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OHEHIR Yankee 2019 Why Gums Bleed - February 2, 2019 OHEHIR Yankee 2019 Why Gums Bleed - February 2, 2019 U of Minn 1967 WHY DO GUMS BLEED? The Impact of Sugar on Systemic Health Trisha E. O’Hehir, MS, RDH Phone: 520-444-2279 [email protected] OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 I became an oral health detective! We are all oral health detectives! OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Using our detective skills… 1. Understand how sugar impacts oral and systemic Why do gums bleed? 2. Describe how sugar influences inflammation 3. Understand the sugar industry coverup 4. Apply a 3-step approach to perio treatment Is it really poor oral hygiene? 5. Implement a radical change in approach to health Where does the blood come from? OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 1. Natural inflammatory Sugar & Refined Carbohydrates response destroys tissue around blood vessels - 1. Excess AGE production granulation tissue. Easily 2. Increased gut permeability penetrated. 3. Higher “bad” LDL 2. Sugar compromises the mitochondria in every cell. 4. Weight gain 3. Blood sugar causes damage 5. Addictive OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Now I’m going to lay out the clues to My goals for you from today’s class… prove my case • Expand your view of oral/systemic link • Think differently to get different results • See yourself as an oral health coach OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Hunter/Gatherers did not feed their oral Oral hygiene became necessary bacteria, no oral hygiene needed when the Western Diet of refined carbohydrates was introduced. OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Dr. Weston Price Dr. Weston Price 1930s traveled the world to discover how nutrition impacted dental caries 1939 published his book: Nutrition and Physical Degeneration Western diet led to oral/ systemic disease OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Dr. Weston Price After Parents Adopted a Western Diet Humans do not need sugar No physical need to consume sugar OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 No Sugar 2009 - Stone Age Diet - Switzerland No Refined Carbohydrates • 10 subjects in a controlled Stone Age environment • Provided a small supply of whole grain barley, • Diet of the Alaskan Inuits wheat and spelt, some salt, herbs, honey, milk and meat from domestic goats and hens. • Fish protein and fat • Not enough food for the 4 week study • Diet of the Swiss mountain folk • They foraged for berries, • Dairy, meat • edible plants and fishing OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 2009 - Stone Age Diet 2009 - Stone Age Diet • No oral hygiene products or tools • Plaque increased, as expected • Stone Age clothes, tools and huts • Surprised by reduction in gingivitis & probing depths • Filmed for a TV special • Bleeding upon probing reduced from 35% to 13% • Sports medicine physicians monitored • Bacteria changed to a balance favoring health rather than disease • Dental examinations before and after OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Pottenger’s Cats Pottenger’s Cats A Study of Nutrition-Cooked vs Raw Meat Milk: raw, pasturized, evaporated or First generation - end of life, lazy with sweetened condensed degenerative diseases Cats on raw mild did better than the others that Second generation - degenerative diseases by showed degeneration similar to the meat study mid-life, loosing coordination Third generation - degenerative diseases early in Conclusion: missing protein necessary for growth life, born blind, weak, shorter lifespan, fewer and development of healthy cats offspring All died out by fourth generation OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Using our detective skills… Sugar 1. Understand how sugar impacts oral and systemic Topical and Systemic Effects 2. Describe how sugar influences inflammation 3. Understand the sugar industry coverup 4. Apply a 3-step approach to perio treatment 5. Implement a radical change in approach to health OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Topically, sugar feeds acid producing Topically, sugar wicks into subgingival area bacteria leading to caries feeding bacteria OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Systemically, sugar impacts periodontal Systemically, sugar directly impacts oral bacteria health on a cell level & leading to bleeding Dietary sugar is measured in GCF, which also feeds subgingival bacteria OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Perio-Systemic Mechanisms Blood vessel walls altered by There is an oral - systemic connection These are secondary to Immunological Soundingperiodontal - disease activates endothelial cells dietary sugars ! Invade endothelial cells, trigger immune response ! Immunological Sounding ! Immune response to PD, activation of endothelial cells Pathogen Trafficking ! TransportCytokine of bacteria movement, activation of endothelial cells ! Auto-immune Reaction ! Bacteria elicit specific antibodies, react with host cells Microbial Invasion Auto-immune Reaction bacteria elicit antibodies OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Using our detective skills… There is a connection between oral 1. Understand how sugar impacts oral and systemic disease and systemic disease. 2. Describe how sugar influences inflammation Oral disease does not cause 3. Understand the sugar industry coverup systemic disease 4. Apply a 3-step approach to perio treatment The common issue is sugar 5. Implement a radical change in approach to health OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Cause of periodontal disease Biofilm • Infection - triggered by bacterial biofilm good non-cariogenic, supragingival bad acid producing strep mutants, • Inflammation - response of the immune subgingival anerobes system and more ugly biofilm over an open wound OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Biofilm - it’s a complex ecosystem worthy of our respect Too bad plaque biofilm isn’t green! OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 What do Does it your teeth feels like feel like the teeth when you are wearing wake up? sweaters? OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Does it feels Does it feels like the army like the marching bottom of a through? bird cage? OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Babies are Or does it born nearly germ-free feel just plain fuzzy! How do I get bacteria in my mouth? OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Bacteria: Bacteria: transferred from parent to child transferred from parent to child OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Bacteria: Bacteria: transferred from parent to child transferred from parent to child OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Bacteria are spread by the family dog What happens when it falls on the floor? OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 It’s true, moms spit on their kids either directly or on a Kleenex Bacteria are spread between partners by kissing Troil-Lindén et al JCP, 1996 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 fimbria Biofilm Formation fibrills Text Quorum sensing OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 fibrills Text OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 1/3 bacteria 2/3 slime - to absorb water and trap particles OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Biofilm grows in a fluid environment: saliva and crevicular fluid OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Bacterial toxic waste subgingivally includes endotoxins that penetrate pocket walls and trigger the immune response destroying tissue and bone OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 •Biofilm - the good, the bad and the ugly good non-cariogenic, supragingival WARNING bad acid producing strep mutants, Ugly biofilm subgingival anerobes ugly biofilm over an open wound OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Medicine Learns from Dental Hygiene photo courtesy of Dr. Randall Wolcott OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Biofilm causes ear infections photos courtesy of Dr. Randall Wolcott OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Medicine Learns from Look at your Toes Dental Hygiene Squirt your Nose OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 All are biofilm Interdental Plaque Biofilm diseases More prevalent Forms more readily More acidogenic OHEHIR Yankee 2019 why gums bleed - February 2, 2019 OHEHIR Yankee 2019 why gums bleed - February 2, 2019 Interdental Plaque Biofilm Col Area Isn’t Keratinized Dr.
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