Posts for: May, 2018
If you have periodontal (gum) disease, you probably already know you’re in danger of eventual tooth and bone loss if the infection isn’t brought under control. But if you also have diabetes, the effects from gum disease could extend well beyond your mouth.
Gum disease is a bacterial infection caused by plaque, a film of food remnant that builds up on tooth surfaces mainly due to poor oral hygiene. As the infection grows, your body’s immune system responds by flooding your gum tissues with antibodies to fight it, resulting in inflammation. As the inflammation persists, though, it damages the gum and underlying bone tissue, which in turn leads to gum and bone loss from the teeth.
Diabetes also causes an inflammatory response within the body. The disease develops either as a result of the body’s decreased ability to produce insulin to balance the glucose (sugar) levels in the bloodstream (Type 1) or the body develops a resistance to insulin’s effects (Type 2). As a result diabetics experience abnormally high blood glucose levels, a condition called hyperglycemia. This triggers chronic inflammation that can lead to inhibited wound healing, increased risk of heart, kidney or eye disease, coma or death.
Gum disease can worsen diabetic inflammation, and vice versa. The effects of the oral infection add to the body’s already overloaded response to diabetes. In turn, the immune system is already compromised due to diabetes, which can then increase the severity of the gum disease.
Research and experience, though, have found that pursuing treatment and disease management for either condition has a positive effect on managing the other. Treating gum disease through plaque removal, antibiotic therapy, surgery (if needed) and renewed oral hygiene will diminish the oral infection and reduce the body’s immune response. Caring for diabetes through medication, diet, exercise and lifestyle changes like quitting smoking will in turn contribute to a quicker healing process for infected gum tissues.
Treating gum disease when you have diabetes calls for a coordinated approach on both fronts. By caring for both conditions you’ll have a more positive effect on your overall health.
Even though an implant is now as close to life-like as modern dentistry can produce, it won’t surpass the function of your own natural tooth. That’s not to say implants are an inferior choice—in fact, it’s often the best one if a tooth is beyond reasonable repair. But first, let’s consider saving your existing tooth.
We first need to know why your tooth is diseased—more than likely either from tooth decay or periodontal (gum) disease. Although different, these infections both begin with bacteria and can eventually lead to tooth loss.
While your mouth is teeming with millions of harmless bacteria, a few strains that live in dental plaque (a thin biofilm on your teeth) can cause disease. As they proliferate—feeding mostly on leftover sugar—they produce acid, which can erode the protective enamel on teeth. This can create cavities, which must be cleared of decayed material and filled.
Sometimes, though, the decay spreads deep within the pulp and through the root canals putting the tooth in danger. We may be able to save it, though, with a root canal treatment. In this common procedure we access the pulp chamber and clean out all the diseased or dead tissue. We then fill the empty chamber and root canals with a gutta percha filling and then seal the tooth. We later cap the tooth with a crown to further protect it.
Dental plaque can also give rise to a gum infection that triggers chronic inflammation. The inflammation can cause the gums to weaken and detach from the teeth to form large, infection-filled voids called periodontal pockets. This could lead to bone deterioration, further loosening the tooth’s hold.
But we can effectively treat gum disease by removing the plaque, which is fueling the infection. We normally do this with special hand instruments, but may also need to use surgical measures for more advanced cases. After plaque removal the inflammation subsides, giving the tissues a chance to heal and strengthen. We may also need to provide further assistance to these tissues to regenerate through gum or bone grafting.
These efforts can be quite involved, but if successful they could give your tooth another lease on life. And that could be a much better outcome for your dental health.
If you would like more information on the best treatment choices for your 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 “Save a Tooth or Get an Implant?”
So you’re tearing up the dance floor at a friend’s wedding, when all of a sudden one of your pals lands an accidental blow to your face — chipping out part of your front tooth, which lands right on the floorboards! Meanwhile, your wife (who is nine months pregnant) is expecting you home in one piece, and you may have to pose for a picture with the baby at any moment. What will you do now?
Take a tip from Prince William of England. According to the British tabloid The Daily Mail, the future king found himself in just this situation in 2013. His solution: Pay a late-night visit to a discreet dentist and get it fixed up — then stay calm and carry on!
Actually, dental emergencies of this type are fairly common. While nobody at the palace is saying exactly what was done for the damaged tooth, there are several ways to remedy this dental dilemma.
If the broken part is relatively small, chances are the tooth can be repaired by bonding with composite resin. In this process, tooth-colored material is used to replace the damaged, chipped or discolored region. Composite resin is a super-strong mixture of plastic and glass components that not only looks quite natural, but bonds tightly to the natural tooth structure. Best of all, the bonding procedure can usually be accomplished in just one visit to the dental office — there’s no lab work involved. And while it won’t last forever, a bonded tooth should hold up well for at least several years with only routine dental care.
If a larger piece of the tooth is broken off and recovered, it is sometimes possible to reattach it via bonding. However, for more serious damage — like a severely fractured or broken tooth — a crown (cap) may be required. In this restoration process, the entire visible portion of the tooth may be capped with a sturdy covering made of porcelain, gold, or porcelain fused to a gold metal alloy.
A crown restoration is more involved than bonding. It begins with making a 3-D model of the damaged tooth and its neighbors. From this model, a tooth replica will be fabricated by a skilled technician; it will match the existing teeth closely and fit into the bite perfectly. Next, the damaged tooth will be prepared, and the crown will be securely attached to it. Crown restorations are strong, lifelike and permanent.
Was the future king “crowned” — or was his tooth bonded? We may never know for sure. But it’s good to know that even if we’ll never be royals, we still have several options for fixing a damaged tooth. If you would like more information, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Crowns and Bridgework.”