The Silent Signs of Gum Disease

Diabetes is a pervasive problem in America, a cultural epidemic with wide-ranging and potentially severe consequences. According to the 2011 National Diabetes Factsheet, 25.8 million people or 8.3 percent of the U.S. population has diabetes at an estimated annual total cost of about $245 billion. 1

November is National Diabetes Month and Delta Dental wants to remind people of the well-documented connection between diabetes and oral health. 2 People with diabetes tend to develop periodontal (gum) disease earlier in life, and more severely. Though it is often painless, Delta Dental cautions people suffering from diabetes to be mindful of its warning signs. These can include bad breath, bleeding gums after brushing or flossing, red, swollen or tender gums, or changes in the way your teeth fit when you bite. Unfortunately, many people ignore those periodontal red flags until it’s too late.3

Individuals often ignore the warning signs of periodontal disease because there is usually no pain involved. So they will brush a little better to get rid of the bleeding or use mouthwash to hide their bad breath. The best idea is to schedule regular visits to your dentist to make sure that you are not developing periodontal disease.

Maintaining regular dental visits is particularly critical for patients suffering from diabetes.Oral diseases such as tooth decay and gum disease are often reversible if they are diagnosed and treated early. Dentists can also check for other common mouth conditions that afflict people with diabetes such as dry mouth, ulcers and infections. Periodontal disease and other mouth conditions may also be a sign that other medical conditions exist elsewhere in the body. Depending on their findings, the dentist might advise patients to seek a medical consultation.

Even before visiting the dentist, patients can use an online risk assessment tool (such as Delta Dental’s myDentalScore) to answer a series of questions that can gauge their risk levels for gum disease, oral cancer and other serious oral health problems. Additional lifestyle best practices for people with diabetes include controlling blood sugar, brushing and flossing daily, and quitting smoking.

1 Centers for Disease Control and Prevention. National Diabetes Fact Sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

2 National Institute of Dental and Craniofacial Research. Diabetes and Oral Health. http://www.nidcr.nih.gov/OralHealth/Topics/Diabetes/default.htm

3American Diabetes Association. 2013  Diabetes Facts.   http://www.diabetes.org/diabetes-basics/diabetes-statistics/

Delta Dental Encourages Major League Baseball to Quit the Spit (Tobacco)

While smokeless tobacco has not been completely banished from baseball, Delta Dental applauds Major League Baseball (MLB) and the Major League Baseball Players Association (MLBPA) during Oral, Head and Neck Cancer Awareness Week for making a positive step toward completely eliminating tobacco’s visibility from impressionable young fans. Under a recent agreement, MLB players, managers and coaches will no longer be able to carry a smokeless tobacco tin or package in their uniforms during games or when fans are in stadiums. Additionally, they will be prohibited from “chewing” during televised interviews, at autograph signings and other fan events.

Smokeless tobacco has been banned from Minor League Baseball since 1993 and from collegiate athletics since 1994. The surge of support for an outright ban on smokeless tobacco has a website, and players like Boston Red Sox outfielder Adrian Gonzalez and Chicago White Sox pitcher John Danks have recorded public service announcements speaking out against smokeless tobacco. Joe Garagiola, an 84-year-old former tobacco chewing-MLB catcher and current broadcaster, is the chairman of NSTEP, the National Spit Tobacco Education Program. NSTEP is a 17-year-old program operated by Oral Health America that educates baseball players of all ages about the dangers of chewing or “spit” tobacco.

The American Cancer Society estimated that more than 39,000 people were diagnosed with oral cancer and nearly 8,000 people died of the disease in 2011, and that men are twice as likely as women to be diagnosed.Tobacco use is considered a major risk factor for the development of oral cancers. Whether they like it or not, athletes serve as role models for impressionable children and teens. The Centers for Disease Control and Prevention (CDC)’s 2009 Behavioral Risk Factor Surveillance Study found that more than 11 percent of male high school students and four percent of male middle school students were current smokeless tobacco users.2 Though smokeless tobacco has been banned in all venues by the NCAA and MILB, a significant number of young players get hooked on the habit earlier in life.

Delta Dental puts its support and resources behind this message. Delta Dental of Tennessee, for instance, leveraged their sponsorship with the Memphis Redbirds (Triple-A affiliate of the St. Louis Cardinals) to present Oral Cancer Awareness Night at AutoZone Park. The event included oral cancer screenings performed by teachers from the University of Tennessee Health Science Center’s College of Dentistry.

Delta Dental wants the professional baseball community to be aware of the inherent risks and dangers of smokeless tobacco use, and the influence that the actions of professional baseball players have on their youthful fans. We ask that – for their own health and that of their young fans – players pause next time before throwing in a dip. We applaud the progress that MLB has made in limiting tobacco use in the sport but would support a complete ban on smokeless tobacco during games when so many young fans are watching attentively.

Below is a video in which Dr. Kohn explores the relationship between smokeless tobacco use and oral cancer.

1 American Cancer Society. Oral Cancer Fact Sheet. Accessed February 2012. http://www.cancer.org/acs/groups/content/@nho/documents/document/oralcancerpdf.pdf

2 Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students—United States, 2000–2009. Morbidity and Mortality Weekly Report 2010;59(33):1063–8

Resolve to Kick Butts in 2012

Of the nearly 8,000 deaths in the United States attributed to oral and pharyngeal cancer annually,1 about 75 percent are due to tobacco and heavy alcohol use.2   Resolving to quit smoking may be one of the most difficult challenges to undertake in 2012, but it also comes with some of the best life- and mouth-saving benefits.

A lifestyle factor that the Surgeon General calls “the single greatest avoidable cause of death,”3 smoking also drastically affects periodontal (gum) health.4-5 According to the Centers for Disease Control and Prevention (CDC), half of the cases of severe gum disease in U.S adults can be attributed to cigarette smoking and the prevalence of gum disease is three times higher among smokers than nonsmokers.6

Smoking is the leading cause of oral and pharyngeal cancer and using tobacco in any form – including dipping snuff 7 or chewing – increases the risk of developing an oral cancer.8 Even if you’ve smoked for decades, you can reap nearly immediate benefits by quitting.9-11 Within 20 minutes, your heart rate drops, and within 12 hours, the carbon monoxide level in your blood returns to normal. Within one year, your added risk for coronary heart disease will fall to half that of a smoker’s, and within 15 years, your risk is that of a nonsmoker’s.10 Quitting reduces many of the cosmetic effects of smoking and can even improve sensitivity to smell and taste.

There are many reasons why smoking is a health risk, but here are the top five ways that kicking butts can immediately improve your oral health:

  1. It significantly reduces your risk of developing oral and pharyngeal cancer
  2. It reduces your risk of developing periodontal disease
  3. It improves the color of your teeth
  4. It can help eliminate halitosis (bad breath)
  5. It can help reduce dental decay12

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1 National Cancer Institute, National Institutes of Health – Oral Cancer http://www.cancer.gov/cancertopics/types/oral

2 Blot WJ, McLaughlin JK, Winn DM, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Research 1988; 48(11):3282–3287

3 U.S. Dept. of Health and Human Services. The health conse­quences of smoking: A report of the Surgeon General. U.S. Dept. of Health and Human Services, CDC, National Center of Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004. Available at: “http://www.surgeongeneral.gov/library/smokingconsequences/”. Accessed June 29, 2010.

4 Tomar SL, Asma S. Smoking-attributable periodontitis in the United States: findings from NHANES III. National Health and Nutrition Examination Survey. . J Periodontol. 2000 May;71(5):743-51

5 “Longitudinal Study of the Association Between Smoking as a Periodontitis Risk and Salivary Biomarkers Related to Periodontitis.” M. Kibayashi. Journal of Periodontology. 2007, vol. 78, no. 5, pages 859–867.

6 Preventing Cavities, Gum Disease, Tooth Loss, and Oral Cancer – 2011 At A Glance. http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm. Accessed 2012.

7 Oral Cancer.” National Institutes of Health. July 2007. http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=106&key=O#O

8 “Oral Health Topics A-Z: Smoking (Tobacco) Cessation.” American Dental Association. http://www.ada.org/public/topics/smoking_tobacco_faq.asp. Accessed 2009.

9 “Quitting Smoking: Why to Quit and How to Get Help.” National Cancer Institute, August 17, 2007. www.cancer.gov/cancertopics/factsheet/Tobacco/cessation Accessed 2010.

10 “Guide to Quitting Smoking.” American Cancer Society, August 7, 2008. www.cancer.org/docroot/PED/content/PED_10_13X_Guide_for_Quitting_Smoking.asp Accessed 2008.

11 “Women and Smoking: Questions and Answers. ” National Cancer Institute, February 27, 2008. www.cancer.gov/cancertopics/factsheet/Tobacco/women Accessed 2010.

12  Rooban T, Vidya K, Joshua E, et.al. Tooth decay in alcohol and tobacco abusers. J Oral Maxillofac Pathol. 2011 Jan;15(1):14-21.