Treatments for Mesothelioma

Treatments for Mesothelioma
Current research focuses on causes, prevention, and improving accuracy of diagnosis and effectiveness of mesothelioma treatments. In spite of advances in research, there is still a great deal to be learned. Mesothelioma treatments that combine surgery, radiation therapy, and chemotherapy, called multimodality therapy, are now being studied. These may provide the most promising option for some patients. New chemotherapy drugs and other types of mesothelioma treatments are the subjects of current clinical trials.
Gene Therapy
A new approach to mesothelioma treatment is gene therapy, using special viruses that have been modified in the laboratory. In gene therapy, the modified virus is injected into the pleural (chest) space and infects the mesothelioma cells. The virus injects a gene into the tumor that heightens the effects of a mesothelioma-fighting drug.
Immunotherapy
Immunotherapy - treatment methods that fight mesothelioma through the body's immune system - is being evaluated in clinical trials. With immunotherapy, substances called biological response modifiers (BRMs) may be made by the body or in a laboratory. BRMs are used to boost, direct, or restore the body's natural ability to defend itself against cancer. This type of mesothelioma treatment is also called biologic therapy or biotherapy.
Intensity Modulated Radiation Therapy (IMRT)
IMRT is a new radiotherapy technique that has proven to be effective in controlling localized malignant mesothelioma. IMRT mesothelioma treatment delivers high doses of radiation to mesothelioma tumors, regardless of their size or shape. Precise targeting of radiation makes IMRT a preferred mesothelioma treatment over standard radiotherapy, in which the healthy tissue surrounding the tumor may also be exposed to high levels of radiation. Tumors that would once have been considered untreatable because of their proximity to vital organs can now be treated using IMRT.
Chemotherapy
Chemotherapy is the use of cancer-fighting drugs in the treatment of mesothelioma. Although chemotherapy has long been used in the treatment of mesothelioma, the search for safer and more effective chemotherapy drugs is ongoing.
Alimta is the brand name for one such drug, chemically similar to folic acid, which is being tested for the treatment of mesothelioma. Alimta is used alone for the treatment of locally advanced or metastatic lung cancers whose growth has not been slowed by traditional chemotherapy treatments. When used in conjunction with cisplatin, Alimta is the only agent approved by the Food and Drug Administration for specific use in combating malignant pleural mesothelioma.
Anti-angiogenesis drugs are relatively new mesothelioma treatments that have been successful in shrinking and killing cancerous cells in animals. Although the success of anti-angiogenesis drugs in humans has not been proven, they are expected to yield similar results. Veglin is an anti-angiogenesis drug designed to target a wide range of cancers, including malignant mesothelioma.
Posted by mandeep tondak at 9:24 PM 0 comments

How is mesothelioma diagnosed?
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient’s medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.
A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
Posted by mandeep tondak at 9:22 PM 0 comments

How is mesothelioma treated?
Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient’s age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.
Surgery is a common treatment for mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.
Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).
Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).
To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.
Posted by mandeep tondak at 9:18 PM 0 comments

What are the symptoms of mesothelioma?
Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis.
Posted by mandeep tondak at 9:13 PM 0 comments

How common is mesothelioma?
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age.

Cancer Symptoms

Cancer Symptoms

• Cancer Symptoms Introduction
• Cancer Signs and Symptoms
• Cancer Facts
• For More Information
• Web Links
• Synonyms and Keywords
• References
• Authors and Editors

Cancer Symptoms Introduction

Cancer often has no specific symptoms, so it is important that you limit your risk factors and undergo appropriate cancer screening.

Nevertheless, you need to know which symptoms might point to cancer. You do not want to ignore a warning that might lead to early diagnosis and possibly to a cure.

Diabetes

• What is diabetes?
• What is pre-diabetes?
• What are the different types of diabetes?
• Who gets diabetes?
• What causes diabetes?
• Am I at risk for diabetes?
• Should I be tested for diabetes?
• What are the signs of diabetes?
• How can I take care of myself if I have diabetes?
• How can I take care of myself if I have gestational diabetes?
• Is there a cure for diabetes?
• Is there anything I can do to prevent diabetes?

What is diabetes?

Diabetes means that your blood sugar is too high. Your blood always has some sugar in it because the body uses sugar for energy; it's the fuel that keeps you going. But too much sugar in the blood is not good for your health.

Your body changes most of the food you eat into sugar. Your blood takes the sugar to the cells throughout your body. The sugar needs insulin to get into the body's cells. Insulin is a hormone made in the pancreas, an organ near the stomach. The pancreas releases insulin into the blood. Insulin helps the sugar from food get into body cells. If your body does not make enough insulin or the insulin does not work right, the sugar can't get into the cells, so it stays in the blood. This makes your blood sugar level high, causing you to have diabetes.

If not controlled, diabetes can lead to blindness, heart disease, stroke, kidney failure, amputations (having a toe or foot removed, for example), and nerve damage. In women, diabetes can cause problems during pregnancy and make it more likely that your baby will be born with birth defects.

What is pre-diabetes?

Pre-diabetes means your blood sugar is higher than normal but lower than the diabetes range. It also means you are at risk of getting type 2 diabetes and heart disease. The good news is: You can reduce the risk of getting diabetes and even return to normal blood sugar levels with modest weight loss and moderate physical activity. If you are told you have pre-diabetes, have your blood glucose (sugar) checked again in 1 to 2 years.

What are the different types of diabetes?

The three main types of diabetes are:

• Type 1 diabetes is commonly diagnosed in children and young adults, but it's a lifelong condition. If you have this type of diabetes, your body does not make insulin, so you must take insulin every day. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, eating healthy, exercising regularly, taking aspirin daily (for some), and controlling blood pressure and cholesterol.
• Type 2 diabetes is the most common type of diabetes — about 9 out of 10 people with diabetes have type 2 diabetes. You can get type 2 diabetes at any age, even during childhood. In type 2 diabetes, your body makes insulin, but the insulin can't do its job, so sugar is not getting into the cells. Treatment includes taking medicine, eating healthy, exercising regularly, taking aspirin daily (for some), and controlling blood pressure and cholesterol.
• Gestational (jess-TAY-shun-ul) diabetes occurs during pregnancy. This type of diabetes occurs in about 1 in 20 pregnancies. During pregnancy your body makes hormones that keep insulin from doing its job. To make up for this, your body makes extra insulin. But in some women this extra insulin is not enough, so they get gestational diabetes. Gestational diabetes usually goes away when the pregnancy is over. Women who have had gestational diabetes are more likely to develop type 2 diabetes later in life.

Who gets diabetes?

About 20 million Americans have diabetes, about half of whom are women. As many as one third do not know they have diabetes.

Type 1 diabetes occurs at about the same rate in men and women, but it is more common in Whites than in minorities.

Type 2 diabetes is more common in older people, mainly in people who are overweight. It is more common in African Americans, Hispanic Americans/Latinos, and American Indians.

What causes diabetes?

Type 1 and type 2 diabetes — The exact causes of both types of diabetes are still not known. Type 1 diabetes tends to show up after a person is exposed to a trigger, such as a virus, which can start an attack on the cells in the pancreas that make insulin. There is no one cause for type 2 diabetes, but it seems to run in families, and most people who get type 2 diabetes are overweight.

Gestational diabetes — Changing hormones and weight gain are part of a healthy pregnancy, but these changes make it hard for your body to keep up with its need for insulin. When that happens, your body doesn't get the energy it needs from the foods you eat.

Am I at risk for diabetes?

Things that can put you at risk for diabetes include:

• Age — being older than 45
• Overweight or obesity
• Family history — having a mother, father, brother, or sister with diabetes
• Race/ethnicity — your family background is African American, American Indian/Alaska Native, Hispanic American/Latino, Asian American/Pacific Islander and Native Hawaiian
• Having a baby with a birth weight more than 9 pounds
• Having diabetes during pregnancy (gestational diabetes)
• High blood pressure — 140/90 mm HG or higher. Both numbers are important. If one or both numbers are usually high, you have high blood pressure.
• High cholesterol — total cholesterol over 240 mg/dL
• Inactivity — exercising less than 3 times a week
• Abnormal results in a prior diabetes test
• Having other health conditions that are linked to problems using insulin, like Polycystic Ovarian Syndrome (PCOS)
• Having a history of heart disease or stroke

Should I be tested for diabetes?

If you're at least 45-years-old, you should get tested for diabetes, and then you should be tested again every 3 years. If you're 45 or older and overweight (Calculate your Body Mass Index (BMI) you may want to get tested more often. If you're younger than 45, overweight, and have one or more of the risk factors listed in "Am I at Risk for Diabetes?" you should get tested now. Ask your doctor for a fasting blood glucose test or an oral glucose tolerance test. Your doctor will tell you if you have normal blood glucose (blood sugar), pre-diabetes, or diabetes.

What are the signs of diabetes?

• being very thirsty
• urinating a lot
• feeling very hungry
• feeling very tired
• losing weight without trying
• having sores that are slow to heal
• having dry, itchy skin
• losing feeling in or having tingling in the hands or feet
• having blurry vision
• having more infections than usual

If you have one or more of these signs, see your doctor.

How can I take care of myself if I have diabetes?

Many people with diabetes live healthy and full lives. By following your doctor's instructions and eating right, you can too. Here are the things you'll need to do to keep your diabetes in check:

• Follow your meal plan — eat often; eat lots of whole grain foods, fruits, and vegetables

• Get moving — try to be active for at least 30 minutes on most days

• Test your blood sugar — Keep track of your blood sugar levels and talk to your doctor about ways to keep your levels on target. Many women report that their blood sugar levels go up or down around their period. If you're going through menopause, you might also notice your blood sugar levels going up and down.

• Take your diabetes medicine exactly as your doctor tells you.

Talk to your doctor about other things you can do to take good care of yourself. Taking care of your diabetes can help prevent serious problems in your eyes, kidneys, nerves, gums and teeth, and blood vessels.

How can I take care of myself if I have gestational diabetes?

Taking care of yourself when you have gestational diabetes is very much like taking care of yourself when you have other types of diabetes. But it can be a little scary when you're pregnant and you also have a new condition to take care of. Don't worry. Many women who've had gestational diabetes have gone on to have healthy babies. Here are the things you'll need to do:

• Follow your meal plan — You will meet with a dietitian or diabetes educator who will help you design a meal plan full of healthy foods for you and your baby. You will be advised to:
  
  
  • limit sweets
  • eat often — three small meals and one to three snacks every day
  • be careful about the carbohydrates you eat – your meal plan will tell you when to eat carbohydrates and how much to eat at each meal and snack
  • eat lots of whole grain foods, fruits, and vegetables
• Get moving — try to be active for at least 30 minutes on most days. If you're already active, your doctor can help you make an exercise plan for your pregnancy. If you haven't been active in the past, talk to your doctor. Your doctor can suggest activities, such as swimming or walking, to help keep your blood sugar on track.

• Test your blood sugar — Your doctor may ask you to use a small device called a blood glucose meter to check your blood sugar levels. You will be shown how to use the meter to check your blood sugar. Your diabetes team will tell you what your target blood sugar range is, how often you need to check your blood sugar, and what to do if it is not where it should be.
  
  The following chart shows blood sugar targets for most women with gestational diabetes. Talk with your health care team about whether these targets are right for you.
  
  

  Blood glucose targets for most women with gestational diabetes
  On awakening	not above 95 mg/dL
  1 hour after a meal	not above 140 mg/dL
  2 hours after a meal	not above 120 mg/dL

  
  Each time you check your blood sugar, write down the results in a record book. Take the book with you when you visit your health care team. If your results are often out of range, your health care team will suggest ways you can reach your targets.

• Take your diabetes medicine exactly as your doctor tells you. You may need to take insulin to keep your blood sugar at the right level. If so, your health care team will show you how to give yourself insulin. Insulin will not harm your baby -- it cannot move from your bloodstream to your baby's.

Is there a cure for diabetes?

There is no cure for diabetes at this time. The National Institutes of Health (NIH) is doing research in hopes of finding cures for both type 1 and type 2 diabetes. Many different approaches to curing diabetes are being studied, and researchers are making progress.

Is there anything I can do to prevent diabetes?

Yes. The best way to prevent diabetes is to make some lifestyle changes:

• Maintain a healthy weight. Being overweight raises your risk for diabetes. Calculate your Body Mass Index (BMI) to see if you're at a healthy weight. If you're overweight, start making small changes to your eating habits by adding more whole grain foods, fruits, and vegetables. Start exercising more, even if taking a short walk is all you can do for now. If you're not sure where to start, talk to your doctor.

• Eat healthy.
  
  
  • Eat lots of whole grains (such as whole wheat or rye bread, whole grain cereal, or brown rice), fruits, and vegetables.
  • Choose foods low in fat and cholesterol. Read food labels. If you eat 2,000 calories per day, you should eat no more than 56 grams of fat each day.
  • Limit your salt intake to less than 2,300 mg (about 1 teaspoon of salt) each day.
  • If you drink alcohol, limit it to no more than one drink (one 12-ounce beer, one 5-ounce glass of wine, or one 1.5-ounce shot of hard liquor) a day.

• Get moving. Try to exercise for at least 30 minutes most days of the week. Some suggestions:
  
  
  • Take the stairs instead of the elevator.
  • Take a brisk walk on your lunch break.
  • Park at the far end of the parking lot and walk.
  • Get off the bus or subway a few stops early and walk the rest of the way.
  • Walk or bicycle whenever you can.

Heart Disease in Women

By Dr. Ranjeet S. Baral

Cardiovascular death rate in developed nations is decreasing due to advanced treatment technology. However, the same cannot be said for women. Due to an aging population, the death rate is in fact increasing in them. Coronary heart disease and stroke are the two most common causes of death in women in most developed countries. Cardiovascular death claims almost 55% of all death in women which is more than all forms of cancer deaths combined or simply one in two women would die of heart disease compared to one in twenty five who would die of breast cancer. The media often erroneously reports breast cancer as being the leading cause of death in women. This misconception has to be addressed as breast cancer claims only one tenth of lives compared to heart disease in women.

It’s of paramount importance to bring increased awareness of heart disease in women because almost 65% of deaths occur in those with no previous symptoms. Women during fertile age have a lower risk of cardiac events but this protection fades away after menopause. The response to therapy may also differ in women because of endogenous hormone levels, lower body weight and higher fat proportions. There have been reports where aspirin tends to have protective effects for stroke in women but not for heart attacks.

The major risk factors for coronary heart disease in women are smoking, hypertension, diabetes, obesity, sedentary lifestyle, poor nutrition and dyslipidemia. Among these risk factors, gender differences have been noted in diabetes and dyslipidemia. Age is an important risk factor for both men and women but women are on average ten years older when they develop coronary heart disease. Smoking is the leading risk factor with more than 50% of heart attacks being attributed to tobacco. We have to realize that cessation of smoking brings risk of heart disease to the non-smokers level within 3-5 years. It’s distressing to know that the demographic pattern shows increase in younger women smoking worldwide when the male counterparts show a decline. Moreover, the use of oral contraceptives in young women who smoke, further increases the risk.

More women than men develop hypertension as they get older and we know that control of hypertension reduces the risk of both stroke and heart disease. Data reveals that more than 50% of women after the age of 55 have high cholesterol levels and that there are significant treatment benefits for post-menopausal women with dyslipidemia.

Risk of coronary heart disease mortality associated with diabetes is again higher in women than men. This gender based difference may be due to a particular deleterious effect of diabetes on lipids and blood pressure. Obesity and sedentary lifestyle are parallel risk factors for both men and women.

Oral contraceptives raise blood pressure and pose additional risk in women who smoke. They do not increase the risk of heart attack on women who do not have other risk factors associated with heart disease. There is a threefold increase in stroke for those taking pills, which increases to tenfold for smokers. It has been found that low dose pills containing less than 50ug estrogens are safe except in smokers. Also, lifetime costs are significantly higher for women than for men of the same age group (over 65) when the majority of strokes occur. Women also have greater tendency to suffer from atypical chest pain or to complain of abdominal pain, nausea, fatigue and shortness of breath. As women tend to have heart attacks later in life than men, they often have other diseases that mask cardiac symptoms. Coronary heart disease is more often of the silent type in women. Also, some of the diagnostic tests used to diagnose heart diseases like the TMT (treadmill test) are less accurate in women. Moreover, HRT (hormone replacement therapy) may induce false positive results. There is also an increased chance of SVD (single vessel disease) being missed out in women. Similarly, breast tissue may result in false positive results with even recent diagnostic investigations like myocardial perfusion thallium test. However, SPECT (computed CT), calcium scoring and exercise ECHO are valuable diagnostic tools in women. Thus, women with heart disease tend to be both under investigated and under treated when actually the female gender is strongly associated with increased risk for heart disease. The one-year post heart attack mortality risk is 41% in women compared to 27% for men. Similarly, in hospitals, mortality rate is 13% for women compared to 7% for men. By and large, women have smaller coronary blood vessels and intervention procedures like angioplasty and by-pass surgery show higher adverse effects like local bleeding and vessel dissection during and immediate post procedures in women. Thus, women with coronary heart disease have most to gain from using risk reduction strategies. HRT (hormone replacement therapy) is controversial to say the least. Uniil recently, affluent women used to be prescribed hormones routinely at menopause for symptom relief, osteoporosis and cardiac protection. However, the latest research data has not shown any remarkable benefit for the heart. Thus, HRT is not solely prescribed for cardiac protection. Women who elected to take hormones were educated and thus had favorable levels of blood pressure, cholesterol, insulin, body weight, alcohol intake and physical activity. Thus, the amount of estrogen protection could be exaggerated. It has also been shown that most risk factors associated with HRT increases with therapy duration. Some are of the view that short term relief of menopausal symptoms with HRT will be worth the small absolute increase in risk for breast cancer, emboli and heart disease for many women provided the therapy is used for the shortest period of time necessary to successfully treat menopausal symptoms. However, until more definitive data is available, HRT should be based on a woman’s baseline risk for heart disease, weighing the potential net benefit on overall health.

In conclusion, all female groups should acknowledge the gender difference in heart disease. Medication has a role in primary prevention in selected groups. However, major emphasis should be placed on lifestyle modifications, smoking, diabetes, obesity, diet and physical activity. Also, awareness of heart disease in women including the delayed onset on them needs to be emphasized at different forum levels of education/seminar programs. As I write this article, international trials such as WTH (women take heart) & WISE (women with ischaemia syndrome evaluation) have just been released in March where they have emphatically concluded that women must aggressively manage their risk factors if they are to live a longer, healthier life.

Dr. Baral is the consultant cardiologist at Ganga Lal Heart Institute & NORVIC Hospital. Ph: 4436612/4437610, Mobile: 98510-53577

Gum Disease

Gum Disease :A common problem

By Dr. Sameer Aryal

If you have been told you have periodontal (gum) disease, you’re not alone. An estimated 80 percent of American adults 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.Gum disease is a threat to your oral health. Research is also pointing to possible health effects of periodontal diseases that go well beyond your mouth (more about this later). Whether it 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.

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

Gingivitis: The longer plaque and tartar remain on your 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.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 “pockets” that are 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 enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Risk Factors : Smoking. Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of periodontitis. Additionally, smoking can lower the chances of success of some treatments.

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 periodontal disease. Stress: Research shows that stress can make it more difficult for our bodies to fight infection, including periodontal disease. Medications: Some drugs, such as antidepressants and some heart medicines, can affect oral health because they lessen the flow of saliva. (Saliva has a protective effect on teeth and gums.) Illnesses: Diseases like cancer or AIDS and their treatments can also affect the health of gums. Genetic susceptibility: Some people are more prone to severe periodontal disease than others.Who gets periodontal disease?People usually don’t show signs of gum disease until they are in their 30s or 40s. Men are more likely to have periodontal 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.

What can I do to prevent gum disease?
Here are some things you can do to prevent periodontal diseases:- Brush your teeth twice a day (with a fluoride toothpaste) - Floss every day - Visit the dentist routinely for a check-up and professional cleaning - Eat a well balanced diet - Don’t use tobacco productsHow do I know if I have periodontal disease?Symptoms are often not noticeable until the disease is advanced. They include:- Red or swollen gums - Tender or bleeding gums - Painful chewing - Loose teeth - Sensitive teeth
How is periodontal 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. Additionally, modifying certain behaviors, such as quitting tobacco use, might also be suggested 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.

Medications: Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending on the severity of gum disease, the dentist or periodontist may still suggest surgical treatment. Long-term studies will be needed to determine whether using medications reduces the need for surgery and whether they are effective over a long period of time.

Surgery: Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A 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.

Can periodontal disease cause health problems beyond the mouth?
Maybe. But so far the research is inconclusive. Studies are ongoing to try to determine whether there is a cause-and-effect relationship between periodontal disease and an increased risk of heart attack or stroke, an increased risk of delivering preterm, low birth weight babies, difficulty controlling blood sugar levels in people with diabetes.In the meantime, it’s a fact that controlling periodontal disease can save your teeth —a very good reason to take care of your teeth and gums.