Over 26 million Americans have diabetes, a systemic condition that interferes with maintaining safe levels of blood sugar in the bloodstream. Over time, diabetes can begin to interfere with other bodily processes, including wound healing—which could affect dental care, and dental implants in particular.
Diabetes affects how the body regulates glucose, a basic sugar derived from food digestion that's the primary source of energy for cell development and function. Our bodies, though, must maintain glucose levels within a certain range — too high or too low could have adverse effects on our health. The body does this with the help of a hormone called insulin that's produced as needed by the pancreas to constantly regulate blood glucose levels.
There are two types of diabetes that interfere with the function of insulin in different ways. With Type I diabetes the pancreas stops producing insulin, forcing the patient to obtain the hormone externally through daily injections or medication. With Type II diabetes, the most common form among diabetics, the body doesn't produce enough insulin or doesn't respond adequately to the insulin that's present.
As mentioned, one of the consequences of diabetes is slow wound healing. This can have a profound effect on the body in general, but it can also potentially cause problems with dental implants. That's because implants once placed need time to integrate with the bone to achieve a strong hold. Slow wound healing caused by diabetes can slow this integration process between implant and bone, which can affect the entire implantation process.
The potential for those kinds of problems is greater if a patient's diabetes isn't under control. Patients who are effectively managing their diabetes with proper diet, exercise and medication have less trouble with wound healing, and so less chance of healing problems with implants.
All in all, though, it appears diabetics as a group have as much success with implants as the general population (above 95 percent). But it can be a smoother process if you're doing everything you can to keep your diabetes under control.
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.”
The most important part of dental health maintenance isn’t what your dentist does—it’s what you do every day when you brush and floss your teeth. And all you really need is a multi-tufted, soft bristle toothbrush, toothpaste, a roll of dental floss—plus a little effort from your hands and fingers.
Of course, manual power isn’t your only option—an electric or battery-powered toothbrush is a convenient and, for people with strength or dexterity issues, a necessary way to remove disease-causing plaque from tooth surfaces. You have a similar option with flossing—a water flosser.
Although water flossers (or oral irrigators) have been around since the early 1960s, they’ve become more efficient and less expensive in recent years. A water flosser delivers a pulsating stream of pressurized water between the teeth through a handheld device that resembles a power toothbrush, but with a special tip. The water action loosens plaque and then flushes it away.
While the convenience these devices provide over traditional flossing is a major selling point, they’re also quite beneficial for people with special challenges keeping plaque from accumulating between teeth. People wearing braces or other orthodontic devices, for example, may find it much more difficult to effectively maneuver thread floss around their hardware. Water flossing can be an effective alternative.
But is water flossing a good method for removing between-teeth plaque? If performed properly, yes. A 2008 study, for example, reviewed orthodontic patients who used water flossing compared to those only brushing. The study found that those using water flossing were able to remove five times as much plaque as the non-flossing group.
If you’re considering water flossing over traditional flossing thread, talk with your dental hygienist. He or she can give you advice on purchasing a water flosser, as well as how to use the device for optimum performance. It could be a great and more convenient way to keep plaque from between your teeth and harming your dental health.
If you would like more information on water flossing, 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 “Cleaning between Your Teeth: How Water Flossing can help.”
Sometimes it's the little things that can be most annoying. Those occasional small sores that pop up on the inside of your mouth are a case in point. Although in most instances they won't last long and aren't anything to be alarmed about, they can still cause you some discomfort.
These small sores are called aphthous ulcers or more commonly “canker sores.” They are breaks in the skin or mucosa, the inner lining of the mouth, and occur most often on the inside cheeks, lips, tongue and occasionally on the soft palate at the back of the throat. They usually appear round with a yellow-gray center and an intensely red outer ring or "halo."
Canker sores often appear during periods of high stress or because of minor trauma, and usually last for a week or two. They often have a tingling pain that can be aggravated when you eat and drink acidic or spicy foods and beverages. About 20 to 25% of people have a form known as recurrent aphthous stomatitis (mouth inflammation) that occurs regularly with multiple sores and heightened pain.
It's possible to manage the discomfort of minor, occasional bouts with a number of over-the-counter products that cover the sore to protect it and boost healing, with some providing a numbing agent for temporary pain relief. For more serious outbreaks we can also prescribe topical steroids in gels or rinses, injections or other medications.
While canker sores don't represent a health danger, there are instances where you should take outbreaks more seriously: if a sore hasn't healed after two weeks; if you've noticed an increase in pain, frequency or duration of outbreaks; or if you're never without a sore. In these cases we may need to biopsy some of the tissue (and possibly run some blood tests) to ensure they're not pre-cancerous or cancerous.
In any event, we can work with you to reduce your symptoms and help the sores heal quickly. This particular “little thing” in life doesn't have to stress you out.
If you would like more information on mouth sores, 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 “Mouth Sores: Understanding and treating canker sores.”
It's a big transition when your child enters college — for both of you. You may find “cutting the apron strings” a little rocky at times.
But like most parents, you'll soon condense what you still want your college kid to do down to a few major habits and choices. Be sure to keep health, diet and lifestyle choices on that list, areas which could have the most effect on their long-term health and well-being.
That should include dental care. Hopefully, they've already developed good hygiene habits like daily brushing and flossing and regular dental visits. But, on their own now, they're faced with other choices that could affect their dental health.
For example, eating a balanced, nutritious diet is necessary for a healthy mouth. That includes limiting sugar intake, especially when snacking. Disease-causing oral bacteria thrive on carbohydrates like sugar. These bacteria also secrete acid, which at consistently high levels can erode tooth enamel.
Tobacco smoking and excessive alcohol affect teeth and gums because both can inhibit secretion of saliva. Besides containing antibodies that fight infection, saliva also neutralizes mouth acid. A dry mouth caused by these habits, could put their mouth at higher risk for disease.
Your college student might also be influenced by the fashion of their peers to display piercings. Mouth piercings with lip or tongue hardware in particular can damage teeth. The constant movement and friction erodes enamel or may even cause a tooth fracture. If possible, try to steer them to self-expression that poses less risk to their dental health.
There's one other area that, believe it or not, could impact dental health: sex. While each family handles this particular subject differently, be sure your child knows that some forms of sexual activity increase the risk for contracting the human papilloma virus (HPV16). Among its many destructive outcomes, HPV16 profoundly raises the risk of oral cancer, a rare but deadly disease with a poor survival rate.
Going from home to college is a big step for a young person — and their parents. As a parent, you can help steer them to practice good habits and make wise choices that will protect their lives and health and, in particular, their teeth and gums.
If you would like more information on helping your college student maintain their dental health, 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 “10 Health Tips for College Students.”
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