Dental and oral care for Diabetic Patients

An estimated 30.3 million Americans live with diagnosed diabetes. Approximately 1.7 million new cases are diagnosed each year and 8.1 million people live with diabetes and don’t even know they have it. Having good oral and dental care is essential for patients with diabetes. Research suggests people with diabetes are at higher risks of oral and dental problems, such as periodontal disease, oral infections, tooth decay, delayed healing of oral sores, and other problems. Medically, patients with diabetes are at higher risks of problems with the eyes, nerves, kidney, heart and other parts of the body.

What is diabetes?  Diabetes affects the body’s ability to process sugar. 

• Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy.
• Type 2 diabetes is the most common type of diabetes and it is a disease that occurs when your blood glucose (blood sugar) is too high. 

Symptoms of untreated diabetes affect oral and dental health

• Dry mouth (less production of saliva)
• Higher risk of dental decay due to less saliva in the mouth
• Inflamed and bleeding gums
• Problems of tasting foods
• Delayed wound healing in the mouth
• Susceptible to infections inside of the mouth

Periodontal disease and diabetes

Periodontal disease is the most common dental disease affecting patients with diabetes. Diabetic patients have poor blood sugar control, and it causes the patients to be more susceptible to oral infections and gum diseases.

*July 2013 issue of JADA (Journal of American Dental Association) wrote findings on the latest research into how gum disease could affect diabetes. 

They found that, compared with those with healthy gums, people with severe gum disease:

• Have higher long-term blood sugar levels (A1c);
• Might be at a higher risk of developing type 2 diabetes;
• Maybe at a higher risk of developing pregnancy diabetes;
• Have a harder time controlling their type 2 diabetes;
• Are at a higher risk of experiencing harm to eyes and kidney, as well as heart attack and stroke if they have diabetes

*JADA 144 (7) http://jada.ada.org July 2013

 Diabetes and oral health issues

• According to the American Diabetes Association, diabetic patients are more likely to suffer from dry mouth and/ or to develop a fungal infection in the mouth
• Dry mouth can be a side effect of medications patients take to control diabetes. Dry mouth increases the chance of developing oral infection and/ or dental decay
• High blood sugar levels and high sugar levels in the saliva create an ideal environment for plaque to grow. Excess plaque increases the risks of oral infection and periodontal disease 
• inflammation, sensitivity, and irritation along the gums 
• taste buds do not work as well
• wounds or mouth sores may have delayed healing

Dental health care/Dental considerations for people with diabetes

• Best time to receive dental care is morning appointment because blood glucose levels tend to be under better control at this time of the day
• Dental procedures should be as short and as stress-free as possible
• Dentists and staff are trained to work with diabetic patients. The dental office should have a protocol for managing diabetic patients
• Coordination with the patient’s physician may be needed to determine the patient’s health status and determine whether the dental treatment can be safely and effectively performed
• Elective dental treatment may need to be delayed until the diabetes is considered stable
• Review the patient’s medical history, medications, take vital signs, and oral evaluation

Recommendation of dental treatment for diabetic patients

• Oral examination and teeth cleaning 2x/year. Your dentist may recommend more than 2 cleanings per year depending upon your periodontal condition
• Patients with diabetes may benefit from periodontal therapy (scaling and root planning) in conjunction with good oral health maintenance at home

Everyday dental care tips

• Keep blood sugar as close to normal as possible
• Reduce sugars and starches from your diet, eat healthy foods and exercise regularly
• If you have dry mouth, try a mouthwash without alcohol
• Brush your teeth at least 2x/day. Brush your teeth after every meal. Wait at least 30 minutes after eating before brushing to protect any tooth enamel that’s been softened by the acid in the food
• Use a toothbrush with soft bristles. Use fluoridated toothpaste.
• Floss at least once a day 
• Rinse daily with an antiseptic mouth wash
• Treat dental infections immediately. 
• Provide your medical and oral health history to both your medical and dental care providers
• Quit smoking

Medical complications of Patients with Diabetes

Diabetic patients with elevated levels of blood glucose (blood sugar) can increase the incidence and severity of complications such as heart disease, stroke, kidney disease, blindness, amputations, and other medical problems. 

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA. She is experienced in all phases of dentistry. She treats patients of all ages. If you are pre-diabetic or have been diagnosed with diabetes, don’t wait and call our office for a dental and oral evaluation. With proper medical and dental care, both diabetes and periodontal disease can be treated and be well under control. Call our office at 626-335-5114 or visit us at www.annaleedds.com

Oral Care Tips for Crown Restorations

                                                                         

Teeth are restored with dental crown restorations for different reasons.  It may be that teeth are broken, damaged by decay, cracked, misshapen, or badly discolored. Crown restorations can be made of all metal, all ceramic, and porcelain fused to metal. A common question from some patients when a crown restoration is recommended by their dentist is the longevity of the crown.  The longevity largely weighs on their oral hygiene, oral habits and regular checkups with their dentists.  Here are some of the oral care tips for the crown restorations:

1.     Practice good oral hygiene  

·       Brush 2x per day and floss daily

-use toothpaste with fluoride

-use antibacterial mouth wash

·       Use interdental cleaners to help remove debris & interproximal dental plaque that collects between teeth. They clean hard to reach tooth surfaces and reduce the susceptibility of gum disease and tooth decay

- interdental brushes-clean spaces between teeth

- rubber tips-massage the gums and help to dislodge food particles and plaque to clean between the teeth

       2.     Practice good oral habits

·       Avoid grinding teeth, biting nails, chewing on ice, eating sticky or hard foods, and using teeth to open packages.  These habits can potentially lead to loosening crown restorations or fracturing the porcelain of the crown.

·       Grinding teeth-talk to the dentist to find out the cause of the habit.  The causes may be stress related, muscle tension or malocclusion.

3.     Regular Dental checkups   

·       Dental checkups and cleaning at least 2 times per year

·       Dental x-rays to check on the crowns as recommended by the dentist

Practice good oral hygiene, good oral habits and visit your dentist for checkups are keys to ensure the longevity of your dental crowns.  Talk to your Glendora Dentist about these oral care tips.

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  If you have any questions about the types of crown restorations or need some advice on keeping the crown restorations in your mouth as long as possible, please call for a FREE consultation at 626-335-5114. You can visit us at www.annaleedds.com.  

                                                                                          

Disadvantages of Amalgam

A filling is necessary in order to protect a tooth once a cavity has been removed. This helps protect the tooth and ensure that the decay does not spread to other teeth. While there are a couple of different options for filings and material that can be used. Here are three problems that you or your child may experience with amalgam fillings.

·         Amalgams are gray in color. This may be a cosmetic problem that can be handled in other ways. Contact Dr. Lee for options.

·         Amalgams may stain or create a dark tattoo on teeth over time. In order to decrease problems with staining or amalgam tattoos choose a different material. If you notice this problem, it may be time to switch out the filling with a composite material instead.

·         Teeth may be temporarily sensitive to hot or cold. While this problem may not last for long, if the problem persists adjusting the temperature of the food and drinks you consume may help to alleviate problems.

In order to find out more information and determine which type of filling will better fit your needs, contact Dr. Lee & her team today.

Children’s Smile and Dental Care

Your children’s smile brings you joy.  The best way to keep your child’s smile healthy is to begin dental care early in life. Teaching good habits of brushing and flossing of their teeth early in life keeps teeth healthy.  Healthy teeth help your children chew and enjoy food, help build self-esteem and create healthy smiles!

Begin Dental Care Early in Life

The American Dental Association (ADA) recommends parents take children to a dentist no later than their first birthday.   Parents can start to provide dental care for their babies, toddlers and older children at home:

·      Begin cleaning the baby’s mouth during the first few days after birth by wiping the gums with a clean washcloth

·      Baby’s front four teeth erupt at about 6 months of age (some children have their first tooth at 12-14 months); 

·      Brush twice daily with an infant toothbrush

·      Floss daily when baby teeth touch each other

·      For children younger than 3 years old, use only a “smear” of fluoridated toothpaste (about the size of a grain of rice) on the bristles of toothbrush; brush 2x daily.  Parents continue the supervision and remind the child not to swallow the toothpaste

·      For children 3 to 6 years of age, use a pea-sized amount of fluoridated toothpaste and brush 2x daily.  Parents continue the supervision and remind the child not to swallow the toothpaste

·      After age 6, continue to brush and floss the children’s teeth daily until parents are comfortable that the child can brush on his or her own

                              Contact Dr. Anna Lee & her team today for more information. 

Common Dental Questions

Asked by Parents

Parents have questions about their child's dental care. Now you can get some of the most commonly asked questions answered by Anna Lee, DDS.

1. Why restore/spend money to fix the baby teeth with cavities when the permanent teeth are coming in soon?

Answer: Baby tooth decay will affect the health of the permanent tooth. Bacteria of untreated teeth may cause a higher risk of permanent teeth to develop cavities. 

2. What happens when the baby tooth is lost too early?

Answer: Baby teeth are like a space retainer for permanent teeth. When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other permanent teeth to find room when they come in. This can make teeth crooked or crowded.

Parents play a critical role in the dental success for their children. Early detection of decay can help solve problems in your child's mouth before they become worse. 

Remember early diagnosis and regular dental check-ups will prevent oral health complications. Don't wait, call Anna Lee DDS, office today for a dental check-up.

Anna Lee, D.D.S

Preventing ECC/BBTD

In order to prevent ECC/BBTD: 

- Remove the bottle when baby falls asleep

- Put water in baby's bottle at nap/bed time

- Wipe off baby's teeth/gum with a damp washcloth at least twice a day and when the baby is done eathing

-Stick to a feeding schedule and limit between meal snacking 

- Try not to share saliva with the baby through common use of feeding utensils (spoons)

- Lift the child's lip to look for signs of decay

- Take the child to a CDA member dentist by age one

ECC/BBTD is an infectious and transmittable disease. The good news is that the disease is preventable. The American Academy of Pedodontics and the American Academy of Pediatrics recognizes that prevention of ECC begins in the prenatal and perinatal period. 

Anna Lee, D.D.S

What is Early Childhood Caries (ECC)?

Tooth decay in infants and toddlers is often referred to as Early Childhood Caries (ECC) or Baby Bottle Tooth Decay (BBTD). It is a common bacterial infectious disease caused by certain types of bacteria that live in the mouth.

Bacteria feed on sugar and produce acids that attack and destroy the tooth's outer surface (enamel). The end result is cavities. Infants and toddlers who go to sleep with a bottle containing milk, breast milk, or fruit juices are more susceptible to have ESS/BBTD.

Glendora Dentistry

Dr. Anna Lee, D.D.S.