Diabetes and Oral Health

Everyone is at risk of developing periodontal disease, but all people with diabetes, regardless of age or type of diabetes, are more susceptible. There are several reasons for this.
For one, people with diabetes can have more sugar in the mouth which provides a more hospitable environment for hostile bacteria. This makes all forms of periodontal disease and tooth decay more likely.
High and fluctuating blood sugar levels are also a factor in the increased risk of periodontitis and more vulnerability to complications. Patients with diabetes may also experience dry mouth as a result of reduced saliva. Neuropathy and certain medications may be the cause of reduced salivary flow which is a natural protectant against oral disease. Healing is also more difficult once an infection sets in. Just like diabetics with poor control have a hard time healing wounds and infections on their feet, their bodies have a hard time fighting infections and healing wounds in the mouth.
If and once an infection takes root a vicious cycle ensues making metabolic and infection control a struggle. This cycle can have drastic consequences. If oral infections get out of control they can lead to problems serious enough to land a person with diabetes in the hospital, to say nothing of the damage to the teeth and gums. Infections can also impact Insulin needs. Authors of a study cited in September's 1997's Practical Diabetology concluded that when an infection is rampant, patients with diabetes often have increased insulin requirements. If periodontal disease is treated and gingival inflammation is eliminated, these insulin needs often decrease. Collagen, which is a building block of the tissue that attaches teeth to bones and the surrounding soft tissue, is also affected by diabetes which make an infection potentially more destructive. 
In conclusion diabetics have an increased risk of dental problems and for this reason not only should they keep their diabetes under control with a healthy diet and meds if needed, they also need to be especially vigilant with their hygiene and visit the dentist on a regular basis.

Veneers

If you are looking to improve your smile, custom-fitted veneers can provide the answer. Veneers are thin, custom-made moldings that cover the fronts of unsightly teeth. They are crafted from tooth-colored, high-tech materials to portray a natural, bright smile. Veneers provide a safe and less invasive alternative to traditional crowns and unlike most bonding materials, they will not change color or wear over time. Veneers cover unattractive gaps, and can mask stained, misshaped or crooked teeth and are intended to last for many years.
 
Initially the tooth is minimally reshaped to allow for the added thickness and proper contour of the veneer. An impression is made of the reshaped tooth and sent to a dental laboratory where the veneer is custom-made to fit your mouth. The veneer is applied with adhesive material which bonds it to the original tooth structure and essentially becomes one with the tooth. Since veneers are individually sculpted for each patient, it is nearly impossible to tell the difference between a veneer and a natural tooth. They resist stains and wear because they are made of high-tech, extremely strong and polishable materials.

Veneers generally cannot be damaged by abrasion from your toothbrush or floss. Good oral hygiene will ensure your veneers stay strong and provide you with a long-lasting, attractive smile.

Dental Care During the Holiday Season.

The holidays can be rough on daily dental and oral care habits. Frequent parties and snacking can constantly expose teeth to sugar and cavity-causing bacterial acids. Travels and overnight stays can disrupt daily brushing and flossing regimens. However, just because the holidays are here does not mean that one should give up on proper oral hygiene. With some preparedness, the festivities of the holidays can still be enjoyed without neglecting one's gums and teeth. Here are some important tips for a realistic dental care plan during the holiday season:

1. Don't leave home without it. Whenever traveling to a friend or family's home, don't forget to pack a spare toothbrush, toothpaste, and some floss. Make sure to pack enough dental supplies should the meal extend into an overnight stay or even longer.
2. Don't delay brushing/flossing. When festivities carry on for many hours and include multiple courses, it is easy to put off or neglect one's dental care. However, once the main course is finished and dessert has been served, it is a good time to excuse oneself to brush and floss. Even if the evening continues with drinks, the excessive sugars and acids that can damage teeth have been mostly cleared out of the mouth.
3. Don't over-indulge in sweet cocktails and food. Not only can excessive sugars cause weight gain and other unhealthy affects, but they can also result in tooth decay. try to make healthier choices and remember moderation is the key!
4. Don't forget about emergency dental contacts. Many dental offices close over the holidays. Be sure to ask your dentist when he is planning on taking a vacation and obtain some emergency dental contact phone numbers. One can never predict just when an emergency may occur.
5. If you know that you need some treatment, don't put off dental work until after the holidays.  Doing so will probably make current dental issues worse. Likewise, it may lead to unnecessary toothaches during the time when one is supposed to be relaxing and having fun. Even if there are only a few days left until the big winter break, it is wise to take care of business first, so that there are no painful episodes later.

By following my advise, you will not be neglecting vital oral care during the holiday season. After all, smiling for photos, and tasting different holiday foods, would be difficult without healthy teeth and gums! 

Happy Holidays!

Eating disorders

It has been estimated that more than 10 million Americans currently are affected by serious eating disorders such as anorexia, bulimia and binge eating.  While anyone can suffer from an eating disorder, they are most common in teen and young adult women.  Eating disorders can have a large negative impact on an individual’s quality of life.

Three different types:

Anorexia typically involves an extreme fear of gaining weight or a dread of becoming fat.  Even though these individuals may be very thin or even extremely underweight, they see themselves as “fat.”  They may attempt to reach or maintain what they think is their perfect body weight by literally starving themselves.  They may also exercise excessively.
Bulimia also includes the fears of being overweight.  But it also includes hidden periods of overeating (binge eating) which may occur several times a week or even several times a day.  After they overeat, the individuals try to “undo” the fact that they ate too much as quickly as possible by forcing themselves to “throw up” or by the misuse of laxatives or enemas.
Binge Eating or Compulsive Overeating may affect almost as many men as women.  In the past, these individuals were sometimes described as “food addicts.”  They overeat (binge eat) as noted in bulimia above, but do not regularly try to get rid of the food immediately by throwing up or by misusing laxatives or enemas. 

General symptoms:

Each of these eating disorders can rob the body of adequate minerals, vitamins, proteins and other nutrients needed for good health. Individuals with eating disorders can display a number of symptoms including dramatic loss of weight, secretive eating patterns, hair loss, feeling cold, constipation and, for women, the loss of their monthly menstrual period. Eating disorders may also cause numerous other physical health complications, such as heart conditions or kidney failure, which can lead to death.
Eating disorders can also affect oral health. Without the proper nutrition, gums and other soft tissue inside your mouth may bleed easily. The glands that produce saliva may swell.  Individuals may experience chronic dry mouth. Throwing up frequently can affect teeth, too. When strong stomach acid repeatedly flows over teeth, the tooth’s outer covering (enamel) can be lost to the point that the teeth change in color, shape and length. The edges of teeth become thin and break off easily. Eating hot or cold food or drink may become uncomfortable.  

Prevention and awareness:

Eating disorders arise from a variety of physical, emotional and social issues all of which need to be addressed to help prevent and treat these disorders.  Family and friends can help by setting good examples about eating and offering positive comments about healthy eating practices.  While eating disorders appear to focus on body image, food and weight, they are often related to many other issues.  Referral to health professionals and encouragement to seek treatment is critical as early diagnosis and intervention greatly improve the opportunities for recovery.

Treatment of Oral Health Consequences of Eating Disorders

• Maintain meticulous oral health care related to toothbrushing and flossing.
• Immediately after throwing up, do NOT brush but rinse with baking soda to help neutralize the effects of the stomach acid.
• Consult with your dentist about your specific treatment needs.
• See your dentist regularly.

How does toothpaste work?

It is a well established belief that brushing daily strengthens our teeth and makes them healthier. Most of us do this on a daily basis without even wondering how it actually works. One should know not only the mechanism of action of a toothpaste but also the role of individual ingredients which will help in choosing an effective brand. There are three basic mechanisms by which a toothpaste improves the health of our teeth and these are as follows:
• Abrasive Action: The abrasive agent in the toothpaste physically removes the solid particles stuck on tooth surfaces and in the oral cavity by abrasive action. It also helps in removing food stains and polishing tooth surface which in turn will improve the tooth's self cleaning contours and limit plaque build up.
• Antiseptic Action: The toothpaste contains antimicrobial agents such as Xylitol which inhibit the growth of bacteria in the mouth which is especially helpful in gum disease.
• Action of fluoride: Fluoride is an important aspect of a toothpaste and in various forms is the most popular active ingredient to prevent cavities. Although it occurs in small amounts in plants, animals, and some natural water sources, and has effects on the formation of dental enamel and bones, it is not considered to be a dietary essential and no deficiency signs are known. Sodium fluoride (NaF) is the most common form. It replaces the hydroxypatite of tooth with fluoropatite which is not only much stronger but also resistant to caries. It has been shown that topical fluoride can actually remineralize damaged Enamel and essentially reverse the process by which cavities form!

Understanding Gum Disease

Generally speaking there are two categories of gum disease; Gingivitis (gum inflammation) usually precedes Periodontitis (gum disease and bone loss). However, it is important to know that not all Gingivitis progresses to Periodontitis.
In the early stage of Gingivitis, bacteria in plaque build up, causes the gums to become inflamed (red and swollen) and often easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.
When Gingivitis is left untreated, it can advance to Periodontitis. In a person with Periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and can become infected and lead to loss of attachment (bone loss). The body's immune system fights the bacteria as the plaque spreads and grows below the gum line.
Toxins or poisons - produced by the bacteria in plaque as well as the body's "good" enzymes involved in fighting infections - start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become loose and tooth loss occurs. Gum disease, in fact, is the leading cause of tooth loss in adults.
What is important clinically is to diagnose and treat gum disease before it progresses. At Elite Dental Studios we have the resources and expertise to diagnose, treat and maintain gum disease regardless of it's severity. As a general rule, the sooner the treatment, the better the outcome!  

Root Canal Therapy

We pride ourselves in spending the time to properly educate our patients on the details of proposed treatment. I have often said that the better informed the patient is, the better the overall dental experience will become. Having said this, I would like to explain one of the most misunderstood procedures in dentistry, the root canal. It is needless to say that root canal treatment has a bad reputation! Perhaps because of the pain and discomfort of a damaged nerve that necessitated the root canal procedure in the first place. However the actual treatment is relatively painless because the pain can be controlled with a local anaesthetic during the procedure and pain control medication can be used before and/or after treatment. Modern root canal treatment is completely safe and usually very predictable.                         
Due to recurrent decay and/or some form of trauma the nerve inside the tooth can become damaged and inflamed. This inflammation is of two varieties; reversible pulpitis or irreversible pulpitis. The former will pass by itself after final restoration but the latter will require further treatment. Irreversible pulpitis usually leads to necrosis or the nerve dying which in turn, if untreated, will lead to infection of the jaw bone. Root canal treatment is the actual removal of the necrotic nerve and filling of the tiny canals in the root of the tooth where the nerve runs. We always utilize a certified Endodontist when such treatment is necessary to ensue the best outcome for our valued patients.
Lastly, it is very important to properly restore the tooth that has had root canal therapy in a timely manner to ensure continued success. this will usually require a post and a crown.

Healthy alternatives in dental materials

There are numerous types of materials being used in dentistry today and some are more non-reactive in the body than others. Many people are sensitive/allergic to metallic restorative materials such as the dental amalgam. The dental amalgam contains mercury and other metals that may be toxic to the body. People who have amalgams replaced by other materials such as porcelain or composite resin actually report that they feel healthier than before. Dental amalgams are still considered safe in the US although are being used less and less. In some European countries, they are seldom or no longer placed. Personally, I have not used any amalgam for a decade or so and I find that the alternatives are not only safer but also better from a restorative point of view.

Oral Hygiene and Cardiovascular Disease

A recent study in the British Medical Journal has suggested that people who don’t brush their teeth twice daily are more susceptible to having heart disease in the future. In the past, most researches were concerned with the role of oral and gingival inflammation in building up atherosclerosis; in fact, this is the first study to examine if the number of teeth brushing has an impact on developing CV diseases, or not. The data was collected from Scottish Health Survey, which was performed on all adult participants . Results have revealed that participants who brushed their teeth less frequently had higher risks of heart disease than individuals who reported teeth brushing twice daily. Scientists believe that bad oral hygiene increases the risk for heart diseases through flaring systemic inflammation. Usually, the increased inflammation is associated with generalized homeostatic responses, besides; periodontal infection is proved to cause the disturbance of lipid metabolism, which will eventually cause most types of cardiovascular disease.
Bottom line is that there is absolutely no substitute for proper oral hygiene . Brushing and flossing your teeth twice daily has numerous benefits that extend well beyond  the mouth!

Multidisciplinary Team

Many years ago a primary dentist was a jack-of-all-trades when it came to different arenas of dentistry. A dentist would fill your cavities, pull your wisdom teeth, preform Root Canal Treatments if necessary and manage your gums. This approach worked at the time mainly because the level of sophistication in diagnosing and treating dental conditions was relatively low. However in this day and age there have been such amazing advances in all categories of dentistry, that the old one-size-fits-all approach is no longer the best option clinically for the patient. A more comprehensive approach, by today's standards, is referred to as a multidisciplinary approach where a group of providers specializing in different areas, collaborate in treating a patient. The primary dentist or in my case a Prosthodontist would initiate the treatment and make the appropriate referrals when necessary. This allows the patient to receive the best and most advanced care no matter what the necessary treatment is. We have been practicing this approach for many years at Elite Dental Studios, utilizing the very best resources available to provide the absolutely best dental care possible for our patients!    

Self Image

In my experience, how people take care of their mouths is often a reflection of how they feel about themselves. Those who feel good about themselves take good oral care and people who have a poor self image generally do not take good care of their mouth. It has also been shown that this works in reverse meaning that addressing one's dental health/aesthetics will usually lead to a better quality of life and self image! This holds especially true for cosmetic procedures. Often I am witness to a patient's general well being and attitude improving substantially after cosmetic treatments such as whitening and/or porcelain veneers. This in turn is extremely rewarding to myself and my staff and creates a deep appreciation for what we do!

Cosmetic Dentistry

Are you dissatisfied with the appearance of your smile? Does the color, shape and/or position of your teeth embarrass you? Do you ever smile with your mouth closed or cover your teeth with your hand? If you answered yes to any of these questions you are a candidate for cosmetic dentistry. In fact, anyone who is unhappy with the appearance of their smile is a good candidate for cosmetic dentistry. Today’s advanced cosmetic procedures have truly come a long way and can transform any smile into the smile you’ve always dreamed of. Cosmetic dentistry covers a multitude of safe and proven methods from smile whitening to repairing, straightening or replacing teeth. A well qualified cosmetic dentist should be able to carry out a comprehensive smile analysis in addition to periodic examinations, to come up with the plan that best suits you. Even the most unsightly smiles can be improved and usually relatively easily as well. Many procedures can be completed in one to three simple visits. Many people are simply amazed to discover the difference cosmetic dentistry can make in their appearance and self-confidence.

Botox

Most people do not associate Botox treatments under a dental setting, but this is about to change.
More and more dentists are becoming trained in Botox application and as it turns out, it is a perfect match for the profession. Very few health care professionals have as much intimate knowledge of the anatomy and function of the musculature and neural pathways of the head and neck. Also dentists as a whole are absolutely proficient in giving injections on a daily, almost hourly basis.
Botox is a purified protein derived from an organic compound, much like penicillin is and thus very safe to use. It is a temporary muscle relaxant that is injected locally into specific muscles of the head and neck. Botox injections have numerous potential purposes in a dental practice. One being treatment of TMJ type pain/migraine headaches. Another purpose is controlling the tone of muscles of mastication(jaw movement) in order to increase the success rate of other dental treatments such as implant restoration and restorative treatments in general. The last purpose is what the majority of the population associate Botox with, that is cosmetics. Botox is the perfect compliment to cosmetic dentistry and overall improvement of facial aesthetics.

Halitosis

Bad breath, medically termed as Halitosis is a condition that produces unpleasant feeling due to a foul smell coming from the mouth. The most common cause is poor oral hygiene which will lead to tooth decay and/or gum disease. Biologically speaking, the bad odor is a result of Volatile sulfur compounds released, which have a typical rotten-egg smell.

To fight bad breath one should maintain proper oral hygiene - Use fluoride toothpaste, and brush and floss your teeth twice daily. After every meal you have to rinse your mouth thoroughly with water. Teeth should be cleaned professionally - Visit your dentist regularly, at least once every 6 months so that any decay and/or gum disease can be diagnosed and treated in a timely manner. Modify your diet - Sometimes changes in the diet timings and the food you eat, can improve things. Maintain a mixed diet of all foods, including carbohydrates, proteins, fats along with fruits and vegetables. Chewing certain herbs like coriander, spearmint, eucalyptus, and cardamom can also help. Try to quit habits like smoking, chewing tobacco and excessive alcohol consumption. Foods like berries, melons and any citrus fruits are rich in vitamin C, and help in locking the growth of bacteria, thus gum disease and periodontal pocket formation are controlled. Use a tongue cleaner, to always keep the surface of the tongue clean.

Halitosis can sometimes be a sign for a medical condition. Most commonly, respiratory tract infection like infected throat, lung infections, sinus tract infections, and other systemic illnesses like diabetes, chronic bronchitis, liver or kidney disorders. If your dentist indicates your oral hygiene as good and no dental pathologies present, then you should visit a physician to determine the cause.

Dry Mouth

Dry mouth is a decreased flow of saliva that may be associated with dehydration, radiation therapy of the salivary gland regions, anxiety, the use of drugs (such as atropine and antihistamines), vitamin deficiency, various forms of parotitis, or various syndromes (such as Plummer-Vinson syndrome). Dry mouth is a significant health problem because it can affect nutrition and psychological well-being, while also contributing to tooth decay and other mouth infections.
To minimize such risks one should brush teeth and use dental floss at least twice a day. Use a toothpaste that contains fluoride. Ask your dentist about using a topical fluoride. Avoid sticky, sugary foods or brush immediately after eating them. See your dentist at least three times a year for cleanings and early treatment of cavities. Ask your dentist if you should use a remineralizing solution or prescription-strength fluoride. Take frequent sips of water or drinks without sugar. Pause often while speaking to sip some liquid. Avoid coffee, tea and soft drinks. Drink frequently while eating. This will make chewing and swallowing easier and may increase the taste of foods. Keep a glass of water by your bed for dryness during the night or upon awakening. Chew sugarless gum - the chewing may produce more saliva. Eat sugarless mints or hard sugarless candy but let them dissolve in your mouth. Avoid tobacco and alcohol. Avoid spicy, salty and highly acidic foods that may irritate the mouth. Ask your dentist about using artificial salivas to help lubricate the mouth. Use a humidifier, particularly at night.

Occlusion

Occlusion is the relationship between top and bottom teeth or the 'bite'. This relationship is of the utmost importance in many aspects of dental treatment and often overlooked with less than optimal results. Everyone has a different type of occlusion which is quite specific to that individual and considered optimal for that person. However, regardless of the type, it is extremely important to always take this patient-specific pattern into consideration when planning and preforming dental treatments. Occlusion effects many different aspects of dental health and ignoring occlusal patterns will more often than not reduce the probability of success. Personally, my staff and I will always spend the extra time to evaluate and equillibrate our patients' occlusions at, as many different intervals as necessary, during a comprehensive treatment schedule to ensure the best end results in our approach.