Diabetes and Dental Care

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

Sources

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

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

Posted in Gums, Health, Mouth Body Connection, Oral Hygiene
Tagged brush, cavities, Decay, dental care, dental cleanings, diabetes, floss, gingivitis, gums, high blood sugar, periodontitis
Leave a comment

June 7, 2015

Periodontal Disease and Diabetes

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.

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

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

Posted in Gums, Health, Mouth Body Connection
Tagged blood sugar, diabetes, diabetic, gum disease, oral systemic link, periodontal disease, periodontal maintenance
Leave a comment

June 3, 2015

The Dangers of Oral Piercings

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.

*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.

*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.

*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

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

Want to learn more? Visit us at

Sources

American Dental Association: “Oral Piercing and Health”

Academy of General Dentistry: “What is oral piercing”

Posted in Community Service News, Gums, Mouth Body Connection, Tooth Talk
Tagged bacteria, cheek piercings, chipped teeth, dentist, infection, lip rings, nerve damage, oral piercings, recession, tongue rings
Leave a comment

May 24, 2015

Guidelines for Antibiotic Pre-medication

Wendy Parker RDH

Guidelines to Follow

How do I prevent heart disease?

With an increase in antibiotic resistance, the American Dental Association has revised their guidelines for Antibiotic Pre-medication prior to dental appointments. Their goals are aimed at those who are at the greatest risk and to prevent any risks of infective endocarditis (an infection around the heart)

In years past, the following medical conditions have needed to routinely pre-medicate with antibiotics for dental procedures:

mitral valve prolapse
rheumatic heart disease
bicuspid valve disease
calcified aortic stenosis
congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy

However, after careful consideration and studies, here are the latest guidelines for pre-medication prior to dental procedures, according to the ADA:

The current guidelines state that use of preventive antibiotics before certain dental procedures is reasonable for patients with:

prosthetic cardiac valve or prosthetic material used for cardiac valve repair
a history of infective endocarditis
a cardiac transplant that develops cardiac valvulopathy
the following congenital (present from birth) heart disease:^a
- unrepaired cyanotic congenital heart disease, including palliative shunts and conduits
- a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure^b
- any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device (that inhibit endothelialization)

If you do not fit into these categories, you do not need to premedicate unless otherwise indicated by your physician.

If you do fit into the above categories, and are currently taking an antibiotic when you are going in for dental procedures, it is recommended that your dentist select an antibiotic from a different class than the one you are currently taking. For example, if you are taking amoxicillin and you need to pre-medicate for a dental prophylaxis, you should be prescribed clindamycin, azithromycin, or clarithromycin.

The other catch to taking antibiotics, is REMEMBERING to take them. If you’re like me, I will forget things if they are not written down! So, if, by chance you do forget before coming in, no worries! The ADA states that if antibiotics are not administered before the procedure, they can be administered up to two hours after the procedure and still have the adequate amounts in the blood to still prevent infective endocarditis.

If you have any questions or concerns about where you fit in these categories, don’t hesitate to mention it to your medical doctor, dentist, or hygienist. We are here to help and keep you healthy, from head to toe!

Heart Disease and Stroke Diabetes Osteoporosis Pregnancy Complications ...

Want to learn more? Visit us at

http://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis

Sources:

http://www.rdhmag.com/articles/print/volume-28/issue-1/columns/staff-rx/new-premedication-guidelines.html

Posted in Mouth Body Connection
Tagged ADA, antibiotic, cardiac transplant, congenital heart disease, dental procedure, dentist, dentistry, heart healthy dentistry, infective endocarditis, pre-med, pre-medication, prosthetic cardiac valve
Leave a comment

May 11, 2015

Which Occlusal Guard is Right for You?

Katie Moynihan BS RDH

Which Occlusal Guard is Right for You ?

Do you grind your teeth when you sleep? Ever noticed pain in your jaw? Bruxism is the term used when a person is grinding or clenching their teeth. Often times, bruxism occurs unconsciously during the day or most often at night. Whether you know you do it or not, there are certain dental signs we look for as oral health professionals in order to properly diagnose the right mouthguard for you.

Occlusal wear on the teeth can lead to gum recession, fracturing, loosening, or loss of teeth. An occlusal guard is custom made to be worn over the biting surfaces of either the upper or lower arch of teeth, and is easily inserted and removed by the patient. It is made out of an acrylic strong enough to minimize the abrasive action of excessive tooth forces. They should be worn on a long-term basis to help to stabilize the occlusion as well as prevent damage to teeth and to the temporomandibular joint.

Another bruxism appliance is called an NTI-tts device. Unlike the occlusal guard, the NTI device only covers part of your mouth, clipping over either the top or bottom front teeth. This small, custom fitted plastic device forms a barrier between your top and bottom teeth, preventing you from biting down completely. You might consider an NTI device if a conventional occlusal guard has not worked for you, you suffer from migraines and headaches, or experience pain associated with your TMJ. The goal of the NTI is to prevent the grinding and touching of the rear molars by limiting the contraction of the temporalis muscle.

Although there is no single cure for bruxism, these devices are available to help reduce symptoms associated with teeth grinding and clenching. If you suspect you may be grinding your teeth, we would be happy to talk to you about it and help you determine which bruxism device is right for you.

Want to learn more? Visit us at

http://www.mayoclinic.org/diseases-conditions/bruxism/basics/causes/con-20029395

Sources:

http://www.medicinenet.com/teeth_grinding_bruxism/article.htm

http://www.o-guard.com/nti-night-guard/

Posted in Mouth Body Connection, Tooth Talk
Tagged bruxism, clenching, grinding, jaw pain, night guard, NTI, occlusal guard, temporomandibular joint, TMJ
Leave a comment

May 4, 2015

Dental “Myth Busters”

Becky Larson, RDH

Dental “Myth Busters”

There are a lot of dental myths out there that are sometimes mistaken for dental truths. Here are a few facts to help clear up some of the confusion.

Myth #1: You don’t need to brush baby teeth because they will fall out eventually anyway.

Absolutely not! Baby teeth can still get cavities, which can spread to other teeth and cause pain. Some baby teeth may even fall out too soon and cause problems with bite or improper development of a child’s permanent teeth. It’s also important to establish good oral hygiene habits early on. Children’s teeth should be brushed twice daily (just like adult teeth).

Myth #2: Fluoride is poisonous and should be avoided.

Wrong! Each day the enamel layers of our teeth lose minerals (demineralization) due to the acidity of plaque and sugars in the mouth. The enamel is remineralized from food and water consumption. Too much demineralization without enough remineralization leads to tooth decay. Fluoride helps strengthen enamel, thus making it more resistant to acidic demineralization. Fluoride can sometimes reverse early tooth decay. According to the American Dental Association, community water fluoridation is the single more effective public health measure to prevent tooth decay. Many dental offices also offer in office fluoride treatments that can help both children and adults.

Myth #3: You lose one tooth each time you have a child.

Now that’s just silly. Some women think that when they are pregnant the baby leeches a lot of their calcium supply. That may be, but it doesn’t mean she will lose any teeth. However, pregnant women are prone to cavities or having other dental problems. This is due to morning sickness and vomiting, dry mouth, and a desire/craving for more sugary or starchy foods. Pregnant women in these circumstances should be sure to continue their regular dental check-ups and try to maintain pristine oral home care.

Myth #4: If your gums are bleeding you should avoid brushing your teeth and flossing.

I can’t even begin to stress how wrong this one is! If your gums are bleeding it means there is active inflammation and infection present. That means you need to improve on oral hygiene by brushing more frequently or more effectively. Bleeding gums is a sign of periodontal disease. If caught early (in the gingivitis stage) it can be reversed. Brushing should be done twice daily with a soft-bristled toothbrush. Flossing should be done at least once daily.

Myth #5: Placing a tablet of aspirin beside an aching tooth can ease the pain.

Wrong again. In order to ease the pain caused by a toothache, aspirin must be fully swallowed. Placing aspirin on gum tissue for long periods of time can actually damage the tissue and possibly cause an abscess.

Myth #6: You don’t need to see the dentist if there is no visible problem with your teeth.

Unfortunately not all dental problems will be visible or obvious. You should continue to visit the dentist for regular check-ups at least twice per year, in conjunction with your cleanings. Dental radiographs or other instruments can detect cavities or other problems that might not be causing any symptoms yet. It’s best to catch things early to minimize the treatment needed.

Myth #7: After a tooth has been treated for decay it will not decay again.

There are no guarantees in dentistry! While the dentist will do their best to restore teeth to last for as long as possible, there is no way of knowing when or if a tooth will get recurrent decay. Proper oral home care can prolong the life of dental restorations.

Don’t always believe what you hear! If you have questions or concerns about your dental health be sure to ask your dentist, hygienist, or other dental professional.

Want to learn more? Visit us at

http://www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation

Sources:

http://www.webmd.com/oral-health/guide/fluoride-treatment

http://www.livescience.com/22463-gain-a-child-lose-a-tooth-myth-or-reality.html

http://tips4dentalcare.com/2008/06/21/popular-myths-about-dentistry/

Posted in Community Service News, Health, Mouth Body Connection, Tooth Talk
Tagged aspirin, baby teeth, bleeding, brushing, cavities, dental, dental myths, flossing, fluoride, myths, Pregnancy and oral health, recurrent decay, routine dental care, tooth ache
1 Comment

April 26, 2015

Periodontal Probing 101

Lindsay Whitlock RDH

John, the patient, is taken back to the dental operatory for his dental cleaning appointment. The dental hygienist reviews John’s chart, his medical history, and John addresses any concerns he has in his mouth. The hygienist lays John back in the chair. John cringes, as he sees the hygienist holding a pointy tool in her hand. She informs him, “John, I am going to take a few measurements around each tooth, to assess how healthy your gums, and bone levels are.” John opens his mouth, and thinks to himself “I wonder if this going to hurt?” “What is she even doing with that tool anyways?”

Prior to becoming a dental hygienist, I too was like John. I did not understand what that “pointy” tool was, or why it needed to be used. With this blog post, I would like to briefly educate my dental patients of what a periodontal probe is, and why it is utilized in the dental office.

That pointy tool the hygienist uses at the beginning of a dental appointment is called a periodontal probe. The periodontal probe is marked in millimeter increments, which is used to evaluate the health of the patient’s gum, and surrounding bone levels of the jaw, with little to NO discomfort!

Each of your teeth are sitting in jawbone. Additionally, each tooth is surrounded by gum tissue (gingiva). To simplify this concept, your gums surround each tooth like a turtleneck sweater.

There is a natural space of pocket between the gum and tooth. The periodontal probe is used to measure this pocket depth, at each dental appointment.

In health, the tooth is surrounded by a gum pocket depth of 1-3 mm (No bone loss of the jaw bone).

If gingivitis is present (Swollen gums-no bone loss of the jaw bone) the tooth is surrounded by a 4 mm. pocket depth.

A periodontal pocket (Mild-Advanced periodontitis) is present when the space between the tooth and gum has been deepened by disease and bone loss. A 5-12 mm pocket depth surround the tooth or teeth.

The next time you are in the dental chair, feel free to ask your dentist or dental hygienist your latest periodontal probing scores. If you have never had these measurements taken before, call our office today and schedule a new patient exam, to determine the health of your mouth!

Want to learn more? Visit us at

http://image.slidesharecdn.com/probing-150304002025-conversion-gate01/95/probing-4-638.jpg?cb=1425450081

Sources:

http://www.google.com/imgres?imgurl=http://www.jabfm.org/content/23/3/285/F6.large.jpg&imgrefurl=http://imgkid.com/oral-cavity-diagram.shtml&h=929&w=1280&tbnid=QTPxgTXY_157NM:&zoom=1&docid=muXuT2D8a_l-rM&ei=gik0VeWcGZKHgwTj8oL4Bw&tbm=isch&ved=0CGwQMyhIMEg

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http%3A%2F%2Fwww.anicesmile.com%2Fgum_care.htm&ei=eB00VZSAAcWqgwS6uIH4DA&bvm=bv.91071109,d.eXY&psig=AFQjCNEelreU-hCgZkFOw-zD66VytX1oWw&ust=1429565102055540

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http%3A%2F%2Fpixshark.com%2Fperiodontal-probe-measurements.htm&ei=IzI0VabtA8HYggTXhICoAQ&bvm=bv.91071109,d.eXY&psig=AFQjCNG8JqFvrTWfgyW7lJDBKPoToB2P0g&ust=1429570410736621

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http%3A%2F%2Fimgbuddy.com%2Fperiodontal-probe-measurements.asp&ei=bBc0Vd3rJYa_ggT9tYHIAg&bvm=bv.91071109,d.eXY&psig=AFQjCNGZO6FQ7Orbd5mXZx5HOFLLyJqYdA&ust=1429563605237318

Posted in Gums, Health, Mouth Body Connection, Oral Hygiene
Tagged gingivitis, gum disease, gums, healthy gums, periodontal probe, periodontitis, pockets
Leave a comment

April 22, 2015

The Platypus Orthodontic Flosser

Lora Cook RDH

“Help! I just got my braces on and it takes me 20 minutes to floss my teeth.”

I have heard this statement before from some of my patients. Well I am here to tell you that your dental hygienist is here to the rescue.

I am sure that the orthodontist carefully demonstrated how to use floss threaders to thread the floss under the wire.

Well I am here let you know about another alternative to threaders. This orthodontic flossing device was invented my a hygienist trying to help her patients with the time consuming and frustrating chore of flossing under braces. It is called the platypus.

The Platypus orthodontic flosser was co-invented by pediatric dental hygienist Laura Morgan and hygiene product developer Fred Van de Perre.

This device fits easily under arch wire and between brackets. Flossing daily will help gum tissue stay health and help to prevent tooth decay. Best of all it will only take you 2 minutes instead of 20!

How to use the Platypus orthodontic flosser.

*Insert spatula end of the flosser under your wire and press lightly against the teeth.

*Press spatula against your teeth to remove floss slack. Slide floss up between your teeth.

*In difficult to reach area, it is key to maintain pressure against your teeth while flossing.

*The bracket brush cleans around your brace brackets.

Where do I get these?

Amazon or drugstore.com sells them.

Want to learn more? Visit us at

http://www.drugstore.com/platypusco-orthodontic-flosser/qxp361704

Sources:

http://www.drugstore.com/popups/largerphoto/default.asp?pid=361704&catid=183799&size=500&trx=29888&trxp1=361704&trxp2=1

http://drmodjeski.com/oralhygiene.html

http://audrey5942f.blogspot.com/2013/01/platypus-ortho-flosser-for-braces.html

http://www.scottsdental.com/product_images/w/972/346-T106__82881_zoom.jpg

Posted in Gums, Health, Mouth Body Connection, Oral Hygiene
Tagged Braces, floss threader, flossing, orthodontics, platypus flosser
Leave a comment

April 5, 2015

Importance of Early Detection

Karen Kelley RDH

Importance of Early Detection

April is Oral Cancer Awareness Month and, as dental professionals, we want our patients to understand the significance of routine oral cancer screenings. When you get your teeth cleaned, the dental hygienist or dentist will look at all the areas in your mouth, including your tongue. They will also check for any swelling along the neck. We do this on every patient regardless of age or habits.

Another way to identify a possible oral cancer lesion is to be aware of what is in your own mouth. Look at your tongue, the tissues of your cheeks and around the teeth. If you notice something like a red or white patch, take note of the appearance. If the lesion doesn’t go away after 2-3 weeks, go see your dentist for his opinion. He may check the area again after 2-3 weeks or he may refer you to a specialist to have the area evaluated.

“There is much that can be done for those who are diagnosed with head and neck cancer. Since early detection and treatment is critical, it’s important to see your dentist regularly and to promptly see a medical professional if there are any warnings signs,” — The Oral Cancer Foundation

Oral cancer symptoms:

Persistent mouth sore: A sore in the mouth that does not heal is the most common symptom of oral cancer

Pain: Persistent mouth pain is another common oral cancer sign

A lump or thickening in the cheek

A white or red patch on the gums, tongue, tonsil, or lining of the mouth

A sore throat or feeling that something is caught in the throat that does not go away

Difficulty swallowing or chewing

Difficulty moving the jaw or tongue

Numbness of the tongue or elsewhere in the mouth

Jaw swelling that makes dentures hurt or fit poorly

Loosening of the teeth

Pain in the teeth or jaw

Voice changes

A lump in the neck

Weight loss

Persistent bad breath

Again, if you notice any of these things, come into the office and get things checked out. The earlier oral cancer is identified, the better the outcome.

Want to learn more? Visit us at