November is National Diabetes Month—a time to focus on a disease that affects more than 400 million people around the world. What does diabetes have to do with oral health? Plenty! Here's a true-or-false quiz to test your knowledge on this important topic.
TRUE OR FALSE:
1. Diabetes and gum disease are connected.
TRUE. Studies have found a clear association between diabetes and gum (periodontal) disease, especially when diabetes is not well controlled. People with poorly controlled diabetes have a more severe inflammatory response to the bacteria that cause gum disease. While inflammation is normally a protective reaction of the body's immune system, too much inflammation can actually make the condition worse. In the case of gum disease, the reverse is also true: Untreated gum disease can worsen blood sugar levels in people with diabetes. The good news is that treatment of periodontal disease has been shown to improve blood sugar control.
2. People with diabetes can't have dental implants.
FALSE. Research has shown that dental implants can be a very successful tooth-replacement treatment for people with diabetes. But again, blood sugar control can be a factor. Dental implants are titanium posts that serve as artificial tooth roots. Minor surgery is required to insert an implant into the bone beneath the gums; a realistic-looking dental crown is later attached to it so it can look and function like a natural tooth. Studies have shown that it takes longer for the bone to heal around implants in people with poorly controlled diabetes. That doesn't make implant treatment impossible, but it does mean that it may be managed differently. For example, an implant may be allowed to heal for a longer period of time before a crown is attached to it.
3. People with diabetes can't do anything to improve their oral health.
FALSE. People with diabetes can have a very positive impact on their oral heath, by doing their best to control blood sugar levels with a healthy diet and exercise, and by sticking to an effective daily oral hygiene routine. This includes brushing twice a day for two minutes each time, and flossing at least once each day to remove bacterial plaque between teeth. Regular dental checkups and cleanings are also essential—not just for people with diabetes, but for everyone!
If you have additional questions about diabetes and oral health, please contact us or schedule an appointment for a consultation. You can learn more about diabetes and oral health by reading the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
Your gums aren’t just for show—they also play an important role in supporting and protecting your teeth. Healthy gums are essential for healthy teeth.
Your gums can take a lot from daily chewing or other environmental factors. Unfortunately, disease or trauma can weaken their resilience. This weakening could lead to gum recession.
Gum recession occurs when the tissues covering a tooth begin to lose their attachment and shrink back (recede). As a result, the tooth appears “longer” as more of it that’s normally below the gum line becomes visible. Not only is gum recession unattractive, it also exposes more of the tooth to disease-causing bacteria.
The most common cause for gum recession is periodontal (gum) disease, an infection arising from the accumulation of a thin bacterial biofilm on the teeth called plaque. Infected gums become inflamed, a normal defensive response to isolate diseased or damaged tissues from the rest of the body. Chronic inflammation, however, weakens affected tissues over time and results in bone loss.
Other factors can also contribute to gum recession. A tooth that didn’t erupt properly and has come in away from the center of its protective bony housing can impede adequate gum coverage. Your gum tissue thickness, which you genetically inherit, can also increase the risk of gum recession. People with thinner gum tissues are more susceptible to recession than with thicker tissues.
You can also damage your gums (ironically) while trying to care for them. Over-aggressive brushing over time may traumatize the gums to the point that they recede. While it’s essential in removing disease-causing dental plaque, brushing only requires a gentle scrubbing action covering all portions of tooth surfaces. The brush bristles and mild abrasives in the toothpaste do most of the work of plaque removal.
To minimize the chances of gum recession, you should practice proper oral hygiene and visit your dentist regularly for professional cleanings and checkups. And you might also consider orthodontics for improperly positioned teeth that could not only improve your smile, but also your gum health.
And by all means see your dentist if you notice any signs of gum infection like swollen, reddened or bleeding gums. The sooner you begin gum disease treatment, the less likely your gums will recede in the future.
If you would like more information on recognizing and treating gum recession, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gum Recession: Getting Long in the Tooth.”
Are you interested in dental implants but a little hesitant about the surgery? Don’t be—this procedure to imbed an implant’s titanium post in the jawbone is relatively minor with little to no discomfort for most patients.
Some time before, however, we’ll need to pre-plan the surgery to pinpoint the best location for the implant, critical to achieving a solid hold and a life-like appearance. During these first visits we often create a surgical guide, a device inserted in the mouth during surgery that identifies the exact location for the hole (or channel) in the bone we’ll drill to insert the implant.
On surgery day, we’ll prepare you for a pain-free and relaxing experience. If you’re normally anxious about dental work, we may prescribe a sedative for you to take ahead of time. As we begin we’ll thoroughly numb the area with local anesthesia to ensure you won’t feel any pain.
The surgery begins with an incision through the gum tissue to access the underlying bone. Once it’s exposed, we’ll insert the surgical guide and begin a drilling sequence to gradually increase the size of the channel. This takes time because we want to avoid damaging the bone from overheating caused by friction.
Once we’ve created a channel that matches precisely the implant’s size and shape, we’ll remove the implant from its sterile packaging and immediately fit and secure it in the channel. We’ll then take x-rays to ensure it’s in the best position possible.
Satisfied we’ve properly situated and secured the implant, we’ll suture the gum tissue back in place to protect the implant with or without attaching a healing abutment to it as it fully integrates with the jawbone over the next few months (after which you’ll come back to receive your permanent crown). After a short recovery, you’ll return to full activity. Most patients only experience mild to moderate discomfort usually manageable with over-the-counter pain medication like aspirin or ibuprofen.
While implantation is a long process, you’ll be obtaining what’s considered by most dentists and their patients as the most durable and life-like tooth replacement available. Your new attractive smile will be well worth it.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Surgery: What to Expect Before, During and After.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”
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