This discussion is about a subject outside of my specialty. But it is relevant because of how it affects plastic surgery and even longevity.

The rate of breast encapsulations (breast firmness and distortion) with breast augmentations varies from 2 percent to 10 percent, according to the surgical technique and post-operative care.

However, through the years I have noticed that a number of breast implant encapsulations occur because of poor dental hygiene.

Why? It’s because gingivitis and periodontal disease (inflamed, swollen or bleeding gums) is a bacterial problem.

The most common cause of implant encapsulations is bacteria – and without a clinical infection.

With gingivitis, bacteria actually invade the blood circulatory system, which is bad for all types of implants, from knees to hips to breasts.

My first question to patients with encapsulations is: “Do you have bleeding, inflamed or swollen gums?” Too frequently, the answer is “yes.”

The bacteria from gingivitis can become blood-borne, and the capsules around the implants can get enough bacteria to cause encapsulations, even many years after breast implant surgery.

Other problems caused by gingivitis are loss and thinning of the bones that house your teeth, the maxilla and mandible.

In severe cases of gingivitis, teeth can be lost. The result is loss of facial volume, causing a dramatic appearance of facial aging.

Two of the main causes of the appearance of facial aging are volume loss of bone and fat, and the loss of skin elasticity. Poor dental hygiene causes volume loss in a big way.

Another result of volume loss is excessive hollowing of the cheeks, creating shadows and depressions, including wrinkling around the mouth. In fact, bone loss of the maxilla causes sagging, drooping and turning down of the nose.

Nasolabial folds between the nose and corner of the mouth are caused by volume loss of the maxilla and cheeks.

The mouth area can become very wrinkled, and the “marionette” lines below the corners of the mouth occur at a younger age with poor dental hygiene.

Additionally, people with periodontal disease have three times the risk of dying prematurely from coronary disease.

How do you avoid periodontal disease? The first step is to visit a dentist twice a year for evaluation and professional cleaning.

For home care, always floss twice a day with a non-waxed floss. Waxed floss glides over the teeth and does not cut the plaque off.

Brush with a SoniCare toothbrush using fluoride toothpaste two to three times per day. The SoniCare toothbrush has a two-minute timer, and one should brush for two full minutes.

A regular toothbrush can be used after lunch at work.

After flossing, use a good mouthwash designed to prevent gum disease and reduce plaque.

Plaque is full of bacteria. Get rid of it.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. www.fingerand