Diabetes and Dental Care

Sharma RDH

Sharma Mulqueen RDH

Diabetes and Dental Care

What do brushing and flossing have to do with diabetes? Plenty. If you have diabetes, here’s why dental care matters — and how to take care of your teeth and gums. 

When you have diabetes, high blood sugar can take a toll on your entire body — including your teeth and gums. The good news? Prevention is in your hands. Learn what you’re up against, and then take charge of your dental health.

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Cavities and gum disease

Whether you have type 1 diabetes or type 2 diabetes, managing your blood sugar level is key. The higher your blood sugar level, the higher your risk of:

  • Tooth decay (cavities). Your mouth naturally contains many types of bacteria. When starches and sugars in food and beverages interact with these bacteria, a sticky film known as plaque forms on your teeth. The acids in plaque attack the hard, outer surface of your teeth (enamel). This can lead to cavities. The higher your blood sugar level, the greater the supply of sugars and starches — and the more acid wearing away at your teeth.
  • Early gum disease (gingivitis). Diabetes reduces your ability to fight bacteria. If you don’t remove plaque with regular brushing and flossing, it’ll harden under your gumline into a substance called tartar (calculus). The longer plaque and tartar remain on your teeth, the more they irritate the gingiva — the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily. This is gingivitis

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  • Advanced gum disease (periodontitis). Left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support your teeth. Eventually, periodontitis causes your gums to pull away from your teeth and your teeth to loosen and even fall out. Periodontitis tends to be more severe among people who have diabetes because diabetes lowers the ability to resist infection and slows healing. An infection such as periodontitis may also cause your blood sugar level to rise, which makes your diabetes more difficult to control. Preventing and treating periodontitis can help improve blood sugar control.

Proper dental care

To help prevent damage to your teeth and gums, take diabetes and dental care seriously:

  • Make a commitment to managing your diabetes. Monitor your blood sugar level, and follow your doctor’s instructions for keeping your blood sugar level within your target range. The better you control your blood sugar level, the less likely you are to develop gingivitis and other dental problems.
  • Brush your teeth at least twice a day. Brush in the morning, at night and, ideally, after meals and snacks. Use a soft-bristled toothbrush and toothpaste that contains fluoride. Avoid vigorous or harsh scrubbing, which can irritate your gums. Consider using an electric toothbrush, especially if you have arthritis or other problems that make it difficult to brush well.

Floss your teeth at least once a day. Flossing helps remove plaque between your teeth and under your gumline. If you have trouble getting floss through your teeth, use the waxed variety. If it’s hard to manipulate the floss, use a floss holder.

  • Schedule regular dental cleanings. Visit your dentist at least three times a year for professional cleanings.
  • Make sure your dentist knows you have diabetes. Every time you visit your dentist, remind him or her that you have diabetes. Make sure your dentist has contact information for your doctor who helps you manage your diabetes.
  • Look for early signs of gum disease. Report any signs of gum disease — including redness, swelling and bleeding gums — to your dentist. Also mention any other signs and symptoms, such as dry mouth, loose teeth or mouth pain.
  • Don’t smoke. Smoking increases the risk of serious diabetes complications, including gum disease. If you smoke, ask your doctor about options to help you quit.

Managing diabetes is a lifelong commitment, and that includes proper dental care. Your efforts will be rewarded with a lifetime of healthy teeth and gums.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources

http://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes/art-20043848?pg=2

https://www.perio.org/consumer/diabetes.htm

http://www.nidcr.nih.gov/OralHealth

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Black Line Stain

AriannaM

Arianna Ritchey, RDH

BLACK LINE STAIN

During the regular prophylaxis cleaning for a recent patient, she inquired as to the black stain on her teeth.  She had excellent brushing and  flossing habits, saw us every six months for her professional cleanings, and has only one filling on her permanent teeth.  This patient does not participate in any behaviours that normally result in staining; she does not drink coffee, tea, wine, and she does not use any tobacco products.  She was also concerned, because this same type of stain is also present on her infant’s teeth, who is strictly breastfed.  So, where was this stain coming from?!

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It was explained to this patient that the stain she was experiencing was most likely a type of stain called “Black Line Stain,” or sometimes simply “Black Stain”.  Black Line Stain is more common in women than men, and can occur in patients with excellent oral hygiene.  It appears as a thin black line, which is firmly attached to the tooth surface, and most commonly near the gumline of the facial and lingual surfaces of a tooth.  This type of stain is associated with a low incidence of cavities in children and adults, and is caused by a type of Gram-positive bacteria that produces a certain colour, or chroma, which makes it identifiable. It is possible that this patient’s child has the same type of Gram-positive chromogenic bacteria on his teeth, creating the same type of Black Line Stain.  This is especially likely if the child has good oral hygiene and a low incidence of cavities.

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This non-metallic type of stain is absorbed onto the tooth surface deposits, such as tartar, plaque, or even the acquired pellicle.  The acquired pellicle is a thin film made up of proteins in our saliva, that forms almost instantly after a tooth is cleaned.  Because this type of bacteria is able to attach to the acquired pellicle,  this condition is not related to oral cleanliness or the presence of periodontal disease.

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To prevent this stain from building up as quickly, patients can use a toothbrush to effectively clean the teeth twice a day, while using a toothpaste that helps to prevent staining.  Powered toothbrushes can often clean the teeth most effectively without causing trauma to the gums.  Once the stain has settled onto the teeth,  the most effective way to remove this Black Line Stain is by a professional cleaning with a dental hygienist.  The hygienist may professionally remove the stain with an ultrasonic scaler, coronal polishing using an abrasive prophy paste, or by using an air-jet polisher with an abrasive powder.

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The only real downside to removing the Black Line Stain from the teeth, is that repeated stain removal using an abrasive paste or powder removes micro-millimeters of enamel from the tooth surface.  The top layer of the teeth which is partially removed during polishing, is the most fluoride-rich part of the tooth, so if frequent polishing is utilized to remove Black Line Stain, it is advisable to have a professional fluoride treatment administered after the polishing to replenish the depleted fluoride from the teeth.  Fluoride is available in a few different forms, the most effective of which are a fluoride varnish or a fluoride foam.

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There are some other types of dark stain that are caused by other sources, including dietary components, beverages, tobacco, mouthrinses and other medicaments. These types of stain have a different source than Black Line Stain, but are removed in a very similar fashion.  If you have any questions or further concerns about staining on your teeth, feel free to ask your dental hygienist!

 

 

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://jairjp.com/JANUARY%202013/02%20SRUTHY%20PRATHAP.pdf

http://www.sammyboy.com/showthread.php?154192-Black-stain-in-teeth-by-chromogenic-bacteria

http://medical-dictionary.thefreedictionary.com/black+line+dental+stain

http://www.carolinasdentist.com/wp-content/uploads/2013/06/toothpaste.jpg

http://www.youngdental.com/wp-content/uploads/2013/09/dlishezpak4.jpg

http://www.sanclementeperiodontist.com/portals/165/images/fluoride.jpeg

 

 Periodontal Disease and Diabetes 

PeggyS

Peggy Stoor, RDH

 Periodontal Disease and Diabetes

Recently much has come to light regarding oral health and its impact on systemic health and disease. While I’ve always been borderline fanatic about oral health and have been aware of some of these relationships, the recent research connecting oral health to systemic health has helped to make my daily work much more relevant and interesting.

Presently there are 18 million diabetic patients in the U.S. and 171 million diabetic patients worldwide. Diabetes is characterized by increased susceptibility to infection, poor wound healing, and a number of complications that can affect quality of life and length of life.  Diabetes is also a risk factor for severe periodontal disease (the destruction of tissues and bone that support the teeth). It’s critically important to realize that diabetics who have periodontal or gum disease have two chronic conditions, each of which affect the other.

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While we have long known that diabetes can predispose one to periodontal disease, research now suggests that treatment of periodontal disease can have a positive impact on the diabetic condition.  Patients with periodontal disease have more difficulty controlling their blood sugar. Patients who have treatment and gain control of their gum disease have been shown to require less insulin and have a decreased hemoglobin A1c level. (A1c denotes a patients average blood sugar level over the past 3 months). In other words, periodontal disease and diabetes is a two-way street with each disease having a potential impact on the other, either positively or negatively.

Management of gum disease in patients with diabetes involves removal of plaque and calculus both at home and professionally, and maintenance of glycemic control. Nearly all diabetics respond to treatment and maintenance, therefore treatment of periodontal disease should be done as soon as possible. Both conditions require frequent professional evaluations, patient-self monitoring, daily brushing and flossing, approved antibacterial mouth rinses, and good blood glucose control.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

Southerland, J.H. (2005.) Diabetes and periodontal infection: Making the connection. Retrieved from http://clincial.diabetesjournals.org/content/23/4/171

Diabetes and Periodontal Disease: Retrieved from http://www.perio.org,  American Academy of Periodontology, Diabetes and periodontal Disease

Diabetes and Oral Health: Retrieved from http://www.nidcr.nih.gov/OralHealth/Topics/Diabetes.National Institute of Dental and Craniofacial Research by National Institutes of Health-(2007)

Mealey, B.L. ,(2006).Periodontal disease and diabetes: A two-way street. Journal of American Dental Association. Oct.137 suppl:26S-31S. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed

Mirza,B.A., Syed A., Izhar F., Ali Khan. (2001). Bidirectional relationship between diabetes and periodontal disease: Review of evidence. J  Pak Med Assoc. Retrieved from http: http://www.ncbi.nlm.nih.gov/pubmed/21381588

Dental Care and Diabetes. http://www.webmed.com/diabetes/dental-health-dental-care-diabetes

Image Credit: http://www.intelligentdental.com/2012/03/31/effect-of-systemic-factors-on-the-periodontium-part1

The Dangers of Oral Piercings

AnnC

Ann Clark, RDH

Oral Piercings
Although attractive to some, tongue, lip, and cheek piercings have a number of health related risks associated with them.  One of the biggest dangers of mouth piercings is the damage to the teeth that can come from bumping or rubbing against the piercing.  There is also a fairly high risk of infection to this area from bacteria that can get trapped.
Dangers of Oral Piercings
   *Infection – Risk of this is increased due to the new wound created.  The array of bacteria that live in the mouth plus the addition of bacteria from handling the jewelry.
   *Transmission of Disease – Oral piercing poses increased risk of the herpes simplex virus and hepatitis B or C.
   *Endocarditis – The piercing site poses risk for mouth bacteria to enter the bloodstream and lead to developing endocarditis–an inflammation of the heart or its valves–in certain people with underlying (many times asymptomatic or undiagnosed) heart issues.
   *Nerve Damage/ prolonged bleeding – Numbness or loss of sensation at the piercing site or movement problems can occur if the nerves are damaged. If blood vessels are punctured, prolonged bleeding can occur.  Tongue swelling following piercing can be severe enough to block the airway and make breathing difficult.
   *Gum Disease – Piercings, especially involving longer jewelry, like barbells, have a greater chance toward this disease.  The jewelry can come into contact with gum tissue causing tissue recession, an injury leading to loss of teeth.
Recession
   *Damage to Teeth – Teeth contacting the jewelry can chip, crack, or wear away.  One study from a dental journal reported 47% of barbell wearers for 4+ years had at least one chipped tooth.
Chipped Anterior
   *Difficulty in daily functions – tongue piercings can result in problems with swallowing, chewing food, and clear speech.  This occurs from the jewelry stimulating an excessive production of saliva.  Taste can also be altered.
   *Allergic Reaction – We call metal hypersensitivity Allergic Contact Dermatitis, which can occurring in susceptible people.
   *Jewelry Aspiration – If jewelry becomes loose in the mouth it poses a possible choking hazard if swallowed causing issue to the digestive tract or lungs.
If oral piercings are still for you, please consider:
-find a recommended studio
-Visit the studio first and ask about hospital-grade autoclaves to sterilize, or use of disposable instruments.  Are disposable gloves used?
-Ask to see a health certificate.
-Are instruments kept in sterilized packages?
-Are employees vaccinated against Hep-B?
-Ask many questions, the staff should be willing to respond
Tongue Ring
WARNING SIGNS!! (Consult your dentist if any of these occur)
-yellow/green discharge (normal is clear or white)
-scarring or thickened tissue build up darkening the piercing site
– an abscess (pimple) at the piercing site
-bleeding or tearing after the piercing
-a resting low-grade fever
Sources
   American Dental Association: “Oral Piercing and Health”
   Academy of General Dentistry: “What is oral piercing”