Posts for category: Oral Health
Periodontal (gum) disease, though it may be invisible to everyone but your dentist, can have a powerful effect on your entire body. Not only is it dangerous to your teeth and jaws, but it can increase your risk of heart attack and stroke, cause preterm births in pregnant women, and affect blood sugar control in diabetics.
Diabetics are our subject for today. Symptoms of diabetes include abnormally high levels of glucose (a form of sugar) in the blood, leading to frequent urination, excessive thirst, blurred vision, unexplained weight loss, and loss of energy. The disease can also cause severe complications in various parts of the body.
Normally, glucose, your body's main energy source, is kept under control by a hormone called insulin, which is made by an organ called the pancreas. In type 1 diabetes, a person's pancreas does not produce enough insulin to deal with all the glucose in his or her blood. In type 2 diabetes — a condition related to increased age, physical inactivity, overweight, and heredity — the pancreas may produce enough insulin, but the body is not able to use it effectively. This condition is called insulin resistance.
People with type 1 diabetes need insulin to survive. Type 2 may be treated with exercise, diet, medications, and insulin supplements.
Serious complications of diabetes range from kidney failure, blindness, and nerve damage to infections that do not heal, gangrene and amputation of limbs.
Diabetes and periodontal disease seem to have reciprocal effects on each other. Diabetics are more likely to have periodontal disease than non-diabetics; and those with periodontal disease are likely to face worsening blood sugar control over time.
Periodontal disease (from “peri”, meaning around and “odont”, meaning tooth), is caused by dental plaque — a film of bacteria that settles on your teeth and gums every day. It's what you remove with daily brushing and flossing. Any bacteria that remain cause inflammation, which can lead in the worst cases to loss of bone and eventual loss of teeth.
The close relationship of diabetes and periodontal disease probably results from changes in the function of immune cells responsible for healing. Inflammation is a part of normal wound healing — but chronic or prolonged inflammation can destroy the tissues it was meant to heal. This may be a major factor in the destructive complications of diabetes.
Many of these complications begin in the blood vessels. Like the eyes and the kidneys, gum tissues are rich in blood vessels. Gum tissues are also under constant attack from bacteria. If you are a diabetic, effective plaque control, along with regular professional dental cleaning, can have positive effects not only on periodontal disease, but also on control of your blood glucose level.
Contact us today to schedule an appointment to discuss your questions about periodontal disease and its connections with diabetes. You can also learn more by reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.”
What does it mean when your dental hygienist recommends root planing? To put it simply, root planing is a method of cleaning the roots of your teeth in order to avoid periodontal (“peri” – around, “odont” – tooth) disease.
Periodontal disease happens when dental plaque, a biofilm of bacteria, is not regularly removed and begins to build up on teeth near the gum line. The bacteria cause inflammation, and this in turn causes the gum tissue to detach from the teeth. The widening spaces between the gum tissue and the teeth, called pockets, are environments in which bacteria can continue to collect and cause further inflammation and infection. Ultimately, this can lead to infection, bone loss, and loss of teeth.
Root planing is a technique designed to avoid such dire results. The bacteria, along with products they manufacture as part of their metabolism, can become ingrained in the surfaces of the tooth's root (the part of the tooth that is below the enamel). These bacterial products will form hard deposits called tartar or calculus.
Deep Cleaning Your Teeth
Of course, the best idea is to brush and floss away the plaque before the bacteria begin to build up on your teeth. If this is not done and pockets begin to form, the bacteria and toxic products are more difficult to remove in order to deep clean your teeth.
The first step is scaling. My hygienist or I will remove superficial collections of calculus. If material still remains within deep pockets, root planing is the next step. It involves actually planing the surface of the root, smoothing the surface free of calculus, bacteria, and toxins that have ingrained into the root surfaces.
Root planing is most often done under local anesthesia so that you remain comfortable while the cleaning procedures are done. The initial cleaning may be done by an ultrasonic instrument that vibrates particles off the root surfaces and flushes the pockets with water. Small hand instruments called curettes are used to finish the process. Antibacterial medication may then be used to help clear away infection from the pockets. Sometimes you may experience some tooth sensitivity to hot and cold after the root planing. If needed, this can be treated by applying fluoride to the root surfaces.
Depending on the extent of your gum disease, it may not be possible to remove all the deposits at one appointment, and it may be necessary to have multiple appointments over a few weeks to remove the remaining deposits. Often after three to four weeks the inflamed tissues have healed, leaving you with healthy gums once again.
Tooth sensitivity is an issue that can range from a slight twinge at times to downright excruciating pain. However, before we continue, understanding the cause of tooth sensitivity is helpful to both relieving and treating it.
Tooth enamel is inert in that it has no nerve supply and thus it protects the teeth from temperature and pressure changes — the main cause of sensitivity. Once it is compromised, worn thin, or exposed due to gum recession, it leaves the delicate nerve fibers within the dentin vulnerable to touch, acid, and temperature change. These nerve fibers most often grab your attention when they come in contact with heat, cold, or a “double whammy” combination of both cold and sweet. They also become sensitive to touch — even the bristles of a soft toothbrush can irritate exposed dentin.
As for the causes of tooth sensitivity, one common cause we see is aggressive brushing. Yes, too much brushing can be bad for you! To be more specific, excessive, improper brushing with a sawing back and forth motion can erode the gum tissues, expose, wear, and even groove the dentin. Another cause for sensitivity can be from the destructive process of tooth decay that eats through the enamel and into the dentin.
If you are experiencing tooth sensitivity or have questions about this condition, please contact us to schedule an appointment. Or you can learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”
Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is a condition that is unusual in that it frequently is quite hard to diagnose, because it often mimics many other conditions. For this reason, many healthcare professionals refer to it as “the great imposter.” The condition arises when there are problems inside the temporomandibular joint and the muscles that attach to it causing pain. The pain is most often due to muscle spasm, thereby limiting the ability to open and close the jaw and to function normally. TMD can impact anyone and has a wide range of similar symptoms.
One of the common causes of TMD is stress, and it may manifest itself through clenching or grinding of teeth while awake or asleep. These habits are often completely subconscious until pointed out by a dental professional or sleeping partner. With stress-induced TMD, the pain often comes and goes in cycles. In other words, it may be present when you are stressed, seem to disappear for a while, and then reappear when you are stressed again. Another cause of TMD can be from an injury or trauma, such as a blow to the jaw. However, regardless of the cause of TMD, the pain is real and needs to be treated properly.
If you feel that you might have TMD, please let us know so that we can address your concerns, starting with a full history and conducting a thorough examination. Or if you are in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”
In times of stress, people have many ways to comfort themselves. For adults, it can be habits such as eating, drinking, or smoking. For children, it is often sucking their thumb, fingers, or a pacifier. Babies have been observed in scans to suck on their fingers and thumbs even before they are born. It makes them feel secure.
When is thumb sucking a problem?
Sucking on fingers or thumbs can be a problem when it is done too vigorously and too long. A young child's jaws are soft and can change their shape to make room for the thumb if the child sucks too hard and too often. If thumb, finger or pacifier habits continue too long, the upper front teeth may tip toward the lip or not come into the correct position in the mouth.
How do you know if your child falls into the group that will suffer from the results of too much thumb sucking? It's best to visit our office so we can check on how the child's teeth and jaws are developing.
What can be done about thumb and finger sucking?
Most children naturally stop sucking their thumbs, fingers, or pacifiers between the age of two and four. The pacifier habit is easier to break than the thumb or finger sucking habit, probably because it is always easier to find their fingers or thumbs. It is a good idea to try to transfer your child's habit to a pacifier at an early age. The next steps are to cut down pacifier usage and gradually stop by 18 months.
If your child is still engaging in these habits at age three, we can recommend strategies for cutting back and stopping. Remember that positive reinforcement, in which a child is rewarded for the desired behavior, always works better than punishment for the behavior you don't like.
Also remember that finger and thumb sucking is normal. Help your child to feel safe, secure, and comfortable as the behavior will probably disappear by itself. If you are worried about your child's sucking a pacifier, thumb or fingers, please visit us to put your mind at rest.