People with diabetes have special concerns when it comes to dental care. In fact, 1 in every 5 cases of total tooth loss is linked to this widespread health condition. November is National Diabetes month, so it’s a good opportunity for us to answer some frequently asked questions about oral health and diabetes.
Q. Can I get a dental implant to replace a missing tooth even if I have diabetes?
A number of studies have shown that people with diabetes can be good candidates for dental implants, but there are some concerns regarding dental implant treatment, which involves minor surgery. Wounds tend to heal more slowly in people with diabetes, who are also more infection-prone than those without diabetes. In diabetic individuals with poor glucose control, research has also shown that it takes longer for the bone to heal after implant placement. We will take these (and other) factors into account when planning your implant treatment. However, in many situations even poorly controlled diabetes does not necessarily preclude dental implant treatment.
Q. I’ve heard people with diabetes have a higher risk for gum disease. Is that true?
Yes. Research shows that people with diabetes are more susceptible to periodontal (gum) disease, especially when their diabetes is poorly controlled. The reverse is also true: untreated periodontal disease can worsen blood sugar levels. So it’s important to manage both of these inflammatory conditions. If you notice the early signs of gum disease, such as inflamed or bleeding gums, please bring this to our attention. Early gum disease (gingivitis) is much easier to treat than more advanced forms—which can eventually lead to tooth loss.
Q. If I have diabetes, how can I protect my oral health?
Keep doing your best to control your blood sugar levels with exercise and a healthy diet—and stick to an effective daily oral hygiene routine, which includes both brushing and flossing and coming in for regular dental checkups and cleanings. Make sure to let us know what medications you are taking and update us on any changes. If you notice any mouth sores, swelling or inflammation, bring this to our attention as soon as possible.
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
The mark of a great dental restoration is that you can’t see it. It’s there in plain sight, but others observing your new and improved smile can’t tell the difference between the restoration and your natural teeth. Everything looks, well, natural.
That’s the great advantage of dental porcelain. A dental technician with technical skill and artistic flair can form this inorganic, ceramic material into a life-like replica of your tooth, with a shape and color that blends in with the rest of your teeth. And because of its strength properties, porcelain restorations can hold up to the normal chewing and biting forces in your mouth, as long as you use prudence when biting down on hard substances.
Porcelain is also highly adaptable to different kinds of restorations. For natural teeth still viable but no longer attractive, porcelain can be the main ingredient in two very popular and effective restorations, the veneer and the crown. Although the porcelain material is the same for both, their construction and application are quite different.
Veneers are very thin laminated layers of dental porcelain custom-colored and shaped for bonding to the outer visible portion of a tooth. They’re a great solution for relatively decay-free teeth that have minor to moderate defects like chipping, slight misalignment or heavy staining. They often require some permanent removal of tooth enamel to ensure their appearance isn’t too bulky, but causes minimal impact to the tooth.
Crowns, on the other hand, are complete tooth replicas that are bonded in place over an existing tooth like a cap. They’re a good choice for teeth in which the root and inner layers are still viable, but the tooth has been significantly damaged by decay or trauma. They’re also useful as a protective cover for teeth that have undergone root canal treatment. But unlike the minimal impact of veneers, crowns require significant tooth alterations to accommodate them.
In either case, though, the end result is much the same: both crowns and veneers can be fashioned to precisely mimic the shape, color and texture of natural teeth. In skillful hands, these porcelain restorations can transform your smile for the better and no one but you and your dentist will ever need to know.
If you would like more information on porcelain restorations, 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 “Porcelain Crowns & Veneers.”
Pregnancy is a very special and exciting time for expectant women and their families. At this time, many moms-to-be make careful choices to try and do what’s best for themselves and their babies. Wondering what’s the right way to take care of your oral health when you’re expecting? Here are answers to a few of the most common questions about dental care during pregnancy.
Q: Does pregnancy make a woman more susceptible to dental problems?
A: Yes. Pregnancy causes big changes in the levels of certain hormones, and these in turn have a powerful influence on your body. For example, many expectant moms experience food cravings and morning sickness at certain times. Changing hormone levels can also affect your oral health in various ways, including making your gums tender, swollen, and highly sensitive to the harmful bacteria in plaque.
Q: What are “pregnancy tumors” in the mouth?
A: These are benign (non-cancerous) overgrowths of tissue that sometimes develop on the gums during the second trimester. Often appearing between the teeth, these swollen reddish growths are thought to be caused by plaque bacteria. They sometimes go away on their own when pregnancy is over, but may be surgically removed if they don’t.
Q: Is it normal to have bleeding gums during pregnancy?
A: It’s not uncommon, but it does indicate that you need to pay careful attention to your oral hygiene at this time. Pregnancy hormones can cause the tiny blood vessels in your gums to become enlarged; when plaque bacteria are not effectively removed from the mouth, the gums may become inflamed and begin to bleed. This condition is often called “pregnancy gingivitis.” If left untreated, it can progress to a more serious form of gum disease called periodontitis. That’s one reason why regular brushing and flossing are so important during pregnancy — as are routine professional cleanings.
Q: Is it safe to have dental cleanings and checkups during pregnancy?
A: Yes; in fact, it’s a very good idea to have at least one. Studies have shown that women who receive dental treatment during pregnancy face no more risks to their developing babies than those who don’t. On the other hand, poor oral health is known to cause gum disease, and is also suspected of being linked to adverse pregnancy outcomes. Routine dental exams and professional cleanings can help you maintain good oral health and avoid many potential problems during this critical time.
Q: Should I postpone more complicated dental work until after I have a baby?
A: It depends. A study recently published in the Journal of the American Dental Association found it was safe for pregnant women to have routine procedures like fillings, root canals, and extractions, even if they require local anesthesia. So treatments that are essential to an expectant mother’s health shouldn’t be put off. However, if you’re planning to have cosmetic dental work, it might be best to err on the side of caution and wait until after your baby is born.
Have more questions about oral health during pregnancy? Contact our office or schedule a consultation — and be sure to let us know that you are pregnant, so we can make sure you get the extra attention you need. You can learn more in the Dear Doctor magazine article “Pregnancy and Oral Health.”
There’s a lot to like about replacing a missing tooth with a dental implant. This state-of-the-art restoration is by far the most durable and life-like option available. And unlike other replacement options implants stimulate bone growth, a major concern after tooth loss.
For that reason we encourage getting an implant as soon as possible — for adults, that is. We don’t recommend implants for younger patients because even a teenager’s jaws haven’t yet reached full maturity. Because it attaches to the jaw differently, an implant can’t move with the growing jaw as real teeth do. It would eventually look as if it were sinking into the jaw below the gum line or being left behind as the rest of the jaw grows.
It’s best, then, to postpone placing an implant until the jaw fully matures, usually in a patient’s early twenties. In the meantime, there are some things we can do to prepare for a future implant while also restoring the tooth with a temporary replacement.
As previously mentioned, our biggest concern is bone health. Like other living tissue, bone has a growth cycle of older cells dissolving and newer ones forming in their place. The teeth transmit the pressure produced when we chew to the bone to stimulate this growth. With the absence of a tooth, the adjacent bone no longer receives this stimulation — the growth cycle slows and may eventually lead to bone loss.
We can help this situation by placing a bone graft in the missing tooth socket at the time of extraction. The graft serves as a scaffold that’s eventually taken over and replaced by new bone growth. We can also try to control how fast the graft is replaced by using grafting material that’s slowly removed and lasts longer — often a preferable situation if an implant is years away.
As for appearance, we can create a custom partial denture or even a type of bridge that bonds a prosthetic tooth to neighboring teeth without significantly altering them. If the patient undergoes orthodontic treatment it’s also possible to add prosthetic teeth to an orthodontic appliance.
Eventually, we’ll be able to provide the permanent solution of a dental implant. With careful planning and measures to preserve bone health, there’s a good chance the outcome will be worth the wait.
If you would like more information on treatments for lost teeth in children and teenagers, 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 Implants for Teenagers.”
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