Posts for tag: oral health
Acquired Immune Deficiency Syndrome (AIDS) jolted our collective consciousness in the 1980s. The deadly disease caused by the human immunodeficiency virus (HIV) had no known cure and, at the time, no effective treatment.
HIV is a retrovirus, a virus with a genetic makeup and reproduction system differing from other kinds. After taking up permanent residency in the body, HIV begins “hijacking” the replication process of cells in the body's immune system and replacing it with a copy of its own. This destroys the cells' ability to protect the body from hostile organisms. As the virus affects more and more cells, the patient's condition ultimately develops into AIDS.
An estimated 35 million people worldwide (1.2 million in the U.S.) are currently infected with the virus. Thanks to new antiretroviral drugs, though, HIV can be kept from accelerating into AIDS. While their condition remains serious, many HIV positive patients can now live long and relatively normal lives. Even so, having the virus requires them to pay close attention to their health, including their mouth.
Even while stalled from becoming AIDS, HIV can still cause oral problems for 30 to 80% of patients. The fungal infection candidiasis (also known as thrush) is the most common of these problems, which appears as lesions, cracking skin or creamy white patches on the tongue or palate that easily bleed. Patients also have higher risks for dry mouth, oral cancer and periodontal (gum) disease.
HIV positive patients must practice diligent daily oral care and see their dentist for checkups regularly. Prevention, early diagnosis and treatment can keep gum disease and other damaging conditions under control. Monitoring oral health is also important because certain mouth conditions could be an early sign the infection is entering a new advanced stage in the body that requires additional attention.
Keeping vigilant in all aspects of health is a way of life for someone with HIV. Such vigilance, though, can help them maintain a healthy mouth and even prolong their life.
Contrary to what you might think, a knocked out tooth doesn’t inevitably mean tooth loss. Time is of the essence — the shorter the interval between injury and replanting the tooth, the better the tooth’s long-term survival. The longer the interval, on the other hand, the less likely the tooth can survive beyond a few years. That phenomenon is due to the mouth’s natural mechanism for holding teeth in place.
The tooth root maintains its attachment with the jaw bone through an intermediary tissue known as the periodontal ligament. Tiny fibers from one side of the ligament securely attach to the tooth root, while similar fibers attach to the bone on the opposite side of the ligament. This maintains stability between the teeth and bone while still allowing incremental tooth movement in response to mouth changes like tooth wear.
While the ligament fibers will attempt to reattach to a replanted tooth’s root, the longer the tooth is out of the socket the less likely the fibers will fully reattach. An “ankylosis” may instead form, in which the root attaches directly to the jaw bone without the periodontal ligament. In this situation the body no longer “recognizes” the tooth and begins to treat it like a foreign substance. In all but the rarest cases, the tooth root will begin to resorb (dissolve); at some point (which varies from patient to patient) the attachment becomes too weak for the tooth to remain in place and is lost.
Ideally, a knocked out tooth should be replanted within 5 minutes of the injury (for step-by-step instructions, refer to The Field-Side Guide to Dental Injuries available on-line at www.deardoctor.com/dental-injuries). Even if you pass the 5-minute window, however, it’s still advisable to attempt replanting. With a subsequent root canal treatment (to remove dead tissue from the inner tooth pulp and seal it from infection), it’s possible the tooth can survive for at least a few years, plenty of time to plan for a dental implant or similar tooth replacement.
If you would like more information on treatment for a knocked out tooth, 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 “Knocked Out Tooth.”
Whatever problems you may have with your teeth and gums, there are effective solutions in modern dentistry. But like other aspects of healthcare, dental treatment can be quite costly. For many it isn't what can be done but what they can afford to have done.
If you too have limited financial means, don't lose hope — there are effective ways to manage your dental care, especially with a little planning ahead.
The most important thing you can do to manage dental costs is to prevent disease through consistent oral hygiene — brushing and flossing — at least once a day. Removing bacterial plaque, a film of leftover food particles that can trigger infection, from your teeth will significantly lower your risk of tooth decay and periodontal (gum) disease, two very common sources of dental care costs.
It's also important that you visit the dentist at least twice a year. Although it's an expense, it's worth budgeting because it could, along with daily hygiene, save you money in the future. During these visits we'll remove plaque and calculus (hardened plaque deposits) from hard to reach places you might have missed. We'll also check for developing problems: the earlier they're detected the less the long-term impact on your finances.
We'll also evaluate your individual risk factors for dental disease. Some, like hereditary factors, we can't control. But others, like diet and lifestyle choices, we can alter to significantly lower your chance of disease.
With this risk factor profile, we can then put together an ongoing treatment strategy. Not only will this help prevent or at least reduce problems with your teeth and gums, it will help reduce costs in the long run.
Unfortunately, even with the best efforts we can't altogether rule out problems. We'll need to treat those that arise, and usually the sooner the better. Even so, we can usually take your financial situation into account, such as a less expensive temporary measure until you can afford a more permanent solution. We also have payment programs that can help you manage costs as well.
The important thing is not to delay regular dental checkups. The sooner you begin quality dental care the less of an impact any problems we find will pose to your dental health and your wallet.
If you would like more information on financial management for your dental care, 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 “Cost-Saving Treatment Alternatives.”
People with diabetes have special concerns when it comes to dental care. In fact, 1 in every 5 cases of total tooth loss is linked to this widespread health condition. November is National Diabetes month, so it’s a good opportunity for us to answer some frequently asked questions about oral health and diabetes.
Q. Can I get a dental implant to replace a missing tooth even if I have diabetes?
A number of studies have shown that people with diabetes can be good candidates for dental implants, but there are some concerns regarding dental implant treatment, which involves minor surgery. Wounds tend to heal more slowly in people with diabetes, who are also more infection-prone than those without diabetes. In diabetic individuals with poor glucose control, research has also shown that it takes longer for the bone to heal after implant placement. We will take these (and other) factors into account when planning your implant treatment. However, in many situations even poorly controlled diabetes does not necessarily preclude dental implant treatment.
Q. I’ve heard people with diabetes have a higher risk for gum disease. Is that true?
Yes. Research shows that people with diabetes are more susceptible to periodontal (gum) disease, especially when their diabetes is poorly controlled. The reverse is also true: untreated periodontal disease can worsen blood sugar levels. So it’s important to manage both of these inflammatory conditions. If you notice the early signs of gum disease, such as inflamed or bleeding gums, please bring this to our attention. Early gum disease (gingivitis) is much easier to treat than more advanced forms—which can eventually lead to tooth loss.
Q. If I have diabetes, how can I protect my oral health?
Keep doing your best to control your blood sugar levels with exercise and a healthy diet—and stick to an effective daily oral hygiene routine, which includes both brushing and flossing and coming in for regular dental checkups and cleanings. Make sure to let us know what medications you are taking and update us on any changes. If you notice any mouth sores, swelling or inflammation, bring this to our attention as soon as possible.
If you’re pregnant, you may find yourself pondering decisions you didn’t have to think about before. Should you have that glass of wine… or skip it, because of the alcohol; go for the sushi… or avoid uncooked foods; take the pain reliever… or live with the headache. And if you have a toothache — or even if you’re overdue for a checkup and a cleaning — you may also be wondering whether having dental treatment (especially treatment that might involve local anesthetics) is safe for you and your developing baby.
Fortunately, a study that recently appeared in the Journal of the American Dental Association (JADA) should let expectant moms breathe a little easier. The research concludes that it’s safe for pregnant women to undergo dental treatment, including procedures that use local anesthetics.
And that’s good news indeed, because while maintaining good oral health during pregnancy is critical for the developing baby, many expectant moms experience problems during this period.Â Some common issues include a higher risk of tooth decay due to increased carbohydrate consumption, and sore or bleeding gums from a condition called pregnancy gingivitis.
According to the study’s lead author, Aharon Hagai, D.M.D., "[Pregnancy] is a crucial period of time in a woman’s life, and maintaining oral health is directly related to good overall health." Yet, as Dr. Hagai notes, pregnant women sometimes avoid the dentist even if they have a problem. So his team set out to determine whether having dental treatment with anesthesia affected the outcome of pregnancies. They compared a total of 1,004 women, some of whom had dental treatment with local anesthesia, and some who did not.
The research showed there was no significant difference between the two groups. This applied in terms of both major medical problems (such as cleft palate, heart defects or cerebral palsy) and other issues, including low birth weight and preterm delivery. Dr. Hagai summed it up this way: "We aimed to determine if there was a significant risk associated with dental treatment with anesthesia and pregnancy outcomes. We did not find any."
So if you’re pregnant, there’s one less thing to worry about. Go ahead and schedule your routine dental check up — and remember that it is particularly important to have cleanings during pregnancy. Â If you experience changes in your oral health, don’t hesitate to come in for an office visit and cleaning; that way, you can make sure your hormonal changes are not playing havoc with your gums. There is an old saying in some cultures that for every child a woman has, she loses a tooth. Don’t let that happen to you.
If you have questions about oral health and pregnancy, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine article “Expectant Mothers: Dental facts you need to know” and “Pregnancy and Oral Health.”