Diabetes and your dental health: How your dentist can help

 If you’ve been diagnosed with diabetes, it’s important that you let your dentist know so that they can give you the best care possible.

As more than 15 million Americans have diabetes, your dentist will be familiar with the issues and will give you the specialist care you need.

This is important because diabetes can lower your resistance to infection and slow the healing process.

It’s important to tell your dentist:

– If you have been diagnosed with .diabetes
– If the disease is under control
– If there has been any other change in your medical history
– Names of all prescription and over-the-counter drugs you are taking

The most common oral health problems associated with diabetes are:

– Tooth decay
– Periodontal (gum) disease
– Salivary gland dysfunction
– Fungal infections
– Infection and delayed healing
– Taste impairment

If you have regular dental checkups – and keep your dentist informed about your status – they’ll be able to help you reduce and manage these risks.

How your oral health links with your general health

Research has shown strong links between periodontitis (advanced form of gum disease) and other health problems such as cardiovascular disease, stroke and bacterial pneumonia.

And pregnant women with periodontitis may be at increased risk of delivering pre-term and/or having babies with low birth weight.

However, just because two conditions occur at the same time, doesn’t necessarily mean that one condition causes the other. The relationship could work the other way.

For example, there is evidence that diabetics are more likely to develop periodontitis and have more severe periodontitis than non-diabetics.

Alternatively, two conditions that occur together may be caused by something else.

In addition, people who smoke or use alcohol have a higher than average risk of developing periodontitis and other conditions, including oral cancer.

Research is looking at what happens when periodontitis is treated in individuals with these problems.

The aim is to find out whether periodontitis does have an effect on other health problems.

If one caused the other, improvement in periodontal health would also improve other health problems.

While the research is not yet conclusive, the potential link between periodontitis and systemic health problems, means that preventing periodontitis may be an important step in maintaining overall health.

In most cases, good oral health can be maintained by brushing and flossing every day and receiving regular professional dental care.

Daily dental tips to cut down on plaque

Plaque is a sticky film of bacteria that forms on teeth and gums. If you let it build up on your teeth, it can lead to several problems.

The best way to remove plaque from the tooth surfaces is by brushing and cleaning between your teeth every day.

You should brush your teeth twice a day, with a soft-bristled brush. The brush should fit your mouth comfortably, allowing you to reach all areas easily.

When you use toothpaste that contains fluoride, this helps protect your teeth.

You can help even more by cleaning between the teeth once a day with floss or interdental cleaners. This removes plaque from between the teeth in areas the toothbrush can’t reach.

By taking a few steps each day to look after your teeth – and visiting your dentist regularly, you’ll be able to enjoy healthy teeth and a great smile all your life.

How the food you eat can cause tooth decay

When you put food in your mouth, it immediately meets the bacteria that live there.

Plaque, for example, is a sticky film of bacteria.

These bacteria love the sugars found in many foods. So, when you don’t clean your teeth after eating, the bacteria and the sugar can combine to produce acids which can destroy the enamel – the hard surface of the tooth.

In time, this can lead to tooth decay. The more often you eat and the longer foods are in your mouth, the more damage occurs.

Many foods that are nutritious and important in our diet contain sugars – such as fruits, milk, bread, cereals and even vegetables.

So the key is not to try and avoid sugar but to think before you eat.

When you eat is also important because each time you eat food that contains sugars, the teeth are attacked by acids for 20 minutes or more.

This means that foods that are eaten as part of a meal cause less harm. More saliva is released during a meal, helping to wash foods from the mouth and reduce the effects of acids.

Here are some tips to follow when choosing your meals and snacks.
– Eat a variety of foods from different food groups
– Limit the number of snacks that you eat
– If you do snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt, or a piece of fruit

Its also important to brush your teeth twice a day and to clean between your teeth daily with floss or interdental cleaners.

And of course regular visits to your dentist will help prevent problems from occurring and catch those that do occur while they are easier to treat.

Treating facial pain and jaw problems

Chronic facial pain is a problem faced by millions of Americans.

Common symptoms can include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth or even head and neck aches.

If you are suffering from this type of pain, your dentist can help identify its source with a thorough exam and appropriate x-rays.

Sometimes, the problem is a sinus or toothache or it could be an early stage of periodontal disease.

But for some pain, the cause is not so easily diagnosed.

There are two joints and several jaw muscles which make it possible to open and close the mouth. They work together when you chew, speak, and swallow.

These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJs.

Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.

There are several ways the TMJ disorders may be treated.

Diagnosis is an important step before treatment.

Part of your clinical examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving.

Your dentist may take x-rays and may make a cast of your teeth to see how your bite fits together.

To help you deal with this pain, your dentist will recommend what type of treatment you need and may refer you to a specialist.

What's involved in getting a dental implant?

Dental implants are increasingly popular as a way to replace missing or damaged teeth.

Their great advantage is that they look natural and feel secure helping you to restore your smile and eat more easily.

Implants are an ideal solution for many people but they are not an option for everyone.

Placing implants requires some surgery so patients must be in good health, have healthy gums and have adequate bone to support the implant.

They must also be committed to taking action to maintain their oral hygiene and to visiting the dentist regularly.

The process for placing implants is as follows:

First, surgery is performed to place the anchor. This can take up to several hours. Following the surgery, you may need to wait up to six months for the bone to grow around the anchor and firmly hold it in place. Sometimes follow up surgery is required to attach a post to connect the anchor to the replacement teeth. Alternatively, the anchor and post may already be attached and are placed at the same time.

After the gums have had several weeks to heal, the next step is to fit specially-made artificial teeth to the post portion of the anchor. This can take a few weeks to complete as several fittings may be required.

Implant surgery can be done either in a dental office or in a hospital, depending upon a number of factors. A local or general anesthetic may be used. Usually pain medications and, when necessary, antibiotics are prescribed.

After your implants are fitted, your dentist will give you tips and advice on maintaining your oral hygiene.

Your dentist can help you decide whether you would be a good candidate for implants.

How scaling and planing can help clean your teeth properly

Dental plaque is a film that builds up on your teeth and, if it is not removed through good oral hygiene, it can lead to tooth decay and gum problems.

Over time it can ultimately form a hard, rough sediment known as dental tartar or calculus, which attracts further plaque buildup.

Calculus has to be removed by a trained professional such as a hygienist or dentist.

They may do this by manual tooth scaling or using an ultrasonic device.

If the buildup is light or moderate, the dentist or hygienist may use manual scaling instruments of various shapes and sizes.

If the buildup of tartar and stains is heavy, an ultrasonic cleaner may be used. This may be followed by hand scaling.

Build up of plaque can cause inflammation of the gums leading to breakdown of the connection between the teeth and the supporting structures.

Root planing is a procedure to treat gum disease by thoroughly scaling the roots of teeth to establish a smooth, calculus-free surface.

This treatment may require local anesthesia to prevent pain. Thorough periodontal scaling customarily involves several dental visits

If conditions are more advanced, surgery may be needed for complete debridement of the roots to arrest the disease process.

Some people tend to have more buildup of calculus than others and some may be more prone to periodontal inflammation or the development of tooth decay.

It’s therefore important to follow your hygienist’s advivce on how often to return for regular cleanings – even if your insurance only covers two a year.

How removable partial dentures can help you

Removable partial dentures usually involve replacement teeth attached to plastic bases, connected by metal framework.

They attach to your natural teeth with metal clasps or precision attachments. Precision attachments generally look better than metal clasps and are nearly invisible.

Crowns may be required on your natural teeth to improve the fit of a removable partial denture.

When you first get a partial denture, it may feel awkward or bulky. But you will gradually get used to wearing it.

It will also take a bit of practice to get used to inserting and removing the denture. It should fit into place easily and you should never force it.

Your dentist may suggest that you wear your partial denture all the time at first. While it will be uncomfortable for a while, it will help you identify if any parts of the denture need adjustment.

After making adjustments, your dentist will probably recommend that you take the denture out of your mouth before going to bed and replace it in the morning.

With a denture, eating should become a more pleasant experience compared to having missing teeth.

But, initially, youll need to eat soft foods cut into small pieces. And avoid foods that are extremely sticky or hard.

Some people with missing teeth find it hard to speak clearly so wearing a partial denture may help. However, youll probably need to practice certain words at first to get completely comfortable.

While it can take a little geting used to initially, a partial denture can help you enjoy your food with less worries.

Maintaining proper nutrition as an older adult

Maintaining proper nutrition is important for everyone, young or old but many older adults find it difficult to eat a balanced diet.

They may avoid meats, raw vegetables and fresh fruits because they have trouble chewing or swallowing.

These problems can be caused by painful teeth, ill-fitting dentures, dry mouth or changes in facial muscles.

Others find their sense of taste has changed, sometimes due to a disease or certain medications.

As a result, older adults often have diets lacking in calcium, protein and other nutrients essential to dental and overall health.

A balanced diet has to be based on the five food groups:
– Milk and dairy products
– Breads and cereals
– Meats and dried beans
– Fruits
– Vegetables

Sometimes a multi-vitamin or mineral supplement will help but it’s best to use supplements only after discussion with your physician.

If your teeth are stopping you from eating the food you enjoy – or that you need for good health – your dentist will be able to help you find a solution.

Your saliva and why its so important

You probably don’t give too much thought to the saliva in your mouth but, if you think of it like a bloodstream you’ll realize how important it is.

Like blood, saliva helps build and maintain the health of the soft and hard tissues.

It removes waste products from the mouth and offers first-line protection against microbial invasion that might lead to disease.

Saliva is derived from blood and therefore can also be used to detect disease.

Saliva enhances enamel protection by providing high levels of calcium and phosphate ions. It contains the minerals that maintain the integrity of the enamel surface and helps protect against caries.

When salivary flow is reduced, oral health deteriorates – much in the same way body tissues suffer if blood circulation is disrupted.

Patients with dry mouths (xerostomia) experience difficulty chewing, speaking and swallowing. A major cause of dry mouth is medication – almost eighty percent of the most commonly prescribed medications lead to dry mouth.

Chewing gum after a snack or meal stimulates salivary flow, clearing food from the mouth and neutralizing plaque acid.

Your saliva is important to your oral health both for preventing disease and in helping to diagnose problems.

Why to look for the ADA Seal of Acceptance

When buying dental products, its a good idea to look out for the American Dental Association (ADA) Seal of Acceptance.

The first Seal of Acceptance was awarded in 1931 and its regarded as an important symbol of a dental product’s safety and effectiveness.

Although the Seal program is strictly voluntary, approximately 100 companies participate in it and they commit significant resources to testing their products in clinical and laboratory conditions.

More than 300 consumer dental products carry the Seal of Acceptance. These include toothpaste, dental floss, manual and electric toothbrushes, mouth rinse and chewing gum.

You can get more information about the seal and how it is awarded for specific products at http://www.ada.org/ada/seal/

This site also contains links to the most current lists of accepted consumer products.

CANKER/COLD SORES

People sometimes confuse canker sores and cold sores, but they are completely unrelated. Both can be painful, but knowing the differences can help you keep them in check.

A canker sore is typically one that occurs on the delicate tissues inside your mouth. It is usually light-colored at its base and can have a red exterior border.

A cold sore or fever blister, on the other hand, usually occurs on the outside of the mouth, usually on or near the nose or lips. A cold sore is contagious because it is caused by the herpes simplex virus, and it is usually painful and filled with fluid.

In most cases, patience is the best medicine for treating canker sores. A healthy diet and good oral hygiene are usually the best remedy, but some special rinses and anesthetics can help. Cold sores can be treated effectively with some over-the-counter topical creams; sometimes, an antiviral medication will be prescribed by your doctor.

BULIMIA NERVOSA

People with eating disorders can suffer from oral health problems as well. This is because many of the behaviors associated with anorexia nervosa and bulimia nervosa such as binge eating, self-induced vomiting, and use of diuretics or laxatives cause changes in the mouth.

For example, repeated episodes of vomiting, which is common in people with bulimia, release harmful stomach acids that pass through the mouth and can erode tooth enamel, causing cavities, discoloration and tooth loss.  Other problems, such as poorly fitting fillings and braces, are another byproduct of such eating disorders.

Brushing after episodic vomiting is actually more harmful than one would think. The best practice is to rinse thoroughly with a neutral solution such as baking soda and water.

ABSCESSED TOOTH

Treatment of an abscessed tooth

An abscessed tooth is a pocket of pus, usually caused by some kind of infection and the spread of bacteria from the root of the tooth to the tissue just below or near the tooth.

In general, a tooth that has become abscessed is one whose underlying pulp (the tooth's soft core) has become infected or swollen. The pulp contains nerves, blood vessels and connective tissue, and lies within the tooth. It extends from the crown of the tooth, to the tip of the root, in the bone of the jaws.

An abscessed tooth can be an extremely painful condition.

In some cases, antibiotics are administered in an attempt to kill an infection. If antibiotics are ineffective and an abscess is shown to be damaging the pulp or lower bony structures, a root canal procedure may be needed to remove the dead pulp and restore the tooth to a healthy state.

NUTRITION AND YOUR TEETH

It has long been known that good nutrition and a well-balanced diet is one of the best defenses for your oral health. Providing your body with the right amounts of vitamins and minerals helps your teeth and gums—as well as your immune system—stay strong and ward off infection, decay and disease.

Harmful acids and bacteria in your mouth are left behind from eating foods high in sugar and carbohydrates. These include carbonated beverages, some kinds of fruit juices, and many kinds of starch foods like pasta, bread and cereal.

Children's Nutrition and Teeth

Good eating habits that begin in early childhood can go a long way to ensuring a lifetime of good oral health.

Children should eat foods rich in calcium and other kinds of minerals, as well as a healthy balance of the essential food groups like vegetables, fruits, dairy products, poultry and meat. Fluoride supplements may be helpful if you live in a community without fluoridated water, but consult with our office first. (Be aware that sugars are even found in some kinds of condiments, as well as fruits and even milk.)

Allowing your children to eat excessive amounts of junk food (starches and sugars)—including potato chips, cookies, crackers, soda, artificial fruit rollups and granola bars—only places them at risk for serious health problems, including obesity, osteoporosis and diabetes. The carbonation found in soda, for example, can actually erode tooth enamel. Encourage your child to use a straw when drinking soda; this will help keep at least some of the carbonated beverage away from the teeth.

Adult Nutrition and Teeth

There's no discounting the importance of continuing a healthy balanced diet throughout your adult life.

SENIORS AND ORAL HEALTH

More and more people are avoiding the need for dentures as they grow older, going against the notion that false teeth are a normal part of growing older.

In fact, there's usually no reason for you NOT to keep your teeth your entire life, providing you maintain a healthy balanced diet and practice good oral hygiene.

Another desirable side effect of good oral hygiene: avoiding more serious problems such as hypertension, cardiovascular disease, diabetes, and even stroke. Indeed, medical research is beginning to show that a healthy mouth equates to a healthy body and a longer life.

 

Dexterity and Arthritis

People who suffer from arthritis or other problems of dexterity may find it difficult and painful to practice good oral hygiene.

Thankfully, industry has responded with ergonomically designed devices such as toothbrushes and floss holders that make it easier to grasp and control.

You can also use items around the house to help you. Inserting the handle of your toothbrush into a small rubber ball, or extending the handle by attaching a small piece of plastic or Popsicle stick may also do the trick.

Floss can also be tied into a tiny loop on either side, making it easier to grasp and control the floss with your fingers

WOMEN AND TOOTH CARE

Women have special needs when it comes to their oral health. That’s because the physical changes they undergo through life—menstruation, pregnancy and childbirth, breastfeeding and menopause cause many changes in the body, some harmful to teeth and gums.

Lesions and ulcers, dry sockets, as well as swollen gums, can sometimes occur during surges in a woman's hormone levels. These periods would be a prime time to visit the dentist. Birth control pills have been shown to increase the risk of gingivitis, and hormone replacement therapy has been shown to cause bleeding and swollen gums. Gum disease can also present a higher risk for premature births.

Some research has shown that women may be more likely to develop dry mouth, eating disorders, jaw problems such as temporomandibular joint disorders, and facial pain,all of which can be difficult from a physical and emotional standpoint.

Taking care of your mouth with proper oral health care is essential, and can go a long way to helping you face the physical changes in your body over the years.

PREVENTION TIPS FOR CHILDREN

Infants

Infants should be seen by our office after the first six months of age, and at least by the child's first birthday. By this time, the baby's first teeth, or primary teeth, are beginning to erupt and it is a critical time to spot any problems before they become big concerns.

Conditions like gum irritation and thumb-sucking could create problems later on. Babies who suck their thumbs may be setting the stage for malformed teeth and bite relationships.

Another problem that can be spotted early is a condition called "baby bottle tooth decay," which is caused by sugary substances in breast milk and some juices, which combine with saliva to form pools inside the baby's mouth.

If left untreated, this can lead to premature decay of your baby's future primary teeth, which can later hamper the proper formation of permanent teeth.

One of the best ways to avoid baby bottle tooth decay is to not allow your baby to nurse on a bottle while going to sleep. Avoid dipping pacifiers in sweet substances such as honey, because this only encourages early decay in the baby's mouth. Encouraging your young child to drink from a cup as early as possible will also help stave off the problems associated with baby bottle tooth decay.

Teething, Pacifiers and Thumb-Sucking

Teething is a sign that your child's gums are sore. This is perfectly normal. You can help relieve this by allowing the baby to suck on a teething ring, or gently rubbing your baby's gums with the back of a small spoon, a piece of wet gauze, or even your finger.

For babies under the age of 4, teething rings and pacifiers can be safely used to facilitate the child's oral needs for relieving gum pain and for suckling. After the age of 4, pacifiers are generally discouraged because they may interfere with the development of your child's teeth.

Moreover, thumb-sucking should be strongly discouraged because it can lead to malformed teeth that become crooked and crowded.

Primary and Permanent Teeth

Every child grows 20 primary teeth, usually by the age of 3. These teeth are gradually replaced by the age of 12 or so with a full set of 28 permanent teeth, and later on, four molars called "wisdom teeth."

It is essential that a child's primary teeth are healthy, because their development sets the stage for permanent teeth. If primary teeth become diseased or do not grow in properly, chances are greater that their permanent replacements will suffer the same fate. For example, poorly formed primary teeth that don't erupt properly could crowd out spaces reserved for other teeth. Space maintainers can sometimes be used to correct this condition, if it is spotted early enough.

Brushing

Babies' gums and teeth can be gently cleaned with special infant toothbrushes that fit over your finger. Water is suitable in lieu of toothpaste (because the baby may swallow the toothpaste). Parents are advised to avoid fluoride toothpastes on children under the age of 2.

Primary teeth can be cleansed with child-sized, soft-bristled toothbrushes. Remember to use small portions of toothpaste (a pea-sized portion is suitable), and teach your child to spit out, not swallow, the toothpaste when finished.

Fluoride

Fluoride is generally present in most public drinking water systems. If you are unsure about your community's water and its fluoride content, or learn that it has an unacceptable level of fluoride in it, there are fluoride supplements your dentist can prescribe. Your child may not be getting enough fluoride just by using fluoride toothpaste.

Toothaches

Toothaches can be common in young children. Sometimes, toothaches are caused by erupting teeth, but they also could indicate a serious problem.

You can safely relieve a small child's toothache without the aid of medication by rinsing the mouth with a solution of warm water and table salt. If the pain doesn't subside, acetaminophen may be used. If such medications don't help, contact your dentist immediately.

Injuries

You can help your child prevent oral injuries by closely supervising him during play and not allowing the child to put foreign objects in the mouth.

For younger children involved in physical activities and sports, mouth guards are strongly encouraged, and can prevent a whole host of injuries to the teeth, gums, lips and other oral structures.

Mouth guards are generally small plastic appliances that safely fit around your child's teeth. Many mouth guards are soft and pliable when opened, and mold to the child's teeth when first inserted.

If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see our office.  Remember to hold the dislocated tooth by the crown—not the root. If you cannot relocate the tooth, place it in a container of cold milk, saline or the victim's own saliva. Place the tooth in the solution.

First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.

For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.

If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.

If a child's primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.

Irritation caused by retainers or braces can sometimes be relieved by placing a tiny piece of cotton or gauze on the tip of the wire or other protruding object. If an injury occurs from a piece of the retainer or braces lodging into a soft tissue, contact our office immediately and avoid dislodging it yourself.

Sealants

Sealants fill in the little ridges on the chewing part of your teeth to protect and seal the tooth from food and plaque. The application is easy to apply and typically last for several years.

EMERGENCY CARE

A knocked out tooth or bitten tongue can cause panic in any parent, but quick thinking and staying calm are the best ways to approach such common dental emergencies and prevent additional unnecessary damage and costly dental restoration. This includes taking measures such as application of cold compresses to reduce swelling, and of course, contacting our office as soon as possible.

DENTURE CARE

Dentures today are made from very advanced materials designed to give you a natural appearance. However, keep in mind that just like your teeth, dentures should be cared for with the same diligence. This means daily brushing and regular visits to your dentist.

Regular visits to your dentist are critical. Your dentist also can make minor adjustments that ensure that your dentures continue fitting naturally and comfortably.

Just like natural teeth, dentures need to be cleansed of plaque, food particles and other debris. Keeping your dentures in top shape will also help keep the soft tissues of your mouth healthy; an unclean or malformed denture can cause infections and irritation.

 

Cleaning Techniques

Remember to rinse and brush your dentures after every meal, and soak them in denture solution overnight. This also allows your gums to breathe while you sleep.

Here are some simple techniques for keeping your dentures clean:

• People can brush their dentures in a variety of ways. Some people use soap and water or a slightly abrasive toothpaste. Popular denture pastes and creams also can be used.
• Avoid using highly abrasive chemicals or pastes, or vigorously brushing with hard bristled toothbrushes. These can scratch or even crack dentures.
• Hold your dentures gently to avoid loosening a tooth.
• Clean your dentures with cool or tepid water over a water-filled sink. Hot water may warp a denture. A small washcloth placed in the bottom of the bowl will ensure that your denture isn't damaged if it falls.
• Soak your dentures overnight in any commercially available product like Efferdent or Polident, and remember to rinse your dentures before placing them back in your mouth.
• Remember to use a separate toothbrush to clean your own natural teeth, as well as all of your gum tissues. In lieu of a toothbrush, a soft washcloth may be used to wipe your gums.

Over time, even daily care of your dentures may require them to be cleaned by the dentist. A powerful ultrasonic cleaner may be used to remove hard accumulations of tartar and other substances.