Ardent Care Dental

February is Heart Health Month!

For several years, a correlation between gum disease and other chronic inflammatory conditions such as heart disease, diabetes, strokes and arthritis have been observed. The relationship between these diseases, however, has not been known. Does having gum disease predispose someone to heart disease, or do some bad genes that predispose someone to inflammation cause both?
This past year, researchers at the University of Toronto demonstrated how periodontal disease contributes to heart disease. In simple terms, the bacteria present in chronic dental infection ‘primes’ someone’s immune system to create an exaggerated, hyperactive immune response in other areas of the body. This inflammation is now known to increase the risk of other chronic diseases.
Cardiac specialist Dr. Amy Doneen of The Heart Attack and Stroke Prevention Center in Spokane, Washington discusses the importance of good oral health in your overall health in this PBS video:
What can you do to celebrate Heart Health Month? Take a walk. Floss your teeth. Ask us to check your blood pressure next time you’re in the office. We care about more than just your teeth!

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The 2020 Life

As we near the end of this year, we’re continuing to live in ways we never imagined last fall. In talking with people about their challenges and disappointments, many have found silver linings in the changes that this year has brought to their lives. While we wish for the day life returns to ‘normal,’ I find it helpful to focus on the bright spots. Working at home has given many people greater flexibility in their day and they will continue to do so even after it’s deemed safe to return to an office environment. Parents have been able to spend more time with their children. We certainly don’t take many things for granted that we had before.

While dental offices across the country closed except for providing emergency services for several weeks to months last spring, we’ve adapted and are providing regular care again in a safe manner. Dentistry has long advocated for regular and preventive care as one of the foundations of good health. Delays in addressing routine needs often leads to disease progression, more expense in repairing damage and worse health outcomes.

The U.S. Center for Disease Control estimates that of the 300,000 ‘excess’ deaths that have occurred this year so far compared to 2019, 2/3 of them are due to COVID and nearly 1/3 are due to other non-COVID conditions. Why are more Americans dying of non-COVID reasons this year? Delays in diagnosis and treatment of other health conditions. While some delays in receiving care were due to health care facilities being closed to state orders and the challenges they face, other delays have been self-imposed by patients who have put off routine tests and care.

A patient recently shared with me that she was diagnosed in June with Stage 2 breast cancer that was detected on her routine mammogram. Although she had considered putting off her annual visit, she was thankful that she was able to receive an early diagnosis, conservative treatment, an easy recovery and good future prognosis. Had she waited another year, her situation may have not been nearly as favorable.

Good oral health has long been tied to good overall health. Maintaining or improving our general health is one of the best defenses against COVID. Dental care is essential health care.

So, what are we doing to help ensure the safety of our patients and team members? We’ve changed our reception area and patient flow and staggered appointment times to keep people a safe distance from each other. We ask family members waiting for patients to do so in their vehicle. Our front desk has plastic barriers and patients are screened for signs or symptoms of any illness prior to appointments. High-touch surfaces such as countertops, door handles and furniture are disinfected regularly. As indoor air quality has been identified as a concern in the spread of COVID, we installed iWave ionic air cleaners in our central ventilation system. We ask all patients to use an anti-microbial mouth rinse prior to appointments to decrease airborne microbes and use high-volume evacuation (suction) during appointments where water spray is generated.

As always, all treatment rooms are disinfected between patients with hospital-grade, EPA-approved products. Disposable barriers and/or disinfectant fog and mist are used to clean difficult-to-clean surfaces. Each treatment room sits for at least thirty minutes between patients to allow any droplets and aerosols present in the air to settle to the ground. Our instruments are sterilized or disposable. All of our team members are masked for the entire day. As more is learned about how COVID and other diseases are spread, we’ll continue to adapt our practices. 

Certainly we have and will continue to have challenges. The increased demand for masks and gloves by many industries has increased the costs and strained the availability of these items to the health care industry. Like many businesses, everything takes a little longer due to all the precautions necessary. We are thankful that so many of our patients continue to recognize the importance of oral health and trust us to be their partner. We appreciate all of you!

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Choosing a Toothbrush


Have you ever stood in the dental products aisle in the store and wondered what to choose? In the book The Paradox of Choice, author Barry Schwartz discusses how we as consumers enjoy having options. However, too many choices can be overwhelming and lead to ‘paralysis by analysis.’ Let’s simplify your decision making so you can get on with your shopping list!

A toothbrush should be replaced about every three months, or when its bristles begin to splay outward as they are no longer effective. If this is happening to your brush within the first couple months, it’s likely a sign of brushing too hard. This is true for both manual and powered toothbrushes. Aggressive brushing over the long-term can wear away delicate gum tissues and tooth structure. Powered brushes sometimes contain a sensor to signal excessive pressure. If it’s been suggested that you brush too hard, using a pencil-style grip can help reduce the pressure.

The shapes of teeth are curved and they are relatively small, so think ‘detail cleaning’ and choose a brush with a smaller head that can be maneuvered easily around all areas of a mouth. Bristles should be soft as medium or firm bristles can damage gums and teeth. While tooth enamel is tough, it needs to last a lifetime. If you had a new car with a shiny paint job and clear coat finish, you probably wouldn’t use a hard brush to clean it. A softer brush is more than adequate to remove the plaque from our teeth and doing so is more dependent on using adequate time and technique.

Many toothbrushes have bristles in varying heights, angles, colors and different materials. These are not necessarily better for performance. The toothbrush handle should be comfortable and easy to hold. Young children or adults with hand dexterity problems may have an easier time with a thicker handle.

Powered toothbrushes are often recommended as they can improve dental checkups. They generally have a smaller brush head and a timer that promotes brushing long enough, usually two minutes. Using them requires different technique than a manual brush. As the bristles oscillate or vibrate and do the work, simply holding them along the tooth and gumline for a few seconds on each tooth surface allows the bristles to clean the area. Move them slowly to the next couple of teeth, and repeat until all tooth surfaces are clean.

Finally, if you’ve had a cold, flu or other upper respiratory illness, it’s a good idea to disinfect or replace your brush. Some powered brushes have a UV brush disinfectant built into the base. Brushes can also be disinfected by running them through a kitchen dishwasher with a heated cycle. Hopefully these tips will help you in your choices the next time you’re at the store. Or, if you’re in the neighborhood stop in and ask for one, we’ll give you one of our favorites!



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4 Things to Know About Teeth Clenching & Grinding

If you’ve every shared a room with someone who grinds their teeth at night, you’ll know the habit and the noise it produces can be concerning. Habitual clenching and/or grinding of our teeth during the day or night has short-term and long-term effects on our dental health, including cracked, worn and sensitive teeth, facial pain, headaches and tired, sore jaw muscles or joints. Often times prople are unaware of the habit until a roommate or family member brings it to their attention, or until they have pain or other symptoms resulting from it.

  1. Nighttime teeth grinding, also known as sleep bruxism, is a sleep movement disorder affecting 8-9% of the general adult population. Bruxing is more commonly seen in children, although it tends to decrease with age and affects males and females equally. It is reported more frequently in families and may have a genetic component. It is associated with sleep disturbances and sleep breathing disorders, such as sleep apnea. Sleep bruxism may be diagnosed during a sleep study or may simply be observed and reported by a bed partner. Often bruxism will decrease throughout life.
  2. Daytime clenching or grinding has not been studied as well as nighttime bruxing and the cause(s) of both are often unknown. Both types may be worsened by stress and anxiety and be contributed to by genetics, smoking, alcohol and medications. The habitual clenching of the jaw muscles can result in tired, sore muscles and facial pain, however does not occur in all cases as muscles that are used regularly can become ‘conditioned’ as they adapt to the stress of the activity.
  3. The strong forces created by clenching and grinding can also take a toll on the teeth and their surrounding bone. This is often seen in teeth that are prematurely worn or that crack. Generalized tooth sensitivity to cold air, food or drinks can be a result of clenching or grinding. Some people will suffer the loss of bone support around their teeth as a result of the mechanical ‘rocking’ of the teeth created by their clenching and grinding. Dentists will usually evaluate for these signs during examinations. They may need a person’s help in identifying when the damage is occuring, whether it be daytime or night.
  4. Although habitual bruxing cannot be ‘cured,’ people may be able to manage it to reduce their symptoms and potential damage to their teeth and bone. Strategies for management may include wearing a plastic nightguard to protect teeth and reduce the intensity of clenching. Medications such as muscle relaxants or Botox therapy may be prescribed to relax tight jaw muscles. Any associated sleep disorders that have been diagnosed such as sleep apnea or upper airway resistance syndrome that may be contributing should also be treated. If life stress is contributing to the problem, stress reduction techniques to improve relaxation can help reduce symptoms.

If you or someone you know may be suffering from clenching or grinding, talk about it with your dental team at your next visit. Although it can sometimes take some work to determine the extent of the problem and figure out solutions, being proactive in addressing it can help prevent long-term damage.



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Diabetes & Dental Health

November is American Diabetes Month. According to the American Diabetes Association 12.8% of the adult population in Oregon have diabetes, which is around 435,000 people. Of these people, nearly 25% are unaware they have diabetes, greatly increasing their health risks. In addition, just over one in three Oregonians (36%) have prediabetes, meaning their blood glucose levels are higher than normal but not yet high enough to be diagnosed with diabetes. Diabetes is an expensive disease, both in dollar costs and in quality of life.

Signs of diabetes frequently show up in our mouths as a dry mouth, infections and/or poor healing of wounds. Diabetics are at greater risk of gum (periodontal) disease, a chronic infection of the bone and tissues that support our teeth. Diabetics are also more susceptible to fungal infections such as thrush and a dry mouth, which can increase the risk of tooth decay. Research indicates that the relationship between diabetes and gum disease is a two-way street, with untreated gum infection making blood sugar more difficult to control, and high blood sugar making gum disease more difficult to manage.

Other signs and symptoms of diabetes include increased hunger, thirst and urination, increased fatigue, numbness or tingling of the hands or feet and blurry vision. Genetics, age, and ethnicity all affect our risk levels. About 25% of seniors over age 65 are diabetic.

Diabetes affects many systems in our body and can cause problems with skin, eyes and our nervous system. It increases our risk of cardiovascular disease and some types of cancer. Although not all cases of diabetes can be prevented, the risk can be reduced by managing weight, quitting smoking and getting regular exercise. Choose a diet high in fruits and vegetables, whole grains and legumes, lean mets and lowfat dairy products. If you’re curious about your risk level, you can take the American Diabetes Asociation risk test for a closer look and talk with your health care provider about testing.

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Can Our Diet Affect Our Gums?

It’s been no secret for years that our dietary habits can contribute to tooth decay. Some of the unfriendly bacteria that can live in our mouth will convert sugars, or carbohydrates, to acid. That acid is what attacks and weakens our tooth enamel.
How our diet affects the health of our gums has not been studied nearly as well, however that may be changing. In the April 2019 Journal of Clnical Periodontology, the results of a small yet interesting study were published that begins to explore this.
Half of a group of thirty people with gingivitis were randomly assigned to follow an “anti-inflammatory” diet, which included increased fruits, vegetables, nuts and fish. They minimized processed foods and animal proteins, and also took vitamin D supplements. The other half of the group continued their normal diet. Both groups brushed their teeth as normal, however did not use anything to clean between their teeth at the instructions of the researchers. At the end of the eight week study, the group following the anti-inflammatory diet had less bleeding and inflammation of their gums. They had also lost a little weight.
Gum disease as we understand it today, is the body’s inflammatory response to the plaque, or film of bacteria that lives on our teeth and gums. The byproducts produced by the plaque in our mouth as well as our immune system’s response to the plaque can destroy the bone and supporting tissues of our teeth. Gum disease is a risk factor for cardiovascular disease and several other health conditions.
Like many chronic diseases, multiple factors can influence it’s progression, including genetics, habits and lifestyle. While this is a small study and the exact reasons for the reduced inflammation are not identified, I look forward to more research being conducted in this area to give us better recommendations for improving our dental and overall health.

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