You would love to replace a troubled tooth with a dental implant. But you have one nagging concern: you also have diabetes. Could that keep you from getting an implant?
The answer, unfortunately, is yes, it might: the effect diabetes can have on the body could affect an implant's success and longevity. The key word, though, is might—it's not inevitable you'll encounter these obstacles with your implant.
Diabetes is a group of metabolic diseases that interfere with the normal levels of blood glucose, a natural sugar that is the energy source for the body's cells. Normally, the pancreas produces a hormone called insulin as needed to regulate glucose in the bloodstream. A diabetic, though either can't produce insulin or not enough, or the body doesn't respond to the insulin that is produced.
And while the condition can often be managed through diet, exercise, medication or supplemental insulin, there can still be complications like slow wound healing. High glucose can damage blood vessels, causing them to deliver less nutrients and antibodies to various parts of the body like the eyes, fingers and toes, or the kidneys. It can also affect the gums and their ability to heal.
Another possible complication from diabetes is with the body's inflammatory response. This is triggered whenever tissues in the body are diseased or injured, sealing them off from damaging the rest of the body. The response, however, can become chronic in diabetics, which could damage otherwise healthy tissues.
Both of these complications can disrupt the process for getting an implant. Like other surgical procedures, implantation disrupts the gum tissues. They will need to heal; likewise, the implant itself must integrate fully with the bone in which it's inserted. Both healing and bone integration might be impeded by slow wound healing and chronic inflammation.
Again, it might. In reality, as a number of studies comparing implant outcomes between diabetics and non-diabetics has shown, there is little difference in the success rate, provided the diabetes is under control. Diabetics with well-managed glucose can have success rates above 95%, well within the normal range.
An implant restoration is a decision you should make with your dentist. But if you're doing a good job managing your diabetes, your chances of a successful outcome are good.
Sports drinks have been widely touted as an ideal way to replenish carbohydrates, electrolytes and, of course, fluids after a strenuous event or workout. But the mixtures of many popular brands often contain acid and added sugar, similar to other types of soft drinks. This can create an acidic environment in the mouth that can be damaging to tooth enamel.
Of course, the best way to replenish fluids after most strenuous activities is nature’s hydrator, water. If, however, you or a family member does drink the occasional sports beverage, you can help reduce the acid impact and help protect tooth enamel by following these 3 tips.
Avoid sipping a sports drink over long periods. Sipping on a drink constantly for hours interferes with saliva, the bodily fluid responsible for neutralizing mouth acid. But because the process can take thirty minutes to an hour to bring the mouth to a normal pH, saliva may not be able to complete neutralization because of the constant presence of acid caused by sipping. It’s best then to limit sports drinks to set periods or preferably during mealtimes.
Rinse your mouth out with water after drinking.Â Enamel damage occurs after extended periods of exposure to acid. Rinsing your mouth out immediately after consuming a sports drink will wash away a good amount of any remaining acid and help normalize your mouth’s pH level. And since water has a neutral pH, it won’t add to the acid levels.
Wait an hour to brush after eating. As mentioned before, saliva takes time to neutralize mouth acid. Even in that short period of time, though, acid can soften some of the mineral content in enamel. If you brush during this “soft” period, you may inadvertently brush away some of the minerals. By waiting an hour, you give saliva time not only to neutralize acid but also restore mineral strength to the enamel.
If you would like more information on sports and energy drinks and their effect on dental health, 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 “Think Before you Drink.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
Removing plaque, a bacterial film that builds up on teeth, daily is crucial in preventing dental disease, but is your brushing and flossing making enough of a difference?
Plaque forms every day in our mouths as a result of eating. The bacteria in it produce acid, which can erode tooth enamel and cause tooth decay. Certain strains can also infect the gums and cause periodontal (gum) disease. Either of these primary diseases could lead to tooth loss.
Daily plaque removal with brushing and flossing keeps bacteria growth under control, so a quick swish of your toothbrush across your teeth won't be enough. Plaque's soft, sticky consistency enables it to hide in hard to reach places below the gum line, irregular biting surfaces, or in fillings or other dental work.
Because it's virtually invisible, it's hard to tell if you've successfully removed it. That's where disclosing agents can help. These are solutions, swabs or tablets with a dye that temporarily stains plaque while not staining tooth surfaces. Dental hygienists use them to show patients where they're missing plaque when brushing and flossing, but you can also use them at home to see how you're doing between dental visits.
After brushing and flossing, use the disclosure product according to the package directions. If you're using a solution, for example, swish it around in your mouth for about thirty seconds and then spit it out. The dye reacts with leftover plaque to stain it a bright color. Some products even offer a two-tone dye that displays older plaque in a different color from newer plaque.
After noticing the dyed plaque in a mirror, brush and floss until you don't see it anymore. You may have to change your approach, which will help you perform better in the future. Although safe in the mouth, you should still avoid swallowing the agent or getting it on your clothes. Any on your lips, gums or tongue will eventually wear off in a few hours.
A disclosing agent gives you a snapshot of where you need to improve your oral hygiene. Occasional “spot checks” will help keep your brushing and flossing well tuned.
If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.
RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.
The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.
Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.
RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.
A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.
If you would like more information on teeth replacement options, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
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