More than 1 in 10 Americans has some form of diabetes. This metabolic condition disrupts the body's regulation of glucose in the bloodstream, giving rise to health problems like slow wound healing, frequent infections and blindness—and it's the seventh leading cause of death in the U.S. It can affect every aspect of your health including your teeth and gums.
Fortunately, people with diabetes can manage it through medication, diet and exercise. Even so, the disease could still have a profound effect on physical health. The mouth in particular becomes more susceptible to a number of oral conditions with diabetes.
In recognition of American Diabetes Month in November, here's how diabetes could put your oral health at risk for other diseases and what you can do about it.
Gum disease. Diabetics are at high risk for severe periodontal (gum) disease because of a characteristic shared by both conditions: inflammation. What is normally a healing response of the body to infection or trauma becomes destructive if it becomes chronic. Studies show that, due to their inflammation connection, diabetes can worsen gum disease, and gum disease can make it harder to bring diabetes under control.
Dry mouth. Chronic dry mouth is another possible consequence of diabetes that harms oral health. It's the result of the body not producing enough saliva. Because saliva supplies antigens to fight infection and neutralizes oral acid, which erodes tooth enamel, inadequate saliva increases the risk of both tooth decay and gum disease.
Thrush. Also known as oral candidiasis, thrush occurs when the fungus Candida albicans spreads along the inside surface of the mouth. This fungal infection can produce painful white lesions that make it difficult to eat or swallow. Complications from diabetes, including dry mouth and raised glucose levels in saliva, increase a diabetic's chances of developing thrush.
Implant complications. An implant's stability depends on the healing period after implant surgery when bone cells grow and adhere to its titanium surface. But because diabetics can experience slow wound healing, the bone may not fully develop around the implant and eventually causing it to fail. Fortunately, this is less of a problem if the patient has their diabetes under control.
So, what can you or someone you love with diabetes do to avoid these oral health pitfalls? For one, practicing daily brushing and flossing—and seeing your dentist on a regular basis—is paramount for reducing the risk of any dental disease. Additionally for diabetics, consistently keeping your condition under control will likewise lessen the impact it may have on your teeth and gums.
Until recently, the standard treatment for tooth decay remained essentially the same for nearly a century: Remove any decayed structure, then prepare and fill the cavity. But that singular protocol has begun to change recently.
Although "drilling and filling" saves teeth, it doesn't fully address the causes of decay. In response, dentists have broadened their approach to the disease—the focus now is on an individual patient's particular set of risk factors for decay and how to reduce those.
At the heart of this new approach is a better understanding of oral bacteria, the true cause of decay. Bacteria produce acid, which can erode tooth enamel and create a gateway into the tooth for decay to advance. We therefore want to lower those risk factors that may lead to bacterial growth and elevated acidity.
One of our major objectives in this newer approach is to reduce plaque, a thin film of food particles used by bacteria for food and habitation. Removing plaque, principally through better oral hygiene, in turn reduces decay-causing bacteria.
Plaque isn't the only mechanism for bacterial growth and acidity. Appliances like dentures or retainers accumulate bacteria if not regularly cleaned. Reduced saliva flow, often due to certain medications or smoking, limits this fluid's ability to buffer acid and acid reflux or acidic beverages like sodas, sports or energy drinks can disrupt the mouth's normal pH and increase the risk for enamel erosion.
Our aim, then, is to develop a long-term strategy based on the patient's individual set of oral disease risk factors. To determine those, we'll need to examine their medical history (including family), current health status and lifestyle habits. From there, we can create a specific plan targeting the identified risk factors for decay.
Some of the elements of such a strategy might include:
- Daily brushing and flossing, along with regular dental cleanings;
- Fluoride dental products or treatments to strengthen enamel;
- Changes in diet and excess snacking, and ceasing from any tobacco use;
- Cleaning and maintaining appliances, as well as monitoring past dental work.
Improving the mouth environment by limiting the presence of oral bacteria and acid can reduce the occurrence of tooth decay and the extent of treatment that might be needed. It's a more nuanced approach that can improve dental health.
If you would like more information on tooth decay prevention and treatment, 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 “Tooth Decay: How to Assess Your Risk.”
In the realm of dental restorations, not all crowns are alike. And, one type isn't necessarily superior to the others. One type of crown may work better for a particular tooth, while a different crown is better suited to another.
Therefore, knowing your options can help you make a more informed choice with your dentist regarding the best crown for your needs. Here, then, is a quick primer on the main types of dental crowns used today.
Metal crowns. Early in the last century, crowns made of gold, silver or other metals were the go-to dental restoration. Because of their strength and durability, metal crowns are still used today, mainly in back teeth that encounter heavy biting forces. Their drawback: They're decidedly not the color of natural teeth and so can stand out if they're placed in the visible "smile zone."
PFM crowns. The first crowns made with dental porcelain solved the appearance problem, but couldn't adequately handle biting forces as well as metal. Out of this came the porcelain fused to metal (PFM) crown, which contains an inner core of metal overlaid with tooth-colored porcelain. Providing both strength and life-likeness, PFM crowns were immensely popular until the mid-2000s.
All-Ceramic crowns. The development of porcelains more durable than earlier versions eventually dethroned the PFM (although the latter is still used today). Sixty percent of the crowns installed in recent years are all-ceramic, many reinforced with a strength material known as Lucite. Many all-ceramic crowns reaching the 15-year mark are still in place and functioning.
All of these crowns continue to be viable options for dental patients. The biggest factor in choosing one particular crown over another is the type of tooth involved and its location. As mentioned before, metal or PFM crowns are usually better for back teeth where durability is a higher priority than aesthetics. All-ceramics work well in high-visibility front teeth that normally encounter lighter biting forces than back teeth.
Regardless of which kind eventually caps your tooth, any of today's modern crowns will function as intended. But the best crown for you will be the one that both protects your tooth and enhances your smile.
If you would like more information on dental crown 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 Dental Crowns.”
Nina Parker, the host of Love & Hip Hop for six seasons, is now busy with the new game show Blockbusters and her own talk show The Nina Parker Show. But even with a full plate, she took time recently for some personal care—getting a new smile.
Parker's fans are familiar with her noticeable tooth gap. But a video on TikTok in February changed all that: In the video, she teasingly pulls away a mask she's wearing to reveal her smile—without the gap.
Parker and other celebrities like Madonna, Michael Strahan and David Letterman are not alone. Teeth gaps are a common smile feature, dating back millennia (even in fiction: Chaucer described the Wife of Bath as being "gap-toothed" in The Canterbury Tales).
So, what causes a tooth gap? Actually, a lot of possibilities. The muscle between the teeth (the frenum) may be overly large and pushing the teeth apart. There may be too much room on the jaw, so the teeth spread apart as they develop. It might also have resulted from tongue thrusting or late thumb sucking as a child, influencing the front teeth to develop forward and outward.
A tooth gap can be embarrassing because they're often front and center for all the world to see, but they can also cause oral health problems like complicating oral hygiene and increasing your risk for tooth decay. They can also contribute to misalignment of other teeth.
Fortunately, there are ways to alleviate a gap. One way is to move the teeth closer together with either braces or removable clear aligners. This may be the best approach if the gap is wide and it's contributing to misalignment of other teeth. You may also need surgery to alter the frenum.
You can also reduce less-pronounced gaps cosmetically with dental bonding or porcelain veneers. Bonding involves applying a type of resin material to the teeth on either side of the gap. After some sculpting to make it appear life-like, we harden the material with a curing light. The result is a durable, tooth-like appearance that closes the gap.
A veneer is a thin wafer of porcelain, custom-made to fit an individual patient's tooth. Bonded to the front of teeth, veneers mask various dental flaws like chips, deformed teeth, heavy staining and, yes, mild to moderate tooth gaps. They do require removing a small amount of enamel on the teeth they cover, but the results can be stunning—completely transformed teeth without the gap.
Getting rid of a tooth gap can be a wise move, both for your smile and your health. You may or may not take to social media to show it off like Nina Parker, but you can feel confident to show the world your new, perfect smile.
If you would like more information about treating teeth gaps and other dental flaws, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Space Between Front Teeth.”
In addition to daily oral hygiene and regular dental visits, a tooth-friendly diet can boost your kid's dental health and development. You can help by setting high standards for eating only nutritious foods and snacks at home.
But what happens when they're not home—when they're at school? Although public schools follow the Smarts Snacks in Schools initiative sponsored by the U.S. Department of Agriculture, those guidelines only recommend minimum nutritional standards for foods and snacks offered on campus. Many dentists, though, don't believe they go far enough to support dental health.
Besides that, your kids may have access to another snack source: their peers. Indeed, some of their classmates' snacks may be high in sugar and not conducive to good dental health. Your kids may face a strong temptation to barter their healthy snacks for their classmates' less than ideal offerings.
So, what can you as a parent do to make sure your kids are eating snacks that benefit their dental health while at school? For one thing, get involved as an advocate for snacks and other food items offered by the school that exceed the USDA's minimum nutritional standards. The better those snacks available through vending machines or the cafeteria are in nutritional value, the better for healthy teeth and gums.
On the home front, work to instill eating habits that major on great, nutritional snacks and foods. Part of that is helping your kids understand the difference in foods: some are conducive to health (including for their teeth and gums) while others aren't. Teach them that healthier foods should make up the vast majority of what they eat, while less healthier choices should be limited or avoided altogether.
Doing that is easier if you take a creative, playful approach to the snacks you send with them to school. For example, if you send them to school with their own snacks, add a little excitement like cinnamon-flavored popcorn or cheese and whole wheat bread bites in different shapes. And make it easier for them with bite-sized snacks like grapes, baby carrots or nuts.
You can't always control what snacks your kids eat, especially at school. But following these tips, you may be able to influence them in the right direction.
If you would like more information on helping your child develop tooth-friendly snacking habits, 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 “Snacking at School.”
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