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The Health Of Your Gums Affects The Health Of Your Entire Body!
WE TREAT GUM DISEASE WITH PERIOLASEtm
LANAP ( Laser Assisted New Attachment Procedure)
"AVOIDING SURGERY WITH UNIVERISTY BACKED RESULTS"
Click here for ABC News video on LANAP
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Through being trained by Millennium Dental Technologies Inc. at Tischler Dental are able to provide LANAP ( Laser Assisted New Attachment Procedure) an FDA approved alternative to periodontal surgery for treating moderate to advanced gum disease. This special certification program allows us to bring to our patients one of the most important advances in dentistry. Only a few dentists in the United States are certified to deliver laser care with the Periolase technique.Maurice Tischler, DDS and Fred Milton DMD are licensed through Millennium Dental Technologies to do the FDA approved Periolase technique.
This Periolase process is only performed by select dentists in US. Through utilizing the Millennium Dental Laser in conjunction with their FDA approved certified process, we can treat gum disease that previously required surgery.
Before and After
Before and after from left to right. Note bone growth from Periolase
FDA clearance for Laser-ENAP® using the PerioLase® MVP-7™ variable pulsed Nd:YAG dental laser follows three years of research at Louisiana State University, School of Dentistry, New Orleans, by principal investigator, Professor Raymond A. Yukna, DMD, MS, and coordinator of post-graduate periodontics at LSU. Professor Yukna led a controlled, blinded, clinical and human histology study that evidenced new root surface coating (cementum) and new connective tissue (periodontal ligament) formation (collagen) on on tooth roots by stimulating existing stem cells to grow following the use of the PerioLase® MVP-7™ & Laser-ENAP® protocol.
Read this articles that show the research on this:
Human Periodontal Regeneration Following A Laser Assisted New Attachment (LNAP) Procedure.
See Diagram of ENAP Periolase process:
The Health Of Your Gums Affects The Health Of Your Entire Body!
Michael Tischler, DDS
Click Here to See PDF Presentation about How Gum Disease Affects Your Heart
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Our office philosophy is based on you having healthy gums. All dental work requires healthy gums as a base and the importance to your over all health is well documented. Proper care and maintenance of your gums is one of the most important things you can do to protect your dental health and over-all health. As a matter of fact, when you initially come to our office this is the area we first evaluate and then discuss with you. Should gum treatment therapy be advisable, we are equipped to offer you all levels of gum care. Our practice philosophy is based on prevention. Through yearly x-rays and twice yearly cleanings and examinations, we can help avoid advanced progression of dental disease. Disease of your mouth affects the entire body, and has been linked in the medical literature to disease of the heart, liver, and other organs. Periodontal bacteria can enter the blood stream and travel to major organs and begin new infections. A protein called C-Reactive Protein is produced when inflammation such as gum disease occurs. C-reactive protein is related to heart disease and other diseases. At Tischler Dental we have a protocol that reduces gum inflammation and therefore C-reactive protein levels. See presentation above for more info. Research is suggesting that this may be attributed to :
The periodontium, comprised of the gingiva, bone, and other supporting tissues that anchor the teeth, plays a key role in the interplay between oral health and systemic disease. Infection in these tissues, primarily by gram-negative anaerobic bacteria, can initiate a series of inflammatory and immunologic changes leading to the destruction of connective tissue and bone. Long considered a localized infection, periodontal diseases are now linked to a variety of conditions with systemic implications.
Treatment Of Gum Disease at Tischler Dental
The first state of gum disease – gingivitis – can be helped through cleanings with the hygienist and proper home care. If your situation is more advanced, then we use a dental laser, localized antibiotic treatment, and deep curretage with anesthesia to bring your gums back to good health.
We treat the most advanced stages of gum disease non surgically witht the Periolase as indicated above. In certain instances Gum surgery is needed and performed in office by Michael Tischler, DDS
Early Gum Disease
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Moderate Gum Disease
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Advanced Gum Disease
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What is gum disease?
Gum disease or periodontal disease, a chronic inflammation and infection of the gums and surrounding tissue, is the major cause of about 70 percent of adult tooth loss, affecting three out of four persons at some point in their life.
What causes gum disease?
Bacterial plaque -- a sticky, colorless film that constantly forms on the teeth -- is recognized as the primary cause of gum disease. Specific periodontal diseases may be associated with specific bacterial types. If plaque isn't removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar). Toxins (poisons) produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets which fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper and the bacteria moves down until the bone that holds the tooth in place is destroyed. The tooth eventually will fall out or require extraction.
Are there other factors?
Yes. Genetics is also a factor, as are lifestyle choices. A diet low in nutrients can diminish the body's ability to fight infection. Smokers and spit tobacco users have more irritation to gum tissues than those who don't, while stress can also affect the ability to ward off disease. Diseases that interfere with the body's immune system, such as leukemia and AIDS, may worsen the condition of the gums. In patients with uncontrolled diabetes, where the body is more prone to infection, gum disease is more severe or harder to control.
What are the warning signs of gum disease?
Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, pus between the gum and tooth, persistent bad breath, change in the way teeth fit together when the patient bites, and a change in the fit of partial dentures. While patients are advised to check for the warning signs, there might not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That's why patients are advised to get frequent dental exams.
What does periodontal treatment involve?
In the early stages, most treatment involves scaling and root planing--removing plaque and calculus around the tooth and smoothing the root surfaces. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums, and removing the hardened plaque build-up and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.
How do you prevent gum disease?
Removing plaque through daily brushing, flossing and professional cleaning is the best way to minimize your risk. Your dentist can design a personalized program of home oral care to meet your needs. If a dentist doesn't do a periodontal exam during a regular visit, the patient should request it. Children should also be examined.
Is maintenance important?
Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of therapy. Patients should visit the dentist every 3-4 months (or more, depending on the patient) for spot scaling and root planing and an overall exam. In between visits, they should brush at least twice a day, floss daily, and brush their tongue. Manual soft nylon bristle brushes are the most dependable and least expensive. Electric brushes are also a good option, but don't reach any further into the pocket than manual brushes. Proxy brushes (small, narrow brushes) are the best way to clean in between the recesses in the teeth, and should be used once a day. Wooden tooth picks and rubber tips should only be used if recommended by your dentist.
Heart Disease and Stroke
A number of studies have shown that people with periodontitis are more likely to develop cardiovascular disease than individuals without periodontal infection. One such study suggests that the risk of fatal heart disease doubles for persons with severe periodontal disease.
Part of the link between these two diseases may be discovered through novel investigations of the opportunistic, infectious bacteria that colonize the mouth. Scientists theorize that certain types of these bacteria, which form biofilms and cause periodontal disease, also activate white blood cells in the body to release pro-inflammatory mediators that may contribute to heart disease and stroke.
To explore the underlying inflammatory responses common to both diseases, NIDCR grantees are examining periodontal disease measures (pocket depth where gingival tissues have pulled away from tooth surfaces and where there is loss of tissue) and biological responses in 14,000 people enrolled in an extensive study of heart disease sponsored by the National Heart, Lung and Blood Institute. Scientists will also analyze gingival crevicular fluid constituents that may contain pro-inflammatory mediators associated with heart disease, as well as blood samples to identify antibodies to periodontal pathogens.
The research team will compare these measures with clinical indicators of heart disease, ultrasound measures of carotid vessel thickening, and the occurrence of heart attacks, stroke, and death to determine if there is a correlation. Should the link between oral disease and heart disease be firmly established, future studies will focus on identifying the specific biological factors involved and transferring this knowledge to prevent disease.
Osteoporosis
Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest that osteoporosis may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation. However, hormone replacement therapy may offer some protection.
A study published in the August 1999 Journal of Periodontology concludes that estrogen supplementation in women within five years of menopause slows the progression of periodontal disease. Researchers have suspected that estrogen deficiency and osteopenia/osteoporosis speed the progression of oral bone loss following menopause, which could lead to tooth loss. The study concluded that estrogen supplementation may lower gingival inflammation and the rate of attachment loss (destruction of the fibers and bone that support the teeth) in women with signs of osteoporosis, thus helping to protect the teeth.
Diabetes Mellitus
The destructive inflammatory processes that define periodontal disease are closely intertwined with diabetes. Persons with noninsulin-dependent diabetes mellitus (NIDDM) are three times more likely to develop periodontal disease than nondiabetic individuals. Add smoking to the mix, and the chances of developing periodontitis with loss of tooth-supporting bone are 20 times higher. An increased risk for destructive periodontal disease also holds for persons with insulin-dependent diabetes mellitus (IDDM).
Much of what is known about the periodontal complications of diabetes has been learned from the Pima Indians of Arizona, who have the highest reported rates of NIDDM in the world. NIDCR-supported research in the Pima community has shown that periodontal infection is more prevalent, more severe, and develops at an earlier age in this population than in nondiabetic persons. As diabetes increases in severity, the rate at which vital tooth-anchoring bone is lost accelerates. Pima Indians with NIDDM are 15 times more likely to be edentulous than those without diabetes.
Now there is evidence that a history of chronic periodontal disease can disrupt diabetic control, suggesting that periodontal infections may have systemic repercussions. The exact nature of this complex relationship is not clear. It is likely, however, that increased genetic susceptibility to infection, impaired host response, and the excessive production of collagenase found in periodontal disease may all play important roles in NIDDM. Similarities in the etiology of periodontal and other complications of diabetes have also emerged.
Studies have shown, for example, that hyperglycemia is the common basis for diabetic complications in the eyes, kidneys and nerves. Glucose in high concentrations attaches to other molecules, stimulating chemical reactions that produce advanced glycosylation end products. These large molecules accumulate in tissues, causing damage and disrupting normal function. Scientists suspect that these cellular reactions figure as well in the tissue destruction seen in periodontal disease.
Investigators are also examining the interplay between periodontal infection and metabolic control. Acute viral and bacterial infections are known to induce insulin resistance, which disrupts blood glucose control. Factors including stress, fever, catabolism, and elevated levels of hormones antagonistic to insulin such as growth hormone, cortisol, and glucagon likely play a role in the development of insulin resistance during infection.
It is possible, then, that chronic gram-negative infections with persistent production of bacterial toxins, like periodontal disease, could have the same deleterious effect. If so, would elimination or control of periodontal infection improve metabolic control of diabetes?
To explore this hypothesis, researchers designed a treatment protocol specifically to manage diabetes-associated periodontitis in a group of Pima Indians with poorly controlled NIDDM. They found that debridement (deep cleaning to remove hardened plaque below the surface of the gingiva), combined with an antimicrobial solution and a 2-week regimen of the antibiotic doxycycline -- chosen for its anticollagenase activity -- resulted in significant short-term improvement in the concentration of hemoglobin A1c, a measure of average blood glucose levels over 3 months.
A control group receiving only debridement did not share the gains in periodontal health, improved hemoglobin A1c levels, and reduced hyperglycemia that the treatment group experienced.
These findings offer evidence that chronic infections such as periodontal disease worsen glycemic control and that eliminating these infections could enhance metabolic control in persons with diabetes. Additional large-scale studies are needed to further evaluate the effects of treating periodontitis on blood glucose levels. Future research should also examine, in other populations, the relationship between severe periodontal disease and poor glycemic control that has been evidenced in the Pima Indian community.
While work proceeds on the oral complications of diabetes, other studies are exploring the molecular pathogenesis of the disease. NIDCR researchers have identified an important marker protein, IA-2ß, for insulin-dependent diabetes mellitus, an autoimmune disorder which affects close to one million people in the United States alone.
Destructive autoantibodies, which attack the body's own insulin-producing beta cells, are the basis of the existing, labor intensive diagnostic test for IDDM. However, the recent identification of target proteins in the pancreas, such as IA-2ß, that react with these autoantibodies makes it possible to develop a rapid and effective test to screen large populations for IDDM.
IA2ß, when used in combination with two other known marker proteins, IA-2 and GAD 65 , recognized autoantibodies in 90 percent of persons with IDDM. The presence of autoantibodies to the marker proteins in otherwise normal individuals was also highly predictive in identifying those at risk of developing the disease. In addition, these proteins are candidates for immune tolerance studies, which attempt to prevent the development of destructive autoantibodies and subsequent IDDM.
The investigators are hopeful that their demonstration of the proteins as major targets of the autoimmune attack will aid in uncovering the actual cause of the disease process.
Preterm Low Birth Weight Babies
Emerging evidence may link severe periodontal disease in pregnant women to a sevenfold increase in the risk of delivering preterm low birth weight babies. NIDCR-supported researchers estimate that as many as 18 percent of the 250,000 premature low-weight infants born in the United States each year may be attributed to infectious oral disease.
The emotional, social, and economic costs associated with these small babies are staggering. Hospital costs alone surpass $5 billion annually. When costs to society in terms of suffering and managing long-term disabilities often associated with prematurity are considered, this figure escalates dramatically.
In a recent study, mothers of preterm low-weight newborns were found to have significantly more severe periodontal disease than did mothers of full-term, normal weight babies. Investigators believe that the molecular pathogenesis may be similar to that characterized for other maternal, bacterial, opportunistic infections, such as genitourinary infections, that are associated with low-weight preterm births.
Scientists theorize that oral pathogens release toxins that reach the human placenta via the mother's blood circulation and interfere with fetal growth and development, which has been shown to occur in animal studies. The oral infection also prompts accelerated production of inflammatory mediators PGE 2 and TNF 
that normally build to a threshold level throughout pregnancy, then cue the onset of labor. Instead, the elevated levels of these inflammatory mediators trigger premature delivery.
Taking into account all the known risk factors for premature birth, the researchers could identify no other reason for the relationship they had found between severe periodontal disease and preterm low-weight births. Additional research is needed to confirm this intriguing finding and to determine if treating and preventing periodontal disease would reduce the incidence of these high risk births.
Respiratory Disease
Bacterial respiratory infections are thought to be acquired through aspiration (inhaling) of fine droplets from the mouth and throat into the lungs. These droplets contain germs that can breed and multiply within the lungs to cause damage. Recent research suggests that bacteria found in the throat, as well as bacteria found in the mouth, can be drawn into the lower respiratory tract. This can cause infections or worsen existing lung conditions. People with respiratory diseases, such as chronic obstructive pulmonary disease, typically suffer from reduced protective systems, making it difficult to eliminate bacteria from the lungs.
Scientists have found that bacteria that grow in the oral cavity can be aspirated into the lung to cause respiratory diseases such as pneumonia, especially in people with periodontal disease. This discovery leads researchers to believe that these respiratory bacteria can travel from the oral cavity into the lungs to cause infection.
Chronic obstructive pulmonary diseases (COPD) cause persistent obstruction of the airways. The main cause of this disease is thought to be long-term smoking. Chemicals from smoke or air pollution irritate the airways to cause obstruction. Further damage to the tissue and working function of the lungs can be prevented, but already damaged tissue cannot be restored - untreated or undetected COPD can result in irreversible damage. Scientists believe that through the aspiration process, bacteria cam cause frequent bouts of infection in patients with COPD. Studies are now in progress to learn to what extent oral hygiene and periodontal disease may be associated with more frequents bouts of respiratory disease in COPD patients.
Sources:
The American Academy of Periodontology;
Atrix Laboratories, Inc.;
"Non-surgical Periodontal Therapy: Essential and Adjunctive Methods," by P.R. Greene, BDS, FDSRCPS, the British Dental Journal, 1995;
"Four Steps to Soft Tissue Management," by S.N., Bhaskar, DDS, Dentistry Today, October, 1995
Academy of General dentistry www.agd.org
