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Complicated cases will be reffered to UCSF

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Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
 

Bacterial Link Between Heart Disease and Gum Disease Clarified 
September 30th, 2015 By Managing Editor, DiabetesinControl.com 

A study, published in Infection and Immunity, has clarified the mechanism behind a known link between gum disease and heart disease. Periodontitis, which results in an infection that damages the soft-tissue surrounding teeth and the bone supporting the teeth, is commonly caused by Porphyromonas gingivalis. P. gingivalis is a Gram-negative anaerobe that colonizes mouth tissues for lengthy periods of time after initial infection. It is commonly found within the arterial plaques common to heart disease patients. 

The study authors discovered that the bacteria alters the gene expression of pro-inflammatory proteins that also promote coronary artery atherosclerosis. This was discovered by infecting cultured human aortic smooth muscle cells with P. gingivalis. Aortic smooth muscle cells were used because they contract the aorta after the pumping of the heart stretches it out. 

After P. gingivalis was injected into the cells, the bacteria released gingipains. Gingipains are enzymes that change the ratio between different angiopoietins (inflammatory proteins) in such a way that inflammation is increased. The pro-inflammatory angiopoietin 2 had its expression increased by the gingipains, whereas the anti-inflammatory angiopoietin 1 had its expression reduced. P gingivalis was found to affect the levels of these proteins independent of tumor necrosis factor (TNF). 

The study is significant because it helps to pinpoint the relationship between periodontitis and heart disease. Further research can help clarify potential targets for treatment of atherosclerosis. 

Practice Pearls: 

Periodontitis and heart disease share a common pathogen, P. gingivitis. 
A study found that P. gingivitis alters gene expression to increase production of the pro-inflammatory protein angiopoietin 2 and decreases presence of the anti-inflammatory protein angiopoietin 1. This results in increased atherosclerosis. 
The study further clarifies the cardiovascular risk of poor oral health and hygiene. 
Paddock C. Scientists uncover bacterial mechanism that links gum disease to heart disease. published in the journal Infection and Immunity. September 14, 2015. 

We recommend 

PERIODONTAL DISEASE AND DIABETES 
Diabetes in control , 2006 
Is Periodontal Disease Influenced by Diabetes Type? 
Diabetes in control , 2014 
Diabetes Linked to Tooth Decay 
Diabetes in control , 2011 
Scientists uncover bacterial mechanism that links gum disease to heart disease 
Catharine Paddock PhD, Medical News Today, 2015 
Periodontitis and heart disease: Researchers connect the molecular dots 
American Society for Microbiology News via MDLinx, 2015 
The Biphasic Virulence Activities of Gingipains: Activation and Inactivation of Host Proteins



Patient Rights

  • You have a right to choose your own dentist and schedule an appointment in a timely manner.
  • You have a right to know the education and training of your dentist and the dental care team.
  • You have a right to arrange to see the dentist every time you receive dental treatment, subject to any state law exceptions.
  • You have a right to adequate time to ask questions and receive answers regarding your dental condition and treatment plan for your care.
  • You have a right to know what the dental team feels is the optimal treatment plan as well as the right to ask for alternative treatment options.
  • You have a right to an explanation of the purpose, probably (short and long term) results, alternatives and risks involved before consenting to a proposed treatment plan.
  • You have a right to be informed of continuing health care needs.
  • You have a right to know in advance the expected cost of treatment.
  • You have a right to accept, defer or decline any part of your treatment recommendations.
  • You have a right to reasonable arrangements for dental care and emergency treatment.
  • You have a right to receive considerate, respectful and confidential treatment by your dentist and dental team.
  • You have a right to expect the dental team members to use appropriate infection and sterilization controls.
  • You have a right to inquire about the availability of processes to mediate disputes about your treatment.

(Adopted by the American Dental Association in 2009)

Your Responsibilities as a Patient

  • You have the responsibility to provide, to the best of your ability, accurate, honest and complete information about your medical history and current health status.
  • You have the responsibility to report changes in your medical status and provide feedback about your needs and expectations.
  • You have the responsibility to participate in your health care decisions and ask questions if you are uncertain about your dental treatment or plan.
  • You have the responsibility to inquire about your treatment options and acknowledge the benefits and limitations of any treatment that you choose.
  • You have the responsibilityfor consequences resulting from declining treatment or from not following the agreed upon treatment plan.
  • You have the responsibilityto keep your scheduled appointments.
  • You have the responsibilityto be available for treatment upon reasonable notice.
  • You have the responsibilityto adhere to regular home oral health care recommendations.
  • You have the responsibilityto assure that your financial obligations for health care received are fulfilled.

(Adopted by the American Dental Association in 2009)

American Dental Association Leads Fight for Patient Rights

The American Dental Association has supported legislation that will set a few basic rules to promote high-quality care and protect patients in an increasingly bottom line-driven health care system.

ADA member dentists have been instrumental in moving the patients' rights issue into the national spotlight. The nation appears closer than ever to finally seeing a comprehensive patients' bill of rights passed into law.

While Congress debates various versions of patient rights legislation, the insurance and managed care industries have long supported legislation that would fail to protect all privately insured Americans against unfair delays and denials of coverage by their health plans, according to the ADA. Some ill-fated bills left out critical protections, such as guaranteeing people the option of choosing their own doctors or creating mechanisms to address patients' grievances against health plans. One proposal even omitted freestanding dental plans, which could have left more than 120 million dental patients without these vital protections.

The American Dental Association continues to lobby for the enactment of bipartisan legislation to help ensure that health plans treat patients fairly and do not discriminate against dentists. Here are some of the key issues identified by the ADA:

  • Coverage for freestanding dental plans, which account for the vast majority of Americans who have dental coverage.
  • Patient choice, by guaranteeing access to at least one plan with a point-of-service option that allows patients the opportunity to choose their own doctors.
  • Health plan accountability, through the availability of impartial, external review and by holding plans accountable when their decisions to delay or deny care harm patients.