One in ten Americans has diabetes, a serious condition that may increase the development and severity of other health problems—including gum disease. Because of this latter connection, dental providers join other health professionals during November's National Diabetes Month to call attention to this chronic disease and its effect on health and well-being.
There's another health condition with a diabetes connection that isn't as well known: obstructive sleep apnea (OSA). It's also of keen interest to dental providers, as dentists are often involved in the discovery and treatment of this common sleep disorder.
OSA is the temporary blockage of the airway during sleep by the tongue or other anatomical structures. The subsequent drop in oxygen awakens the body to remove the obstruction. People with OSA may not realize they have the condition, but their bed partner can often attest to their snoring, snorting and gasping for breath during the night. Such episodes can occur several times per night, depriving the person of sufficient sleep.
Chronic OSA can contribute to the development of other health problems, among them Type 2 diabetes. It can do this first by interfering with the metabolization of glucose (blood sugar). It may also increase the body's resistance to insulin, the primary hormone regulating glucose.
Fortunately, properly managing OSA can lower your risk for diabetes, and that's where dentists may be able to help. For one thing, we dentists are often the first to notice early signs of OSA—sometimes even before our patients do.
According to the American Sleep Apnea Association, as many as 80% of the estimated 22 million Americans with OSA may not know they have it. But dentists often identify OSA indicators while examining patients: signs like an enlarged tongue or tonsils, or patients falling asleep in the exam chair. While we can't formally diagnose OSA, we often refer symptomatic patients to a sleep specialist.
Dentists also offer an alternative to the most common OSA therapy, which is continuous positive airway pressure (CPAP). This therapy employs a motorized pump that delivers pressurized air into the throat via face mask to keep the airway open during sleep. Although effective, some people find a CPAP machine noisy and uncomfortable to use.
Alternatively, dentists can provide an oral device that can often help patients with mild to moderate OSA that's worn in the mouth during sleep. Most of the various types of these appliances either reposition the lower jaw with a hinge mechanism to keep the throat open or pull the tongue away from the airway through a suction effect.
Diabetes is one part of a chain reaction that can bring unexpected challenges to your health, including to your teeth and gums. You can slow or even stop its development with proper diet, exercise and good, restful sleep. Dealing with OSA is often part of that equation—and we may be able to help.
If you would like more information about the prevention and treatment of diabetes, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Oral Appliances for Sleep Apnea.”
During his exploration of the Americas, Christopher Columbus encountered a native in a canoe loaded with water, food and a strange bunching of leaves. This marked the first European encounter with tobacco, a discovery that still haunts us to the present day. Today, millions smoke tobacco—and many suffer serious health problems as a result, including dental diseases like tooth decay and gum disease.
The American Cancer Society is sponsoring its 44th annual Great American Smokeout this November 19 when health providers across the country encourage smokers to kick the tobacco habit. Dentists will certainly be among them: Studies show that smokers are five times more likely to lose teeth than non-smokers due to a higher incidence of dental disease. Here's why.
Increased plaque and tartar. The main cause for tooth decay and gum disease is dental plaque, a thin, bacterial film that builds up on teeth. Brushing and flossing, along with regular dental cleanings, can keep plaque and its hardened form tartar from accumulating. But substances in tobacco restrict the flow of saliva needed to curb bacterial growth. This in turn can increase plaque accumulation and the risk for disease.
Hidden symptoms. Your gums often “tell” you when you have early gum disease by becoming swollen and red, and bleeding easily. But if you smoke, you might not get that early warning—the nicotine in tobacco interferes with your body's inflammatory response, so your gums, although infected, may look normal. By the time you find out, the infection may have already spread, increasing your chances of tooth loss.
Slow healing. Nicotine can also constrict the mouth's blood vessels, slowing the delivery of nutrients and infection-fighting antibodies to your teeth and gums. As a result, your body may have a harder time fighting tooth decay or gum disease, and diseased tissues can take longer to heal. Slower healing can also complicate the process of getting dental implants.
Increased oral cancer risk. Although it's not as prevalent as other cancers, oral cancer is still among the deadliest with a dismal 50% survival rate after five years. Smokers are six times more likely than non-smokers to develop oral cancer. But by quitting smoking and other forms of tobacco, you could reduce your oral cancer risk to that of a non-user in just a few years.
Kicking the smoking habit often takes a monumental effort, but it's worth it. Quitting not only improves your overall well-being, it could help you gain healthier teeth and gums. To learn how, see us for an up-to-date dental exam—we can show you how getting Columbus's most notorious discovery out of your life could do wonders for your smile and dental health.
If you would like more information about the effects of tobacco on your oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Strategies to Stop Smoking.”
Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.
Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).
Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.
So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.
There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.
And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.
Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.
If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.
Do you remember when one of your baby teeth began to wiggle? You knew it wouldn't be long before it came out, followed by a little something from the “tooth fairy” under your pillow.
Those were the days! But a loose permanent tooth is something else entirely: Often a sign of advanced periodontal (gum) disease, you may be on the verge of losing the tooth forever.
This sad affair begins with dental plaque, a thin biofilm found on tooth surfaces and the ideal haven for oral bacteria that can trigger a gum infection. You might not notice such an infection in its early stages, other than a few initial signs like gum redness, swelling, or bleeding. If these occur, it's imperative you seek treatment promptly.
Without treatment, the infection can spread below the gum line, weakening gum attachments to teeth (which actually hold teeth in place) and eventually doing the same to underlying bone. All of this damage can lead to a tooth becoming loose and eventually falling out.
But it's not inevitable a loose tooth will eventually be lost, though it may require long-term efforts to save it. We may first need to do a bite adjustment, which will often allow a tooth to decrease its mobility. If the mobility has not been reduced enough, we may recommend stabilizing the teeth through splinting: These are techniques used to join the loose tooth to more stable teeth, usually with a thin strip of metal or other dental material.
We'll also need to treat the underlying cause, which in the case of gum disease requires aggressive plaque removal. Our goal is to manually remove all plaque and tartar (calcified plaque) deposits, particularly below the gum line. It may also require surgery to fully access deep pockets of infection. But once we remove the offending plaque, the gums can begin to heal.
The best strategy, though, is to avoid gum disease altogether. You can substantially lower your infection risk by brushing and flossing daily and getting a dental cleaning every six months. Dental visits also allow us to check your gums for any signs of infection that might require prompt action.
A loose tooth for a kid is a cause for celebration. It's the exact opposite for an adult loose tooth. Taking care of your gums with daily hygiene and receiving prompt treatment for any emerging infection could help you avoid it.
If you would like more information on treating gum disease, 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 “When Permanent Teeth Become Loose.”
The subject of allergies covers a wide swath in medicine. Among other things, people have allergic reactions to animal fur, various foods and plant pollen. The effects are equally wide-ranging, anything from a mild rash to anaphylaxis, a life-threatening shutdown of the body's vital systems.
Approximately 5% of people are also allergic to various metals including nickel, cobalt, chromium and gold. Reactions to metal can occur when an allergic person comes in contact with items like jewelry, clothing or even mobile phones. There's even a chance of a metal allergy reaction from certain kinds of dental work.
It's unlikely, though, that you should be concerned if you're considering dental treatment or cosmetic work to upgrade your smile. Although allergic reactions like inflammation or a rash have been known to occur with amalgam “silver” fillings, it's quite rare. It's even less of a concern since “tooth-colored” materials for fillings are now outpacing the use of amalgam fillings, which are used in out-of-sight back teeth.
Of course, metal is used for other dental treatments besides fillings, including the most popular of tooth replacement systems, dental implants. An implant is essentially a metal post, usually made of pure titanium or a titanium alloy, which is imbedded into the jawbone. Even so, there's little chance you'll develop an allergic reaction to them.
For one thing, titanium is highly prized in both medical and dental treatments because of its biocompatibility. This means titanium devices like prosthetic joints and implants won't normally disrupt or cause reactions with human tissue. Titanium is also osteophilic: Bone cells readily grow and adhere to titanium surfaces, a major reason for dental implants' long-term durability.
That's not to say titanium allergies don't exist, but their occurrence is very low. One recent study detected a titanium allergy in only 0.6% of 1,500 implant patients who participated.
At worst, you may need to consider a different type of tooth replacement restoration in the rare chance you have a titanium allergy. More than likely, though, you'll be able obtain implants and enjoy the transformation they can bring to your smile.
If you would like more information on allergic reactions and dental 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 “Metal Allergies to Dental Implants.”
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