Thoughts of a caring dentist

Dr Sandlin of Sandlin DDS | Discusses Oral Health and Heart Disease

Dr. James Sandlin - Tuesday, January 13, 2015

More News on Oral Health and Heart Disease

I came across an article on MedScape, a news service for health professionals. It's authored by Sue Hughes from the UK. Bottom line, the healthier your mouth, the less likely you are to have heart problems. Brush your teeth less than once a day and you're twice as likely to have heart problems!


Ms Hughes' article cited a recent study published online in the British Medical Journal by Prof Richard Watt of University College London, UK. Prof Watt and his group noted that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis. The study investigated whether the number of times individuals brushes their teeth influences their risk for heart disease.


The article stated that researchers looked at over 11,000 adults. Individuals were asked about lifestyle choices such as smoking, physical activity, and their oral health habits. They were also asked how often they visited the dentist and how often they brushed their teeth. Medical history and family history of heart disease and blood pressure were then factored in. Blood samples were analyzed from some participants and levels of C-reactive protein (CRP) and fibrinogen were determined. The data gathered from the interviews was then linked to hospitalizations and death.


(C-reactive protein is an indirect measurement of inflammation in your body, and fibrinogen is a building block for blood clots. Levels of both chemicals rise with your degree of inflammation.)


The study found generally good oral hygiene habits, with 62% of participants visiting the dentist every six months and 71% reporting that they brushed their teeth twice a day. After risk factors were accounted for, participants who brushed their teeth less than twice a day were found to have an increased risk of heart disease. Those who had poor oral hygiene had increased levels of CRP and fibrinogen.


Here are some of the research findings:


Hazard Ratio for Cardiovascular Events (Fatal and Nonfatal) Relative to How Often Teeth Are Brushed Each Day

Frequency of tooth brushing      HR* (95% CI)

Twice a day 1.0

Once a day 1.3 (1.0–1.5)

Less than once a day 1.7 (1.3–2.3)

p for trend 0.001


*Adjusted for age, sex, socioeconomic group, smoking, physical activity, visits to dentist, body-mass index, family history of cardiovascular disease, hypertension, and diabetes


The researchers think that this is the first study linking toothbrushing and the rate of heart problems in adults who do not already have cardiovascular disease.


They feel this study suggests the role of poor oral hygiene in the risk of cardiovascular disease by raising systemic inflammation. Inflammation and clotting activity could be an underlying cause of periodontal disease and create an increased risk for heart disease.


More research is needed, but a body of evidence is pointing to oral health being a major factor in your overall health.




de Oliveira C, Watt R, and Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: Results from Scottish Health Survey. BMJ 2010; DOI:10.1136/bmj.c2451. Available at:


Dr Sandlin | Sandlin DDS Lawrenceville, Ga

Dr Sandlin from Sandlin DDS of Lawrenceville, Ga | Discusses a Rise in the Number of Oral Cancer Patients

Dr. James Sandlin - Tuesday, December 30, 2014

Oral Cancer on the Rise

While all other forms of cancer are becoming less frequent, the incidence of head and neck cancers is increasing. Some of these cancers, such as esophageal cancer, are both aggressive and usually fatal. Not only are head and neck cancers becoming more frequent, they are also affecting individuals who do not have classic risk factors for the disease (tobacco and/or alcohol consumption.) Most alarming, the group seeing the highest increase is men and women between the ages of 20-44.


Recent medical research has concluded that the rise in oropharyngeal squamous cell carcinoma is directly related to the spread of the Human Papilloma Virus (HPV). This finding suggests that many cancers of the head and neck are “sexually acquired”.


The Human Papilloma Virus is thought to spread both orally and genitally. It is a prevalent cause for Cervical Carcinoma and cancers around the tonsils. One strain of the virus, HPV-16, is the most aggressive form and is responsible for the majority of HPV positive cancers.


The good news is that HPV-associated oral cancers respond much more favorable to radiation therapy and chemotherapy. Also, HPV vaccines are being developed which should sharply decrease the rate of Cervical and HPV-associated Oral Cancer.


Another breakthrough in early detection of Oral Cancer is the development of better diagnostic tools. Pap Smears have long been the “gold standard” for detection of Cervical Cancers, but the equivalent method for detecting Oral Cancer is both complex and expensive. Recently, a new diagnostic tool has become available which reveals 98% of all early (Stage 1) Oral Cancers. Using a special rinse and light source, the test identifies suspicious areas. These areas are then stained with a dye to reveal any change in cellular structure. Questionable areas are then biopsied.


Risk Factors for Oral Cancer


Use of tobacco products.

This includes smoking cigarettes, cigars, and pipes, plus chewing,

and dipping snuff. Consumption of alcohol products. While the

amount of use varies in each study, more than one oz each day can

lead to many problems.


High risk sexual behavior.

Multiple lifetime partners and contact with HPV positive individuals.

HPV transmission can be both genital-oral and oral-oral.


Poor diet, lack of exercise, high stress.

Low resistance factors raise your risk for all cancers.


If it’s been a while, get checked today!


Dr Sandlin | Sandlin DDS Lawrenceville, Ga

Dr Sandlin of Sandlin DDS | Talks about Bioesthetics Level 4

Dr. James Sandlin - Tuesday, September 23, 2014

Bioesthetics Level 4 Complete!

After more than six years, and numerous trips to three cities (Denver, Louisville, and Boston), I've completed my training in Bioesthetic Dental Rehabilitation. Whew.


A lot of things came out of my experience. I've learned a great deal about managing facial and jaw joint (TMJ) pain. I've learned how to stabilize diseased and injured joint systems. And I've learned how to treat someone whose mouth is severely deteriorated. A lot more than they teach in dental school!


What I've learned most is the importance of diagnosing problems early. Dr Robert Lee, the founder of Bioesthetics, used to say, "Save the children!" I've come to appreciate his plea. Identifying developmental problems early can allow intervention and relatively easy correction. Once facial growth is completed (ages 17-20), solutions become limited and complex (as in expensive and involved.)


So many of the problems I've seen: painful jaws; headaches/neck pain; worn teeth; and even advanced bone deterioration, are directly related to growth patterns gone wrong. Sometimes one of the jaws doesn't develop in a way to coordinate with the opposing arch. Sometimes the teeth don't erupt to coordinate with other teeth. Sometimes the chewing system deteriorates until every other element is adversely affected - tooth form (worn down teeth), shape of the teeth in either or both arches (crowded, drifted, or rotated teeth), deterioration of the jaw joint(s) (TMJ), and overused and strained muscles (headaches and neck aches.) It's a complex system that deserves a lot of respect.


During my training, I've had the opportunity to treat patients who presented with a variety of symptoms. While their underlying problems were different, and ultimately the solutions were unique to each case, everyone had the same bottom line cause: their jaws and teeth didn't fit within their chewing system. Their treatment sequence all started with stabilizing the jaw joints and muscles (with a mouth splint), determining how their chewing systems operated outside of the stable model, and designing solutions to their functional challenges. Our treatment goals sought to achieve a stable chewing complex with attractive, comfortable, and stress free function.


I want to thank our staff for being supportive during my training. It's been tough for them as well, extra work, learning new techniques, and being able to discuss new treatment options with our patients. Thanks also to the specialists who have supported my class cases. Dr Turner (root canals), Dr Fussel (orthodontist), and Dr McIntosh (surgery and implants.) I want to especially thank Jay, our lab technician, who traveled with me to class and who's accepted the challenge of working at a demanding level of accuracy. Without them all, I could never have accomplished my dream of providing the highest level in dental care.


Dr Sandlin | Sandlin DDS Lawrenceville, Ga