The Importance of Gum Health with Anne Clemons, DMD

Podcast Transcript

John Horton:

Hey there and welcome to another Health Essentials podcast. I'm John Horton. Your host. Odds are you don't spend much time thinking about the health of your gums. Today we're going to try to change that. Your gums, after all are far more than just a place for your teeth to hang out. This tissue in your upper and lower jaw is a frontline defense system against harmful bacteria that can harm your heart and lead to disease. It's a big responsibility and your gums need your help to get the job done. That's why Dr. Anne Clemons is joining us to talk about gum care and signs indicating you might need to be doing a little bit more. She is one of the many experts at Cleveland Clinic who join our weekly podcast to help guide you down the path of wellness. So grab your floss and let's explore why gum health is so important to your overall health. Dr. Clemons, thanks so much for joining us today.

Dr. Anne Clemons:

Thanks for having me.

John Horton:

So when folks talk about oral health, they usually just think about their teeth. I got to be honest, I was really blown away by the connection between what's happening in your mouth and the rest of your body.

Dr. Anne Clemons:

It's funny how surprising that sometimes feels, even for dentists sometimes to remember your mouth is part of your body. It's all connected. For some reason we tend to put the mouth and put oral health kind of over here to the side, and then over here is the rest of the body, but your mouth is the starting point for your GI tract, your whole digestive system and your respiratory tract. You breathing in through your nose. So it should be kind of obvious that that and kind of everything else, it's all connected. We don't have the luxury of saying, hey, we put the mouth over here and it doesn't really matter. It's going to affect everything.

John Horton:

Well, and we're going to connect those dots for everybody today. And so let's start things off with a basic rundown of our gums. Kind of a, was it gingiva 101. Hopefully I said that right. But just to kind of better understand what our gums are doing in our mouths.

Dr. Anne Clemons:

Right. So dentists tend to think of our gums or the gingiva as part of kind of an overall system. We call the support structure for your teeth the periodontium. Periodontium is really composed of four different things. The tooth structure itself or the cementum that's on your root, what we call the PDL or a periodontal ligament, sits around that root, connecting it to the bone and then beyond that bone is the fourth component, our gums. Our gums are essentially soft tissues that are covering that bone and a little kind of collar the tooth up at the top there. The gums are kind of our first protection for everything else that happens underneath there and can be a really helpful barrier to make sure that things stay healthy or can be the point of connection of things that start to get unhealthy with the gums and the overall periodontium.

John Horton:

Wow. I got to be honest, when you look in your mouth, you just don't think your gums are doing that much.

Dr. Anne Clemons:

Right. We kind of tend to ignore them. We tend to think about the teeth and don't even really pay attention to the pink part. Right. It's so important.

John Horton:

So obviously then it sounds like keeping our gums healthy should be a priority, but from the statistics that I found, it seems like a lot of us are a little lax when it comes to gum care. How common are gum related issues?

Dr. Anne Clemons:

It can be really common. And if we look at the stats and we look at gum disease and how common it is in the US, it's close to 50% of people have some amount of gum disease. If I look at my own patient population, people maybe that are coming in for the first time or haven't been in in a while, especially we're looking at the gum condition, super common to see some amount of inflammation, some amount of a bleeding or irritation around the gums. It's way more common than we give it credit for.

John Horton:

It really is common. Let me ask you this, how quickly can your gums deteriorate if you don't consistently get dental care?

Dr. Anne Clemons:

Yeah. It can happen pretty quickly. Every day, kind of all day long plaque, which contains bacteria, wants to build up on your teeth. It's going to try to do that all day long. If we're not staying on top of things, brushing, flossing, really managing that plaque, it really quickly is going to turn into tartar, which is essentially mineralize kind of harder plaque. That plaque and that tartar sitting around the gum, it's going to start creating some inflammation and that inflammation can spread and evolve and really take root pretty quickly.

John Horton:

Yeah. Now the two big things people hear about a lot are gingivitis and periodontal disease. Can you kind of walk us through what each of those are? Because I think we're all familiar with them, but I don't really know if we truly know what's going on there.

Dr. Anne Clemons:

So gingivitis is an inflammation of the gingiva, so gums that are inflamed, we tend to think of it as kind of the early stage of gum disease where we're thinking about that inflammation just kind of being localized more to that gum tissue, just kind of that color of gum around the tooth. If gingivitis doesn't get treated, doesn't get managed and that inflammation stays around the plaque, the tartar doesn't get cleaned off, then it can pretty quickly move down into those next layers of the periodontium affecting the bone and PDL and all of those surrounding support structures for the tooth. That's when we really start seeing what we call full-blown gum disease or periodontal disease.

John Horton:

Okay. What are the signs of emerging gum disease that people should watch for?

Dr. Anne Clemons:

Yeah. One of the challenges of gum disease is it tends to be something that doesn't have a lot of symptoms. So people don't tend to feel a big difference in the early stages of gum disease, but there are still things that we can see and that we can notice if we're paying attention. Some of the big ones are gums that bleed easily. If when you're brushing, you're flossing, your gums are bleeding, they're telling you there's something going on, there's some inflammation there. You may even start to see that the gums get more red, a little more swollen, maybe even starting to get a little bit of tenderness. You may notice that you're developing some bad breath or even starting to see some other changes with the gums. Gums are kind of pulling away from the teeth or teeth are, in later stages of gum disease, permanent teeth can start to get loose or even look like they're separating or even changing the way they come together when you bite. These tend to be later stages of gum disease, but all these sort of things can happen.

John Horton:

Yeah. You mentioned those things. Let's kind of just focus for a moment on what healthy gums should look like and if there are ways that you can kind of check on the health of them.

Dr. Anne Clemons:

Yeah. So healthy gums can be any number of colors, just like our skin tone, our gum tone can vary based on your ethnic background, but they should be nice and firm. They shouldn't have any redness to them. They shouldn't have any swelling. They should not be uncomfortable most of the time. You should be able to brush and floss comfortably without having any bleeding or any real pain as you're doing that.

John Horton:

Now, you had mentioned if your gums bleed when you floss that it's not a great sign. Is there some, I mean, flossing seems like it can be a pretty aggressive thing. You're sticking that floss in there and doing everything. I mean, is some bleeding normal or is any sort of bleeding a sign that there's something going on?

Dr. Anne Clemons:

Yeah. Generally healthy gums shouldn't bleed. Most often if there's some bleeding going on in the gums that's telling us there's some gingivitis, some inflammation of the gums, it may just be localized to one area or it could be pretty broad throughout the mouth. But sometimes, like say you haven't been a regular flosser, but you're kind of starting to get back into the routine, you'll probably notice that at first your gums are going to bleed as you're flossing. But with time, honestly, usually within a week or so that bleeding should subside. There are some other things that can cause bleeding or make bleeding more common. Some of the things that we tend to think of are hormonal changes like pregnancy can make bleeding more common. Patients that take certain medications like blood thinners. Blood thinners may make the bleeding a little bit more common, but there are some other health conditions that may make bleeding more common and if you have bleeding that seems unusual for you or it isn't going away with regular flossing, should check in with your dentist or your physician.

John Horton:

Now, I'd kind of like to turn our attention to one of the more fascinating elements of gum health, and that's the relationship it has with heart health, which is really not two things you'd normally connect. Tell us how they're linked.

Dr. Anne Clemons:

Right. Yeah, that's a really interesting area of research and frankly something that we still don't know exactly how they're connected. We know that we see a connection, we see people that have periodontal disease and people that have heart disease more commonly have both. People that have gum disease are more likely to have heart disease and vice versa. Even when we control for other kind of common risk factors in both, we still see a higher association. We don't know exactly what it is, but we know it's there. We know also that things like healthier gums and preventing or treating gum disease can have some positive effects and may make maybe the risk of heart disease a little bit lower.

John Horton:

That's amazing to think about and people worry so much about what's happening with your heart and the idea that you can maybe address that by just taking better care of your teeth is really kind of mind-blowing.

Dr. Anne Clemons:

Yeah, yeah. We definitely don't know everything about it. We don't know exactly what the link is and exactly what effect periodontal disease or gum health on the other side can have on preventing or treating heart health. But we know there's a connection and we know that the better managed one condition is helps the other.

John Horton:

All right. Well, I'm sold on it and say we all want to get moving that way. So what can we do to keep our gums at their very best?

Dr. Anne Clemons:

Yeah. The most important thing is what you're doing every day at home. So brushing at least two times a day for at least two minutes each time is really the first step.

John Horton:

I got to say, I think I been a little lax. So two minutes.

Dr. Anne Clemons:

Two minutes. Yeah. It doesn't sound like a lot of time usually, but it can feel like a lot when you're brushing. But there are a lot of things that can help you kind of stay on track. If you're using electric toothbrush, a lot of those actually have timers to kind of help you keep track of how long you're working and also set a timer for yourself. But two minutes, twice a day can be super effective. But even really great brushing, perfect technique isn't going to be able to clean in between the teeth. We've got to clean in between the teeth at least once a day. Typically, we do that with flossing.

John Horton:

Okay. And how long should you spend flossing so I can make sure I set aside enough time?

Dr. Anne Clemons:

Yeah. Yeah. Flossing doesn't have to take too long. Flossing should be deliberate, should be thoughtful. A lot of people kind of just take the floss and kind of go up and down in between the teeth really quickly and sometimes kind of aggressively. It should be gentle, it should be wrapping that floss around the teeth, kind of creating a nice little hug around the tooth kind of on either side. But it doesn't have to take too long. Honestly, a minute, maybe two, you can really get around pretty nicely.

John Horton:

Sounds like an investment of time we should all be able to make. With gum health too, does it matter? Does diet matter and what foods you eat? Are there things you should avoid? What about there?

Dr. Anne Clemons:

All health starts in some ways with your diet. Diet is really, really important to our systemic health, our overall health, but the health of your gums as well. So thinking about a diet rich in vegetables, vegetable oils, fruits, legumes, nuts, healthy kind of fatty fish, all those really good essential nutrients are going to help your overall health, going to help suppress kind of the inflammation, those sorts of things. Overall, we see that reflected in the mouth as well.

John Horton:

And you had mentioned obviously smoking bad, which it seems like we shouldn't even have to say that in today's day and age, but it sounds like it creates mayhem in your mouth.

Dr. Anne Clemons:

Absolutely. Yeah. Smoking is one of those big things that we know has a strong association with gum disease. Like you said, smoking wreaks havoc kind of all over the body, but it really, really can kind of set the stage for gum disease and can be pretty aggressive gum disease.

John Horton:

And what about alcohol? Because a lot of us enjoy an occasional glass or something.

Dr. Anne Clemons:

Yeah.

John Horton:

What will that do?

Dr. Anne Clemons:

Yeah, excess alcohol or even foods that have excess sugar, all of that is going to lead to inflammation and can contribute to, not a causative factor for gum disease, but definitely can contribute to kind of worsening gum disease.

John Horton:

And I take it one of the best things we can do for our gum care is just to come and see you.

Dr. Anne Clemons:

Exactly. Exactly.

John Horton:

And yeah. How often should people make dental appointments?

Dr. Anne Clemons:

Yeah, so it's going to vary for sure, person to person. Some people that have gum disease may get a professional cleaning and may see their dentist a lot more often, can be really helpful in managing that gum disease. Sometimes they'll see their dentist every three or four months. For people that have healthier gums or gingivitis that's pretty well controlled, twice a year usually tends to work pretty well, but everyone at the bare minimum should be seeing a dentist at least once a year for checkup.

John Horton:

All right, well I feel like I'm leaving our chat with a little extra motivation to floss and I'm going to set the two-minute timer tonight and make sure I go that long. Before we part ways though, do you have anything else you'd like to add regarding the importance of gum health and what we can do to keep it healthy?

Dr. Anne Clemons:

Yeah, I think as maybe not exciting as gum health is to think about for most people, I think that it is really cool how much power we have in controlling or managing our gum health and the effects that it has overall. It doesn't sound fun to think about adding another few minutes every day to brush and to floss, but when I see the difference that it makes for people that it makes, have their gums look and how they feel overall, it can be so worth it. It really can be so empowering to be able to have such an effect on your health just by increasing this one little habit every day.

John Horton:

Well, you can't argue with that. So thanks so much for joining us today, Dr. Clemons, and I can't wait to have you back on.

Dr. Anne Clemons:

It was a pleasure. Thanks so much.

John Horton:

Focusing on your oral health a few minutes every day won't just help your gums and teeth. It can protect your whole body, including your heart. So invest the time and you may brush away some big time health worries. If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

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