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What is a Diabetes Dentist?

The facts regarding Diabetes are staggering. In 2012 almost 10% of all Americans had diabetes. That is 29.1 million people. The percentage of Americans age 65 and older with diabetes is over 25%. Diabetes was the 7th leading cause of death in the United States in 2010, causing 69,071 deaths and contributing to 234,051 more deaths.

What is Diabetes?

We eat food so that it can be turned into sugar (glucose) for our body to use for energy. Insulin is a hormone that is made in the pancreas and is used to help transport sugar into our cells. With diabetes, your body does not make enough insulin or it can not use its own insulin as well as it is supposed to. This causes a build up of sugar in your blood which is referred to as high blood sugar. This stresses the blood vessels leading to heart disease, kidney failure, blindness, and lower-extremity amputations.

How is the Mouth Connected to Diabetes?

Another complication of diabetes is that the high blood sugar impairs white blood cells ability to fight off infection. White blood cells are the body’s main defense against infections that occur throughout the body and in the mouth. Mouth infections include mouth sores, tooth infections, and periodontal (gum) disease.

Consequently, dental care is of particularly importance for people with diabetes as is good blood sugar control. The less well controlled the blood sugar, the greater the chance of having oral health problems arise.

What are the Oral Health Risks of Diabetes?

Periodontitis and gingivitis (gum inflammation) Besides hindering white blood cells, another complication of diabetes is that it causes blood vessels to thicken, which slows the flow of nutrients to and waste products from body tissues. When this happens, the body's has a harder time fighting off infection, and since periodontal disease is a bacterial infection, diabetics can have an escalation of gum disease.

Xerostomia (dry mouth). Saliva flow can be reduced with uncontrolled diabetes resulting in a dryer mouth. Dry mouth can further lead to ulcers, infections, and tooth decay.

Fungal Infections (thrush). People with diabetes who frequently take antibiotics to fight off various infections run a higher risk of developing a fungal infection on the mouth and tongue. The fungus thrives on the high levels of sugar in the saliva of diabetics with uncontrolled blood sugar.

Poor oral healing. Uncontrolled diabetics do not heal as quickly after oral surgery or other dental procedures as others because the blood flow to the treatment site can be impaired.

Smoking also hinders the flow of blood to the gums, so the diabetic decrease in blood flow is exacerbated by smoking. Risk of periodontal disease and thrush are up to twenty times higher than non smokers. 

It's a Two-Way Street

Recent studies show that as diabetes worsens periodontal disease, the reverse is also true. Periodontal disease worsens diabetes. Uncontrolled periodontal disease can make controlling your blood sugar very difficult.  Good oral hygiene and good professional care is crucial for controlling blood sugar levels.

So, What is a diabetic dentist?

Although most dentists are quite knowledgable when it come to systemic disease, many lack the special knowledge that is required in order to give the best protection for the diabetic patient. It requires a more modern view of periodontal disease as a contributing factor to the disease and more specifically the role of oral inflammation’s effect on the body’s systemic inflammation.

The dentists at Camarillo Smiles are all about wellness based dentistry. They are always considering the systemic effects of the oral cavity. This helps them make lives better and more long lasting through individualized care and education. If they can save a tooth great, but save a life…even better.

Preventing gum inflammation leads to better blood sugar control which leads to less stress on the blood vessels and a better chance for the white blood cells to travel around and do what they do best…fight infection.

My Gums on One Side Hurt

Pain in the gums is one of the most common patient complaints that we hear in our office. While any change in your gums is a serious symptom, it is especially important to let your Camarillo Smiles dentist know if you experience any pain in your gums, even if it’s only on one side. You wouldn’t let a chronic pain in your right or left hand go on indefinitely; why would you ignore the same pain in your gums?

In some cases, pain that is localized to one side of your gums may be caused by inflammation. This is often caused by using improper brushing and flossing techniques. It is important to ensure that you use a soft-bristled toothbrush that has been approved by the American Dental Association, and that you’re brushing twice per day. It is also essential that you use a circular, massaging motion on the teeth and gums rather than a harsh, back-and-forth motion with lots of pressure. You may also want to use a warm saltwater rinse twice per day until the inflammation subsides.

Canker Sores

If none of the above measures helps to alleviate your pain, you need to schedule an appointment to have your gums checked by us. Your gums may have suffered an injury, or may have developed a canker sore. Canker sores may form when your gum tissue has been injured, but may also be caused by the consumption of highly acidic fruits such as lemons and oranges. They may also be caused by conditions such as Crohn’s disease or celiac disease.

Symptoms of canker sores include:

·       A burning or tingling in the gums

·       Painful white or gray sores that are round with red edges

-     Difficulty eating or drinking

·       Feeling tired or sluggish

·       Fever

·       Swollen lymph nodes

Gum Disease

Another common cause of pain in the gums is gum disease. Though the pain from gum disease usually occurs throughout the mouth, it should not be discounted as a possible cause unless ruled out by a dentist. Gum disease occurs in two stages: gingivitis, the more mild form and periodontitis, the more serious and severe type.

The treatment for gingivitis will vary based on what stage of gum disease you have. It can range from a simple deep cleaning to gum surgery. As plaque and tartar build up on your teeth and below the gum line, these areas can become infected. As your immune system attacks the harmful bacteria, it also breaks down the gums, connective tissue, and bone holding your teeth in place. Contact your dentist right away if you have any of these symptoms:

·       Bad breath (halitosis) that is unrelated to diet and doesn’t fade with brushing

·       Red or swollen gums

·       Gums that bleed easily or are very tender

·       Pain when you eat or drink

·       Increased sensitivity to hot, cold, or pressure

·       Receding gum tissue

If your gum pain does not get better after any of the home treatment methods that we have listed at the beginning of this article, it’s important that you call our office right away for diagnosis and treatment. Pain in the gums can indicate a serious dental issue that should be treated as soon as possible.

My Tooth Root Hurts

ROOT SENSITIVITY

Why are my teeth sensitive. Gum recession and sensitivity.

Tooth sensitivity to touch, cold or sweets may be a sign of a cavity or infection, but it may also be caused by tooth root sensitivity. Teeth are covered by enamel which is a very hard substance, which insulates the nerve inside the tooth from the stimuli your teeth experience, such as cold, hot, sweets, and chewing. The enamel surface covers the tooth down to the level on the gums and then the root surface starts. The roots are covered by a substance called cementum. This cementum as shown in the picture to the left, is not as strong as enamel, but is normally protected by the overlying gums. Root sensitivity occurs when something happens to cause the gums to recede, leaving the cementum exposed. The cementum is not a very good insulator, so that is why we get sensitivity.

What causes gum recession?

Your toothbrush could be one of the biggest culprits. Root recession can occur by brushing too hard or by using a hard bristled toothbrush. The use of a soft toothbrush with proper technique, which our wonderful Camarillo Smiles hygienists can help you with, is paramount to preventing recession.

Clenching and grinding of your teeth can cause the recession of the gum tissue. As the teeth come together hard, the teeth flex causing enamel to chip out at the gum line which usually presents itself as a small, or sometimes very large, indentation or shelf at the gum line. These are called abfraction lesions and are very common in people with clenching or grinding habits. These biting forces can also cause the bone that holds the teeth in to recede down away from the tooth exposing the root surface.

Root sensitivity can also be caused by chemical erosion. This can occur in people who drink a lot of carbonated beverages like Pepsi and Coke, or highly acidic drinks like Gatorade and lemonade or suck on highly acidic foods, such as lemons or limes. The strong acids in these products eat away at the protective enamel coating of the teeth right along the gum line, leading to sensitivity. And if you add this to using a hard bristle toothbrush or clenching or grinding your teeth you will get even more recession.

Tooth root sensitivity can also occur after dental treatments. This is especially true if the dental treatment affects the position of the gum tissue on the tooth. Some examples would be gum surgeries that expose more tooth structure or the extraction of teeth, which may cause shrinkage of the gum tissue in the area adjacent to other teeth or even a dental cleaning if there was quite a bit of build up on the teeth.

What Can Be Done For Root Sensitivity

The most critical aspect in treating tooth root sensitivity is accurately diagnosing the cause. If the cause is not known and corrected, the problem will continue to recur in spite of treatment. Since the root surface does not have the benefits of insulation that of enamel affords, the treatment goal is to coat or seal the surface of the exposed root to prevent the stimulus (cold, sweets, etc.) from transmitting to the nerve of the tooth, causing sensitivity.

There are desensitizing toothpastes available at most stores that are made specifically for sensitive teeth. It can take a few weeks, but these toothpastes decrease the tooth root sensitivity over time. Because often times the cause of the sensitivity is not addressed, the sensitivity returns once the toothpaste is stopped. Another option that just came out are the Crest Sensi Stop sensitivity strips. They are a small clear patch that goes over the root surface. You wear them for 10 minutes and it is supposed to give you a month of relief. We will keep you informed about how this and other new products are working. You can see, sensitivity is a widespread issue which is why every major manufacturer of dental products make something for it.

Another option is to have us apply a highly concentrated fluoride varnish to the sensitive areas in our office. We can also seal the area with a thin coating of resin, which is like a thin coat of a clear liquid that helps to seal your tooth. We also offer the most current technologies available that can also desensitize the root surfaces using a laser.

Putting a filling over the exposed area can also seal them. We will do that if the root area has a divot that needs to be filled in, but of course, the cause of the divot needs to be identified and corrected, otherwise the gum may continue to recede past where the filling was placed, causing a new area of root sensitivity. If the recession is more extreme, or it is an esthetic concern, a gum graft may be done. A lot of progress has been made with these procedures and they are better than ever. The results are wonderful.

Handing Out Poisoned Candy?

Convicted and executed for poisoning a child with tainted halloween candy

What is it about Halloween candy that scares you the most? As a dentist, you probably figure that for me, it is the bacteria fueling, cavity causing, tooth rotting sugar that scares me the most. Truth be told, one night of indulgence does not make a rotten mouth. With that said, of course, moderation is the key to most vices:) But, habits of sending small children to bed with a bottle of anything other than water- scary. Children drinking from Sippy cups filled with juice- scary. Sipping on a Pepsi all day long at work- scary!

This got me thinking about the idea of trick or treating and the fear that many people have of strangers (neighbors?) handing out tainted treats. It never made much sense to me since it doesn’t seem like a very likely way to terrorize little kids. The risk of getting caught as people would know exactly where you lived made me wonder if there have been true cases of poisoned Halloween candy being given out to random kids or is this just another urban myth.

So, I came across an article in Mental Floss magazine that seemed to have the answer. Yes, but not really. There wasn’t any evidence to support the idea of random kids being targeted by some mad man. To find where it all began, you have to go back to 1974 when Timothy O’Bryan, a nine year old, died from ingesting Pixy Stix laced with cyanide. At first, the police thought it was the work of some deranged homeowner handing out these deadly treats. But the investigation revealed that no one in the neighborhood was handing out Pixy Stix. Soon, the focus was on Timothy’s father. He had recently bought large insurance policies on Timothy and his sister. It turned out that he had put these Pixy Stix in his children’s bags as well as the bags of two other children to try to divert attention from himself. Fortunately for them, they passed on the Pixy Stix in favor of other candies. Timothy’s father, Ronald O’Bryan, was convicted and executed for the murder of his son.

Pixy Stix

When I heard it was alleged to be a random poisoning by way of Pixy Stix, it jogged my memory of this story from back in the day when I was a teenager. I had just never heard that it turned out to be a targeted attack, by the kid’s own father. There are more stories like this of alleged poisonings by strangers that turn out not to be so on snopes.com. Reports come in to the police every Halloween. It invariably is the result of someone’s bright idea for a prank.

This doesn’t mean that people should not exercise some caution when junior comes home with his loot. An inspection to pull out any candies that look like they could have been tampered with and, of course, to remove all of your favorites is certainly in order :) 

Dr. Pez's Did U Floss Pumpkin

Dr. Pez's Did U Floss Pumpkin

The most damage I see from Halloween candy is not kids with cavities, it is their parents old fillings and crowns (after stealing their kids candy) that have been pulled out. Luckily, we can usually fix that back up quite easily as long as you don’t wait too long.

It seems like what we should fear the most is not our neighbors but instead it is our own lack of willpower!

Pregnancy and Gum Disease

Over 12% of pregnancies in the United States end with a preterm birth (less than 37 weeks). Preterm birth will affect 500,000 families each year and will cost our medical system $26 billion.

Fusobacterium Nucleatum

Recent medical studies have shown that the mouth is the breeding ground for the type of bacteria that have been found to be a major cause of preterm births. Controlling the level of bacteria in your mouth is of paramount importance for your overall health and for your baby’s health, too.

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Camarillo Smiles is dedicated to being on the leading edge of good health and wellness guided by solid science. Benefit from tomorrow’s standard of care…today!