling medication through your mouth can cause a fungal infection called oral candidiasis. Sometimes called thrush, this infection appears as white spots in your mouth and can be painful. Rinsing your mouth after using your inhaler may prevent this infection.

Cancer treatments also can affect oral health. If possible, see your dentist before beginning treatment. He or she can ensure that your mouth is healthy and, if necessary, can prescribe treatments to help you maintain good oral health. Your dentist also is interested in the medications you are taking because many can affect your dental treatments. Your dentist may want to speak with your physician when planning your treatment. Rare but serious jaw problems also can occur in people who’ve received bone strengthening drugs to treat cancer and, to a lesser extent, osteoporosis.

These are only a few examples of how medications can affect your oral health. It is important that your dentist knows about the medications you are taking so that he or she can provide the best dental care for you. Tell your dentist about your medication use and your overall health, especially if you have had any recent illnesses or have any chronic conditions. Provide a health history including both prescription and over-the-counter products. Always let your dentist know when there are changes in your health or medication use.

Be sure to talk with your dentist about how to properly secure and dispose of any unused, unwanted or expired medications, especially if there are any children in the household. Also, take the time to talk with your children about the dangers of using prescription drugs for non-medical purposes.

How to Keep Your Fitness Goals on Track

Start with a workout plan that's a good fit for you, expert says

The New Year's resolutions many made to get fit have stalled by now. And one expert thinks that's because many people set their goals too high.

"The point isn't to become a marathoner in one exercise session or return to your high school athletic glory days all at once," Dr. Jamy Ard, co-director of the Weight Management Center at Wake Forest Baptist Medical Center, said in a center news release.

"The point is to get over the inertia that has taken root in your self-motivation world and remind yourself of why you value being active," he explained.

You'll improve your chances of success if you have a workout program that's a good fit for you, Ard said.

"Physical activity not only needs to be simple and structured enough to meet your lifestyle demands, but also enjoyable enough for you to look forward to it," he added.

Ard offered some advice about how to start and maintain an exercise regimen. It begins with finding something you enjoy, whether it's going to the gym, starting a walking program or joining a running group.

You need to start slowly and have a simple plan. That could be a short stroll around the block or a 10-minute walk at work. Your plan should be so easy to do that it will be almost impossible for you to find excuses not to do it.

Keep challenging yourself by adding a little more to your fitness routine on a regular basis. If you're more active today than yesterday, you're moving in the right direction, Ard said.

"Seeing positive change can be extremely reinforcing, no matter how small. And maybe that will be enough to get you springing back sooner rather than later," he said.

Diet Soft Drinks and Women's Hearts

Those who consumed the most had highest risk, but the study results are preliminary

Women who are heavy consumers of diet drinks might be more likely to experience heart attacks , dangerous blood clots and other cardiovascular problems than those who rarely or never consume artificially sweetened beverages, according to a large, new study.

The findings come from a study of nearly 60,000 healthy postmenopausal women in the United States. Participants were asked to estimate how many artificially sweetened drinks they'd had each day for the past three months. Diet soft drinks and low-calorie fruit drinks were counted toward the daily total.

Researchers divided the women, whose average age was 63, into four groups based on their overall consumption. The heaviest consumers had two or more diet drinks a day. The next group had five to seven artificially sweetened drinks a week. The third group had one to four drinks a week. The least frequent consumers said they never or only rarely indulged in diet drinks, reporting between zero and three in a month.

About nine years later, researchers checked to see how many women had experienced any of these heart-related problems: heart attacks; strokes; blood clots that threaten the legs, arms, organs or head; surgery to reopen clogged arteries ; heart failure ; or death from heart trouble.

Heavy consumers of diet drinks were about 30 percent more likely to have suffered heart trouble during the course of the study than women who rarely or never had artificially sweetened beverages. Nearly 9 percent of frequent consumers had a serious heart event compared to about 7 percent of women who rarely or never indulged.

"This is not the first study to show a relationship between diet soda intake and the risk of stroke and cardiovascular disease ," said Susie Swithers, a professor of psychological sciences at Purdue University who was not involved in the study.

"This shouldn't be a surprise to us anymore," said Swithers, who is studying the effects of artificial sweeteners in animals.

The findings are scheduled for presentation Sunday at the annual meeting of the American College of Cardiology, in Washington, D.C.

The study authors and beverage industry representatives point out that the study has some significant limitations. Because it only followed women over time, asking about habits and patterns that were already in place, it can't prove that diet drinks caused their heart problems.

"The women who had the greatest risk of cardiovascular effects consumed two or more diet beverages per day," the American Beverage Association said in a statement prepared in response to the study. "However, they also had higher incidence of smoking , diabetes , hypertension and overweight -- all known risk factors for heart disease. Thus, it is impossible to attribute their cardiovascular health issues to their diet beverage intake."

The researchers said they adjusted their numbers to try to account for those differences, as well as other relevant factors such as exercise and caloric intake .

Still, an expert said this one study isn't a reason to give up a favorite low-calorie drink.

"I don't think these findings in and of themselves are grounds for changing any habits right now," said study author Dr. Ankur Vyas, a cardiovascular disease fellow at the University of Iowa Hospitals and Clinics. "A lot more work needs to be done."

Still, Swithers said her studies have pointed to a couple ways diet drinks might lead to heart problems. She said animals that eat regular sugar after consuming a diet heavy in artificial sweeteners have a disrupted response to the real thing.

"[Like diabetics], they become hyperglycemic," she said. "Their blood sugars go up higher than they should."

They also make less of a heart-protective protein, she said.

"If drinking diet soda interferes with this system, then over the long term you're taking something away that protects your cardiovascular health, and that could be what's contributing to these effects," Swithers said.

Data for the study came from the U.S. government-funded Women's Health Initiative Observational Study.

Results presented at medical meetings are considered preliminary until they are scrutinized by outside experts for publication in a medical journal.

 

Dental Health and Overall Health

Healthy mouth, healthy body: The link between them may surprise you.

 

The condition of your mouth is closely tied to your overall health. Find out how oral health is linked to diabetes, heart disease, cancer, and more.

Taking care of your teeth isn't just about having a nice smile and pleasant breath. Recent research has found a number of links between oral health and overall health.  While in many cases, the nature of this link still isn't clear — researchers have yet to conclude whether the connections are causal or correlative — what is certain is that the condition of your mouth is closely tied to your overall physical health.

Oral Health and Diabetes

Doctors have known for years that type 2 diabetics have an increased incidence of periodontitis, or gum disease. In July 2008 the connection was further highlighted: Researchers at Columbia University's Mailman School of Public Health followed 9,296 nondiabetic participants, measuring their level of periodontic bacteria over the course of 20 years. "We found that people who had higher levels of periodontal disease had a twofold risk of developing type 2 diabetes over that time period compared to people with low levels or no gum disease," explains Ryan Demmer, PhD, associate researcher at the department of epidemiology at the Mailman School and the lead author. While more research is needed before doctors can conclude that gum disease actually leads to diabetes, there are already a few theories about why this might be the case: One proposes that when infections in your mouth get bad enough, they can lead to low-grade inflammation throughout your body, which in turn wreaks havoc on your sugar-processing abilities. "There are all kinds of inflammatory molecules," says Dr. Demmer, "and it's believed that maybe some attach to insulin receptors and prevent the body's cells from using the insulin to get glucose into the cell."

Oral Health and Heart Disease

As with diabetes, the connection between poor oral health and cardiovascular conditions has been recognized — the two are often found together — but it still hasn't been determined conclusively whether or not there is a direct causal relationship between them. (One reason is that there are a number of other potential risk factors — such as smoking and old age — that can lead both to gum disease and heart disease.) However, in a 2005 study funded by the NIH, 1,056 randomly selected participants with no prior heart attacks or strokes were evaluated for levels of periodontal bacteria: After removing the effects of the other risk factors of age, gender, and smoking, it was found that there was an independent relationship between gum disease and heart disease, says Moise Desvarieux, MD, PhD, associate professor of epidemiology at the Mailman School and lead author of the study. One theory about why this may occur, says Dr. Desvarieux, is that small amounts of bacteria enter your bloodstream while you're chewing. "Bad" bacteria from an infected mouth may lodge itself inside blood vessels, ultimately causing dangerous blockages. Strengthening his theory is the fact that when scientists have looked at atherosclerotic blood vessels, they have sometimes found fragments of periodontal bacteria. Meanwhile, a study published in the New England Journal of Medicine in 2007 established that aggressive treatment of gum disease reduces the incidence of atherosclerosis within six months.

Pregnancy Complications and Gum Disease

For many pregnant women, gum infections stem from the fluctuating hormone levels that come with pregnancy, says Marsha Rubin, DDS, practicing diplomat of special-care dentistry at New York-Presbyterian/Weill Cornell, who sees many pregnant patients in her practice. Others neglect their oral care during pregnancy, since they have much on their minds, she adds. But that's a mistake: Scientists believe that gum disease or inflammation in the mouth possibly triggers an increase in a chemical compound called prostaglandin, which induces early labor. While this theory has not yet been confirmed, a 2001 study found that pregnant women who develop gum disease between weeks 21 and 24 are four to seven times more likely to give birth before week 37. There is evidence that poor gum health in the extreme can lead to low birth weight as well. A number of studies — including a 2007 study of 3,567 Turkish women and a 2007 study of 1,305 Brazilian women — found a relationship between periodontal disease, preterm birth, and low birth weight.

Pneumonia and Gum Disease

There has been a link established between poor oral health and pneumonia, though much of the research focuses on high-risk populations. A 2008 study of elderly participants found that the number who developed pneumonia was 3.9 times higher in patients with periodontal infection than in those free from it. "The lungs are very close to the mouth," says Rubin. "Even in a healthy mouth there is lots of bacteria, but bacteria in a not-healthy mouth can get aspirated into the lungs, causing pneumonia or aggravating COPD, chronic obstructive pulmonary disorder." Several intervention studies cited by the CDC show that an improvement in oral health can lead to a reduction in respiratory infection.

Pancreatic Cancer and Gum Disease

A study published in 2007 in the Journal of the National Cancer Institute surveyed 51,529 American men about their health every two years between 1986 and 2002. Of the 216 participants who developed pancreatic cancer, 67 of them also had periodontal disease. Independent of the participants' smoking status, the study found that having a history of periodontal disease was associated with an increased risk of pancreatic cancer. This, according to the study, could be because of systemic inflammation or increased levels of carcinogenic compounds produced in the infected mouth. Interestingly, another viable theory about why gum disease may cause type 2 diabetes points to damage to the pancreas as well. "With the pancreatic cancer study, we thought it was very interesting that you have this localized infection that has an impact on a systemic organ that is very intimately tied to the pathophysiology of diabetes," says Dr. Desvarieux. Reasons for why this might be are as yet unknown.

Gardening, Housework May Help Boost Your Heart Health

Study of Swedish seniors found a reduced death risk of up to 30 percent 

 

Activities such as gardening, do-it-yourself projects and housework may be as good as formal exercise when it comes to reducing the risk for heart attack and stroke, Swedish researchers say.

For people 60 and older, just keeping busy with daily activities can reduce the risk of cardiovascular problems by nearly 30 percent and even prolong life, they added.

Being on your feet and active cuts the time spent sitting around, pointed out lead researcher Elin Ekblom-Bak, of the Swedish School of Sport and Health Sciences and the Karolinska Institute, in Stockholm.

"Sitting is mainly replacing time you spend in daily activity and vice versa," Ekblom-Bak said. A recent study found long periods of sitting actually increased the risk for diabetes, cardiovascular disease and death, she noted.

"The results of this study showed that activities of daily life are as important as regular intentional exercise for older adults for cardiovascular health and longevity," she said.

But that doesn't mean formal exercise isn't important. "We saw that those who exercised regularly and that also had a daily physically active life had the lowest risk of all," Ekblom-Bak explained.

The time people spend exercising, however, is only a small part of the day, which leaves a lot of time for daily activities or sitting, she added.

For the new study, researchers collected data on more than 3,800 men and women in Sweden who were born in 1937 and 1938. Participants were asked about their lifestyle, which included information on their diet, whether they smoked or drank alcohol, and how physically active they were.

The participants were also asked how often they took part in activities, such as gardening, do-it-yourself projects, car maintenance and blackberry picking over the past year. They were also asked about any exercise they did.

To see how heart-healthy they were, the researchers examined the participants and took blood samples to assess levels of fat and sugar. They also checked for high levels of blood-clotting factor, which is linked to a raised heart attack and stroke risk.

During more than 12 years of follow-up, 476 of the participants died from or experienced a first heart attack or stroke, and 383 died from other various causes.

People whose daily activities kept them moving reduced their risk of a heart attack or stroke by 27 percent and the risk of dying from any cause by 30 percent, compared to people who spent the least amount of time on their feet.

"Promoting daily life activities is as important as recommending regular exercise for older adults for cardiovascular health and longevity," Ekblom-Bak said.

"This is particularly important for older adults as they tend to spend a greater portion of their active day performing non-exercise physical activity, as they often find it difficult to achieve recommended exercise intensity levels," she said.

 

Traditional notions of retirement often don't support continued physical activity at this stage of life, a U.S. expert said.

"It is almost expected that as we age, we move less," said Samantha Heller, a senior clinical nutritionist and exercise physiologist at NYU Langone Medical Center, in New York City.

"Retirement, a patient told me, is for sitting around, resting and watching TV," she said. "Unfortunately, sedentary lifestyles now range across all ages with the same unhealthy results: increased risk for diseases such as cardiovascular disease, metabolic syndrome and certain cancers."

The human body is designed to be moving a good portion of the day, Heller said. "The less one physically moves, the less they are able to move," she said.

Regular physical activities such as house cleaning, gardening, lawn care and climbing stairs help keep the body mobile and strong, Heller said.

"You can burn up to six times as much energy per minute when house cleaning as you do when you are sitting still. People of all ages need to be encouraged to get up off the couch and turn off the computer and TV and move," she said.

Heller said there are simple ways to add more physical activity into the day, such as the following:

·         Standing up when talking on the phone.

·         Marching in place when watching TV -- at least during the commercials.

·         Getting up from your desk every hour and doing jumping jacks, knee lifts or knee bends for three to five minutes.

·         Climbing a flight of stairs every few hours.

·         Vacuuming the house.

·         Mopping the floor.

Another expert described the physical fallout of being sedentary.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said sitting for too long may have adverse effects including burning fewer calories, and increasing insulin resistance and fats in the blood.

"Greater time spent in non-exercise physical activities can potentially counter these effects," Fonarow said. "These findings further emphasize the importance of decreasing sedentary time and encouraging everyday regular non-exercise physical activity to improve cardiovascular health."

Healthy Aging: What Can You Control?

When it comes to aging, Bebe Shaw didn't hit the genetic lottery. Her mother died from congestive heart failure , her father of a heart condition. The younger of her two brothers had a heart attack at age 52, and her younger sister is on the verge of congestive heart failure . Shaw, 69, has high cholesterol -- a serious risk factor for heart disease .

With such a checkered health history, she's not taking any chances. "I am an advocate of exercise and diet ," says Shaw, who works as a paralegal in Ocala, Fla. "I play tennis 3 days a week, go to spinning and Zumba classes at the Y twice a week, and try to ride my bike on a nearby trail every day." She also eats well, takes a statin drug to control her cholesterol, and visits her doctor regularly for checkups and screenings.

Aging: Nature or Nurture?

Looking at your relatives' medical histories is like peering into a crystal ball. You get a glimpse at your future but not the whole picture. You can't change the genes you inherited, but you can avoid habits that contributed to your family's health problems.

"Some people can have a family history of heart disease, but it's actually a history of smoking , overeating, and [an inactive] lifestyle. And if you adopt that lifestyle, you're going to run into the same problems your parents did," says James Pacala, MD. He is the associate head of the Department of Family Medicine and Community Health at the University of Minnesota.

Lifestyle was a big factor in Shaw's family: Her father was overweight, and her younger brother, a smoker.

Take preventive action now to help make sure you're healthy into your 60s, 70s, 80s, and beyond. "You must remain active and engaged. By that, I mean physically and mentally active and socially engaged," says Pacala, who is also president of the American Geriatrics Society. He ticks off the necessities: aerobic and resistance exercises, a balanced diet that's low in saturated fat and high in fruits and vegetables, and brain games and social outings to keep you sharp.

You also want to try to avoid diseases. "Get your immunizations , your cancer screening tests, your cardiac and osteoporosis risk factors assessed before you have those problems," Pacala says.

Staying Forever Young

We've all seen 70- and 80-year-olds who look and act decades younger. How do they do it? Pacala shares a few secrets.

Refuse to take it slow. "There's a sort of societal expectation that you're supposed to slow down as you get old, and I think you should fight against that," Pacala says. "Don't let your grandkids get up and mow the lawn for you and get you a glass of water. Get up and do it yourself."

Take a daily walk. Even if your pace is gentle and the distance is short, the time spent on your feet will help keep your bones strong.

Read the newspaper with your morning bowl of oatmeal. Keeping your mind engaged could ward off the brain changes that lead to Alzheimer's and other forms of dementia , while the whole grains in your bowl help prevent heart disease.

Downsize your portions. Overeating leads to obesity and diabetes , which can shorten your lifespan. An overstuffed plate has also been linked to memory loss in people 70 and older.

 

Dental X-Rays, Teeth Cleanings = Safe During Pregnancy

Ob-Gyns Recommend Routine Oral Health Assessments at First Prenatal Visit

Teeth cleanings and dental X-rays are safe for pregnant women, according to new recommendations issued by The American College of Obstetricians and Gynecologists (The College). Ob-gyns are now being advised to perform routine oral health assessments at the first prenatal visit and encourage their patients to see a dentist during pregnancy.

“These new recommendations address the questions and concerns that many ob-gyns, dentists, and our patients have about whether it is safe to have dental work during pregnancy,” said Diana Cheng, MD, vice chair of The College’s Committee on Health Care for Underserved Women, which issued the guidelines. According to The College, oral health problems are associated with other diseases, including heart disease, diabetes, and respiratory infections. “We want ob-gyns to routinely counsel all of their patients, including pregnant women, about the importance of oral health to their overall health,” said Dr. Cheng.

More than a third (35%) of all women report they haven’t been to the dentist within the past year. Approximately 40% of pregnant women in the US have some form of periodontal disease, including gingivitis (inflammation of the gums), cavities (tooth decay), and periodontitis (inflammation of ligaments and bones that support the teeth). The physical changes caused by pregnancy can result in changes in the gums and teeth. Periodontal disease during pregnancy is most prevalent among black women, smokers, and women on public assistance.

 “We can all reassure our patients that routine teeth cleanings, dental X-rays, and local anesthesia are safe during pregnancy,” said Dr. Cheng. “Pregnancy is not a reason to delay root canals or filling cavities if they are needed because putting off treatment may lead to further complications.” One potential benefit of improving a woman’s oral health: It may decrease the transmission of cavity-causing bacteria from mother to baby. This can help lessen the future risk of cavities in children.

Ob-gyns are encouraged to reinforce practical advice for their patients: Limit sugary foods and drinks, brush teeth twice daily with a fluoridated toothpaste, floss once daily, and visit the dentist twice a year. Pregnant women with severe vomiting (hyperemesis) or gastric reflux can help avoid damage to their teeth from stomach acid by using an antacid or by rinsing with a teaspoon of baking soda in a cup of water after vomiting.