I. Stephen Brown, DDS
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The Perio Group Blog

Dr. Brown: First to Provide Pinhole Surgical Technique in Philadelphia

March 30th, 2021 by sbrown

Periodontal disease is something that impacts as many as half of all of the adults in the United States. For those who are unaware, periodontal disease is gum disease. One of the key signs that you could be suffering from this condition is gum recession. Below, we will reveal more about this condition, as well as telling you more about the Pinhole Surgical Technique and why it is a better option than gum grafting.

Understanding gum recession

Gum recession can occur as a consequence of periodontal disease. This happens when the gum tissue margin around your teeth pulls back or wears away, resulting in more of the tooth being exposed or the root of the tooth. When gum recession happens, gaps or ‘pockets’ are created between the gum line and teeth, which makes it very easy for bacteria that cause disease to build up.

There are a number of different reasons why gum recession occurs, including aggressive tooth brushing and hormonal changes. However, one of the main reasons for gum recession is periodontal disease. This is a bacterial gum infection, which damages and destroys the gum tissue, as well as the bone surrounding the tissue that holds your teeth in position. Gum disease is, without a doubt, the main cause of gum recession.

The good news is that there are treatment options available when it comes to gum recession, and one of the best options is to have pinhole surgical treatment. But, what is this treatment, and is it the best option for you?

What is pinhole surgical treatment?

The pinhole surgical technique is a minimally invasive treatment that helps with gingival recession. Unlike other procedures, such as tissue grafting, this treatment will begin with the creation of a pinhole in the tissue of the gum that is receding. After the pinhole has been made, a special device is placed inside the hole.

This is a device that will peel and stretch the gum into a more suitable and healthier position on the tooth. After the gum tissue is in the position the dentist desires, a collagen strip will be inserted into the pinhole that has been created in the gums. These strips will keep the gums in place, helping to create new tissue that is going to ultimately make sure the gums are secured in their new location.

What makes pinhole surgical treatment a better option than gum grafting?

Also known as a gingival graft, a gum graft can also be used to treat receding gums. With a gum graft, a periodontist first removes a tissue piece from the root of your mouth or from near to the healthy gum tissue. This is then attached to the area where your gums have started to wear away. While this is a treatment that is carried out by many dentists, we certainly recommend the pinhole surgical technique as a better option.

The main reason for this is because the pinhole surgical technique is minimally invasive. This means that there are no incisions and no graft site. As a consequence, you are only going to have one part of your mouth to care for. You can also expect the healing process to be much quicker.

Plus, with the pinhole surgical technique, collagen strips are used to keep the gums in place. With a graft, it is stitches that are used, which is a much more invasive approach. If you’re looking for something that is gentler on your gums, you will definitely prefer to go down the pinhole surgical route.

With pinhole gum rejuvenation, the discomfort and swelling are typically a lot less when compared with gum graft surgery. Overall, it is a treatment that is a lot less invasive and provides a quicker and easier recovery, and this is why it comes highly recommended.

Are you a candidate for the pinhole surgical technique?

If you are thinking about the pinhole surgical technique, you will want to make sure that you are the ideal candidate. Don’t worry, though, as this is something we will be able to discuss with you and assess during your consultation.

Nevertheless, there are certainly some factors that can make or break whether you are a candidate for the pinhole surgical technique. This is a good option if you have tooth sensitivity that has arisen due to your receding gums and/or you’re bothered by the cosmetic appearance of them.

If you are currently a smoker, please note that you will need to quit smoking in order to be considered for this treatment. It is also important that you are in good overall health.

If you are unsure as to whether or not this treatment is going to be the right one for you, the best thing to do is book an appointment so that Dr. Brown can assess your gums and find out about your general health. If this is not the best treatment solution, he will be able to recommend the right one for you.

Dr. Brown was the first periodontist in Philadelphia to provide the Pinhole Surgical Technique

We are proud to say that Dr. Brown was the first periodontist in Philadelphia to provide the Pinhole Surgical Technique! Therefore, when it comes to benefit from the best treatment for gum recession, you will struggle to find better than The Perio Group. After all, we have been carrying out this treatment longer than anyone else in the Philadelphia area, so you can have complete peace of mind when you choose our service.

Contact The Perio Group today to book an appointment or find out more about the Pinhole Surgical Technique

If you would like to find out more about the Pinhole Surgical Technique or you have any queries about this treatment or any of the others we provide, please do not hesitate to get in touch with us today. We would be more than happy to answer any queries you have or to get you booked in for an appointment. The number you need is (267) 828-1656. We look forward to hearing from you and helping you to get the dental treatment you need.

Impact of COVID-19 on Oral Health

March 15th, 2021 by sbrown

There is no denying that the past 12 months have been incredibly difficult for many people in many different ways. The impact of COVID-19 has been widespread, and there have been more knock-on effects than a lot of people realize. For example, one area that COVID-19 has caused havoc is with regard to our dental health. Many people have booked appointments with their periodontist because they have suffered oral health issues due to coronavirus. With that being said, in this blog post, we are going to take a look at the impact of COVID-19 on oral health so that you can get a better understanding.

COVID-19 causes stress, and stress is bad for oral health

There is only one place to begin when it comes to the impact of the pandemic on our health, and this is with stress. This has been an incredibly stressful time for a lot of people. From worries about job security to the loss of a loved one, there are many heartaches that families and individuals have experienced during the past year. The sheer mental battle of struggling with the unknown and being unable to plan for the future can be too much to handle for many, resulting in huge amounts of stress.

Stress can impact the body in so many ways. One way that it can do so is by causing oral health issues. A lot of people grind their teeth in their sleep when they are stressed. This can result in cracked and chipped teeth, as well as wearing down your enamel. Without treatment, the issue can get worse and worse. Your dentist may recommend that you wear a mouth guard that has been specifically designed for you to protect your teeth while you are sleeping.

Of course, it can be difficult to recognize that you’re grinding your teeth when you are sleeping. How are you supposed to know? Often, it is your partner that will realize first. However, you may find that you end up waking yourself up in your sleep because of the grinding sound. Other symptoms include jaw pain and toothache when you wake up. The pain can often spread to other areas of the face.

Dry mouth

We have also noticed that more people are suffering from dry mouths than ever before. There are a number of different reasons why dry mouth can happen. However, when it comes to the pandemic, it is very likely that this has happened because we’re wearing masks so much! Evidence indicates that mouth breathing will desiccate oral tissues, which causes halitosis (bad breath) and an increase in the unhealthy bacteria in the mouth.

However, there does need to be more research regarding the link between COVID-19 and xerostomia, as it is not very well-understood at the moment. Clinicians need to carry out more research to determine the causal mechanisms that underlie the correlation. Nevertheless, the increase in the prevalence of dry mouth is concerning for some, as this can lead to an increase in both candida caries and infections as a consequence.

Gum disease

We have also seen some worrying research regarding the link between gum disease and COVID-19. It has been indicated that those with gum disease are more likely to experience severe COVID-19. This is a study that was published in the Journal of Clinical Periodontology. The research revealed that gum disease is a significant risk factor for coronavirus, which is worrying when you consider the fact that as many as half of the adults in America have this condition.

There were 568 patients that were involved in the study. They were divided into two groups. In one group, there were those that only had mild symptoms. The second group was individuals who faced complications like ventilation and ICU admission. The research found that patients with COVID-19 were nine times more likely to die if they had gum disease. They were also 3.5 times more likely to be admitted to ICU than patients who did not have any signs of dental problems. Furthermore, they were 4.5 times more likely to need a ventilator.

When you take this research into consideration, it is not difficult to see why people are concerned regarding the link between gum disease and coronavirus. If you are someone who suffers from gum disease, it certainly makes sense to book an appointment with your dentist sooner rather than later to begin treatment. Some of the signs of gum disease are as follows:

  • Bad breath
  • Gums that bleed with ease
  • Pus between your gums and teeth
  • Puffy or swollen gums
  • Spitting out blood when flossing or brushing your teeth
  • Bright red or purplish gums
  • Gums that feel tender when you touch them

Oral ulcerations and gingival tissue breakdown

Evidence indicates that COVID-19 causes damage to the blood vessels within our body, which include the blood vessels that supply the mouth. This could end up resulting in an increase in oral ulcerations and gingival breakdown.

One group that works to find out more about the mechanism of cardiovascular disease, The Angiogenesis Foundation, believes that the endothelial cells that line blood vessels are susceptible to SARS-CoV-2 because of carrying the ACE-2 receptor. When they are penetrated by the virus, they end up becoming damaged, which deprives the body’s downstream areas of oxygen. In the mouth, the procedure manifests as dying gum tissue and ulcerations. The symptoms become worse because of the inflammation that COVID-19 induces.

Contact The Perio Group team today for the treatment you need

As you can see, there are many different ways that COVID-19 has impacted oral health. If you have experienced any dental issues relating to COVID-19, we will be happy to provide you with the treatment you need. Please do not hesitate to get in touch to schedule an appointment with Dr. Brown and The Perio Group team for related treatment. You can reach us at (267) 828-1656. We look forward to hearing from you and helping you to get those pearly white teeth you dream of!

Relationship Between Periodontal Disease and COVID-19

February 25th, 2021 by sbrown

There is no denying that the world has changed considerably over the past 12 months. Due to the pandemic, life is not as we once knew it. One thing that has changed from a dentistry perspective is the need to wear facemasks when entering the clinic and to respect social distancing rules. However, there are advancements that have been made in terms of researching the connection between oral health and the virus itself. With that being said, in this post, we are going to take a look at the relationship between COVID-19 and periodontal disease specifically in further detail.

Systemic inflammation can be a symptom of both periodontal disease and COVID-19 as well. After noticing this similarity, there has been new research that has been conducted and then published in the Journal of Clinical Periodontology. It certainly makes good reading because it draws some conclusions regarding the connection between coronavirus and gum disease. In fact, the journal revealed that there is a link between severe COVID-19-related complications and gum disease. So, let’s explore this in further depth.

The nation’s leading organization of periodontists, the American Academy of Periodontology, has stated that these findings show just how significant effective, diligent, and proactive oral care is during the pandemic. It has been clearly established that systemic inflammation is linked with periodontal disease, as well as being linked with a number of different respiratory diseases. As a consequence of this, it is imperative that you keep your gums and teeth in good condition to give yourself the best chance of avoiding periodontal disease developing or getting worse. This is imperative at all times, but it is even more so important during a worldwide pandemic, like COVID-19.

Also known as gum disease, periodontal disease, can result in a number of other symptoms, including bad breath and bleeding gums. If it is not treated, it can also end up causing tooth loss. Research that has been carried out by the Centers for Disease Control and Prevention, as well as the American Academy of Periodontology, has indicated that up to half of the adults in the United States over the age of 30-years-old have some type of periodontal disease. Periodontal disease has been linked to a number of other serious diseases and conditions aside from COVID-19, such as Alzheimer’s, heart disease, and diabetes.

There are further studies and research that has been carried out in regard to the relationship between COVID-19 and periodontal disease. Using the electronic national health records of the State of Qatar between the months of February and July of 2020, the study assessed patient cases with severe complications relating to COVID-19, for instance, assisted ventilation, ICU admissions, and death. The control group consisted of patients who have had COVID-19 and been discharged without any sort of significant complications. Data from the two groups were assessed in regards to the periodontal disease, utilizing dental radiographs from the same database.

The findings from the study were certainly interesting, to say the least. The study involved 568 patients being assessed. Of those patients, those with the most severe cases of gum disease, i.e. periodontitis, were at least three times more likely to experience complications from coronavirus, which include the need for assisted ventilation, ICU admission, and even death. In addition to this, patients with COVID-19 and periodontitis showed a heightened level of biomarkers associated with worsened disease outcomes, including c-reactive protein, D-dimer, and white blood cells.

Of course, there is more research that needs to be done on this virus. It is still very early days and there is a lot that needs to be done. However, if you look at the research that has been done up to this point, you can see that there is clearly a connection between periodontal disease and COVID-19.

Treating periodontal disease is imperative

Treating periodontal disease has always been important. Allowing it to get worse can result in tooth loss eventually, which is the last thing anyone wants. Plus, when you consider the link between COVID-19 and periodontal disease, you see why it is even more important that you schedule an appointment with a periodontist if you notice any of the signs of periodontal disease.

So, what sort of signs and indications should you be looking for? Examples include the following:

  • Pus that is in between your gums and your teeth
  • Bad breath
  • Spitting out blood when you floss or brush your teeth
  • Gums that bleed with ease
  • Gums that feel tender whenever you touch them
  • A toothbrush that is tinged pink once you have brushed your teeth
  • Purplish, dusky red, or bright red gums
  • Puffy or swollen gums

If you notice any of the signs that have been mentioned above, the best thing to do is contact us as soon as possible so that we can provide a thorough dental examination. This will enable us to get to the bottom of the symptoms you have and whether or not this is periodontal disease. If it is periodontal disease, we will be able to discuss your treatment options with you to make sure you have the best recovery plan in place and the condition does not get worse.

Contact The Perio Group to schedule an appointment today

If you require periodontal disease treatment, or you want to achieve the perfect smile with the help of one of the best periodontists in Philadelphia, all you need to do is give The Perio Group a call today. You will speak to one of our friendly and professional team members who will be more than happy to answer any questions you have. We look forward to hearing from you and helping you with your dental concerns.

Dr. I. Stephen Brown: 12 Time Philadelphia Magazine Top Dentist

February 25th, 2021 by sbrown

When it comes to your smile, you don’t want to trust just anyone with the condition of your teeth, right? You need someone experienced. You want to be safe in the knowledge that your teeth are going to look greater and that your dentist is going to be able to spot any signs or symptoms that need to be acted on. This is something that you can be sure of with Dr. I. Stephen Brown, the 12 Time Philadelphia Magazine Top Dentist award winner.

Working at The Perio Group, Dr. I. Stephen Brown has a reputation as one of the best periodontists in Philadelphia. In fact, he has been awarded the Top Dentist accolade for periodontics in the Philadelphia Magazine for the past 12 years. That’s quite a statement, and this should leave you with no doubts if you are looking for an experienced and reputable periodontist. Well-respected and incredibly talented, Dr. I. Stephen Brown leads the way when it comes to innovation in the dental field.

The Philadelphia Magazine Top Dentist Accolade

Let’s take a look at the Philadelphia Magazine accolade in further detail. Each year, the Philadelphia Magazine puts together a list of the top dental professionals in the area. These are individuals that have made an exceptional contribution to the local community, and they have shown they provide a professional, dependable, and reliable service to their patients. This is certainly the case for Dr. I. Stephen Brown, as he has now had the Top Dentist award for the past 12 years. This is an accolade that is very prestigious, determining excellence in the field. When looking for the best periodontist in Philadelphia, this is something that a lot of people will refer to. After all, reputable awards and published lists like this are always great when looking for any service professional. This can give you complete peace of mind that Dr. I. Stephen Brown is an excellent periodontist for anyone looking for oral health treatment in Philadelphia.

Understanding what makes Dr. I. Stephen Brown such a great periodontist

There are many dentists across Philadelphia, so what sets apart the great from the good? Well, there are a number of different reasons why Dr. I. Stephen Brown continually gets recognized when it comes to the Top Dentist award in Philadelphia. This is not the type of award that is won by just about anyone, and this is evident by the case that Dr. I. Stephen Brown has now won it 12 times in a row. So, what is it about Dr. I. Stephen Brown that makes him such a worthy choice?

Well, there is only one place to begin, and this is with his high level of training, education, and experience in the industry. His skill set is unrivaled, and he has become one of the clear educators in the dental field. This is what has resulted in him achieving such attention in the industry. He has made a number of contributions to the dental sector, which includes sponsoring a number of educational programs. These contributions have lifted his status, as it shows that he cares not just about his status, but about helping the dental industry to progress and ensuring the next generation of periodontists are ready to provide an excellent dental service. As a consequence, he is held in very high esteem by a lot of people inside the dental field, as well as those out of it.

Dr. I. Stephen Brown has a great team of people working at The Perio Group as well

While Dr. I. Stephen Brown is an excellent professional, he also has an amazing team working by his side. This is certainly the case at The Perio Group. Not only does Dr. I. Stephen Brown have an outstanding reputation, but so does The Perio Group practice. The outstanding team here is helpful, knowledgeable, and friendly, and they make a dedicated effort to make sure that all patients feel completely at home.

A lot of patients feel nervous about receiving dental treatment, and we understand why this is the case. After all, when it comes to stepping into the unknown, it is always difficult. You do not know what to expect. You see all of these dental tools and it can cause panic. However, we can assure you that there is nothing for you to worry about when having treatment at The Perio Group. We will make sure that everything is explained to you in full, and we are always there if you have any queries or concerns. It is our aim to make you feel comfortable and at ease.

We offer a full assortment of periodontal treatment as well, making sure you get all of the care and assistance you need. This includes periodontics, implant dentistry, and much more. Whether it is treating gum disease or it is ensuring your teeth look amazing and make you feel confident, we can help. We will put together a personalized treatment plan that is just right for you.

Contact The Perio Group to Schedule an appointment today

If you would like to have your smile treated by one of the best periodontists in Philadelphia, all you need to do is give The Perio Group a call today. You will speak to one of our friendly and professional team members who will be more than happy to answer any questions you have and to get an appointment scheduled with the Dr. I. Stephen Brown. Contact us today!

Bad Breath: Causes and Fixes

January 30th, 2021 by sbrown

It is something we all feel self-conscious about. From the “morning breath” we have when we wake up, to the food we eat containing pungent ingredients, as well as the increased use of face masks right now, bad breath (aka halitosis) is something that affects millions of people. While we can feel conscious in a public setting that our breath smells pretty bad, the fact is we’re not alone. Bad breath doesn’t just impact your self-consciousness but can have a direct impact on your social life and your confidence. But there are simple reasons why you may have bad breath, but there are also simple methods to solve them.

Poor Oral Hygiene

This is culprit number one when it comes to bad breath. Poor oral hygiene causes plaque buildup, which, if left untreated, can calcify, resulting in calculus, commonly known as tartar. This leaves you at risk for periodontal disease or gingivitis. The solution to fixing this is to brush your teeth properly for the recommended 2 minutes. Doing this twice a day, as well as flossing and brushing your tongue, will ensure that you are doing your utmost.

Your Diet Is High in Sugar

When you eat too much sugar, you are giving the bacteria in your mouth the opportunity to thrive. As bacteria feeds off sugar, the excess bacteria in the mouth can lead to bad breath. If you cannot completely kick the sweet treats, switch to diet soda and sugar-free candy. In addition, if you consume any sugary treats, either rinse your mouth out with water or brush your teeth to reduce the sugar concentration on the teeth and in the mouth.

Old Dental Work

You may have fillings, but leaving them when they need updated treatment is unwise. Old fillings can gradually wear out, which allows bacteria to seep into the tooth and may result in infection. Whether you’ve had restoration surgery, such as cavities or crowns, they can crack or oxidize, which is the breakdown due to the bacteria and acids in your mouth, resulting in bad breath. To fix this, contact Dr. I. Stephen Brown to check if any crowns or fillings need replacing and ensure that the latest high-quality materials and techniques are used.

A Highly Acidic Diet

If you are prone to acidic foods in your diet, this can cause acid reflux, which results in bad breath. Common symptoms of acid reflux include burping, heartburn, and a bitter taste in the mouth. If you notice bad breath and have acid reflux, you may want to keep a food log to identify acidic foods and make changes to your diet. You may also want to enquire about antacid medicines to reduce acid reflux symptoms.

Dry Mouth

Also known as Xerostomia, this decreases the production of saliva. If you have low saliva flow, bacteria can flourish, which can result in bad breath, as well as periodontal disease and gingivitis. To prevent dry mouth, drinking lots of water is a simple method, as well as products that contain Xylitol. You can purchase over-the-counter medication to stimulate saliva flow.

You Follow the Ketogenic Diet

A very popular diet trend is the ketogenic diet, where individuals consume high amounts of fat, while greatly limiting the consumption of carbohydrates. Individuals can find themselves suffering from “keto breath,” which is caused by the high level of acetone in the body. The process of ketosis burns fatty acids rather than carbohydrates, and as fatty acids are converted into ketones, a by-product of this process is metallic-tasting “keto breath.” If you’ve just started a ketogenic diet, it can subside within days or a week of this diet. But you can also minimize your keto breath by increasing your water intake, choosing sugar-free mints and gum, as well as practicing good oral hygiene.

Cavities or an Infection

As these are caused by bacteria overgrowth in the mouth, the bacteria secrete sulfur, which can cause malodor, which is another term for an offensive odor. The best way to combat this is to see your dentist for regular check-ups. Cavities do not disappear by themselves. It is important that you visit your dentist at least twice a year to make sure your cavities are kept at bay. But practicing good oral hygiene will also be a fantastic preventative measure.

Underlying Health Issues

Many underlying medical conditions, such as diabetes, kidney disease, or sinus infections, can cause bad breath. If you believe you are experiencing an underlying health condition, especially if you’re not able to get rid of your bad breath, you should schedule an appointment with a doctor to rule this out. Any build-up of bacteria can result in bad breath.

You Do Not Floss

Nearly a third of Americans do not floss their teeth. This is a very simple way to reduce bacteria in your mouth. Brushing your teeth does not reduce bacteria alone. When you remove the plaque in the gum pocket and in between the teeth, you are getting rid of bacteria that can fester. Flossing before you go to sleep should be a key part of your nighttime routine.

Poor Dental Practices

When was the last time you made a dental appointment? One of the best things you can do to prevent halitosis is to visit the dentist on a regular basis. Regular dental care can make sure that your teeth and gums are healthy without any signs of periodontal disease. Dr. Brown can provide you with a proper cleaning every 3 or 6 months to guarantee that you are keeping your mouth as healthy as possible.

If you have not scheduled an appointment recently, now is the time to see Dr. Brown to address any issues with dental care. We provide a personal, professional, and ultimately caring service. Halitosis is more common than you think, and by giving you some tips and tricks to manage bad breath while also maintaining your oral hygiene, you can feel confident and assured that your bad breath is at bay. Contact us to schedule an appointment for bad breath treatment today!

What Is The Link Between Gingivitis and Alzheimer’s Disease?

January 16th, 2021 by sbrown

What is the worst thing that can happen if we don’t take care of our teeth and maintain good oral hygiene? If you look after your teeth, you won’t just avoid holes in your teeth and keep your pearly whites, but you may very well prevent yourself from something that goes far deeper. Gum disease, commonly known as gingivitis, may very well play a role in someone developing Alzheimer’s disease. How is this, and how does it impact us?

A study published in the medical journal Science Advances highlighted a pathogen called Porphyromonas gingivalis that was discovered in the brain tissue of people with Alzheimer’s disease. In addition to this, gingipains, toxic enzymes made by the Porphyromonas gingivalis bacterium, were also present in many brain samples. The link between gingivitis and Alzheimer’s disease is that the toxic substances produced by the gingipains are directly related to the levels of tau and ubiquitin, which are proteins linked with the development of Alzheimer’s disease.

The idea was initially mentioned in the early 20th century by Alois Alzheimer, who suggested that infections contribute to the development of Alzheimer’s disease. In addition, there was evidence to highlight that chronic inflammation can be a cause of Alzheimer’s disease, which is a common battle we are fighting when it comes to our oral health.

How Is This Being Combated?

While there is evidence to highlight a strong link between Porphyromonas gingivalis and Alzheimer’s, the research doesn’t point exclusively towards gingivitis as the sole reason behind Alzheimer’s disease. There are many things that you would need to consider. While infections are not the root cause of Alzheimer’s disease, they can play a role. For example, the production of proteins called beta-amyloid can be the brain’s way of protecting itself against Alzheimer’s. And an over-accumulation of beta-amyloid could result in the plaques that are linked to Alzheimer’s disease.

Additional research has highlighted the effects of certain medications on blocking the enzymes from the bacteria, which postpones the development of Alzheimer’s disease. There is still more research to be conducted, but what does this mean?

Will I Get Alzheimer’s Disease if I Don’t Brush My Teeth?

The study has highlighted that the enzymes from the bacteria can be a cause of Alzheimer’s disease, but the research is still in its infancy. It would not be correct to say that if you don’t brush your teeth, your chances of getting Alzheimer’s greatly increase. But rather, it is important to realize that preventing the bacteria in your mouth is more of a priority. Alzheimer’s is the result of many different external factors, such as genetics and lifestyle.

How Can I Reduce the Risk of Gingivitis?

The studies have highlighted the impacts of the enzymes caused by bacteria in relation to developing Alzheimer’s. The lesson is very simple, that prevention is better than cure. The bottom line when it comes to reducing the risk of gingivitis is to maintain good oral hygiene. We can have concerns that if we do not prevent gingivitis, that we are at a higher risk of Alzheimer’s disease. But there are many factors to consider in regards to this, such as your genetics, your predisposition to certain illnesses and ailments, as well as your oral hygiene.

The research conducted by Broegelmanns Research Laboratory, Department of Clinical Science, University of Bergen (UiB) has highlighted the impacts of the enzymes from the bacteria moving from the mouth to the brain. But in the same study, bacteria are not shown as the root cause. Merely, it is the presence of the bacteria that raises the risk of developing Alzheimer’s. In the same study, researcher Piotr Mydel states there are two very simple, but critical, things that you can do to slow down Alzheimer’s: Brush your teeth and floss

Preventing gingivitis by brushing your teeth twice a day, and flossing at least once a day as well as having regular check-ups will keep gingivitis at bay.

What Are the Risk Factors for Gingivitis?

Addressing your lifestyle can be key to minimize the risk factors for gingivitis. Some diseases like diabetes and cancer are linked to a higher risk of gingivitis. In addition, certain lifestyle choices, such as smoking, are more likely to develop gingivitis. In addition, a poor diet, such as one lacking in vitamin C is linked to gum disease. Also, those with a family history of gingivitis are more predisposed to developing it.

What if I Already Have Gingivitis?

If you have concerns that you have gingivitis, it is important to recognize the symptoms:

  • Bright, red, or purple gums
  • Bleeding from the gums when flossing or brushing
  • Inflammation or swollen gums
  • Soft gums
  • Tender gums that may be painful to touch

If you have any of the symptoms, it is important to schedule an appointment with Dr. I. Stephen Brown for an exam. If a diagnosis is reached early, and the treatment is undertaken quickly, gingivitis can be reversed.

Is It Time To Schedule an Appointment?

We shouldn’t be gingerly when it comes to gingivitis. As you can see, there is a link between gingivitis and Alzheimer’s. While there is still a lot of research left to go to truly highlight if gingivitis is a direct cause of Alzheimer’s, you should not hesitate to get any symptoms of gingivitis checked out as soon as possible. Dr. Brown and his team are ready to help you diagnose and treat gingivitis. If you are experiencing any symptoms, get in contact with us by calling or requesting a virtual consultation.

Gingivitis can be, at best, frustrating, but at worst, it could leave too many complications, such as loss of teeth, but at the very worst, it could be a signifier for Alzheimer’s disease. Contact us so we can provide the best possible care and help you look after your oral health and future.

Oral Conditions Associated with COVID-19

December 30th, 2020 by sbrown

The general public associates COVID-19 with respiratory symptoms, such as difficulty breathing and a dry persistent cough. But the virus has been found in virtually every part of the body, including the mouth.

Recently, new data emerged from clinical practice showing that COVID-19 also has a deleterious effect on the oral cavity, causing a host of clinically significant symptoms. Dentists are noticing that patients with “long COVID-19” are experiencing tooth loss, greying gums, and tooth cracking alongside at a higher rate than usual.

For many, the question is why the disease appears to affect oral tissue so severely. So far, evidence suggests that it relates to the preponderance of ACE-2 receptors in the mouth targeted by the SARS-CoV-2 virus. The salivary glands, tonsils, and tongue carry more of the specific RNA-linked proteins that the coronavirus requires to infect cells, including specific enzymes that make it easier for it to penetrate the cell wall.

As a consequence, dentists are seeing more oral manifestations associated with COVID-19. Here’s a rundown.

Taste And Smell Loss

Loss of taste and smell were among the first identified symptoms of COVID-19. Doctors noticed that case-patients who tested positive would lose these senses early on, especially if their other symptoms were mild. Estimates suggest that the average prevalence of loss of taste among cases is around 38 percent.

The cause of loss of taste and smell in COVID-19 was originally thought to be the viral invasion of facial nerve cells. However, more recent studies cast doubt on that idea because of the absence of ACE-2 receptors in these tissues. Now the theory is that the virus infects susceptible cells surrounding the oral and nasal nervous system and this causes inflammation which then impacts patients’ sense capacities.

Cracked Teeth

Before the virus, the typical dentist might see one cracked tooth every other day. But with the onset of the pandemic, the number of patients with fractured teeth has risen significantly. Two visits per day are now the norm.

Dentists don’t believe that the virus is weakening teeth (although this remains a possibility). Instead, the current theory is that the stress of the pandemic is leading to more teeth grinding which, in turn, is leading to higher-than-usual levels of damage to dentition. COVID-19, looting, rioting, politics, and the general state of the nation has everyone on edge and unconscious bruxing is rising.

Gingival Tissue Breakdown And Oral Ulcerations

Evidence suggests that COVID-19 damages blood vessels across the body, including those that supply the mouth. And this could be leading to an increase in gingival breakdown and oral ulcerations.

The Angiogenesis Foundation – a group that works to uncover the mechanisms of cardiovascular disease – believes that the endothelial cells that line blood vessels are susceptible to SARS-CoV-2 because they carry the ACE-2 receptor. When the virus penetrates them, it damages them, depriving downstream areas of the body of oxygen. In the mouth, this process manifests as ulcerations and dying gum tissue. Generalized COVID-19-induced inflammation compounds the damage, worsening symptoms.

Dry Mouth

Pre-pandemic, dry mouth, or xerostomia, was a condition that dentists saw mainly in the elderly and smokers. Both age and tobacco use damage the salivary glands that keep the oral cavity moist. However, since the advent of the COVID-19 pandemic, more patients than usual are presenting with the condition.

Dry mouth is problematic because it causes bad breath and increases the rate of both cavities and oral infections. Saliva plays a vital role in the mouth, clearing away microbes and providing mild antiseptic action. When it is absent, the rate of oral health issues increases.

COVID-19 may be leading to an epidemic of dry mouth because of frequent mask use. Mouth breathing, evidence suggests, desiccates oral tissues, leading to halitosis and an increase in unhealthy bacteria.

Direct assault by the virus of salivary glands is a secondary mechanism. Data suggest that SARS-CoV-2 can enter salivary cells via the ACE-2 receptor, damage them, and cause them to produce less saliva than usual.

At present, the relationship between xerostomia and COVID-19 is poorly understood. Clinicians require more research to identify the causal mechanisms underlying the correlation. However, the rise in the prevalence of the condition is worrying for some, since in normal practice, dry mouth leads to an increase in both candida infection and caries.

Gingival Inflammation

Gingival inflammation typically occurs when bacteria in the oral cavity damage the gumline. Patients who fail to brush their teeth, for instance, often experience gum bleeding and damage to superficial tissues. And these problems get worse, the longer the oral hygiene hiatus lasts. However, many COVID-19 patients with excellent oral health practices are also experiencing gum problems.

Cytokines and interleukins – inflammatory signaling compounds – direct the immune system to target tissues afflicted by the SARS-CoV-2 virus, leading to redness and swelling. Since inflammation occurs across the whole body, it also adversely affects tissues in the mouth. And this, many researchers believe, is behind the rise of gingival inflammation.

Some patients experience severe inflammatory signaling dysregulation during COVID-19. Here, the body produces an abundance of cytokines and interleukins, inducing a “cytokine storm” as it attempts to direct the immune system to fight infection in multiple tissues. In small doses, inflammatory signaling compounds are helpful and marshal the body’s response to external threats. But in high quantities, they can be very damaging.

Regular periodontal disease causes elevated cytokine levels. Now evidence is emerging that the condition could also be contributing to cases where patients experience a cytokine storm, making the overall course of the disease worse.

Schedule An Appointment

The COVID-19 pandemic has been challenging for everyone. But it is also leading to a new raft of oral health problems.

If you’re concerned about your teeth and gums and would like a consultation, please schedule an appointment with Philadelphia Periodontist Dr. I. Stephen Brown. Solve any problems you may have and get peace of mind today!

Increase of Dry Mouth During COVID-19

November 30th, 2020 by sbrown

The COVID-19 pandemic has presented new challenges in all aspects of our lives, and oral health isn’t any different. The increased presence of dry mouth has become one of the major issues facing patients from all backgrounds. Dr. I. Stephen Brown and The Perio Group team have witnessed a noticeable increase in cases of dry mouth since safely reopening the dental practice.

What causes dry mouth?

Dry mouth is an oral health condition that can be broken into two distinct types: xerostomia relates to a patient’s perception of dry mouth while hyposalivation is a pathological issue defined by reduced saliva flow. In either case, it is a problem that is caused by a lack of saliva production in the salivary glands.

While it is a condition that affects almost everyone from time to time, persistent dry mouth can be immensely damaging to a person’s overall oral health. Given its nature, figures on how many people have ongoing dry mouth range from anywhere between 1% and 65%. The main causes of dry mouth are;

  • Aging,
  • Dehydration,
  • Medication side effects,
  • Cancer treatment,
  • Tobacco,
  • Underlying health issues.

The plethora of underlying health conditions include; Sjögren’s syndrome, Alzheimer’s disease, HIV, diabetes, Parkinson’s disease, Hepatitis C, Lymphoma, hypertension, and various mental health conditions ranging from anxiety to depression.

Dry mouth caused by a lack of saliva production by the salivary glands can impact the oral cavity as well as your general quality of life. It can increase the risk of tooth decay and oral viruses while also making it harder to chew, swallow, and talk. When you have dry mouth, finding a solution is vital.

Due to COVID-19, it’s a challenge that even more people are faced with.

Why is dry mouth more common during COVID-19?

The reasons behind the lack of saliva production can be linked to many issues, but the most common are;

  • Changes in mental wellbeing,
  • Dehydration,
  • Dietary and lifestyle changes.

Changes in mental wellbeing

Anxiety is the most common health issue linked to hypersalivation, impacting the composition and flow of saliva production. This is partly due to the fact that the central nervous system (CNS) is responsible for regulating the salivary reflexes. Meanwhile, depression and other stress-inducing mental health conditions are a huge threat to the activity of the salivary glands.

Right now, our collective mental health is under greater strain than ever before thanks to COVID-19. Experts at The American Psychological Association (APA) have pinpointed the impacts of social detachment and isolation during this time as one of the pandemic’s biggest problems.

Loneliness is further exacerbated by the stress of job insecurity, along with the continued fears of getting the disease. Worse still, it is virtually impossible to trick your body into feeling unstressed. If the situations caused by the pandemic are making you stressed or anxious, saliva production and regulation may undergo noticeable changes, thus leading to xerostomia.

Dehydration

The human body needs regular hydration, and even a minor drop in hydration levels can severely impact your physical and mental wellbeing. Dry mouth is naturally one of the most noticeable changes. The average adult can use the 8×8 rule (eight 8oz glasses per day), although contributing factors such as climate and physical activity can impact this.

COVID-19 makes it significantly harder to stay hydrated throughout the day due to wearing Personal Protective Equipment throughout the day, potentially for several hours at a time. Likewise, you may be hesitant to carry a bottle in public areas as the virus can stay on surfaces all day long.

Even patients that have largely stayed indoors may find that dehydration has increased as a sedentary lifestyle can make it easier to ignore your thirst. When this process is repeated for a few days, the impact on your hydration levels can be vast. Consequently, then, saliva production levels may fall as a result. Moreover, dehydration may harm your immune systems, increasing the threat of COVID-19.

Dietary and lifestyle changes

Boredom, a loss of routine, and restricted possibilities are a common theme at this immensely difficult time. If your lifestyle has changed dramatically since the pandemic, it’s likely that biological impacts will have occurred. Dry mouth is one of the most common, especially if lifestyle alterations have been coupled with modifications to your diet and nutritional habits.

Alcohol is a diuretic, which will lead to dehydration and dry mouth. Alcohol consumption has increased for a lot of people since the start of the pandemic, which has contributed to the growing presence of dry mouth cases. Alcohol consumption is often worsened by the heightened use of tobacco.

Lifestyle changes may also extend to dehydrating yourself by spending more time wrapped up in the warm, especially over the colder months. Meanwhile, most patients are now self-medicating in a wide range of health conditions. The side effects of various medicines can have a telling influence on the activities of your salivary glands and could be a leading cause of your common issues.

Overcoming dry mouth during COVID-19

Beating dry mouth during COVID-19 is largely an assignment that revolves around trying to restore normality to your daily habits, including hydration, lifestyle choices, and oral hygiene. While the pandemic does pose new challenges, maintaining habits that encourage healthy salivary glands will establish the strongest platform for success throughout the coming months.

A conscious effort to avoid falling into bad habits during these times can be supported further by daily routines to reduce stress. Nonetheless, professional dental care remains an important ingredient in the recipe for success. And even the pandemic should not stop you from seeking the right care.

Dr. Brown and his team can provide a safe environment and a comprehensive dental care that includes spotting the clear signs of dehydration. This could include a wide range of symptoms, including but not limited to;

  • Oral thrush,
  • Inflammation,
  • Gum disease,
  • Sialadenitis,
  • Saliva composition,
  • Oral mucosa fissuring.

When dry mouth is diagnosed, Dr. Brown can also investigate the reasons for it surfacing during COVID-19 before devising the best lifestyle changes or course of treatment for dry mouth.

Pathogens Contributing to Oral Cancer

October 30th, 2020 by sbrown


A new study posted in last month’s issue of PLOS Pathogens (1) by Yvonne Kapila of the University of California, San Francisco, has determined that pathogens surrounding the teeth are a leading contributor to a highly aggressive form of Oral Squamous cell Carcinoma (OSCC), commonly known as oral cancer. As a result, regular oral cancer screenings are advised to high-risk patients including tobacco smokers and regular alcohol consumers and should be incorporated as part of a good oral health routine.

Dr. I. Stephen Brown and The Perio Group team offer oral cancer screenings alongside a wide range of dental treatments to identify early signs of oral malignancies and select the right treatment for patients that are found to have the oral disease that can be closely linked to pathogens within the oral cavity.

What is oral cancer?

Oral cancer, also known as mouth cancer, is a term that describes any cancer that develops in the mouth or at the back of the throat. While several forms of oral cancer exist, over 90% of all oral cancers are defined as Oral Squamous Cell carcinoma (OSCC). This occurs when the fish-scale looking squamous cells found on the skin surface tissues are mutated. It can start out as any of the following, before spreading to other parts of the body;

  • Buccal mucosa cancer,
  • Floor of mouth cancer,
  • Gum cancer,
  • Hard palate cancer,
  • Lip cancer,
  • Tongue cancer.

Less common forms of mouth cancer include Oral Verrucous Carcinoma and Oral Melanoma, which can develop in the pigment-producing cells within any part of the oral cavity. When diagnosed early, the five-year survival rate of oral cancer is 84% (2). However, this rate does fall significantly if the cancer is allowed to spread. An oral cancer screening with Dr. Brown and his team will help you stay in control of the situation.

Pathogens causing oral cancer

Pathogens are any organism that can cause a disease. In relation to oral health, this may cover viruses, bacteria, and various other microorganisms. Unfortunately, this issue often goes unnoticed by patients due to a lack of pain while visible changes may be hard to spot due to their location too. This is one of the reasons that, in addition to the 9,750 annual deaths, oral cancer patients are up to 20 times (3) more likely to develop a secondary cancer.

While risk factors do extend to smoking, alcohol consumption, and human papilloma virus infection, Kapila’s study into the impact of periodontal pathogens in the development, progression and metastasis of OSCC tumors has been quite conclusive. It identified three oral pathogens as problematic for cell migration, invasion, and tumor growth. They are;

  • Porphyromonas gingivalis,
  • Treponema denticola,
  • Fusobacterium nucleatum.

The studies conducted on mice analyzed mediation through two pathways, integrin/FAK, and TLR/MyDD88, and determined that processes were inhibited by treatment with the nisin bacteriocin while also indicating its therapeutic potential as an antimicrobial and anticancer agent, which could subsequently inhibit the pathogen-mediated cancer formation.

It is suggested that the findings of Kapila’s study could alter the future of oral cancer treatment, with a greater focus on antimicrobial-based therapies. In turn, it may hold the key to finally unlocking an increased rate of five-year survival after decades of hovering around the 55% mark across patients of all oral cancers and stages. Crucially, an increased understanding of the role that pathogens play can further boost the impact of oral cancer screenings.

Diagnosing mouth cancer with oral screenings

The statistics are pretty clear regarding the importance of finding oral cancer at the earliest stage. It will boost survival rates from the initial cancer while simultaneously reducing the threat of developing secondary cancers. A professional screening with Dr. Brown can look for the presence of pathogens on the tissues surrounding the teeth, as well as other oral cancer symptoms, including lumps and various types of cell degeneration.

Comprehensive oral cancer screenings cover a wide range of factors to test all potential cancer sources.

Extraoral screenings

External examinations will include checking the entire face for a range of issues, such as;

  • Asymmetry,
  • Masses,
  • Swelling,
  • Discoloration,
  • Pigmented skin.

Further steps will include checking the eyes for swelling during movement, analyzing the nasal passages and the neck. The thyroid and lips will additionally undergo screenings.

Intraoral cavity examination

Internal examinations of oral cavities will include visual inspections in which Dr. Brown will use a gloved hand to move the tongue and gain visible access to the tongue, hard and soft palate, tonsils, floor of mouth, and buccal mucosa as well as the tissues surrounding the teeth.

Each part of the examination will look for different signs of oral cancer, which could include;

  • Swelling,
  • Discoloration,
  • Lumps,
  • Lesions,
  • Ulcerations,
  • Other abnormalities.

The examinations will be conducted using various dental appliances that allow for even greater visibility, including a gauze and added light. The examination should only take a few minutes to complete while Dr. Brown ensures a comfortable and safe setting for all patients.

In addition to examining your mouth for signs of cancer, the oral screening can look for additional oral health conditions while also checking your overall oral health. Following the examinations, then, you may be provided helpful advice on how to stay on top of your oral health and reduce the likelihood of getting oral cancer in the future (such as quitting smoking), which makes it a useful procedure even if it is found that no symptoms are present.

Contact Dr. Brown to arrange an oral cancer screening today

Have you noticed changes to your oral health, or wish to gain peace of mind by ruling out the development of oral cancer? If so, contact us to arrange your oral cancer screening today! The Perio Group proudly provides a safe dental practice that has been adapted to meet COVID-19 regulations to keep you protected while still providing the same high standards of dental care throughout every stage of your oral cancer screening. To find out more, including what steps we’ve taken, give us a call today!

Vaping and Periodontal Disease

September 30th, 2020 by sbrown

Vaping has grown in popularity over the last few years. It is seen by many as an alternative to smoking cigarettes, offering a healthier option for smokers. By using e-cigarettes, it’s believed that individuals will avoid many of the health complications associated with traditional tobacco cigarettes. As a result, you’d expect dentists to be over the moon at the prospect of something that reduces the consumption of cigarettes. It’s well known that cigarettes cause a lot of oral health problems – most notably staining and periodontal disease.

However, while vaping might be ‘healthier’ than smoking, it’s certainly not healthy. In fact, research suggests there is a strong link between vaping and periodontal disease. This is down to the chemicals present in e-cigarettes and how they interact with your mouth. Some dentists argue that they might be worse for your oral health than traditional cigarettes.

What is vaping?

Vaping is a term used to describe the act of using e-cigarettes. For all intents and purposes, an e-cigarette is an electronic version of a typical tobacco cigarette. Of course, it is built out of entirely different things and uses technology. The science behind vaping is pretty straightforward: a liquid is heated to generate vapor, which is then inhaled by the user.

A typical e-cigarette will have a few key components:

  • A replaceable inhaler cartridge – this contains the e-liquid that is heated. You can buy many different cartridges of liquids in loads of various flavors. Most e-liquids are made of vegetable glycerin, polyethylene glycol, flavoring, and nicotine/THC.
  • A heating chamber – this is known as the ‘vaporizer’ as it produces the heat that turns the liquid into a gas. It is usually either built into the inhaler cartridge or the main body of the e-cigarette.
  • Rechargeable battery – all vape pens/e-cigarettes will have a rechargeable lithium-ion battery. Obviously, this is required to heat the heating chamber. It is connected to a circuit board that’s often linked to an LED light telling the user when heating is occurring.

Many people choose to vape as it is seen as the best way to stop smoking. The nicotine concentration is far lower – and some e-liquids are completely nicotine-free. The feeling of having an e-cigarette in your hand makes your body associate it with the feeling of smoking, so it’s easier to adapt and slowly decrease your nicotine consumption. However, some of the ingredients in these devices are bad for your oral health.

How does vaping damage your oral health?

Primarily, the concerns stem from the three main ingredients in e-liquids:

  • Propylene glycol (PG)
  • Vegetable glycerin (VG) & flavorings
  • Nicotine

The sole purpose of PG is to act as a carrier for the e-liquid. You can’t taste it, it doesn’t smell, and it is used in many different products throughout the food industry. The problem is that it is directly ingested through the mouth when vaping. As this happens, PG will break down into propionaldehyde, lactic acid, and acetic acid. These things all have a direct impact on your oral health! Specifically, they’re shown to break down enamel and soft tissues in the mouth. Thus, PG can cause gum issues and potentially pave the way for cavity formation. It’s also found that it can cause dry mouth, which is a very bad condition as it makes it easier for cavities to form.

VG isn’t that dangerous when used on its own. While it is a sugary liquid, it will not cause cavities. The issue is that VG is used alongside other flavorings to make the vape liquid taste better. Here, the combination of VG and flavorings leads to a massive increase in both microbial adhesions to enamel and biofilm formation. This was discovered by a study in 2018, and it also found that enamel hardness decreased by 27%. In essence, this combination leads to more bacteria in the mouth, weaker enamel, and the perfect breeding ground for cavities.

Lastly, you have nicotine – a product that’s also found in traditional cigarettes. The effects of nicotine on oral health are known by many. Essentially, it can stem the flow of blood to the gum tissue, which can cause gum disease. Excessive nicotine use has been linked to tooth loss due to severe periodontitis. Granted, the concentration of nicotine is far less in e-cigarettes, but there’s still enough to cause problems.

To summarize, the ingredients in e-liquids will increase the likelihood of tooth decay forming, causing cavities in the mouth. There are also very strong links that suggest periodontal disease is more likely with regular vaping. Nicotine is still a prime culprit, but the VG and PG are also at fault. Ultimately, using these chemicals in your mouth is not a good idea as it can cause gums to recede and bleed, which causes teeth to fall out.

Additional concerns about vaping

As well as the ingredients, vaping devices present another serious threat. The lithium-ion battery has been known to explode when being used. Seeing as this product is used in your mouth, the likelihood of oral health complications is very high. While this doesn’t have a direct impact on periodontal disease, it’s still worth thinking about.

The dangers of periodontal disease

Clearly, all oral health issues are serious. However, periodontal disease is one of the biggest challenges as it often goes untreated. The main danger is that your gums will slowly start to fade away. They recede further and further until they expose the roots of your teeth. This weakens the supporting structures of your teeth and makes you more prone to tooth loss.

Thankfully, periodontal disease can be treated, and the effects can be reversed. It’s a simple case of cutting out bad habits and following a strict oral hygiene routine. You will also benefit from some periodontal disease treatment by a qualified periodontist.

If you’re in need of periodontal treatment, don’t hesitate to contact us today. Schedule an appointment with Dr. I. Stephen Brown for a full consultation. This will identify your main problems and allow Dr. Brown to formulate the perfect treatment plan to repair your gums.