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Risks of using antibiotics when treating gum disease

Risks of using antibiotics when treating gum disease

The oral cavity naturally houses a number of microorganisms; they make up the normal flora of your mouth. These microbes benefit their host by acting as a protective barrier against non-indigenous pathogens by producing byproducts such as fatty acids, peroxides and bacteriocins. They also help strengthen the body’s immune system by introducing small amounts of antibodies.

However, they can also cause various oral diseases from caries, gingivitis to periodontal infections. Gum disease is a common diagnosis to receive when it comes to oral diseases. In fact, 47.2% of adults aged 30 years and older have some form of periodontal disease. Periodontal disease increases with age. 70.1% of adults 65 years and older have periodontal disease.How do you know if you have gum disease?

There are telltale signs of gum disease. These are: 

- Bad breath

- Swollen gums

- Bleeding gums

- Sensitive teeth

- Painful chewing

Diagnosis

A professional dentist or dental hygienist will measure the pocket (sulcus) between the tooth and the gums using a dental probe. The average space measures less than 3mm and does not bleed—factors include the depth of the sulcus, inflammation, bleeding and other variables. These will help diagnose if you have gingivitis, periodontitis, or advanced periodontitis.

Gingivitis

The first stage of gum disease where biofilms start to irritate the gums, resulting in tender, inflamed or bleeding gums.

Periodontitis

When deeper pockets form between the gums and teeth due to tartar build-ups, the gum line starts to recede. The sulcus is filled with bacteria and pus, leading to a slight bone loss.

Advanced periodontitis

Characterised by generalised or moderate bone loss with destroyed periodontal ligaments. The teeth lose more support leading to tooth loss when left untreated.

Treatment

Treating gum diseases varies depending on their gravity. Acute gum infection may be treated with a non-surgical technique, while a chronic oral condition requires surgical procedures.

  1. Scaling

Scaling removes tartar build-ups and bacteria from the tooth surface and under the gums—a common practice when you visit your dentist for your regular teeth cleaning.

  1. Root planing

Root planing is a procedure used to remove bacterial derivatives that cause inflammation and slow healing. This also smoothens the surface of the root, reducing further tartar biofilm accumulation.

  1. Antibiotics

Antimicrobial therapy is extensively used in dentistry as preventive and treatment measures. Painful chewing, bleeding gums can manifest with plaque build-up and periodontal diseases. Periodontal diseases are reported to be the most common cause of tooth loss. The introduction of antimicrobial drugs has saved millions of lives that transformed the healthcare industry in treating infectious diseases. However, improper use of antibiotics has resulted in antimicrobial resistance.

What is Antimicrobial Resistance (AMR)

AMR is a global concern affecting the healthcare industry. AMR naturally happens when bacteria are exposed to antibacterial drugs. Susceptible bacteria are killed or inhibited, while non-susceptible bacteria live and acquire resistance and multiply. This phenomenon is similar to humans taking a vaccine, where the vaccinated individual will develop immunity to the bacteria or virus.

Contributing factors to antimicrobial resistance

  1. Overuse

Antibiotics have been overused in health care and agriculture which have led to bacteria strains which are resistant to most of the known antibiotics. Nowadays, most dental practices are moving away from antibiotics because of the reduced effectiveness and increasing knowledge from associated side-effects on complex oral microbiomes. 

  1. Misuse

Inappropriate choice of antibiotics largely contributes to AMR. The prescribed drug is not suitable to eliminate the infection-causing bacteria giving it immunity to the antibiotic used. This may root in the lack of sensitivity testing done prior to drug prescription or the harmful effect of word of mouth.

For example, patient A took antimicrobial A that has cured him. He then recommends the same drug to patient B that may have the same symptoms. However, patient B’s infection was caused by different bacteria, which is non-susceptible to drug A. This will now lead to AMR.

  1. Poor adherence

Some patients do not fully comply with the antibiotic therapy prescribed. Reasons such as inadequate information, financial situation or personal belief may contribute to their poor adherence.

- Inadequate information

Lack of information about the negative effect of non-compliance during antibiotic therapy is why patients do not complete the prescribed treatment. Patients have the tendency to stop taking medicine whenever they feel better or casually take their medication at a random time. This is a definite no in taking antibacterial drugs. The patient must follow the full course of treatment together with the correct time and dose to completely eradicate the source of infection.

- Financial situation

Antibiotics are costly and not everyone can afford to purchase a full course treatment.

  1. Photodynamic Therapy (PDT)

PDT is the latest non-invasive treatment used in dentistry using photosensitizers and light with specific wavelengths.This system produces singlet oxygen and reactive oxygen to eliminate infection-causing pathogens in the mouth.

PDT’s main advantage over antibiotic therapy is that it provides a broad range of action against pathogens without the threat of producing AMR.

PDT produces reliable results in the treatment of periodontitis. PDT also offers an effective and professional way to remove plaque and therefore reduces the incidence of caries, a method of primary prevention. 

Why include Lumoral to your oral hygiene routine

- Lumoral provides patented dual-light PDT. Dual-light PDT has shown excellent antibacterial properties in repeated use without resistance formation.

-  Lumoral is the first most reliable addition to brushing from biofilm management, resulting in a 99.9% bacterial reduction in tooth biofilm.

- Lumoral is proven effective against Streptococcus mutans bacteria, the main culprit of tooth decay and against periodontitis causing Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans bacteria.

- Lumoral is excellent for continuous use as the strong antibacterial cleaning effect is directed to dental plaque and it doesn’t cause a change in normal bacterial flora or bacterial diversity.

- This technology helps increase teeth’s smoothness resulting in a naturally bright smile.

Prevent gum diseases and take home your Lumoral Kit today

Lumoral is a professional-level personal oral hygiene device that can be used in the comfort of your own home. It is certified by the Therapeutic Goods Administration of Australia (TGA), meeting Australian standards of quality, safety and efficacy. It prevents gum inflammation and eliminates unhealthy bacteria. Use Lumoral 10 minutes twice a week to take your oral health to a new level.

For more information, please contact us at info@lumoral.com

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Reduce the risk of catching COVID-19 by maintaining good oral hygiene

Reduce the risk of catching COVID-19 by maintaining good oral hygiene

Access to dental care has been limited because of the coronavirus disease pandemic (COVID-19). Quarantine restrictions caused lifestyle changes where some people were encouraged to live a sedentary way of life, consuming unhealthy food choices and sugary beverages. 

The said changes have resulted in an increase in dental problems leading to cavity formation and gum problems. Some studies have linked SARS-Cov-2 to poor oral hygiene, where poor oral hygiene is believed to be a determining factor for the severity of a patient's condition.

A background on COVID-19

COVID-19 is transmitted from one infected person to another in various ways. But to put it simply, infected droplets are passed when they reach  the eyes, nose or mouth's soft tissues. The virus is then absorbed into the body.

The initial symptoms of COVID-19 are fever, fatigue, dry cough, sore throat and diarrhea. In severe cases, pneumonia is also observed. This causes reduced blood oxygen that affects organs like the kidney and the heart. As you may have noticed, the lungs are also primarily affected, which leads to other complications. Another distinct symptom of COVID-19 is diarrhea. It causes stomach irritation. However, please note that there is no evidence supporting that the virus is passed through food.

COVID-19 and oral hygiene

You may have asked: what’s the connection of COVID-19 and dental hygiene? Let's now dive deeper into this topic.

1) Balanced microbiome and infectious bacteria

Maintaining a balanced oral microbiome helps fight infectious bacteria that lands in the mouth. The community of microorganisms produce enzymes that can fight pathogens and promote the growth of their co-living microorganisms.

Streptococcus Gordonii, for example, produces hydrogen peroxide that kills foreign bacteria. However, this also contributes to the formation of biofilms that causes oral problems. When left unchecked, S Gordonii, together with other cariogenic bacteria, will attach themselves to the teeth's surface, slowly eroding the tooth, creating pockets. These pockets are a gaping entry point for pathogens like COVID-19.

A balanced oral microbiome is sustained with proper oral hygiene. A balanced microbiome ensures that you have a healthy number of microorganisms that are equipped to fight against foreign bacteria and viruses.

2) Salivary glands and foreign pathogens

Normal secretion of the salivary glands is also an essential factor in combating foreign pathogens. Human saliva contains some antiviral proteins and peptides that are effective in fighting viruses. Salivary cystatins are documented to prevent coronavirus replication.

Aside from this, human saliva contains 98% water with a pH ranging from 6.2 to 7.6. This neutralizes the acids in the mouth while leaving a thin protective covering on the teeth and mucosal walls. An average saliva production should also be able to transfer bacteria down the pharynx to the gut, where it is eliminated by the stomach acid and bacteriocins produced by the microflora of the gut.

3) COVID-19 severity and poor oral hygiene

The mucosal surface of the mouth is an entry point for microbes that affects the respiratory (lungs), digestive (stomach), reproductive and urinary tract. A typical balanceof microorganisms living in the mouth will not cause diseases. However, with oral cavities and periodontitis, there is an increased number of bacteria living inside the oral cavity. 

The increase in the number of bacteria leads to a higher risk of inter-bacterial exchange between the mouth and the lungs. An example is with gum diseases, the dead tissues produce an enzyme called cytokine, which is aspirated into the lungs, causing lung infection and pneumonia. This scenario plays the same role in how oral diseases affect COVID-19 patients.

A study shows that a high oral viral and bacterial load leads to a higher risk of contracting pneumonia, sepsis and septic shock in COVID-19 patients. This increases the severity of the infection leading to the demise of the patient.

How to maintain good oral hygiene

Reduce the risk of catching COVID-19 by practicing simple methods that will help improve your oral health.

1) Brush and floss regularly

Brush your teeth at least twice a day with a toothpaste and a toothbrush that has soft bristles. For areas that can’t be reached by your toothbrush such as the space between the teeth and gums, remember to floss daily or wash with mouthwash. Thoroughly remove plaque that may build up in your mouth by wrapping your floss around both sides of each tooth and doing a push-pull motion.

2) Avoid food and drinks that are high in sugar

Food and drinks that are high in sugar encourage plaque growth, a sticky film of bacteria which can disturb a normal microbiome. Instead of taking in food and drinks that are high in sugar, consider hydrating yourself with plenty of water and eating a balanced diet loaded with vitamins that will help keep your mouth healthy.   

3) Use Lumoral twice a week

Lumoral is a home solution that fights the accumulation of bacteria in the mouth. Lumoral uses dual-light photodynamic therapy that is effective in reducing cariogenic and periodontal pathogens. It is designed with 48-custom made LED light source, with carefully selected LED light wavelengths to prevent plaque and gum diseases.

Streptococcus mutans is the leading cause of biofilm formation and a key culprit in cavity formation. Lumoral prevents the formation of biofilms at its planktonic level by targeting Streptococcus mutans weak spot, preventing its development. Lumoral's dental care system helps maintain a balanced oral microbiome. It is safe and effective and leaves the normal flora of the mouth unaffected.

In addition to regular tooth brushing and flossing, using Lumoral twice a week is proven to decrease gingival bleeding and cavity formation.

Prevent the risk of contracting the COVID-19 virus with a healthy mouth.

Lumoral is recommended by dentists around the world to support dental hygiene. Using the latest PDT technology, it is effective against cavities and periodontitis-causing bacteria. Get a fresh breath and a naturally bright smile. Get Lumoral today and enjoy free shipping Australia-wide.

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What makes a balanced or imbalanced microbiome in your mouth?

What makes a balanced or imbalanced microbiome in your mouth?

Your mouth houses a community of bacteria (microbiome) that contributes to a healthy body. Oral microbiome imbalance occurs when bacteria goes haywire, disrupting the balance in the oral ecosystem by producing acids damaging the teeth's protective enamel. Furthermore, these pathogens destroy tissues supporting the teeth leading to gum diseases.

Oral Microbiome

The number of microorganisms present in our body can be compared to our cells—the oral cavity houses more than 700 species of bacteria. The oral microbiome is defined as the collective genome of microorganisms that reside in the oral cavity. Its function is to transport minerals from the saliva to remineralise the teeth and molecular oxygen to the soft tissues. They play a critical role in various physiologic, metabolic and immunologic functions from digestion, energy generation, fat storage, detoxification, protection, and the balance between inflammatory processes. It also protects us from external pathogens preventing invasion and disease growth.

The oral ecosystem balance changes rapidly with the oral microbiome's activity and composition—factors include a change in the pH level, diets and interactions among the bacteria. Microorganism in the oral cavity has a symbiotic relationship. Imbalance happens when commensalism is broken, causing infection.

Common Causes of Oral Microbiome Imbalance

  1. High sugar diet

Sugar is the leading food of oral pathogens. Glucose, fructose, sucrose undergoes glycolysis, converting them to acids. Streptococcus mutans that cause dental caries use sucrose to build its capsule used to stick to the teeth's surface while producing lactic acid, which causes an immediate decrease in the PH level, making the saliva more acidic. This acid, in turn, dissolves teeth enamel that leads to teeth tooth erosion. 

Here are some foods that cause enamel erosion:

- Hard and sticky candies and alike

- Citrus fruit (excessive citrus fruit intake can lead to enamel erosion owing to its high acid content)

- Carbohydrate-rich food. Carbohydrates break down into sugar that metabolises into acids causing cavities.

- Coffee and tea. These beverages are highly acidic and stain teeth.

- Soda, fruit juices and sports drinks all have high sugar content with an acidic pH.

  1. 2. Stress

A study shows that people with more significant perceived stress are reported to have poor oral hygiene. Stress, anxiety and depression decrease saliva production, which is critical in maintaining a balanced oral microbiome. Saliva has a protective effect on teeth preventing tooth decay. Research shows that individuals with an increased saliva flow rate are directly proportional to an increase in pH level, calcium and phosphorus concentrations, increased aldolase activity and O2 uptake of bacteria and high general antibacterial activity.

How to Maintain a Balanced Microbiome

  1. Nutrition

You are what you eat. Consuming a healthy and balanced diet is an essential contributing factor in maintaining a balance in the mouth and the entire body. Eating alkaline, antioxidant rich food helps to maintain a neutral body pH level. These include organic fruits, vegetables and meat products. Organically grown produce also contains a higher amount of flavonoids that have antioxidant property.

Eat and drink acidic food in moderation, for these help in keeping a healthy body.

  1. Limit sugar intake

Sugar is dubbed as a silent killer that we regularly consume. It is everywhere that you need to be mindful of your sugar consumption. Note that artificial sweetener also contributes to oral microbiome imbalance.

  1. Exercise

Exercise is a proven way to relieve stress and helps with body detoxification. Exercise also helps increase blood flow with increased oxygen intake, improving immunologic functions. Exercise promotes an increase in dentinal tubular flow, which prevents tooth decay formation. 

  1. Oral hygiene

Practice good dental hygiene to maintain a healthy oral ecosystem. American Dental Association (ADA) recommends brushing your teeth twice a day for two minutes using a soft-bristled toothbrush. Floss daily to remove decay causing-bacteria in between teeth. However, there are cases when brushing and flossing is not enough.

Food consumption is part of our lives, similar to living with microorganisms. Maintaining balanced oral microbiome results from not just one factor but a trifecta of nutrition, exercise and proper dental hygiene. Killing harmful microorganism before it makes its way to the roots is the most effective way in preventing oral diseases saving us from pain and costly treatments.

One way to maintain a balanced oral ecosystem is to use antibacterial photodynamic therapy (aPDT) used in Lumoral.

Lumoral in Maintaining a Healthy Oral Ecosystem

Lumoral is the first photodynamic method that you can use at home. Lumorinse has been developed to easily attach to dental plaque. In this way, the antibacterial effect can be targeted to the desired area, and the normal oral bacterial flora remains undisturbed. The antibacterial blue light of the device works in the same way as traditional photodynamic therapy, but it uses internal bacterial dyes, porphyrins and flavins as the photosensitising molecules. The interaction between Lumoral's photodynamic therapy and antibacterial blue light has been shown to be very effective against harmful oral bacteria, and no bacterial resistance is developed against this interaction, even with repeated use.

Upgrade your oral hygiene to a professional level. 

Lumoral is a professional-level personal oral hygiene device that can be used in the comfort of your own home. It is certified by the Therapeutic Goods Administration of Australia (TGA), meeting Australian standards of quality, safety and efficacy. It prevents gum inflammation and eliminates unhealthy bacteria with regular use. Use Lumoral 10 minutes twice a week to take your oral health to a new level.

For more information, please contact us at info@lumoral.com