D: Dan Goldberg / J: John (Radio Host)
J: Welcome back! My guest today is Dr. Goldberg of Go Dental in Calgary, Alberta. Doctor, just before the break we were talking about the importance of seeing the dentist regularly because there are things that can happen in your mouth that you are totally unaware of, and by getting regular check-ups you can avoid bigger problems down the road, such as you might have a small cavity but not feeling any pain in it, but if you wait until there is pain, then it gets way more expensive, is that correct?
D: Yeah, that’s right.
J: There are other benefits to see a dentist on a regular basis as well; getting regular cleanings… can you talk about those?
D: Absolutely, in April 2006, the American Dental Association published that there is a link between periodontal diseases and other health problems like cardiovascular diseases, stroke, and bacterial pneumonia and oral health. In fact, it’s fascinating because it’s shocking news for the public and the professionals. In fact, even pregnant women may be at increased risk of delivering a pre-term or low birth weight infant. Smokers and diabetics actually have the greatest risk of developing periodontitis.
J: Oh my… so, how does what’s going on in the mouth actually affect the cardiovascular system?
D: Well, everything is connected. So, the same bacteria in your mouth goes down…when you get periodontal disease, let me explain that, what that is. It’s a very common thing that happens to people especially as you age. Some people are more prone to getting it, like I said, smokers and diabetics are the most likely people to get this disease. And there is no cure for this disease. All we can do at this point is slow it down because it is caused from bacteria. There are genetic reasons, there are health reasons and also if you have some medical conditions. So, what periodontitis is… people call it “gum disease”, so eventually; the result of periodontitis is that your teeth become loose, you end up losing them and then you have to look at different options to replace those teeth. So, that’s what periodontitis is. There is now a link between periodontitis and cardiovascular disease: The bacteria that causes periodontitis is the same bacteria that is found in cardiovascular disease. And so, when people have periodontal disease, their gums are more prompt to bleeding and so that blood, the bacteria that surrounds your teeth, gets into that blood and into your circulation - that causes a lot of problems.
J: The old adage of the hip bone is connected to the thigh bone it’s all connected together is real here.
D: Exactly. So, another thing I probably mention is, why should you come to the dentist on a regular basis? There are a lot of things that people don’t know about, that we [dentists] can find out. A lot of people have problems, like they might have been diagnosed for diabetes. Well, to get that diagnosis, you can have all these symptoms and problems… and eventually you go to your doctor, do a lot of tests, and they tell you: “OK, you know, unfortunately, you have diabetes.” The interesting thing about coming to a dentist on a regular basis, is that we can predict or see signs in the mouth before all these things happen.
J: Oh my! Like what? What do you see?
D: When you have diabetes, it affects how you heal and… for example, if we were to take a tooth out, diabetics typically take a lot longer to heal. In fact, I just had a patient, it’s going to be a discussion I am going to have with him in the near future - is that they have a hard time to heal. So, I ask them straight out “Do you know if you have diabetes?” and they are like “No, I am fine. I don’t have that. “ But now, I think we have to take it to the next level and get the testing done because, there are not a lot of reasons why people might not heal properly. They could have diabetes or they may be undergoing cancer treatment. It’s fascinating for me to be able to be involved in this process before the medical doctor is involved, and we are able to provide a referral, and have the patient get treated quicker than if they did not come to the dentist. People might have nutrition deficiencies or various systemic diseases that can show up first in the mouth - going to the dentist on a regular basis allows for early diagnosis. Some of these conditions are diabetes, AIDS, something called Sjogren’s syndrome, and all these things first show up in your mouth. You ask what it is they appear as. It could be mouth lesions, poor healing or the tongue might look a bit different, or it is different things that we notice are not normal.
J: Interesting, so disease, if you allow this analogy, leaves a finger print in your mouth, so to speak?
J: Or tell-tale science.
D: That’s right.
J: You know, you mentioned that if something progresses to a far enough point that they might actually lose the tooth or they might have to have the tooth removed, depending where that tooth is located, is it important to replace it or, you know, if it’s in the back and nobody can see it, can you just let it go? Can you talk a bit about that?
D: Sure. You know, it’s really case dependant. It’s a hard question to ask and this again ties into part of my vision. I am not going to be here to say you need this done, you need this done, there are always different options, and it depends on what the patient wants to do. The reality check is, as you age, it does not matter how well you take care of your teeth, you are going to lose a tooth. It’s just part of the nature, unfortunately. There are few people on this planet that still have all their teeth. And even today, I mean, I think technology is getting better, but because of all the refined food we eat, and you know a lot of us have a terrible diet, things are getting worse. So, I am saying in my practice, people are losing more of their teeth instead of keeping them unfortunately. So to answer your question “Should we … what are the options or look at? What can we do?” One option is doing nothing. You know if you lose a tooth, you just see how you can deal with it. It’s a very poor option, but it’s still an option. Another option would be to do something called the partial denture. And that’s just something that’s removable, that we can take in and out of your mouth. That’s probably the least invasive option. It’s good, it’s a good fix but there are some annoying things about it as well. You are constantly cleaning it, taking it in and out, but it’s still a great option for some people. Another option we have, we call the bridge, and this is probably the most common option. People like it the most, and it’s usually covered by insurance. You shape the two teeth beside the space and then we take a mold of the teeth and we send it out to a lab. It comes back about a week later and you basically get artificial teeth that fill up the space. And that’s a fairly permanent option. Then, the last option is something called a dental implant. That’s becoming more and more popular these days, and it’s a really exciting thing to get done. It’s the most expensive option, but the greatest thing about an implant is that you can never get a cavity on it. So, you know, as long as you take care of it, it should be a lifelong investment.
J: People should rip off their teeth and have an implant done so they don’t get cavities! (Laugh)
D: That’s a terrible idea! (Laugh) It does sound great but … no, I mean the best thing to do is not to fix your teeth, but keep your own teeth, but there are advances in technology that we can provide to our patients that will enable that.
J: That’s fascinating. It’s nice to know that there are all these options available. You know, I am looking at the clock - we do need to take another quick break but when we come back, you mentioned something about food and processed food and I want to talk about what kind of foods are good for your teeth. Can we talk about that when we come back?
D: I am really excited to talk about that. I can’t wait.