Some Dental Things To Be Thankful For!

November 13, 2013


As Thanksgiving approaches, many of us are happy to be thankful for so many things, but how many people are thinking “dental” when making their list?

Well – worry no more. Your friends at Dr. Malenius’ office are ready to help you with some important dental things to be thankful for!

Your Smile!

Numerous surveys have shown that someone’s smile is the first thing others notice, and members of the opposite sex often rank it as the most important physical characteristic. A smile doesn’t have to be movie star perfect, just sincere and uniquely yours. So smile!

Your Health!

Several recent studies have shown that dental disease is related to heart disease, stroke, and many other illnesses. If you’re healthy, don’t forget to thank your teeth and gums!

Your Breath!

Having pleasant breath is certainly an asset socially and professionally, and excellent dental health is one of the biggest factors in having a clean smelling mouth. So let’s be thankful for fresh breath. And if your breath is a bit stinky, be thankful for a close friend or relative who will let you know!

Your teeth!

Without your teeth you couldn’t bite and chew delicious food, speak clearly, smile broadly, or nibble on your best friend. And people with healthy teeth live longer!

Your Tongue!

Sure – when you were a kid it was fun to stick your tongue out at people. But even if you no longer do that, that very strong muscle on the floor of your mouth helps to chew food and taste those delicious (and hopefully healthy!) things that you are eating.

Your Dental Team!

At the office of Dr. Malenius , we are proud of our team! Our dentist, dental hygienists, dental assistants, and dental business team members are highly trained professionals who are here to serve you! We take your comfort and health very seriously and constantly undergo rigorous training to make your dental experience the best it can be!

If you have any questions, need to make an appointment, or would like to refer a friend or family member to our practice, please call 1-630-668-6180 right away!

We are thankful for all of our great patients and are here for you!

Please, Don’t Pass This On!

October 23, 2013

“She has her father’s gorgeous eyes!”

“He sings beautifully, just like his mother.”

“He’s so smart – must have gotten that from his Dad!” “Just like her Mom – a natural athlete!”

We love to brag about our children, and it gives us extra pleasure when we think they inherited their positive traits from us! But how about when they get something from us that might not be so good?

According to a recent study performed at Rey Juan Carolos University of Madrid, fear of the dentist may be associated with a similar fear in their parents – especially the father!

“Children seem to mainly pay attention to the emotional reactions of the fathers when deciding if situations at the dentist are potentially stressful,” said study co-author Professor America Lara-Sacido. They went on to discuss that dental fear by either parent can set up their children for a lifetime of difficulty at the dentist.

At Malenius dental, it is our goal to take dental fear out of the equation and make your dental visit as easy as possible. Our modern techniques and caring approach will provide you with the most pleasant dental experience imaginable. And if you have any worries at all, please feel free to discuss them with us.

Here are some tips from The American Dental Association on making your young child’s dental visit as easy as possible:

ü Consider making a morning appointment when children tend to be rested and’ cooperative.

ü Keep any anxiety or concerns you have to yourself. Children can pick up on your

Emotions, so emphasize the positive.

ü Never bribe your child.

ü Never use a dental visit as a punishment or threat.

ü Talk with your child about visiting the dentist.

And remember – if your child is anxious about a dental visit, it may be because of you!! Please come in and discuss any dental issues you may be having, and we will show you how modern dentistry is more comfortable than ever – and maybe even fun!

To make an appointment for any member of the family or to discuss your dental needs, please call us today at 630-668-6180. At Malenius Dental, your comfort is our primary concern!

Here’s Something To Be Thankful For!!

October 16, 2013

According to a recent study done by The American Dental Association, the feature that others find most attractive is not our hair, eyes, or body – it’s our smile!!

So don’t worry about trying to compete with the latest supermodel or those impossible-to-beat images we see on every billboard and magazine ad. Just flash your pearly whites and smile!!

But there’s more to it than that. Anti-aging expert Dr. Mark Stibich has come up with some fantastic reasons to smile. Here are just a few of them.

• Smiling Changes Our Mood

Next time you are feeling down, try putting on a smile. Smiling can trick the body into helping you change your mood for the better.

• Smiling Is Contagious

When someone is smiling they lighten up the room and make things happier. Smile lots and you will draw people to you.

• Smiling Relieves Stress

Stress can really show up in our faces. Smiling helps to prevent us from looking tired, worn down, and overwhelmed. When you are stressed, take time to put on a smile. The stress should be reduced and you’ll be better able to take action.

Smiling Boosts Your Immune System

Smiling helps the immune system to work better. When you smile, immune function improves, possibly because you are more relaxed. Prevent the flu and colds by smiling.

•Smiling Releases Endorphins, Natural Pain Killers and Serotonin

Studies have shown that smiling releases endorphins, natural pain killers, and serotonin, making us feel great. Smiling is a natural drug.

Smiling Lifts the Face and Makes You Look Younger

The muscles we use to smile lift the face, making a person appear younger. Don’t go for a facelift, just try smiling your way through the day — you’ll look younger and feel better.

There is no doubt about it – smiling is something we should be extremely thankful for. Malenius Dental , it is our mission to give our patients something to smile about!

If you’re not happy with your smile, call us right away at 630-668-6180. We would love to help!!

Eight Benefits of Tooth Brushing – That Have Nothing To Do With Your Teeth!!

October 16, 2013


We are all aware that brushing your teeth on a regular basis prevents cavities and keeps you smiling. But there are many other surprising benefits, including these eight that don’t have to do with your teeth!

  1. According to a study published in The Journal of the American Geriatrics Society, participants who did not brush on a regular basis had a 65 percent greater chance of developing dementia compared to those who did brush. So don’t forget to brush!!
  2. A study in The American Journal of Medicine found that regular brushing decreases the chance of stroke! Wow – two very serious diseases can be curtailed with good oral hygiene. And the list goes on…..
  3. As any dentist, hygienist or physician can tell you, regular brushing (and flossing) helps to prevent gum disease. But you may not know that along with causing stinky breath and unattractive smiles, gum disease is a major indicator of heart disease and the number one cause of tooth loss in adults.
  4. A study published in the Journal of Periodontology has shown that increased brushing decreases the risk of respiratory diseases such as pneumonia and COPD. Why? Bacteria which form on the teeth make their way into the lungs and respiratory tract, wreaking havoc along the way.
  5. Dental researcher Dr. Caitia Gazola has shown that having healthy teeth and gums increases the chances of having healthy babies, while dental disease can cause underweight pre-term babies. And men – you aren’t off the hook! We strongly suspect that not brushing your teeth regularly can exclude you from the whole pregnancy process!
  6. Prevention magazine has reported that regular brushing can help you maintain a healthy weight! Why? Brushing your teeth indicates to your brain that mealtime is over. Plus – food just doesn’t taste as good with squeaky clean teeth!
  7. Okay guys – here’s your turn. Several studies have shown that men with poor oral hygiene are at greater risk for erectile dysfunction. Scared yet???
  8. Have a heart – a healthy one that is! The American Journal of Medicine has linked dental health

    with heart attack risk.

So if clean teeth, fresh breath, a beautiful smile and fewer cavities aren’t enough, here are eight reasons why brushing your teeth on a regular basis can save your life! Plus let’s face it – going around with a big piece of tomato stuck between your chompers is not the most attractive look in the world!

Just as important as brushing your teeth is doing it correctly. And if you are not getting regular dental cleanings, your efforts aren’t nearly as effective.

At Dr. Malenius’ office, we care about your dental health and your medical health too!! If you have any questions or need to make an appointment, please call us right away at 1-630-668-6180. We are

here to help you!!

Who Gave The Tooth Fairy A Raise?

October 8, 2013

If you are of a “certain age,” you may remember gently placing your lost baby tooth under the pillow and hoping the tooth fairy (or one of their agents) would come by in the middle of the night and replace it with a dollar. Well it seems those days are gone!

According to a survey by Visa, the national average is now $3.70
per tooth, up 42 percent in the last two years!

“Tooth Fairy inflation clearly is surging,” says Jason Alderman, Visa’s director of global education. Alderman goes on to say this rise in rates is due to several things and names an improving economy and parental guilt as the two main drivers. “It’s hard for us to say ‘no’ to our kids,” he adds.

Neale Godfrey, chair of The Children’s Financial Network, agrees on the guilt aspect. They have seen that about 6 percent of tooth fairies (or their parental representatives) are leaving more than twenty dollars and two percent are tipping the scales with a whopping fifty bucks per tooth!!

So while we can’t counsel you on how much to suggest that your local tooth fairy slips under the pillow, when it comes to all things concerning children and their teeth, at Dr.Robert Malenius and Associates we are here for you!

To discuss any problems or questions, or to schedule an appointment for you or your children, please call us today at 630-668-6180. And remember – having regular dental examinations saves you money – so you can be prepared for whatever the tooth fairy requires!!

Tooth Brushing Basics

September 26, 2013

Do You Know The Basics?

Recently the American Dental Association did a survey to see if typical Americans knew some basic facts about dental health. Here are some of the questions – play along and see how you do!

• What type of bristles should you have on your toothbrush – soft, medium or hard?

Most people chose either medium or hard, but the fact is soft bristles are best! Medium or hard can actually damage your sensitive gum tissue and wear your teeth!

• Sugar causes cavities – true or false?

Practically everyone answered “true” to this one, but the answer is actually “false!” But you may feel it’s a trick question. Cavities are caused by bacteria, but the problem causing organisms feed on sugar that is stuck to your teeth! We recommend limiting sweets and soft drinks, especially the sticky kind!

• Does The American Dental Association recommend brushing your teeth for sixty seconds after every meal, or for two minutes twice per day?

Again, most people got this one wrong! The ADA suggests twice per day for two minutes. Of course, if you want to throw in a few extra brushing sessions each day we won’t object – especially before you come to visit us!

• True or false – it is normal for your gums to bleed while brushing and flossing.

Okay – this one is a little scary. 35% of respondents answered “true” – but the answer is definitely false! Think about it – what would you do if your nose bled every time you sneezed, or your arm bled when you scratched it? Well, the same goes for your gums! Bleeding is a sign of gum disease and infection, and is certainly not normal or healthy!

So how did you do? Hopefully this little quiz was fun, and maybe you even learned something!

At Malenius Dental, we are here to answer any questions you may have, no matter how basic! Give us a call at 630-668-6180
and we will be glad to help you – or to set up an appointment for a dental examination, cleaning, to look at any dental problem you may be having, or even to brighten up your smile. Whatever it is – we can help!

Do You Brush Your Teeth Correctly? Probably Not!

December 6, 2012

Almost everybody brushes their teeth, but only one in ten people are doing it effectively!

To that, we have to say a great big “YUCK!!” Imagine if only ten percent of the population showered correctly. That would be pretty gross. But according to researchers at The University of Gothenburg, ninety percent of the population does not brush their teeth in the right way!

Don’t worry!! Your friends at Dr. Malenius and Associates are here to help you. So sit back and open wide as we present….

The Top Eight Toothbrushing Tips!

  1. Size Matters!

Many people use a large toothbrush head thinking the bigger the better.” But you can brush just as effectively if not more so with a smaller brush, especially if you have to strain your mouth to use a larger one.

According to dental consumer advisor Dr. Richard Price, the more comfortable it is in your mouth and your hand, then the more likely you will use it and use it properly.”

  1. It’s Good To Be A Softy!

It would seem to make sense that firmer bristles would clean your teeth better, but many times they just wind up damaging your sensitive gum tissue. The American Dental Association recommends a soft-bristled brush and we agree!

  1. Don’t Do A Rush Job!

While most people spend fifteen seconds or so per round of brushing, a full two minutes is best. And to make sure you don’t play favorites, divide your mouth into four sections (upper right, lower right, etc..) and spend thirty seconds on each.

Some electric toothbrushes actually have timers, but you don’t need to be so fancy. Find a thirty second song and sing it to yourself for each mouth quarter. Or multitask by watching TV until the full two minutes is up.

  1. What’s Your Angle?

While we typically picture toothbrushing to be a horizontal affair, that leaves out many important tooth surfaces, including the crucial area where the tooth meets the gum line. Aim your bristles at a forty-five degree angle and make sure they gently dip below

the outer surface of your gums. This can get very tricky, and we recommend that you have one of the fantastic members of our dental hygiene team give you a full demonstration!

  1. It’s An Inside Job!

The inner surfaces of the teeth are often overlooked, but just because they hide from daylight doesn’t mean you should neglect them! Take the time to brush all tooth surfaces, inside and out. Oh – don’t forget your tongue either!

  1. Rinse-a-rama!

After you brush, loose bacteria are floating around in your mouth having a big old party. It’s time to finish them up with a rinse of mouthwash or even water. They’re on your toothbrush too, so it’s always a good idea to run that under the faucet for a few seconds when you finish!

  1. Forced Retirement

Many people get nostalgic over their old toothbrushes, but keeping them for too long is a big mistake!! Frayed bristles can’t clean correctly, and even worse – they harbor all kinds of nasty germs. The American Dental Association suggests changing your toothbrush every three to four months – but we think that may even be too long of an interval for many. When in doubt – toss it out!

  1. And There’s One More Thing

Even though we are discussing toothbrushing, it just wouldn’t be complete without mentioning those tooth surfaces between your teeth – the ones that can’t be reached with a brush. Yes, that’s right – we all need to floss!! Daily flossing prevents cavities and helps to keep your gums in good shape.

At Malenius Dental and Associates, we want you to have strong healthy teeth and gums, fresh breath and a beautiful smile!! Please call us now at 630-668-6180 to schedule an appointment, ask any questions about keeping your teeth and gums nice and clean, or even to schedule a complimentary Imagebrushing and flossing lesson! We are here for you!

Don’t Believe Everything You Hear!

May 23, 2012

 Here’s an interesting quiz for you.

Who Originally dispensed the famous recommendation to “see your dentist twice a year?”

Is this true or not?- so when and where do you think that bit of advice originated?

  1. The American Dental Association in 1933
  2. The world’s first dental college- The University of Maryland school of Dentistry in 1845.
  3. An article in the Journal of Oral surgery by Dr. Henry Horseacre in 1909 entitled “Proper Protocol for dental cleanings.”
  4. A  radio ad for Pepsodent Toothpaste in 1929.

Believe it or not, if you guessed  “4” you are correct!

Most of us known the famous order to “see your dentist twice a year.”  Some insurance companies even use that  interval to define their standard for payment.  But  the fact is that phrase was developed with no scientific basis at all-and to sell toothpaste!

Another example of this logic was the campaign for Pear’s Soap in the late 1800’s. The slogan “Have you used Pear’s Soap today?” ushered in the habit of daily bathing! And while that was certainly a good thing, the fact is that we are all different and to think that everyone requires the same schedule for their health needs just doesn’t make sense.

When you wash your hair, do you “rinse and repeat?” Do you associate diamonds with engagement rings?  Are you convinced that Volvo builds the safest cars?  If so, you’ve been influenced by advertising, not necessarily facts.  Don’t worry- we are all guilty of it!

At Dr. Malenius & Associates, Dr. Davis an I don’t believe in a cookie cutter approach when your health is involved.  In ordre to determine the correct dental treatment for you (including how often you should have your teeth cleaned) we perform a thorough examination, checking your teeth, gums, medical history, bite, jaw muscles and more.  We even do an oral cancer screening at every check -up.

Everyone is different, so despite what the ad men from Pepsodent once said, let’s scientifically determine the correct schedule for your dental visits by looking at the facts, not an ad slogan.  Then you can look forward to a lifetime of healthy teet and gums – ad keep smiling forever!

If you have any questions, or you would like to schedule a visit, please call 1-630-668-6180.  We are here to help you!


May 9, 2012

If you have been shopping for toothpaste lately, you know that it can be very confusing.

Unlike the old days -when the choices were few, these days it seems that there are just too many options!  Whitening toothpastes, tartar control, paste or gel, gum health, desensitizing……. which is best? This is a question we are asked all the time.  Sometimes it seems the best thing to do would be just forget the labels and buy whatever is on sale!

The fact is – buying a particular type or brand of toothpaste is usually not as important as how you brush and how often you do so.  However, if you’re interested, here is a quick run-down.

Tartar control toothpaste: Tartar is calcified plaque which naturally forms on your teeth and can wreak  havoc on both your teeth and gums.  While tartar control toothpaste has been shown to reduce the formation of new tartar deposits, it still won’t remove existing ones and does nothing to prevent these formations where they are the most dangerous – underneath the gum line.

Paste vs.gel: No significant difference here;  it’s more of a personal preference. However, it has been thought gels can cause a higher occurrence of cancre sores mostly because  have they have a higher level of SLS  or sodium laurel sulfate which is used to make the toothpaste foam.

Desensitizing toothpaste: These pastes have ingredients in them which block the small tube-like channels in the root surfaces that connect to the nerve tissue inside of your teeth. If you have exposed roots due to gum recession or teeth that are generally sensitive to hot and cold, this may be a good solution for you. But please be patient – it takes 4 to 6 weeks for the “magic” to kick in.

Whitening pastes:  The abrasives in these products may reduce surface stains, but they do little to treat the actual yellowing of teeth from the inside.  The good news is that most teeth can be whitened with the right treatment. Be sure to ask us what the proper whitening method is for you.

“Gum Care” toothpaste:  Studies have shown these to be questionable at best, and they may not be as valuable as standard toothpastes in preventing cavities.

Expensive or bargain brand?  The good news, price doesn’t seem to be related to effectiveness when choosing a toothpaste.  Actually, very recently, Consumer Reports magazine rated an expensive paste near the bottom of their list with bargain basement brand Ultra-Brite near the top in several categories!

So which brand should you use?

Most studies are fairly inconclusive on this one. Your best bet is always a brand that contains fluoride and has the American Dental Association seal of approval. And if that brand happens to be on sale – all the better!!

In the end, the most important thing is to brush often (morning,bedtime, and if possible, after every meal), use a soft brush, try to reach every surface of every tooth, and spend two minutes doing so.

The proper technique is important as well, and we will be glad to demonstrate this to you at your next visit to Dr. Robert C.Malenius and Associates! If you have any more questions or would like to set up a visit, please give us a call at 630-668-6180. W e are here to help you!

Did you know that we are now on Facebook? Please “like” our page at Malenius|Dental for great dental health tips, contests, giveaways,and great special announcements!

Great Article by Mary Otto, Shedding light on the link between periodontitis, diabetes, CVD, and more

February 29, 2012
By Mary Otto, contributing writer

After more than three decades spent exploring the connections between periodontal disease and other diseases and health conditions, Robert Genco, DDS, PhD, believes he’s got the big picture.

He sees periodontal disease as synergistically bound together with a set of other afflictions, including diabetes, obesity, and cardiovascular disease (CVD) — disorders that burden and kill millions of Americans.

“There’s a term for that,” he said. “It’s a syndemic.”

The tie that binds them? “Systemic inflammation is a reasonable hypothesis,” said Dr. Genco, a distinguished professor of oral biology and microbiology at the University at Buffalo.

Other researchers are more cautious in their assessments. Yet even with much still unknown, systemic inflammation may become the tie that also finally binds oral health professionals to physicians, nurses, and pharmacists.

There’s a term for that too. It’s “interprofessional patient care,” said Anthony Iacopino, DMD, PhD, the dean of the University of Manitoba Faculty of Dentistry and the director of the International Centre for Oral-Systemic Health. Across the health professions, caregivers are recognizing the importance of addressing inflammation. And that includes periodontal disease.

“That’s where the oral health community comes in,” Dr. Iacopino said. “For dentists and hygienists, that’s where the rubber meets the road.”

Underlying mechanisms

Meanwhile, major insurers also are beginning to look at the mouth as part of the body, said Robert Compton, DDS, vice president of quality management for DentaQuest, which administers dental benefits for more than 15 million people across the U.S. They see periodontal care paying off in lower risk scores and medical costs for patients coping with diseases such as diabetes.

“I think the industry as a whole is starting to recognize these connections,” Dr. Compton said.

But science moves slowly. Researchers have been probing the associations for years. And on their way to discovering the truth, they have needed to negotiate a host of complex causations, shared risk factors, and study biases that may distort findings. One ongoing debate, over periodontal treatments and pregnancy outcomes, is a case in point.

Research funded by the National Institutes of Health’s (NIH) National Institute of Dental and Craniofacial Research (NIDCR) is aimed at continuing to advance the understanding of mechanisms that may link periodontal disease to other diseases, as well as determining the risk reduction that may be afforded by specific periodontal treatments.

“The NIDCR is committed to supporting well-designed clinical research projects. This includes studies that demonstrate the importance of oral health to overall health and individuals’ quality of life,” said Jane Atkinson, DDS, the NIDCR’s director for clinical research.

There is much left to know. Work goes forward, she said, particularly in learning about relationships between periodontal disease and three major disorders.

“The associations of periodontal disease and diabetes, periodontal disease and cardiovascular disease, and periodontal disease and pregnancy outcomes have been studied intensely in the last 15 to 20 years,” Dr. Atkinson said. “Periodontal disease is a recognized complication of diabetes.”

Back to the beginnings

Some of Dr. Genco’s landmark work helped establish that key recognition. His research got a humble start in 1981, in a trailer clinic on the Gila River Indian Community in central Arizona.

He was there at the request of what was then known as the National Institute of Dental Research, now the NIDCR. Diabetes was rampant in the community and so was periodontal disease. Following 3,600 Pima Indians over time, Dr. Genco pondered the question “Are people more likely to have periodontal disease if they also have diabetes?”

“The answer is overwhelmingly yes,” he and colleagues concluded.

The rate of periodontal disease in the Pima people with type 2 diabetes was 2.6 times that observed in those without the condition. Although periodontal disease was common in Pima Indians without diabetes, in whom most of the incident cases occurred, diabetes clearly conferred a substantially increased risk, Dr. Genco and his team found (Diabetes Care, August 1990, Vol. 13:8, pp. 836-840).

The finding that periodontal disease is a complication of diabetes has been borne out since by studies in other populations (Journal of the American Dental Association [JADA], October 2008, Vol. 139:suppl 5, pp. 19S-24S).

The connections are still not completely understood, yet to many researchers the double-edged sword of the body’s inflammatory response seems central. In response to a periodontal infection, the immune system launches its defense, in the form of macrophages and proinflammatory cytokines such as tumor necrosis factor alpha (TNF-α). These inflammation-heightening proteins are essential to fighting disease. But when inflammation persists and becomes chronic, it can also cause harm, destroying tissue and bone and also setting off what Dr. Genco characterizes as a cascade of other effects.

He and others have found the degree of hyperglycemia, or high blood sugar, relates to the severity of periodontal disease. And they point to growing evidence that there is a two-way relationship between diabetes and periodontal disease. Not only are people with diabetes more likely to suffer from periodontal disease, but periodontal inflammation seems to complicate the control of blood sugar levels.

Dr. Genco believes that the cytokines responding to periodontal disease “spill out into the blood and cause the body to be resistant to insulin,” inhibiting the ability to process sugars. Some studies have found periodontal treatments have been followed by improved glycemic control (Journal of Periodontology, August 2006, Vol. 77:8, pp. 1289-1303).

Dr. Genco, who serves as a member of the dental clinical advisory panel for insurance giant Cigna, helped lead a three-year study that last year concluded that periodontal treatment may help reduce medical costs for patients with diabetes. He is confident enough to put it this way: “If you reduce the periodontal infection, you reduce the whole process. The blood sugar goes down.”

Others are more guarded. A 2010 review of 690 papers and seven studies, conducted by researchers at the University of Edinburgh, found that the treatment of periodontal disease in patients with type 2 diabetes may be reflected in lower hemoglobin HbA1c levels, indicating long-term control of blood glucose (Cochrane Database of Systemic Reviews, May 12, 2010, Issue 5: CD004714).

The Edinburgh team concluded that not enough evidence was available to support the benefit for those with type 1 diabetes.

More large, carefully controlled studies are needed to understand the overall potential of periodontal treatment to improve glycemic control, the researchers said. They stressed that findings cast an important light upon a connection that patients and healthcare providers do not always make.

“It would be wise to advise patients of the relationship between treating periodontal disease and the possibility of lowering their blood sugar levels,” said lead author Terry Simpson, an honorary research fellow at the University of Edinburgh, when the study was released.

Now an NIH-funded multicenter randomized single-masked clinical trial is testing the effect of nonsurgical treatments such as scaling, root planing, and supportive periodontal therapy upon the glycosylated hemoglobin levels of subjects with type 2 diabetes.

Beyond diabetes

For his part, Dr. Genco has gone on to explore the possible place of periodontal disease in a much larger systemic field.

He and colleagues, drawing upon their own data and that of many other researchers, assembled an “informational mosaic” suggesting a three-way relationship among periodontal disease, diabetes, and obesity (Journal of Periodontology, November 2005, Vol. 76:11-s, pp. 2075-2084). Again, the workings of the inflammatory response were central to the connections they saw, with excessive fat cells playing a central role in secreting TNF-α and interleukin-6 (IL-6), an immune protein that also causes inflammation.

Likewise, researchers at the Case Western Reserve University School of Dental Medicine also have focused upon fat, investigating possible relationships among inflammation, diabetes, periodontal disease, and obesity. In a paper published online on October 20, 2011, in the Journal of Periodontology, they described the results of a pilot study involving 31 obese people with chronic periodontal disease.

Half the group underwent gastric bypass surgery, had fat cells from the abdomen removed, and had periodontal treatments. Those patients fared better than others in a control group who had the periodontal treatments but did not have gastric bypass surgery or abdominal fat cells removed.

The majority of those who underwent surgery had a drop in glucose levels after the procedure, a result that bodes well for overweight people predisposed to diabetes and insulin-related problems, the researchers noted.

The researchers offered two hypotheses to explain the outcome. One related to the reduction of the leptin hormone that regulates appetite and has been linked to inflammation by increasing the production of cytokines and C-reactive protein, also linked to inflammation.

The other hypothesis involved the workings of excessive fat cells, which the researchers speculated might secrete more cytokines, making insulin more resistant to performing its function.

Inflammation and cardiovascular disease

The way Dr. Genco sees it, the cascade of inflammatory response also ties cardiovascular disease into the same syndemic of interlocking disorders.

“You can see how periodontal disease and obesity are related to diabetes, and how diabetes is related to heart disease,” he said.

But Kaumudi Joshipura, BDS, ScD, needs to see more proof. As an adjunct professor of epidemiology at the Harvard School of Public Health and the director of the Center for Clinical Research and Health Promotion at the University of Puerto Rico School of Dental Medicine, she also has done important work researching periodontal disease, cardiovascular disease, diabetes, and obesity and their relationships.

“There is that potential connection,” she said. “I tend to be more conservative.”

Research into the possible links between periodontal disease and cardiovascular disease is particularly challenging. Large-scale research is expensive, both diseases take years to develop, and they share many risk factors, including smoking, aging, gender (males are more likely to suffer from both diseases), low-fiber diet, and a sedentary lifestyle, she said.

“Just about everything that makes you susceptible to cardiovascular disease makes you susceptible to periodontal disease,” Dr. Joshipura said. “It’s very complex.”

Amol Ashok Bahekar, MD, studies his patients’ diseased gums while he is treating their diseased hearts and wonders about the complexities too.

“Studies show there is definitely some association there,” said Dr. Bahekar, a cardiology fellow at Chicago’s Rosalind Franklin University of Medicine and Science. But like Dr. Joshipura, he is cautious in speaking about them.

In 2007, he conducted a meta-analysis that concluded that both the prevalence and incidence of coronary heart disease are significantly increased in individuals with periodontal disease (American Heart Journal, November 2007, Vol. 154:5, pp. 830-837).

His study, based upon research involving tens of thousands of patients, supported the idea that periodontal disease may be a risk factor for coronary heart disease.

“I think periodontal disease contributes to it to a certain extent,” Dr. Bahekar said. He’s glad he spent those months conducting the meta-analysis.

“It made my mind more clear,” he noted. “But it’s still very preliminary.”

Periodontal pathogens have been identified in plaques that narrow coronary arteries. The release of bacteria and pro-inflammatory mediators such as cytokines into the bloodstream lead to increased inflammation in atherosclerotic lesions, a process that may represent the link between periodontal disease and CVD, some researchers suggest.

In 2010, a large international study found that people with a significant burden of periodontal bacteria are more than three times as likely to have hypertension as those with low-level bacteria (Journal of Hypertension, July 2010, Vol. 28:7, pp. 1413-1421).

And last year, researchers who led a study involving 621 subjects in Brazil announced at the March 2011 International Association for Dental Research meeting that they had found that patients with periodontal disease faced increased chances of presenting with acute myocardial infarction.

Future large studies may provide a clearer picture.

“What we need is not a randomized trial but a prospective cohort study,” Dr. Bahekar said.

In the meantime, what do oral health professionals tell their patients?

Dr. Iacopino put it this way: “It’s too soon to say, ‘If you keep your mouth clean, you won’t have a heart attack.’ ” But, he added, “If you don’t keep your mouth clean, your burden of systemic inflammation will be higher. The inflammation doesn’t stay in your mouth. It gets into your body.”

Living with uncertainty

In related research, scientists from the New York University College of Dentistry announced in 2010 they had found evidence that periodontal disease may increase the risk of cognitive dysfunction associated with Alzheimer’s disease.

Periodontal disease and edentulism have also been independently associated with kidney disease, according to researchers at Case Western Reserve University (American Journal of Kidney Diseases, January 2008, Vol. 51:1, pp. 45-52).

Last fall, a bacterium associated with the development of periodontal disease was detected in colon cancer by scientists at the Dana-Farber Cancer Institute and the Broad Institute (Genome Research, October 18, 2011). Such findings call for further research, senior study author Matthew Meyerson, MD, PhD, said at the time.

Likewise, studies into the possible effects of periodontal treatment on other diseases and conditions raise further questions. Witness the ongoing debate over the impact periodontal therapy may have in reducing preterm births. For years, periodontal disease has been associated with an increased risk of preterm births, and researchers have suggested a causal connection may exist, with pathogens or cytokines originating in the periodontal infection possibly affecting embryonic tissue or amniotic fluid.

Many studies have looked at the potential benefits of periodontal treatments upon pregnancy outcomes, with some trials finding benefits, and others failing to find them.

Then a systematic review and meta-analysis published in 2010 by the British Medical Journal (BMJ, December 2010, Vol. 341, c7017) and a critical summary of the meta-analysis published in 2011 in JADA (October 2011, Vol. 142:10, pp. 1192-1193) weighed the evidence. Both concluded that scaling and root planing had no significant impact upon the incidence of preterm births.

In the BMJ meta-analysis, researchers looked at 11 randomized control trials with 6,558 pregnant women. Five of the trials were considered to be of high methodological quality with a low risk of bias, and the rest were judged to be of low quality with a high or unclear risk of bias. The BMJ authors found that the low-quality trials supported the beneficial effect of treatment while the high-quality trials did not.

Women may be advised to have periodontal exams and treatment during pregnancy, but should be told that such treatment is unlikely to reduce the risk of preterm birth, they concluded.

In her critical analysis of the BMJ study, published in JADA, Lorena Baccaglini, DDS, PhD, an assistant professor in the department of community dentistry and behavioral science at the University of Florida College of Dentistry, agreed with the findings.

But the findings were contested by others, including Marjorie Jeffcoat, DMD, a professor and dean emeritus at the University of Pennsylvania School of Dental Medicine, whose research found a reduction in preterm births among women who had periodontal treatments. She called for more research.

In the January 2012 issue of JADA, an animated discussion of the topic continued. Stephanie C. Rose, DMD, of Portland, OR, contended in a letter to the editor that periodontal treatments to remove the source of the infection were not enough to improve pregnancy outcomes because they did not address the host’s immune response and increased systemic inflammation.

“Periodontal disease is just a sign of a much bigger process that is adversely affecting the pregnancy,” Dr. Rose wrote.

In a response, Dr. Baccaglini thanked Dr. Rose for her cautionary words and offered her own thoughts about the ability of randomized trials and meta-analyses to show evidence of causal associations — when they exist.

“The bottom line is that after several research studies and thousands of women, there still is no convincing evidence that dentists can improve pregnancy outcomes through scaling and root planing,” Dr. Baccaglini wrote.

In an interview with, Dr. Baccaglini added further thoughts on the importance of precision in interpreting science.

“This is not talking about whether in pregnancy people should have their teeth cleaned,” she said. “There may be other good reasons for doing it. But reducing the chances for preterm birth is, according to this research, not among them. We have to think twice before we say, ‘You’ll have a baby if you clean your teeth.’ “