Diabetes and periodontal (gum) disease are two types of inflammatory conditions that have more in common than was once thought. There is strong evidence to show that each of these diseases is a risk factor for the development and growth of the other. Studies have also found that treating one condition successfully may have a positive impact on the treatment of the other.
From the Greek meaning “to pass through the urine,” diabetes mellitus causes an abnormal rise in blood glucose level that can't be adequately controlled by insulin, the body's primary hormone for that task. Either the pancreas can't produce an adequate supply of insulin (as with Type 1 diabetes) or there is resistance to the hormone's effects (as with Type 2 and gestational/pregnancy diabetes). If you are a diabetic patient, you face many difficult issues with your health: your body develops an altered response to inflammation that may severely inhibit wound healing. You also may become more prone to chronic cardiovascular disease.
Periodontal (gum) disease describes a group of diseases caused by dental plaque, a whitish film that contains infection-causing bacteria. As infection rises within the gum tissues, the auto-immune system of the body responds to this threat and inflammation results. If the person is also a diabetic, this response may be impaired and may have a direct effect on how severe the periodontal disease progresses.
Periodontal disease can also affect your blood glucose level, if you are a diabetic. A number of studies have demonstrated that diabetic patients who have improved control of their periodontal disease through better oral hygiene and dental treatments have shown improvement in their blood sugar levels. There's even some evidence that effective periodontal treatment that reduces inflammation may improve the body's sensitivity to insulin. Likewise, bringing diabetes under control with supplemental insulin or positive lifestyle changes can help lessen the likelihood and severity of periodontal disease.
To sum it up, if you have been diagnosed with some form of diabetes, taking care of your teeth and gum tissues can have a positive impact on your diabetes. Likewise, making healthy changes in your lifestyle to bring your diabetes under control can reduce your risk for periodontal disease.
If you would like more information about periodontal disease and its effect along with diabetes, 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 “Diabetes and Periodontal Disease.”
You're planning for one of the most important days in your life — your wedding — and you want everything to be perfect. You've chosen the outfits, the setting, the flowers... but there's one more thing to think about. Is your smile just as bright as your hopes for the future? Do you wish you could improve its appearance in time for the big date?
Here's good news: You can! Depending on how much advance notice you have — and what level of enhancement you need — your wedding day smile makeover can range from a thorough dental cleaning to a full-scale orthodontic treatment program. Let's look at a few options that can help you look and feel your best on this very special day.
Getting your teeth thoroughly, professionally cleaned can help remove some surface stains and tartar in just one appointment! Depending on the level of discoloration, and how long it's been since your last cleaning, more than one session may be needed. You have this basic and effective treatment done every three to six months anyway — right? So, be sure and schedule one before your wedding!
Sometimes your smile needs more than just routine maintenance. If that's the case, there are many other options to help it look its best. Tooth whitening is a safe, effective and economical way to lighten teeth by several shades. In-office treatments are quicker and more predictable, but dentist-supervised at-home bleaching kits are also an option if you have more time.
Porcelain veneers offer a more striking and more permanent solution for discolored teeth. To get the optimum “wow” effect from this treatment, figure from two to four office visits, and a total treatment time of at least three months.
Cosmetic bonding is a great way to hide those little chips in the front teeth, or discolored old fillings in back. Using the newest high-tech materials and a dose of old-fashioned artistry, we can restore the shiny, translucent look of your natural teeth — only with fewer imperfections. After a thorough evaluation, cosmetic bonding can often be performed as a one-visit procedure.
If your smile needs even more help, don't despair — there are still plenty of ways to improve it.
Teeth that are damaged or missing can be restored by crowns or bridgework. When the roots are intact, a crown replaces the visible part of the tooth above the gum line. If the tooth is missing, a bridge is used to secure a false tooth to two abutments on either side. Properly done, these restorations may last a decade or more, and generally require two or more visits.
Dental implants are a great way to restore missing teeth. They offer a permanent, natural-looking tooth replacement with numerous advantages over other restorative treatments. Achieving these results requires careful planning and takes a bit more time. If you need tooth restoration, be sure to ask us whether dental implants might be right for you.
If you would like more information about a wedding-day smile makeover, don't hesitate to contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Wedding Day Smiles.”
If you're looking to improve the appearance of your smile, tooth whitening treatments — whether done at home or in our office — are a popular option. Here are the answers to some questions that many people ask before they begin the process.
Q: Are commonly used tooth-whitening methods safe?
A: Yes — provided they are used as directed. A large body of research has shown that using the correct concentration of peroxide — the bleach that whitens teeth — for the proper amount of time is not known to cause any major health problems. However, there have been cases where poor-quality bleaching solutions and/or excessive usage have caused deterioration of tooth enamel and extreme gum sensitivity. Always follow our office's recommendation.
Q: Does this mean I have to have in-office treatments to whiten my teeth?
A: No. But you should come in for a thorough dental examination, with x-rays, before you begin whitening treatments. Why? Because if there is trouble with the underlying tooth structure, then whitening the tooth is like painting over rusty metal: It hides the symptom, but doesn't fix the problem. Abscesses and root-canal problems are just two of the underlying causes of tooth discoloration that should be treated before teeth are whitened.
Q: What are some different methods for whitening teeth, and how long do they take?
A: The fastest is in-office whitening treatments, using a strong bleaching solution and appropriate gum protection. Next comes the cost-effective method of at-home bleaching with custom-made flexible plastic trays (sometimes called nightguard vital bleaching.) If you're not in a hurry, over-the-counter (OTC) products can do the same thing — given enough time. One study comparing different whitening treatments found that a six-shade improvement in whitening was accomplished by three in-office treatments. A week was needed for custom-tray bleach applications, or 16 daily applications of OTC products, to achieve comparable results.
Q: Can any tooth be made bright white?
A: No. Every tooth has a maximum level of whiteness, beyond which it can't get any lighter. Furthermore, fillings, crowns and other dental restorations can't be lightened with bleach — another reason to talk to our office; we can help you achieve the best possible look for your particular smile.
Q: How long will my white teeth last?
A: It depends. No whitening method is permanent, but the typical result lasts for up to two years. To preserve that bright smile, you can take some positive steps: Avoid tobacco and beverages that stain, like red wine, tea and coffee; keep up with regular cleanings in our office; and, practice good oral hygiene at home. You can also have a touch-up treatment once or twice a year.
If you need more information about tooth whitening, or you're ready to start the process, 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 “Important Teeth Whitening Questions Answered.”
If you were recently in an accident or received a hard hit while playing sports and you have been feeling jaw pain ever since, you may be suffering from a serious injury. It is important that you make an appointment with us immediately, so that we can conduct a proper examination, make a diagnosis and prescribe a suitable treatment. Even if the pain is lessening, you should still make an appointment.
Without seeing you, we have no way of definitively diagnosing the cause of your pain. However, here are a few possibilities:
- You displaced a tooth or teeth.
- You indirectly traumatized or injured the jaw joint (TMJ — temporomandibular joint). This trauma will cause swelling in the joint space, and the ball of the jaw joint will not fully seat into the joint space. If this is the issue, it is likely that your back teeth on the affected side will not be able to touch. Over time, the swelling should subside, allowing the teeth to fit together normally.
- You may have a minor fracture of your lower jaw. The most common is a “sub-condylar” fracture (just below the head of the joint), which will persist in symptoms that are more severe than simply bruising and swelling.
- You may have dislocated the joint, which means the condyle or joint head has been moved out of the joint space.
All of the above injuries can also cause muscle spasms, meaning that the inflammation from the injury results in the muscles on both sides of the jaw locking it in position to stop further movement and damage.
The most critical step is for you to make an appointment with our office, so we can conduct a physical examination, using x-rays to reveal the extent of your injury. We'll also be able to see whether the injury is to the soft tissue or bone.
Treatment may involve a variety of things, including anti-inflammatory and muscle relaxant medications. If your teeth have been damaged, we'll recommend a way to fix this issue. If you have dislocated your jaw, we may be able to place it back through gentle manipulation. If you have fractured your jaw, we'll need to reposition the broken parts and splint them to keep them still, so that they can heal.
Periodontal disease is the leading cause of tooth loss in adults. A recent survey by the Centers for Disease Control and Prevention showed that nearly half of Americans older than 30 had some signs of periodontal disease. That's more than 64 million people.
How much do you know about this potentially serious disease? Take our quiz and find out.
True or False: Gum Disease is caused by bacteria in the mouth
TRUE. Of the hundreds of types of bacteria that occur naturally in the mouth, only a small percentage are harmful. But when oral hygiene (brushing and flossing) is lacking, these can build up in a dental plaque, or biofilm. This often causes inflammation of the gums, the first step in the progression of gum disease.
True or False: Gum disease is more prevalent among younger people
FALSE. Gum disease is most often a chronic disease, meaning that it progresses over time. Statistics show that as we age, our chances of developing gum disease increase, as does the disease's severity. In fact, according to the study mentioned above, about 70% of adults 65 and over have mild, moderate or severe periodontitis, or gum disease.
True or False: Bleeding of the gums shows that you're brushing too hard
FALSE. You might be brushing too hard — but any bleeding of the gum tissue is abnormal. Gum sensitivity, redness and bleeding are typically the early warning signs of gum disease. Another is bad breath, which may be caused by the same harmful bacteria. If you notice these symptoms, it's time for a checkup.
True or False: Smokers are more likely to develop gum disease
TRUE. Not only are smokers more likely to develop gum disease, but in its later stages they typically show more rapid bone loss. Smoking also prevents the warning signs of gum disease - bleeding and swelling of the gum tissues - from becoming apparent. Other risk factors for developing the disease include diabetes and pregnancy (due to hormonal changes). Genetics is also thought to play a role in who gets the disease — so if you have a family history of gum disease, you should be extra vigilant.
True or False: The effects of gum disease are limited to the mouth
FALSE. Numerous studies suggest that there is a relationship between periodontal health and overall health. Severe gum disease, a chronic inflammatory disease, is thought to increase the risk of cardiovascular diseases like heart attack and stroke. It may also lead to complications in pregnancy, and problems of blood-sugar control in diabetics.
So if you have any risk factors for gum disease, or if you notice possible symptoms, don't ignore it: let us have a look. We can quickly evaluate your condition and recommend the appropriate treatments if necessary. With proper management, and your help in prevention, we can control gum disease.
If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.