Sleeping Tips

Sleep tips: 7 steps to better sleep

You're not doomed to toss and turn every night. Consider simple tips for better sleep, from setting a sleep schedule to including physical activity in your daily routine.

By Mayo Clinic staff

Feeling crabby lately? Or simply worn out? Perhaps the solution is better sleep.

Think about all the factors that can interfere with a good night's sleep — from pressure at work and family responsibilities to unexpected challenges, such as layoffs, relationship issues or illnesses. It's no wonder that quality sleep is sometimes elusive.

Although you might not be able to control all of the factors that interfere with your sleep, you can adopt habits that encourage better sleep. Start with these simple sleep tips.

No. 1: Stick to a sleep schedule

Go to bed and get up at the same time every day, even on weekends, holidays and days off. Being consistent reinforces your body's sleep-wake cycle and helps promote better sleep at night. There's a caveat, though. If you don't fall asleep within about 15 minutes, get up and do something relaxing. Go back to bed when you're tired. If you agonize over falling asleep, you might find it even tougher to nod off.

No. 2: Pay attention to what you eat and drink

Don't go to bed either hungry or stuffed. Your discomfort might keep you up. Also limit how much you drink before bed, to prevent disruptive middle-of-the-night trips to the toilet.

Nicotine, caffeine and alcohol deserve caution, too. The stimulating effects of nicotine and caffeine — which take hours to wear off — can wreak havoc with quality sleep. And even though alcohol might make you feel sleepy at first, it can disrupt sleep later in the night.

No. 3: Create a bedtime ritual

Do the same things each night to tell your body it's time to wind down. This might include taking a warm bath or shower, reading a book, or listening to soothing music — preferably with the lights dimmed. Relaxing activities can promote better sleep by easing the transition between wakefulness and drowsiness.

Be wary of using the TV or other electronic devices as part of your bedtime ritual. Some research suggests that screen time or other media use before bedtime interferes with sleep.

No. 4: Get comfortable

Create a room that's ideal for sleeping. Often, this means cool, dark and quiet. Consider using room-darkening shades, earplugs, a fan or other devices to create an environment that suits your needs.

Your mattress and pillow can contribute to better sleep, too. Since the features of good bedding are subjective, choose what feels most comfortable to you. If you share your bed, make sure there's enough room for two. If you have children or pets, set limits on how often they sleep with you — or insist on separate sleeping quarters.

No. 5: Limit daytime naps

Long daytime naps can interfere with nighttime sleep — especially if you're struggling with insomnia or poor sleep quality at night. If you choose to nap during the day, limit yourself to about 10 to 30 minutes and make it during the midafternoon.

If you work nights, you'll need to make an exception to the rules about daytime sleeping. In this case, keep your window coverings closed so that sunlight — which adjusts your internal clock — doesn't interrupt your daytime sleep.

No. 6: Include physical activity in your daily routine

Regular physical activity can promote better sleep, helping you to fall asleep faster and to enjoy deeper sleep. Timing is important, though. If you exercise too close to bedtime, you might be too energized to fall asleep. If this seems to be an issue for you, exercise earlier in the day.

No. 7: Manage stress

When you have too much to do — and too much to think about — your sleep is likely to suffer. To help restore peace to your life, consider healthy ways to manage stress. Start with the basics, such as getting organized, setting priorities and delegating tasks. Give yourself permission to take a break when you need one. Share a good laugh with an old friend. Before bed, jot down what's on your mind and then set it aside for tomorrow.

Get Your Sleep!!

Question

Sleep and weight gain: What's the connection?

Is too little sleep a cause of weight gain?

Answer

from Donald Hensrud, M.D.

It may be. Recent studies have suggested an association between sleep duration and weight gain. Sleeping less than five hours — or more than nine hours — a night appears to increase the likelihood of weight gain.

In one study, recurrent sleep deprivation in men increased their preferences for high-calorie foods and their overall calorie intake. In another study, women who slept less than six hours a night or more than nine hours were more likely to gain 11 pounds (5 kilograms) compared with women who slept seven hours a night. Other studies have found similar patterns in children and adolescents.

One explanation may be that sleep duration affects hormones regulating hunger — ghrelin and leptin — and stimulates the appetite. Another contributing factor may be that lack of sleep leads to fatigue and results in less physical activity.

So now you have another reason to get a good night's sleep.

The Health Benefits of Fiber

Dietary fiber comes in two forms − soluble and insoluble – both of which provide certain health benefits. Sufficient soluble fiber intake is more important, because it has the unique ability of impeding absorption of cholesterol and sugar.

The term “soluble” refers to the fiber’s response to water. Pectin, gums and mucilage are soluble fibers that dissolve in contact with water. During the dissolving process, they become gel-like and sticky, which allows them to bind with other substances, including cholesterol and sugar. When cholesterol and sugar molecules get trapped in soluble fiber, they are less absorbable and, therefore, less able to enter the blood stream.

The dietary guidelines for total fiber intake per day prescribe 20 to 35 grams or more, including soluble fiber. Good sources for soluble fiber are dried beans, peas, oatmeal, whole oat products and certain high-pectin fruits, like apples and prunes.

- See more at: http://www.timigustafson.com/2010/the-health-benefits-of-fiber/#sthash.UtvmylpB.dpuf

The Many Health Benefits of a Good Belly Laugh

It feels good to laugh once in a while. Everyone knows that. But laughter as a health-promoting exercise is not as widely practiced, despite of the fact that scientists have long known about the healing effects of good humor.

Through Laughter the Body Releases
Endorphins That Act Like Opiates

In his best-selling book, “Anatomy of an Illness as Perceived by the Patient” (W.W. Norton & Co., 1979), Norman Cousins describes his own recovery from a life-threatening disease, which he credits in large parts to laughter.

What at first sounds like a good story – man cures himself by watching funny movies – is in fact an account of what scientists call the “natural recuperative mechanism” of the body, a.k.a. “homeostatic response,” meaning that the body is able to heal itself and return to a state of normalcy from injuries suffered at a time of illness.

Of course, proper medical care can support and accelerate the natural healing process, but recovery almost always also depends on the body’s own defense mechanisms. Among these defenses is the patient’s state of mind. In Cousins’ case, it seemed that a positive attitude and specifically a great sense of humor helped him muster the inner resources needed to overcome his ailments.

This, obviously, is a dramatic and rare example of the potential benefits of positive thinking. More common are reports that laughter has helped ease pain and suffering, not just the mental but also the physical kind. A recent study conducted at the University of Oxford, England, found that belly laughs caused the body to release endorphins, which act like opiates by inducing emotional calm and enhancing an overall sense of well-being.

During my internship as a clinical dietitian, I observed these effects more than once. I distinctly remember one occasion around Mardi Gras when a nurse dressed up in a clown costume tried her best to cheer up patients, some of whom were desperately ill. That night, the nursing staff reported having dispensed significantly less pain medication than on other days. The laughter in response to the nurse’s performance worked just like a painkiller.

Even if you are not seriously ill but just feel a bit run down, laughing can be good medicine for you, says R. Morgan Griffin who writes for WebMD. We change physiologically when we laugh, she says, our blood pressure goes up and we breathe faster, sending more oxygen through our system – “like a mild workout.” Laughing may actually offer similar benefits as physical exercise.

Other possible side effects of laughter include stress relief, sounder sleep, better blood sugar regulation and strengthening of the immune system.

As plausible as some of these claims about the health benefits of laughter may sound, it is hard to prove any of them scientifically, warns Dr. Robert R. Provine, professor of psychology and neuroscience at the University of Maryland, Baltimore and author of “Laughter: A Scientific Investigation.” It’s difficult to determine cause and effect when it comes to understanding what laughter actually does, he says in an interview with WebMD. “But we all know that laughing, being with friends and family, and being happy can make us feel better and give us a boost – even though studies may not show why,” he concludes.

P.S. If you liked this article, you may also enjoy watching the movie “Patch Adams” (1998) with Robin Williams, which is based on the true story of a medical student trying to improve hospital patients’ quality of life through humor.

- See more at: http://www.timigustafson.com/2012/the-many-health-benefits-of-a-good-belly-laugh/#sthash.wzNP1jrp.dpuf

The Health Benefits of Loving and Being Loved

Love may not be all you need, but the difference between being in loving relationships and being without can have a significant impact on both body and mind, according to researchers in a relatively new scientific field, called “Interpersonal Neurobiology.”

Our Relationships With Loved Ones Affect Us
Physically and Mentally in Countless Ways

Relationships can change the brain with multiple consequences for our health and well-being, says Daniel J. Siegel, professor of psychiatry at the University of California, Los Angeles (UCLA) School of Medicine and author of several books on the development of the mind, who first coined the term “Interpersonal Neurobiology” (IPNB). He proposes an interdisciplinary view of life experiences that draws from different branches of science to create a framework for a better understanding of our subjective and interpersonal lives.

There has been a lot of renewed interest in recent years in the inner workings of the human brain. Thanks to recent advances in neuroscience, we now know that the brain does not stop developing after a certain age, followed by continuous, irreversible decline – as previously thought – but that it actually keeps changing throughout our entire lifespan, including old age.

What causes brain growth, what accelerates it and what slows it down, however, remains less clear. What we can say with reasonable confidence is that the brain constantly rewires itself, not only when we undergo challenging learning processes, but even when we deal with the simplest, most mundane experiences of everyday life. Everything we do, what motivates us and gets our attention, how we deal with challenges and solve problems, how we interact socially and respond emotionally – all of it shapes and reshapes the delicate circuits in our brain and ultimately defines us as who we are.

Dr. Siegel and his fellow-researchers believe that the greatest impact on our brain comes from interpersonal relationships because they produce by far the most important experiences at the beginning of our lives. Perhaps already starting in the womb, certainly at birth, a bond between mother and child is established that lays the foundation for everything that is to follow. The patterns of a lifetime’s behavior, thoughts, self-regard and choice of partners all begin when baby’s first attachments are imprinted in its brain, writes Dianne Ackerman, author of “One Hundred Names for Love” in an article for the New York Times (3/25/2012) on the subject.

Throughout life, our relationships with others “inspire us to rewire,” says Dr. Siegel. As lovers, spouses, parents, co-workers and friends, our brain is affected differently in each role. Intimate relationships alter the brain most profoundly. Anyone who has ever fallen in love knows how the experience encompasses the entire person. The same happens during a breakup or divorce. The pain from a broken heart is as real as from any physical injury, except that it seems to hurt everywhere.

But even without emotional highs and lows, love in its countless expressions can work wonders for us. Long-married couples sometimes report that they still are madly in love, feeling calm and content in each other’s company and anxious in times of separation.

Even clinical research confirms the importance of physical contact and closeness. “The benefits of touch to a person’s health are phenomenal. Touch can reassure, relax and comfort,” says Tina Phillips, author of “Human Touch.” “Touch reduces depression, anxiety, stress and physical pain and can be healing. It increases the number of immune cells in the body and has powerful affects on behavior and mood. Touch can be used as a form of healing in touch therapy.”

Studies have shown a direct link between physical touch and a decrease of blood pressure as well as an increase in the number of immune cells in the body. Similar effects can also be achieved by interacting with beloved pet animals. On the other hand, people who experience loneliness and isolation, especially the elderly, suffer greatly from the lack of physically expressed affection.

Therapists often emphasize the healing power of the human touch in form of massage. Researchers at the Touch Research Institute in conjunction with Duke University found that after a therapeutic massage, the body secretes lower levels of stress hormones like cortisol, norepinephrine and dopamine, which, if chronically elevated, can cause stress-related diseases, including heart disease.

Whether we will ever be able to fully understand the implications of complex phenomena such as love is questionable, but we can already see with clarity that love is much more than just a feeling.

- See more at: http://www.timigustafson.com/2012/the-health-benefits-of-loving-and-being-loved/#sthash.u2612cN0.dpuf

The Many Health Benefits of Reading

Reading is a rapidly vanishing skill. Why trudge through a newspaper when you can watch the news on television? Why buy a novel or a biography in print form when you can listen to it on audio disk? Why bother with instruction manuals when it’s all explained via video clips on YouTube? Is there any need for the printed word anymore?

The answer is a resounding yes. Your mind likes reading and it actually has a number of important health effects you can’t get in any other way. “Reading gives you a unique pause button for comprehension and insight,” said Maryanne Wolf, director of the Center for Reading and Language Research at Tufts University. “Typically, when you read, you have more time to think. When you watch a film or listen to a tape, you don’t press that pause button.” Reading, she said, requires a great deal of concentration, which calls your intelligence to action. You are forced to follow a specific narrative, and for this you must activate your imagination. “There’s a richness that reading gives you, an opportunity to probe more than with any other medium.”

Why Reading Books and Newspapers
Continues to Have Its Place

Just like any other muscle in the body, the brain benefits from a good workout every now and then. Reading is more neurobiologically demanding than processing images or speech. That is because a specific neural circuit is required for reading that is very challenging, according to Dr. Ken Pugh of Haskins Laboratories, a science institute for language research, associated with Yale University.

Most people who don’t read regularly say it’s too time-consuming by comparison to watching television or videos online. Obviously that’s true, reading takes time. I remember trying to prepare for upcoming exams by listening to audiotapes while driving. At first, I thought of it as a more efficient use of my time. Soon, however, I realized that I wasn’t able to digest the information as well by merely listening as opposed to reading the material myself. It was as if being read to created an extra layer, making the absorption of the subject matter more difficult.

One of the reasons for this may be that reading can provide a greater amount of stress relief than listening to someone else’s voice, according to one study conducted in England and reported by PRNewswire (3/25/2009). Because our brains are constantly bombarded with information, much of which we have little or no practical use for, we have learned to tune out when being talked to by outside sources. Reading, on the other hand, can provide a greater sense of privacy.

Reading also improves people’s mood, according to a survey commissioned by the “National Year of Reading,” a program that was conducted in England in 2008 to explore the benefits of reading in everyday life. 63 percent of participants in the study reported they were more relaxed when reading a favorite book or magazine. A nearly equal number claimed that reading influenced some aspects in their lives for the better.

The latter effect was confirmed in a recent study conducted by researchers from Dartmouth College and Ohio State University. Inspiration taken from literary characters can actually change some reader’s behavior, even if it’s based on fiction, said Dr. Geoff Kauffman, one of the authors of the study report, which was published in the Journal of Personality and Social Psychology. “When people read a fictional story, they vicariously experience their favorite character’s emotions, thoughts and beliefs in the process.” But that effect only comes with the written word, he added. “When we watch a movie, by the very essence of it, we’re positioned as spectators. So it’s hard to imagine yourself as the character. I suspect that if you read the screenplay, it would be more powerful.”

Some people can even become addicted to the experiences they derive from reading – and, of course, from watching movies as well. This is not necessarily a bad thing, according to Cristel Russell, a consumer behavior researcher at American University. Reading a favorite book (or watching a beloved movie) over and over again can be a way by which past experiences are relived like new ones or with new perspectives. It can even be therapeutic, she said.

Whatever the benefits of reading may be, real ones or perceived ones (or both), positive stimulation of the mind is a crucial ingredient at every stage in life. It helps to reduce stress, increases concentration and the ability to focus, slows memory loss and, let’s not forget, makes life a whole lot more interesting.

- See more at: http://www.timigustafson.com/2012/the-many-health-benefits-of-reading/#sthash.oRah6ytL.dpuf

6 Reasons to Drink Water

Americans seem to carry bottled water everywhere they go these days. In fact, it has become the second most popular drink (behind soft drinks). But water lovers got a jolt recently when we heard that a new report had found that the benefits of drinking water may have been oversold. Apparently, the old suggestion to drink eight glasses a day was nothing more than a guideline, not based on scientific evidence.

But don't put your water bottle or glass down just yet. While we may not need eight glasses, there are plenty of reasons to drink water. In fact, drinking water (either plain or in the form of other fluids or foods) is essential to your health.

"Think of water as a nutrient your body needs that is present in liquids, plain water, and foods. All of these are essential daily to replace the large amounts of water lost each day," says Joan Koelemay, RD, dietitian for the Beverage Institute, an industry group.

Kaiser Permanente nephrologist Steven Guest, MD, agrees: "Fluid losses occur continuously, from skin evaporation, breathing, urine, and stool, and these losses must be replaced daily for good health," he says.

When your water intake does not equal your output, you can become dehydrated. Fluid losses are accentuated in warmer climates, during strenuous exercise, in high altitudes, and in older adults, whose sense of thirst may not be as sharp.

Here are six reasons to make sure you're drinking enough water or other fluids every day:

1. Drinking Water Helps Maintain the Balance of Body Fluids. Your body is composed of about 60% water. The functions of these bodily fluids include digestion, absorption, circulation, creation of saliva, transportation of nutrients, and maintenance of body temperature.

"Through the posterior pituitary gland, your brain communicates with your kidneys and tells it how much water to excrete as urine or hold onto for reserves," says Guest, who is also an adjunct professor of medicine at Stanford University.

When you're low on fluids, the brain triggers the body's thirst mechanism. And unless you are taking medications that make you thirsty, Guest says, you should listen to those cues and get yourself a drink of water, juice, milk, coffee -- anything but alcohol.

"Alcohol interferes with the brain and kidney communication and causes excess excretion of fluids which can then lead to dehydration," he says.

2. Water Can Help Control Calories. For years, dieters have been drinking lots of water as a weight loss strategy. While water doesn't have any magical effect onweight loss, substituting it for higher calorie beverages can certainly help.

"What works with weight loss is if you choose water or a non-caloric beverage over a caloric beverage and/or eat a diet higher in water-rich foods that are healthier, more filling, and help you trim calorie intake," says Penn State researcher Barbara Rolls, PhD, author of The Volumetrics Weight Control Plan.

Food with high water content tends to look larger, its higher volume requires more chewing, and it is absorbed more slowly by the body, which helps you feel full. Water-rich foods include fruits, vegetables, broth-based soups, oatmeal, and beans.

3. Water Helps Energize Muscles. Cells that don't maintain their balance of fluids and electrolytes shrivel, which can result in muscle fatigue. "When muscle cells don't have adequate fluids, they don't work as well and performance can suffer," says Guest.

Drinking enough fluids is important when exercising. Follow the American College of Sports Medicine guidelines for fluid intake before and during physical activity. These guidelines recommend that people drink about 17 ounces of fluid about two hours before exercise. During exercise, they recommend that people start drinking fluids early, and drink them at regular intervals to replace fluids lost by sweating.

4. Water Helps Keep Skin Looking Good. Your skin contains plenty of water, and functions as a protective barrier to prevent excess fluid loss. But don't expect over-hydration to erase wrinkles or fine lines, says Atlanta dermatologist Kenneth Ellner, MD.

"Dehydration makes your skin look more dry and wrinkled, which can be improved with proper hydration," he says. "But once you are adequately hydrated, the kidneys take over and excrete excess fluids."

You can also help "lock" moisture into your skin by using moisturizer, which creates a physical barrier to keep moisture in.

5. Water Helps Your Kidneys. Body fluids transport waste products in and out of cells. The main toxin in the body is blood urea nitrogen, a water-soluble waste that is able to pass through the kidneys to be excreted in the urine, explains Guest. "Your kidneys do an amazing job of cleansing and ridding your body of toxins as long as your intake of fluids is adequate," he says.

When you're getting enough fluids, urine flows freely, is light in color and free of odor. When your body is not getting enough fluids, urine concentration, color, and odor increases because the kidneys trap extra fluid for bodily functions.

If you chronically drink too little, you may be at higher risk for kidney stones, especially in warm climates, Guest warns.

6. Water Helps Maintain Normal Bowel Function. Adequate hydration keeps things flowing along your gastrointestinal tract and prevents constipation. When you don't get enough fluid, the colon pulls water from stools to maintain hydration -- and the result is constipation.

"Adequate fluid and fiber is the perfect combination, because the fluid pumps up the fiber and acts like a broom to keep your bowel functioning properly," says Koelemay.

5 Tips to Help You Drink More

If you think you need to be drinking more, here are some tips to increase your fluid intake and reap the benefits of water:

1. Have a beverage with every snack and meal.
2. Choose beverages you enjoy; you're likely to drink more liquids if you like the way they taste.
3. Eat more fruits and vegetables. Their high water content will add to your hydration. About 20% of our fluid intake comes from foods.
4. Keep a bottle of water with you in your car, at your desk, or in your bag.
5. Choose beverages that meet your individual needs. If you're watching calories, go for non-caloric beverages or water.

Periodontal (Gum) Disease: Causes, Symptoms, and Treatments

Introduction

If you have been told you have periodontal (gum) disease, you’re not alone. Many adults in the U.S. currently have some form of the disease. Periodontal diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.

Whether your gum disease is stopped, slowed, or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward.

Back to top

What causes gum disease?

Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless “plaque” on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form “tartar” that brushing doesn’t clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.

Back to top

Gingivitis

The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called “gingivitis.” In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.

Back to top

Periodontitis

When gingivitis is not treated, it can advance to “periodontitis” (which means “inflammation around the tooth”). In periodontitis, gums pull away from the teeth and form spaces (called “pockets”) that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Back to top

Risk Factors 

• Smoking.  Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment.
• Hormonal changes in girls/women. These changes can make gums more sensitive and make it easier for gingivitis to develop.
• Diabetes. People with diabetes are at higher risk for developing infections, including gum disease.
• Other illnesses. Diseases like cancer or AIDS and their treatments can also negatively affect the health of gums.
• Medications. There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medicines can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep teeth and gums clean.
• Genetic susceptibility. Some people are more prone to severe gum disease than others.

Back to top

Who gets gum disease?

People usually don’t show signs of gum disease until they are in their 30s or 40s. Men are more likely to have gum disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line.

Back to top

How do I know if I have gum disease?

Symptoms of gum disease include:

• Bad breath that won’t go away
• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Receding gums or longer appearing teeth

Any of these symptoms may be a sign of a serious problem, which should be checked by a dentist. At your dental visit the dentist or hygienist should:

• Ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to gum disease.
• Examine your gums and note any signs of inflammation.
• Use a tiny ruler called a “probe” to check for and measure any pockets. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters. This test for pocket depth is usually painless.

The dentist or hygienist may also:

• Take an x-ray to see whether there is any bone loss.
• Refer you to a periodontist. Periodontists are experts in the diagnosis and treatment of gum disease and may provide you with treatment options that are not offered by your dentist.

Back to top

How is gum disease treated?

The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. The doctor may also suggest changing certain behaviors, such as quitting smoking, as a way to improve treatment outcome.

Deep Cleaning (Scaling and Root Planing)

The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease. In some cases a laser may be used to remove plaque and tartar. This procedure can result in less bleeding, swelling, and discomfort compared to traditional deep cleaning methods.

Medications

Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment. Long-term studies are needed to find out if using medications reduces the need for surgery and whether they are effective over a long period of time. Listed on the next page are some medications that are currently used.

Medications	What is it?	Why is it used?	How is it used?
Prescription antimicrobial mouthrinse	A prescription mouthrinse containing an antimicrobial called chlorhexidine	To control bacteria when treating gingivitis and after gum surgery	It’s used like a regular mouthwash.
Antiseptic chip	A tiny piece of gelatin filled with the medicine chlorhexidine	To control bacteria and reduce the size of periodontal pockets	After root planing, it’s placed in the pockets where the medicine is slowly released over time.
Antibiotic gel	A gel that contains the antibiotic doxycycline	To control bacteria and reduce the size of periodontal pockets	The periodontist puts it in the pockets after scaling and root planing. The antibiotic is released slowly over a period of about seven days.
Antibiotic microspheres	Tiny, round particles that contain the antibiotic minocycline	To control bacteria and reduce the size of periodontal pockets	The periodontist puts the microspheres into the pockets after scaling and root planing. The particles release minocycline slowly over time.
Enzyme suppressant	A low dose of the medication doxycycline that keeps destructive enzymes in check	To hold back the body’s enzyme response — If not controlled, certain enzymes can break down gum tissue	This medication is in tablet form. It is used in combination with scaling and root planing.
Oral antibiotics	Antibiotic tablets or capsules	For the short term treatment of an acute or locally persistent periodontal infection	These come as tablets or capsules and are taken by mouth.

Surgical Treatments

Flap Surgery. Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A dentist or periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. After surgery the gums will heal and fit more tightly around the tooth. This sometimes results in the teeth appearing longer.

Bone and Tissue Grafts. In addition to flap surgery, your periodontist or dentist may suggest procedures to help regenerate any bone or gum tissue lost to periodontitis. Bone grafting, in which natural or synthetic bone is placed in the area of bone loss, can help promote bone growth. A technique that can be used with bone grafting is called guided tissue regeneration. In this procedure, a small piece of mesh-like material is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow. Growth factors – proteins that can help your body naturally regrow bone – may also be used. In cases where gum tissue has been lost, your dentist or periodontist may suggest a soft tissue graft, in which synthetic material or tissue taken from another area of your mouth is used to cover exposed tooth roots.

Since each case is different, it is not possible to predict with certainty which grafts will be successful over the long-term. Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the chances of success. Ask your periodontist what the level of success might be in your particular case.

Second Opinion

When considering any extensive dental or medical treatment options, you should think about getting a second opinion. To find a dentist or periodontist for a second opinion, call your local dental society. They can provide you with names of practitioners in your area. Additionally, dental schools may sometimes be able to offer a second opinion. Call the dental school in your area to find out whether it offers this service.

Back to top

How can I keep my teeth and gums healthy?

• Brush your teeth twice a day (with a fluoride toothpaste).
• Floss regularly to remove plaque from between teeth. Or use a device such as a special brush or wooden or plastic pick recommended by a dental professional.
• Visit the dentist routinely for a check-up and professional cleaning.
• Don’t smoke

Can gum disease cause health problems beyond the mouth? 

In some studies, researchers have observed that people with gum disease (when compared to people without gum disease) were more likely to develop heart disease or have difficulty controlling blood sugar. Other studies showed that women with gum disease were more likely than those with healthy gums to deliver preterm, low birth weight babies. But so far, it has not been determined whether gum disease is the cause of these conditions.

There may be other reasons people with gum disease sometimes develop additional health problems.

For example, something else may be causing both the gum disease and the other condition, or it could be a coincidence that gum disease and other health problems are present together.

More research is needed to clarify whether gum disease actually causes health problems beyond the mouth, and whether treating gum disease can keep other health conditions from developing.

In the meantime, it’s a fact that controlling gum disease can save your teeth – a very good reason to take care of your teeth and gums.

Back to top

Clinical Trials

Clinical trials are research studies of new and promising ways to prevent, diagnose, or treat disease. If you want to take part in a clinical trial about periodontal disease, visit http://www.clinicaltrials.gov. In the box under “Search Clinical Trials,” type in: periodontal diseases. This will give you a list of clinical trials on gum disease for which you might be eligible.

Screening for Breast Cancer

Kinds of Screening Tests

Breast cancer screening means checking a woman's breasts for cancer before there are signs or symptoms of the disease. Three main tests are used to screen the breasts for cancer. Talk to your doctor about which tests are right for you, and when you should have them.

• Mammogram. A mammogram is an X-ray of the breast. Mammograms are the best method to detect breast cancer early when it is easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from breast cancer. If you are age 50 to 74 years, be sure to have a screening mammogram every two years. If you are age 40–49 years, talk to your doctor about when and how often you should have a screening mammogram.
• Clinical breast exam. A clinical breast exam is an examination by a doctor or nurse, who uses his or her hands to feel for lumps or other changes.1
• Breast self-exam. A breast self-exam is when you check your own breasts for lumps, changes in size or shape of the breast, or any other changes in the breasts or underarm (armpit).

Which tests to choose: Having a clinical breast exam or a breast self-exam have not been found to decrease risk of dying from breast cancer.2 Keep in mind that, at this time, the best way to find breast cancer is with a mammogram. If you choose to have clinical breast exams and to perform breast self-exams, be sure you also get regular mammograms.

Where Can I Go to Get Screened?

Most likely, you can get screened for breast cancer at a clinic, hospital, or doctor's office. If you want to be screened for breast cancer, call your doctor's office. They can help you schedule an appointment. Most health insurance companies pay for the cost of breast cancer screening tests.

Are you worried about the cost? The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) offers free or low-cost mammograms and education about breast cancer. Find out if you qualify.

Early Detection of Cancer

American Cancer Society Guidelines for the Early Detection of Cancer

The American Cancer Society recommends these screening guidelines for most adults.

Breast cancer

• Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health
• Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over
• Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.

Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.

For more information, call the American Cancer Society and ask for our document called Breast Cancer: Early Detection.

Colorectal cancer and polyps

Beginning at age 50, both men and women should follow one of these testing schedules:

Tests that find polyps and cancer

• Flexible sigmoidoscopy every 5 years*, or
• Colonoscopy every 10 years, or
• Double-contrast barium enema every 5 years*, or
• CT colonography (virtual colonoscopy) every 5 years*

Tests that primarily find cancer

• Yearly fecal occult blood test (gFOBT)*,**, or
• Yearly fecal immunochemical test (FIT) every year*,**, or
• Stool DNA test (sDNA)***

* If the test is positive, a colonoscopy should be done.

** The multiple stool take-home test should be used. One test done by the doctor in the office is not adequate for testing. A colonoscopy should be done if the test is positive.

*** This test is no longer available.

The tests that are designed to find both early cancer and polyps are preferred if these tests are available to you and you are willing to have one of these more invasive tests. Talk to your doctor about which test is best for you.

Some people should be screened using a different schedule because of their personal history or family history. Talk with your doctor about your history and what colorectal cancer screening schedule is best for you.

For more information on colorectal cancer screening, please call the American Cancer Society and ask for our document called Colorectal Cancer: Early Detection.

Cervical cancer

• Cervical cancer screening (testing) should begin at age 21. Women under age 21 should not be tested.
• Women between ages 21 and 29 should have a Pap test every 3 years. Now there is also a test called the HPV test. HPV testing should not be used in this age group unless it is needed after an abnormal Pap test result.
• Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
• Women over age 65 who have had regular cervical cancer testing with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.
• A woman who has had her uterus removed (and also her cervix) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.
• A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.

Some women – because of their health history – may need to have a different screening schedule for cervical cancer.

Please see our document called Cervical Cancer: Prevention and Early Detection for more information.

Endometrial (uterine) cancer

The American Cancer Society recommends that at the time of menopause, all women should be told about the risks and symptoms of endometrial cancer. Women should report any unexpected bleeding or spotting to their doctors.

Some women – because of their history – may need to consider having a yearly endometrial biopsy. Please talk with your doctor about your history.

See our document called Endometrial Cancer for more information.

Lung cancer

The American Cancer Society does not recommend tests to screen for lung cancer in people who are at average risk of this disease. However, the ACS does have screening guidelines for individuals who are at high risk of lung cancer due to cigarette smoking. If you meet all of the following criteria then you might be a candidate for screening:

• 55 to 74 years of age
• In fairly good health
• Have at least a 30 pack-year smoking history AND are eithers till smoking or have quit smoking within the last 15 years

For more information on the lung cancer screening guidelines, please see “Can non-small cell lung cancer be found early?” in our document Lung cancer (non-small cell) for more information.

Prostate cancer

The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment.

Starting at age 50, men should talk to a doctor about the pros and cons of testing so they can decide if testing is the right choice for them. If they are African American or have a father or brother who had prostate cancer before age 65, men should have this talk with a doctor starting at age 45. If men decide to be tested, they should have the PSA blood test with or without a rectal exam. How often they are tested will depend on their PSA level.

For more information, please see our document called Prostate Cancer: Early Detection.

Cancer-related check-ups

For people aged 20 or older having periodic health exams, a cancer-related check-up should include health counseling and, depending on a person’s age and gender, exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some non-malignant (non-cancerous) diseases.

Take control of your health, and reduce your cancer risk.

• Stay away from tobacco.
• Stay at a healthy weight.
• Get moving with regular physical activity.
• Eat healthy with plenty of fruits and vegetables.
• Limit how much alcohol you drink (if you drink at all).
• Protect your skin.
• Know yourself, your family history, and your risks.
• Have regular check-ups and cancer screening tests.
• For information on how to reduce your cancer risk and other questions about cancer, please call us anytime, day or night, at 1-800-227-2345 or visit us online at www.cancer.org.