Dr. Rick Newhart Updates

CIGARETTES SMOKE ROOT COVERAGE

Silva et al. (JPerio2006;77:81-87) studied the coronally positioned flap surgical procedure’s effectiveness on 10 smokers and 10 non-smokers.  Subjects were matched in terms of amount of recession and Miller Class I gingival defects.  Silva found that none of the 10 smokers obtained complete root coverage versus almost half of non-smokers obtaining complete root coverage.  The authors concluded that smoking negatively impacts this attempted root coverage procedure, with smokers have increased residual root exposure and a decreased likelihood of complete resolution of the gingival lesion.  Dr. Newhart consistently suggests smoking cessation to his patients due to the negative effects of smoking on the periodonteum.

BULLETIN: PULLING ALL TEETH MAY REDUCE HEART DISEASE!

Austrailian researchers (J Dent Res 2006;85:74-78) report in the Journal of Dental Research on the reduction of inflammatory markers of heart disease with 67 patients with severe periodontal disease had full mouth extractions.  The levels of C-reactive protein (CRP), plasminogen activator inhibitor (PAI-1), fibrinogen, and tissue plasminogen activator antigen (TPA) were measured at baseline and then at 12 weeks following extraction of all the teeth.  The researchers found reductions in

CRP, PAI-1, and fibrinogen compared to the baseline levels.  The authors hypothesize that advanced and uncontrolled periodontal disease may induce a prothrombotic state, which increased the level of possible heart attack or stroke.  The authors also point out that full mouth extractions are not indicated for everyone with heart disease.  Dr. Newhart feels that the periodontal condition of cardiac patients should be known, and that efforts should be made to reduce the level of periodontal inflammation in this group of patients. 

TO FLOSS, OR? . . .

Biesbrock et al. (JPerio2006;77:1386-1391) studied the effect of flossing and tongue brushing in a parallel group, examiner-blind, randomized, controlled study with a 2-week supervised treatment regimen in 51 twin pairs between 12 and 21 years of age.  One group’s regimen consisted of tongue brushing and toothbrushing and the other group’s consisted of toothbrushing and flossing.  The authors checked for papillary bleeding and oral malodor.  After the two-week treatment regimen, Biesbrock found  tongue brushing  reduced intraoral breath values and the toothbrushing and flossing group had a statistically significant decrease in papillary bleeding scores. The authors conclude that tongue and toothbrushing plus flossing significantly decreased breath odor and gingival bleeding after two weeks.  Dr. Newhart feels that flossing is very important in terms of reducing papillary bleeding and controlling gum disease.

NOT TO FLOSS !!!?

Zimmer et al. (JPerio2006;77:1380-1385) studied the effectiveness of flossing versus use of antimicrobial rinses may by GlaxoSmithKline. The 156 healthy volunteers were assigned into tooth brushing and flossing groups or tooth brushing and rinsing groups.  Individuals were excluded from the study if they had periodontal disease, any type of orthodontic appliance, or they had good oral hygiene.  The subjects were not given any instructions regarding brushing techniques or brushing times, and minimal instructions for flossing were given once for two minutes at the start of the study.  There is no objective measure to determine the floss was consistently used.  Interestingly, there were no differences found between the so-called floss group and the control group in which no flossing was used.  The best results were retained with the GlaxoSmithKline antimicrobial rinsing group.  The authors conclude the study clearly shows that flossing is not as effective at removing plaque as the mouth rinses which are being promoted by Glaxo SmithKline.  Dr. Newhart disagrees with the results of this study and feels that GlaxoSmithKline may have had a vested interest in showing that their mouth rinse was superior to flossing.  Dr. Newhart still recommends flossing and brushing.

Thank you for your continued referral of dental implant and periodontal patients!

Please visit our website at: thegumdr.com

Dr. Richard Newhart, Periodontist

Dental Implant Placement

1308 Market Street     

Parkersburg , WV 26101

(304) 422-4867

Dr. Newhart ’s periodontal update is a scientific, referenced literature and research review and newsletter.  Dr. Newhart is not claiming to perform, endorse, or achieve the results of every surgical technique or procedure published in this newsletter.  Dr. Newhart is a licensed periodontal specialist, who has achieved significant post-doctoral implant and periodontal education and training.