gum disease

shokadelika

Toothsmith wrote: »

Whilst I can't disagree with the above, I would suggest that this is a very rare occurance.

How do you know that patients with gum problems are not vitamin C deficient?.The only way to tell would be to measure their blood serum levels.

shokadelika

Higher antioxidant levels correlate with lower periodontitis prevalence

A report published in the March, 2006 issue of the Journal of Nutrition revealed the finding of researchers at the University of Birmingham in England and Boston University that higher serum antioxidant levels are associated with a reduction in the risk of periodontitis. Periodontitis is an inflammatory condition of the tissue surrounding the teeth which has been linked with an increase in stroke, type-2 diabetes, and heart disease.

The current study examined data from 11,480 participants in the Third National Health and Nutrition Examination Survey (NHANES III), for whom periodontal measurements and serum levels of alpha-carotene, beta-carotene, selenium, lutein, uric acid, beta-cryptoxanthin, vitamins A, C and E, bilirubin, and total antioxidant levels were available.

Fourteen percent of the subjects were found to have mild periodontitis and 5 percent had severe disease. Higher vitamin C, bilirubin, and total antioxidant levels were associated with a lower incidence of periodontitis, particularly with severe disease. Individuals whose vitamin C levels were in the top 20 percent of participants had a 39 percent lower risk of periodontitis than that of participants in the lowest fifth. For subjects who had never smoked, the risk experienced by the top fifth was half that of the lowest fifth.

Vitamin C's protective benefit against periodontitis may arise from its involvement in collagen synthesis which helps maintain the structural integrity of connective tissue. Additionally it acts as a free radical scavenger and may help reduce inflammation.

The authors remark that longitudinal studies would be necessary to determine whether periodontal therapy reduces the inflammatory burden in the peripheral vasculature and to confirm the role of antioxidant levels as risk factors for periodontal disease. They write, "If confirmed, intervention studies involving antioxidant approaches would be indicated to determine the potential for reducing the risk of periodontitis."

—D Dye

Toothsmith

shokadelika wrote: »

How do you know that patients with gum problems are not vitamin C deficient?.The only way to tell would be to measure their blood serum levels.

Very true, an maybe that's what I should do to those 2 patients with clean teeth who still show problems.

For the other 99.9% I would be strung up for wasting resources if I sent them all off for blood tests for deficiences, when they still have an obvious excess of plaque!

To iceice baby - Has your hygienist shown you interdental brushes like Tepes?
These are much more efficient in bigger gaps between back teeth.

iceicebaby

No toothsmith she showed me like this floss on a handle thay sell at the dentists tho!

Merlot

angel wrote: »

YES!! You're so right about that!

I both clench AND grind at night. I've had a guard made that I wear at night now and I coudn't sleep without it. It was worth every penny. My dentist said that it could well be the best investment that I ever make for my teeth. It was funny because I've disputed it with him for ages that I grind. He's just bought a new camera and it wasn't until I saw the ridges on the back of my front teeth and the tiny cracks in the back ones that I actually gave in and agreed.

Toothsmith,

I hope you can offer me some advice. I see my NHS dentist once every year, very short of NHS dentist in my area so they only offer 12 months appointments.

I too have receeding gums, and according to my OH, make grinding noises in my sleep, where can I can a tooth guard from, can the NHS dentist provide one at a cost. I am terrified at the thought of losing my teeth, having sleepless nights about it, I cannot afford a private dentist, I am due to go to the dentist in September for my annual appointment, but to be honest the dentist I use in my opinion is so far over stretched you're in and out, he didn't even clean my back teeth last time, the previous patient appointment over ran so i didn't get the full appointment time.

Yours, for ever hopeful that I wouldn't lose my teeth before I'm 40.

Merlot

LondonDiva

Merlot, are you prepared to travel to the dentist? If so why not visit a friend's recommended dentist in another area?

Unlike with GPs you can register with any NHS dentist in the country rather than by catchment area.

Toothsmith

Merlot wrote: »

I too have receeding gums, and according to my OH, make grinding noises in my sleep, where can I can a tooth guard from, can the NHS dentist provide one at a cost.

Yes they can, but this is one of the many huge problems of the new NHS contract.

A night bite guard is a lab-made item, and so it will fall into the Band 3 charge.

The band 3 charge is £190!!!!

The dentist may well be able to provide it privately around the £50-£60 mark.

Ask him next time if you can get a word in!!

Merlot

Thanks Toothsmith, I'll ask him when I have my annual appointment, £190 is not a lot of money if I can slow down the receding. Can a NHS dentist offer a private service? This chappie is on his own and he is the hygienist as well, just him and one dental nurse.

One other point, I appreciate that NHS Dentistry is in a crisis, but is an annual appointment for myself and my children acceptable,(I wouldn't mind going twice a year cause he is a real looker). I waited for 3 years to get a dentist in my area so I am grateful that I have one unlike many others still waiting, but I would appreciate your comments Toothsmith.

Merlot

Merlot

LondonDiva wrote: »

Merlot, are you prepared to travel to the dentist? If so why not visit a friend's recommended dentist in another area?

Unlike with GPs you can register with any NHS dentist in the country rather than by catchment area.

London Diva, I live in a semi rural town, with only two NHS practices, their is currently a 2/3 waiting list for these practices and the nearest town to me is 15 miles away and I don't drive and the buses are not reliable, so unfortunately it would not be practical.

Toothsmith

Merlot wrote:

Thanks Toothsmith, I'll ask him when I have my annual appointment, £190 is not a lot of money if I can slow down the receding. Can a NHS dentist offer a private service? This chappie is on his own and he is the hygienist as well, just him and one dental nurse.

One other point, I appreciate that NHS Dentistry is in a crisis, but is an annual appointment for myself and my children acceptable,(I wouldn't mind going twice a year cause he is a real looker). I waited for 3 years to get a dentist in my area so I am grateful that I have one unlike many others still waiting, but I would appreciate your comments Toothsmith.

Merlot

Yes - he can do it privately. So long as you are aware it's private, and agree to it.

I appreciate that you value your dentist and his services, but I would say that £190 is a s0d of a lot of money for something that can be provided privately for £50! It's the PCT that get the £190 - not the dentist. He will be awarded 12 funding points for doing the treatment. The PCT may be pretty miffed if he provides things like this privately too often, but essentially, so long as the patient is fully informed, there's not a lot they can do.

The check-up interval is debateable.

NICE looked at dental recall intervals, and their conclusion was that recall intervals shouldn't be set in stone at 6 monthly, but should vary depending on the patient. - And that 12 -24 months was not too infrequent for the right sort of low-need patient.

This was completely mis-represented by the Department of Health and morphed into - 'Patients should come to the dentist less frequently' and they set dentists NHS contracts assuming that patients would now be seen 12 monthly.

The assumed all dentists were seeing all patients 6 monthly, and so halved the check up numbers.

This was quite a problem for some far-sighted dentists who were already seeing their low need patients 12 monthly anyway!!! No account was made for this!

So - if you are a low need adult - then maybe 12 monthly appointments are appropriate. From what you say of your concerns though, I very much doubt I'd have you on yearly recalls if you were one of my patients.

As for children - I personally would not have any child on 12 monthly recalls. This was one of the reasons I refused to have anything to do with the new NHS contract.

Too much is changing in their mouth with growth and increased independence meaning that they can spend their own pocket money on things that are bad for the teeth.

Now - technically, the choice of recall intervals is still up to the dentist - even if he isn't getting paid for all the check-ups he 'chooses' to do. That means that if anything does go seriously wrong and his choice of recall interval is judged to be poor - he is still accountable.

So - if your kids are on 12 monthly recalls, I would suggest that they are low-need and your dentist is happy with that interval.