Diabetes and Oral Health

November 23, 2010 By Leave a Comment
Probably one of the most common diseases among us is diabetes. Diabetes affects nearly 24 million children and adults in the U.S. With diabetes being such a prevalent disease, I thought it would be beneficial to address how diabetes affects the mouth.
 
Diabetic patients are at a higher risk for gum problems (gingivitis, periodontitis, oral infections, fungal infections); this issue is attributed to poor blood glucose levels. Therefore, one of the most important things a diabetic person can do is control their blood glucose levels (normal: 70-130 mg/dl). Some other things one can do to prevent serious issues with the mouth are to have good oral home care and to have regular six-month check ups with the dentist.
 
Here are some of the warning signs that you may have an oral infection that may be associated with diabetes:
  • Swelling or pus around your teeth or gums or any place in your mouth; the swelling can be large, or as small as a pimple.
  • Pain in the mouth or sinus area that doesn't go away
  • White or red patches on your gums, tongue, cheeks or the roof of your mouth
 
Some of the signs of gingivitis and/or serious gum disease are:
  • Bleeding and red, swollen, or tender gums
  • Gums that have pulled away from the teeth
  • Pus between the teeth and gums (when you press on the gums)
  • Bad breath
  • Permanent teeth that are loose or moving away from each other
One last symptom that is often associated with someone with diabetes, dry mouth. This may be caused by medicines you take. You may notice a dry mouth if your blood sugar levels are high. A dry mouth can increase your risk of cavities, because there is less saliva to wash away germs and take care of the acids they create. Some of the best things to help with dry mouth are to suck on sugar free mints, use artificial wetting agents (such as Biotene), suck on ice, or drink water frequently.
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What is Better?

July 26, 2010 By Leave a Comment
Many patients ask us, “What is better? A manual toothbrush or an electric toothbrush?” The important thing to remember is that a toothbrush’s main purpose is to remove dental plaque. Dental plaque causes gingivitis or gum inflammation. The toothpaste you use should include fluoride as one of its main ingredients. Fluoride helps prevent tooth decay.
 
Now to the main question at hand. In my professional opinion, the best kind of toothbrush is the one that works for you. If you feel like you are doing a better job brushing your teeth with a manual toothbrush, then use it. If you believe you are doing a better job with the electric toothbrush, then use it. It does not matter which toothbrush, the important thing is to use a toothbrush at least twice a day for approximately 2 minutes, and remove the dental plaque in your mouth. 
 
However, if you want an article that has done some research on which toothbrush is better, here is such an article. This article is called “Manual versus powered toothbrushing for oral health1”, in this article it specifically states, “When compared to manual toothbrushes, powered toothbrushes with a rotation oscillation action provide protection against gum inflammation in the long and short term and better plaque removal in the short term.” In summary, this article states that rotating oscillating toothbrushes are better at plaque control and gingivitis reduction than manual tooth brushing or other electric toothbrushes.
 
In the August 2009 Clinicians Report, they conducted a randomized study on electric toothbrushes. Clinicians Report came up with some advantages and disadvantages to using an electric toothbrush, and I would like to share the information. Advantages: “(1) Requires less manual dexterity, (2) Excellent for special needs [orthodontics, debilitated, elderly, pediatric], (3) Potential ability to remove more plaque, (4) Timers available on rechargeable models improve length of brushing, (5) Designs are improved [smaller, lighter, and reduced head size], and Patient’s perception of cleaner teeth.” Limitations: “(1) Best plaque brushes have higher costs, (2) Potential mechanical breakdown, (3) Requires battery replacement or recharging to maintain function, (4) Larger size than manual brushes, (5) May aggravated sensitive soft and hard tissues, and (6) Wears teeth if over-used on recession, enamel defects, etc.”2
 
1Manual versus powered toothbrushing for oral health, Robinson PG, Deacon SA, Deery C, Heanue M, Walmsley AD, Worthington HV, Glenny AM, Shaw WC.
2 Toothbrushes: Is It Time to Turn the Power On?, Clinicians Report, August 2009, Vol 2, Issue 8.
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Mini Implants

June 22, 2010 By Leave a Comment
Yesterday I had the opportunity to sit down with a patient who is very unhappy with her existing lower denture. She has had it for a year now and has had to have it realigned multiple times throughout the year. Nothing we could do or what the previous dentist could do could help her out. Our patient has a very small ridge for her denture to rest on, plus there are the lips, cheek muscles, and the tongue moving around and bumping into the denture to displace it.
 
There is a solution for her loose denture. I talked with her about placing small diameter implants in her mouth that will secure the denture into place and not allow it to move. She was so excited to know about this procedure. We will keep you posted on her procedure. Here is a little bit more information about small diameter implants:
One of the newest branches in implant dentistry is the small diameter, or commonly known as the “mini”, implant. “Mini” implants have a diameter size ranging from 3.5mm and below, whereas the standard-sized implants have a diameter size of 3.75mm to 6.0mm. 
 
The “mini” implant is a great alternative for those patients who otherwise could not be served with the “traditional” standard-sized implants. The “mini” implant is a great implant for those patients who have minimal bone (or bone loss), the patient does not want a bone graft, or where the standard-sized implants cannot be placed. 
 
The best part about the “mini” implant is how minimally invasive the procedure is in placing the implants. The small diameter implants are a wonderful procedure, however, they do have their limitations. “Mini” implants are not traditionally used for single tooth restoration due to the excessive forces that are applied to one tiny implant. However, with a couple of implants placed, “mini” implants have proven an invaluable service for complete and partial denture retention. This means no more moving lower denture or no more metal clasps visible with a partial denture.
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Sealants

June 1, 2010 By Leave a Comment
Recently I have started working with the San Antonio Public Health Department. One of my assignments is to go to some of the public elementary schools in the area and provide sealants to the children. This has been a wonderful opportunity for them as they are able to receive a great dental service and for me to be able to help those kids whose parents may not be able to afford sealants for their children. What a great experience it is to help these kids out!

Sealants are safe, painless, and a great way to protect teeth from tooth decay (cavities), because our teeth have tiny grooves in them where our toothbrushes cannot always clean. Sealants are a thin, plastic, tooth-colored material bonded to the chewing surfaces of the molars and sometimes the premolars. This forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth and causing decay. 

In my professional experience so far, I’ve noticed a decrease in the number of cavities per patient. On a more personal note, my mouth so far has been cavity free because of sealants. My mom (a dental hygienist herself) made sure I had sealants at a very young age. A practice I will definitely carry on with my own children!

Most insurances only cover sealants for children up to 16 or 18 years old, but I think adults should get them as well. What a great way to protect your teeth from decay! In the long run, it would be cheaper and less invasive. I also think sealants are a must if someone is going in for either chemo or radiation therapy.

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Update on Canker Sores

May 3, 2010 By Leave a Comment

A couple of weeks ago I posted a little entry on Canker Sores.  My information was based on things I had studied and/or seen, but I had never had one before…until last week.  My canker sore was under my tongue and it hurt!  So, I decided I would try what Dr. Henslee suggested, and use the Chlorhexidine for 30 seconds (multiple times a day).  Let me tell you, my sore went away within 3-4 days.  The Chlorhexidine helped in shortening the life of the canker sore and it helped to reduce the sensitivity as well.  From personal experience, Chlorhexidine really can help those that suffer from canker sores.  I thought you might want to see what a canker sore looks like, the distinct characteristics are the bright red "halo" or ring around the white or yellow ulcer.

Hope this helps

Dr Hafen

Proudly Providing Caring Dentistry
for the residents of
Universal City, Converse, Live Oak, Schertz and Cibilo

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