If you're one of the more than 26 million people in the U.S. with diabetes, you know first hand how the disease impacts your life. That includes your dental health — and whether or not implants are a good tooth replacement option for you.
Diabetes is actually the name for a group of diseases affecting how your body processes glucose, a simple sugar that provides energy for the body's cells. The level of glucose in the blood is regulated by insulin, a hormone produced in the pancreas. Diabetes causes the pancreas to either stop producing insulin (Type 1) or not produce enough (Type 2). Also in Type 2, the body can become unresponsive to the insulin produced.
The implications for either type are serious and can be life-threatening. If glucose levels are chronically too low or high the patient could eventually go blind, suffer nerve damage, or develop kidney disease. Diabetes also interferes with wound healing and creates a greater susceptibility for gangrene: diabetics thus have a higher risk for losing fingers, toes and limbs, and can even succumb to coma or death.
Type 2 is the most common form of diabetes. Fortunately, most people with this type can effectively manage it through diet, exercise and regular glucose monitoring; if need be, prescription medication can help regulate their levels. Even so, diabetics with their disease under control must still be alert to slower wound healing and a higher risk of infection.
Because implant placement is a minor surgical procedure, the aspects of diabetes related to healing, infection and inflammation could have an adverse impact on the ultimate success of the placement. Implant surgery creates a wound in the surrounding gum tissues and bone that will need to heal; the body's immune response in a diabetic can interfere with that process. And if infection sets in, the risks of implant failure increase.
But research has shown that diabetics with good glucose management have as high a success rate (over 95% after ten years) as non-diabetic patients. That means the implant option is a viable one for you as a diabetic — but only if you have your disease under control.
From the moment your child's first tooth appears, usually between six and nine months, you need to be concerned about Early Childhood Caries (ECC). This particular form of tooth decay can have a devastating effect on primary (baby) teeth and lead to their premature demise. Losing one before its time could adversely affect how the future permanent tooth comes in.
You can help prevent ECC with daily brushing and cleaning, regular dental visits (beginning around their first birthday) and limiting the sugar they eat. Here are 3 more things to consider for boosting your prevention efforts.
Breastfeeding. Pediatricians generally recommend breastfeeding if possible for a baby's overall health, including dental development. And although breast milk contains fermentable carbohydrates that boost bacterial growth, it no more promotes tooth decay than similar foods and beverages. That said, though, once the child begins to eat and drink other foods and beverages, the combination of sugars in them and breast milk could increase the bacteria that causes ECC. This is another good reason to wean the child from breast milk as they begin to eat more solid foods.
Bottles and pacifiers. It's quite common for parents and caregivers to soothe a fussing or crying baby with a bottle filled with formula, milk or juice for sipping, or even a pacifier dipped in jam, sugar or some form of sweetener. But these practices can create an environment that promotes high acid production from bacteria feeding on the sugars. Instead, avoid giving them a “prop-up” bottle filled with liquids containing sugar and try to limit bottle use to mealtimes. And provide them pacifiers without sugary additives if you use them.
Medicines. Children with chronic illnesses or other needs often take medication containing sugar or with antihistamines that reduce the flow of acid-neutralizing saliva. If the medications can't be altered, then it's extra important for you to practice diligent, daily hygiene to reduce the effect of higher mouth acid.
If you would like more information on dental disease prevention in babies and young children, 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 “Age One Dental Visit: Why it's Important for Your Baby.”
In the last half century, fluoride has become an effective weapon against tooth decay. The naturally occurring mineral helps strengthen enamel, the teeth's hard, protective cover.
Although it's safe for consumption overall, too much during early tooth development can lead to fluorosis, a brownish, mottled staining in enamel. To avoid it, a child's daily consumption of fluoride should optimally be kept at around 0.05-0.07 milligrams per kilogram of body weight, or an amount equal to one-tenth of a grain of salt per two pounds of weight.
The two main therapeutic fluoride sources have limits to help maintain this balance: utilities that fluoridate drinking water are required to add no more than 4 parts fluoride per million (ppm) of water; toothpaste manufacturers likewise only add a small amount of fluoride compared to clinical gels and pastes dentists apply to teeth for added decay protection.
But drinking water and toothpaste aren't the only sources of fluoride your child may encounter. Even if you have a non-fluoridated water supply, you should still keep a close watch on the following items that could contain fluoride, and discuss with us if you should take any action in regard to them.
Infant formula. The powdered form especially if mixed with fluoridated water can result in fluoride concentrations 100 to 200 times higher than breast or cow's milk. If there's a concern, use fluoride-free distilled or bottled spring water to mix formula.
Beverages. Many manufacturers use fluoridated water preparing a number of packaged beverages including sodas (two-thirds of those manufactured exceed .6 ppm), soft drinks and reconstituted fruit juices. You may need to limit your family's consumption of these kinds of beverages.
Certain foods. Processed foods like cereals, soups or containing fish or mechanically separated chicken can have high fluoride concentrations, especially if fluoridated water was used in their processing. When combined with other fluoride sources, their consumption could put children at higher risk for fluorosis.
Toothpaste. Although mentioned previously as a moderate fluoride source, you should still pay attention to how much your child uses. It doesn't take much: in fact, a full brush of toothpaste is too much, even for an adult. For an infant, you only need a smear on the end of the brush; as they grow older you can increase it but to no more than a pea-sized amount.
If you would like more information on fluoride and how it strengthens teeth, 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 “Fluoride & Fluoridation in Dentistry.”
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
If you notice a small sore or a change in the appearance of the tissues inside your mouth, don’t panic. It’s likely a common, minor ailment that appears on a lot of skin surfaces (like the wrists or legs) besides the cheeks, gums, or tongue.
These small sores or lesions are called lichen planus, named so because their coloration and patterns (white, lacy lines) look a lot like lichen that grow on trees or rocks. They’re only similar in appearance to the algae or fungi growing in the forest — these are lesions thought to be a form of auto-immune disease. Although they can affect anyone, they’re more common in women than men and with middle-aged or older people.
Most people aren’t even aware they have the condition, although some can produce itching or mild discomfort. They’re often discovered during dental checkups, and although they’re usually benign, we’ll often consider a biopsy of them to make sure the lesion isn’t a symptom of something more serious.
There currently isn’t a cure for the condition, but it can be managed to reduce symptoms; for most people, the lesions will go away on their own. You may need to avoid spicy or acidic foods like citrus, tomatoes, hot peppers or caffeinated drinks that tend to worsen the symptoms. If chronic stress is a problem, finding ways to reduce it can also help alleviate symptoms as well as quitting tobacco and reducing your alcohol intake.
Our biggest concern is to first assure the lesion isn’t cancerous. Even after confirming it’s not, we still want to keep a close eye on the lesion, so regular monitoring is a good precaution. Just keep up with the basics — good oral hygiene and regular checkups — to ensure you have the most optimum oral health possible.
If you would like more information on lichen planus lesions, 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 “Lichen Planus: Mouth Lesions that are Usually Benign.”
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