Generations of Smiles|Issue 11

Generations Smiles

of Oral Health Means Better Health For Women Of All Ages

A link between oral health and breast cancer?

See what research says.

Quality care from sea to shining sea.

Are you there, Oral Health? It’s Me, Margaret.

Too bad Judy Blume never wrote about teeth.

Changes in sex steroid hormones during puberty, pregnancy and menopause greatly impact the risk of inflammation in the gums and the health of gums, jawbones and teeth.

I’m not Judy Blume, but if I were trying to inspire women of all ages to take control of their oral health, I’d offer a few tips:

Puberty. An influx of hormones during puberty can cause girls to suffer from red, swollen and bleeding gums – the telltale signs of gingivitis.¹

Periods. Menstruation brings hormonal fluctuations that affect every part of the body, including the gums.

Pregnancy. Seeing the dentist during pregnancy is not only safe, it is critical. There is evidence to suggest that maternal periodontal disease is associated with low birth weight and/or preterm birth.²

Post-Menopause. During menopause, the body slows down production of estrogen and progesterone, sending the body into a flurry of new sensations, including chronic dry mouth, which can mean a higher risk of tooth decay and gum disease.³

In each of these phases of life, your dentist will partner with you to monitor and treat any changes in your oral health.

No, Judy Blume never wrote about teeth. But, she made generations of young women smile. Now, it is up to all of us to keep those smiles healthy throughout life’s journey.

Until next time,

Dr. Carolyn Ghazal, DDS

Contents

Brushing Up on the Link Between Oral Health and Breast Cancer

Learn why we’re focusing more attention on the link between gum disease and breast cancer.

Keeping Your Mouth Healthy During Pregnancy

Pregnant? Keep your dental appointment! Here’s why a healthier mouth can help with a healthier pregnancy.

Calcium: An Essential for Healthy Teeth

Calcium is a key building block for good teeth and good health. So, how much do you need? Hmmm. Let’s find out.

Serve Day

In honor of Women’s Health Month, hear about one very special woman’s journey to healthier and happier with Smile Generation.

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B rushing Up:

The Link Between Oral Health and Breast Cancer

Imagine a fistful of snow in the palm of your hand. Not too threatening, right?

Now, roll that snow down a steep hill, and – as it gains mass and speed – watch it grow into a power to be reckoned with.

That’s exactly the “snowball” effect poor oral health can have on overall health. By increasing the amount of inflammation in the body, periodontal disease taxes the body’s immune system, increasing a person’s risk of diabetes, preterm labor and even cancer.

In particular, researchers are focusing more attention on the link between untreated gum and tooth disease and breast cancer1. A 2020 study found that periodontal disease may actually promote2 metastatic breast cancer. So, what can women do to stop that snowball from bowling them over?

Deepika Dhama, D.D.S., a dentist based in Norco, Calif., says that along with eating well, exercising and being seen regularly by a doctor, women can improve their overall health by partnering with their dentist and maintaining their oral hygiene.

“The Mouth-Body Connection® comes down to the profound way that oral health affects whole body health, and vice-versa,” Dr. Dhama said. “Just consider, for example, the ways in which hormonal shifts during menopause increase a woman’s risks for gingivitis. Gingivitis, in turn, increases her risk of breast cancer. It’s cyclical.”

Dr. Dhama addressed a few questions about that cyclical relationship, explaining,

Q. What effect does untreated periodontal disease have on overall health as well as on cancer risk?

A. Untreated periodontal disease causes the body's immune system to be under constant attack, hampering the basic functioning of the body. Instead of doing the job of healing, immune cells are constantly responding to stimuli. This impacts the body’s basic physiology, which is one reason chronic inflammation3 is a major risk factor for cancer.

This link between periodontal disease and chronic inflammation also has an impact on the way the body processes glucose, which affects diabetes. Poor oral health even affects atherosclerosis, rheumatoid arthritis and pneumonia, as well as the cardiovascular system.”

“Understanding the connection between breast cancer and periodontal disease can help women reduce their risk of both.”

Q. Can curbing oral inflammation help reduce a person's risk of breast cancer?

A. Inflammation is the body’s way of trying to fight a source of irritation. If that stimulus is removed, then the body will no longer need to fight and can return to a healthy state. That said, we don’t know for sure that treating periodontal disease can reduce cancer risk because we are only now beginning to understand how much the mouth microbiome affects chronic diseases.

For example, we know that treating gum disease reduces periodontal pathogens, or disease-causing bacteria, in the body as a whole. Some of these pathogens4, including gingivalis (which causes the gum disease gingivitis), are also associated with breast and other cancers. Results of future studies could help us better understand how keeping your teeth and gum healthy could help control or prevent cancer.

Q. What do patients need to know about the effect of cancer treatment on oral health?

A. Battling cancer involves chemotherapy, radiation and other treatments that can affect all aspects of a person’s health, including their oral health. Issues5 such as mucositis, or inflamed mouth; saliva changes, taste alterations, infection and bleeding gums are commonly associated with chemotherapy treatments. These can cause pain and/or impair nutrition. In addition, some cancer treatments lead to “dry mouth,” which increases a person’s risk of developing cavities and periodontal disease.

So, once your doctor clears you for routine dental exams, make regular dental visits a priority. Treating your mouth well is just as important in preventing cancer as it is in treating and surviving it.

Keeping Your Mouth Healthy during pregnancy

Just found out you’re pregnant? It’s more important than ever to maintain good dental hygiene habits to protect your health and that of your baby.

During pregnancy, a rise in your hormones, morning sickness and increased snacking may raise your risk of gum disease and cavities:

• The higher level of the hormones estrogen and progesterone stimulates the growth of bacteria in your mouth, causing plaque to develop.

• Vomiting creates a more acidic environment in your mouth, which can damage teeth.

• Pregnancy cravings can lead to more snacking throughout the day and night, which can also contribute to plaque buildup.1

The early stage of gum disease is gingivitis, which generally occurs in 60 percent to 70 percent of pregnant women. If you have gingivitis, your gums might be red, swollen and tender and might bleed after you brush or floss. Untreated, this can lead to periodontitis. Your gums can become infected and you might lose the bone that supports your teeth. Left with little bone support, your teeth can become loose and may have to be extracted.

Periodontitis has been associated with poor pregnancy outcomes, such as preterm birth and low birth weight of babies, but there isn’t enough research yet to explain this link. 2

To keep gum disease at bay, maintain your dental well-check visits and let your dentist know that you’re pregnant during your check-up. Brush twice a day with a soft-bristled brush for two minutes, using a fluoridecontaining toothpaste, and clean between your teeth once a day. Do not brush your teeth immediately after a bout of morning sickness so as not to expose them to acids from your stomach. Instead, rinse your mouth with one teaspoon of baking soda in a glass of water.3

The early stage of gum disease is gingivitis, which generally occurs in 60% to 70% of pregnant women.

Calcium:

Calcium is the building block of teeth, giving them hardness and structure. When you’re not consuming enough food with calcium, the resulting deficiency can have an impact on your teeth, causing them to weaken and become less dense and making you more susceptible to tooth decay and even tooth loss.

Teenage girls and post-menopausal women are especially more vulnerable to calcium deficiency. During puberty, the body demands more calcium

(mg)3:

BIRTH TO 6 MO

INFANTS 7–12 MO

CHILDREN 1–3 YRS

CHILDREN 4–8 YRS

CHILDREN 9-13 YRS

TEENS 14–18 YRS

ADULTS 19–50 YRS

ADULT MEN 51–70 YRS

ADULT WOMEN 51–70 YRS

ADULTS 71 YRS AND OLDER

PREGNANT & BREASTFEEDING TEENS

PREGNANT & BREASTFEEDING ADULTS

for teeth and bone growth but teens may not consume enough foods rich in calcium. Meanwhile, hormonal changes and a decreased ability to absorb calcium during menopause may lead to calcium deficiency later in life.1

Regular dental visits can help your dentist evaluate the state of your teeth and determine whether you might be calcium deficient. To help keep your teeth strong and healthy, it’s important to regularly include foods with calcium such as milk, yogurt, cheese, kale, broccoli and bok choi.. 2

The amount of calcium you need each day depends on your age and sex. Average daily recommended amounts are listed below in milligrams

Serve Day

One Woman’s Smile Journey

Smile Generation-trusted dentists and their teams take one day out of the year to help people in need in their communities. Here’s one woman’s story of how she regained her smile and so much more.

"Sherry's Story"

Happier Healthier Generations Smiles of

A Smile Generation Magazine

LET'S DO THIS AGAIN!

The Smile Generation exists to connect you with trusted dentists in your area and to offer education on the critical link between oral and overall health. We’d love to know what you think of our magazine.

DROP US A NOTE!

Healthi

Buy a Bag

GIVE A SMILE

The Love People, Love Coffee campaign runs through Sept. 15 to help provide oral health care access in Guatemala.

What if your morning coffee had the power to cross borders and change lives? Now through Sept. 15, it can.

Buy a limited-edition, mediumroast 10oz. bag (or several) of certified organic and fair trade, non-GMO coffee lovingly created by 128 female Guatemalan coffee producers, featuring notes of orange, mango, banana and dark chocolate. All proceeds go to support Smile Generation’s nonprofit partner, the Pacific Dental Services Foundation (PDSF) and its International Dentistry Program. The PDSF is a 501 (c)(3) charitable organization whose mission is creating opportunities to serve through improving oral health care locally, nationally and internationally.

Love People, Love Coffee

Access to care, oral health literacy, and lack of local dental professionals are urgent challenges in Guatemala. There is only 1 licensed dentist per 100,000 people with a daily diet heavy in sugar and light on oral health.

With 54 percent of Guatemala’s population living in poverty and 13 percent in extreme conditions, dental disease is a tremendous problem in this country of over 16 million people. The PDSF Clinical Dental in Xenacoj, Guatemala provides 100% free oral health care to residents, some who travel long distances for the opportunity to be seen.

A Force-for-Good Trifecta

To help bring awareness to the clinic’s important work, the PDSF has partnered with Asociación Barillense de Agricultores (ASOBAGRI), a nonprofit, all-female coffee producer co-op known for its high-quality coffee and Sir Owlvericks Coffee, a womanowned roaster in California.

By purchasing this coffee, you allow the PDSF to continue to provide vital oral health care to the underserved Guatemalan population while also empowering female coffee producers and entrepreneurs to defeat the cycle of poverty.

The power to make a difference is in your hands - and coffee mug.

Sources

Are you there, Oral Health? It’s Me, Margaret.

1. Puberty-associated gingivitis, https://pubmed.ncbi.nlm.nih.gov/1555394/

2. Association between periodontal disease and preterm prelabour rupture of membranes, https://pubmed.ncbi.nlm.nih.gov/30638274/

3. Oral Health and Menopause: A Comprehensive Review on Current Knowledge and Associated Dental Management, https://www.ncbi.nlm.nih. gov/pmc/articles/PMC3793432/

Brushing Up on the Link Between Oral Health and Breast Cancer

1. https://www.breastcancer.org/research-news/gum-disease-may-belinked-to-higher-risk

2. https://www.nature.com/articles/s41388-019-1084-z

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328760/

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328760/#prd12329bib-0100

5. https://www.cancer.gov/about-cancer/treatment/side-effects/ mouth-throat/oral-complications-hp-pdq#:~:text=The%20 most%20common%20oral%20complications,dehydration%2C%20 dysgeusia%2C%20and%20malnutrition.

Keeping Your Mouth Healthy During Pregnancy

1. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC6883753/

2. https://www.cdc.gov/oralhealth/publications/features/ pregnancy-and-oral-health.html

3. https://www.ada.org/en/resources/research/ science-and-research-institute/oral-health-topics/ pregnancy#:~:text=Gingivitis%20may%20result%20 from%20hormonal,bacteria%20in%20the%20gum%20 tissue&text=Dental%20caries%20may%20occur%20 due,stemming%20from%20nausea%20and%20vomiting

Calcium: An Essential for Healthy Teeth

1. https://ods.od.nih.gov/factsheets/Calcium-Consumer/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337919/

3. https://www.hsph.harvard.edu/nutritionsource/calcium/