Good News: Healthy Gums Lower Blood Sugar | Alhambra Dentist

According to the American Diabetic Association, roughly 10% of the U.S. population have diabetes and about 30% (84 million) have prediabetes. 1.5 million Americans are diagnosed with diabetes. It is the 7th leading cause of death in the U.S.

Now for the good news…

It has been known for a long time that people with diabetes, especially uncontrolled diabetes, have more gum disease than those without diabetes. According to the American Dental Association, scientists are finding that gum disease may raise blood sugar levels in people with and without diabetes. Conversely, the good news is that in people with type 2 diabetes, treatment of severe gum disease can lead to a drop in blood sugar levels. The benefit is about the same as you might find if you add another drug to your usual diabetes medicine.

For the 84 million Americans who have prediabetes, there is also good news. The American Dental Association has reported a study in Denmark that showed periodontitis accelerates the progression of prediabetes into diabetes. Hence, treating and controlling periodontitis is a way to lower the risk onset of diabetes for these 84 million Americans who are pre-diabetic.

How would one know whether or not one is already pre-diabetic? When you see your physician on a regular basis for routine blood tests, screening for diabetes will reveal your status. One of the clues to whether you have additional risk factors for diabetes is a family history of diabetes. And incidentally, one of the risk factors for gum disease is family history of gum disease and loss of teeth.

How does gum disease make blood sugar levels go up? Scientists think that some of the germs in infected gums lead into the bloodstream after normal activities such as chewing or tooth brushing. This starts a reaction from your body’s defense system, which in turn produces some powerful molecules (biochemicals, such as cytokines) that have harmful effects all over your body. One of the things these molecules do is to raise blood sugar levels.

Since 40% of the population has issues with diabetes or prediabetes, and half of the population have periodontitis, it is essential that everyone visit the physician and the dentist regularly.  It will save your life and your teeth. Healthy teeth mean a healthy life, and a healthy life means healthy teeth.

If you would like more information about gum disease, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

What Causes Loose Teeth and How to Save Them | Alhambra Dentist

A loose tooth in a child often signals an exciting rite of passage. Once a person reaches adolescence, however, a loose tooth is no longer a normal occurrence. Adults may be alarmed when they notice loose teeth. Adult teeth are permanent and designed to last a lifetime. Some causes of loose teeth in adults are harmless. Others require the care of a dental professional to save the tooth, remove it, or replace it with an implant or bridge.

Gum disease. Poor dental hygiene may cause a loose tooth. Also known as periodontitis, this stage of gum disease involves inflammation and infection of the gums, usually caused by poor dental hygiene habits. The Centers for Disease Control and Prevention (CDC) in the United States report that half of the country’s adults aged 30 or older have gum disease.

When brushing and flossing efforts do not remove plaque, gum disease can develop. Plaque contains bacteria. It sticks to teeth and hardens over time until only a dental health professional can remove it. Hardened plaque, known as tartar, causes the gums to pull away from the teeth, creating gaps that can become infected. Over time, this process can break down the bone and tissue supporting the teeth, causing the teeth to become loose.

Other signs of gum disease include:

  • Gums that are tender, red, painful, or swollen
  • Gums that bleed when the teeth are brushed
  • Gum recession
  • Changes in the way the teeth fit together

Any signs of gum disease should be checked by a dentist as soon as possible. Early detection and treatment can prevent tooth loss.

Pregnancy. Raised levels of estrogen and progesterone during pregnancy can affect the bones and tissues in the mouth. Having more of these hormones can alter the periodontium, which is the collection of bones and ligaments that support the teeth and keep them in place. When the periodontium is affected, one or more teeth may feel loose.

The changes to this part of the body will resolve after pregnancy, and they are not a cause for concern. However, anyone experiencing pain or loose teeth during pregnancy should see a dentist to rule out gum disease and other oral health problems. It is safe for pregnant people to have dental checkups, cleanings, and X-rays, according to the American Dental Association and the American Congress of Obstetricians and Gynecologists. In fact, because of a possible link between gum disease and premature birth, pregnant women are encouraged to see dentists regularly.

Injury to the teeth. Injuries sustained because of contact sports may cause loose teeth. Healthy teeth are strong, but an impact from a blow to the face or a car accident, for example, can damage teeth and surrounding tissue. The result may be chipped or loose teeth.

Similarly, clenching the teeth during times of stress or grinding them at night can wear down the tissues and loosen the teeth. Many people are unaware of their clenching or grinding habits until they result in jaw pain. A dentist may be able to detect the problem before the teeth are permanently damaged. Anyone who suspects that an injury has damaged the teeth should see a dentist as soon as possible. Sports injuries, accidents, and falls, for example, can cause dental damage.

Osteoporosis. Osteoporosis is a disease that causes the bones to weaken and become porous. As a result, even minor bumps and impacts can lead to broken bones. While osteoporosis commonly affects the spine, hips, and wrists, it can also damage the bones in the jaw that support the teeth. If the jaw bones become less dense, the teeth may loosen and fall out. The National Institutes of Health (NIH) in the U.S. also report a possible link between bone loss and an increased risk of gum disease.

Certain medications used to treat osteoporosis can cause dental health problems, though this is uncommon. In rare cases, drugs called bisphosphonates, which help to treat bone loss, can lead to lose teeth. This is known as osteonecrosis of the jaw.

Authors of one study suggest that osteonecrosis rarely occurs in people who are taking bisphosphonates in pill form, but that the condition may develop in people who receive the medication intravenously. Trauma and surgical procedures, such as tooth extraction, can also cause osteonecrosis.

How to prevent teeth from coming loose:

Loose teeth cannot always be prevented, but a person can take steps to reduce the risk. Tips for tooth and gum health include:

  • Brushing the teeth thoroughly twice a day
  • Flossing once a day
  • Refraining from smoking
  • Attending dental checkups and cleanings as often as recommended
  • Wearing a properly fitted mouth guard while playing sports
  • Wearing a bite splint, when nighttime grinding or clenching is an issue
  • Asking a doctor about calcium and vitamin D supplementation to help prevent osteoporosis
  • Keeping diabetes under control, as diabetes is a risk factor for gum disease
  • Being aware of medications that may affect the teeth

Treatment options for a loose tooth:

A range of treatments can help, and the best option will depend on the cause of the looseness. Treatments include:

Splint loose teeth to firmer teeth.  Splinting means a way of stitching your teeth together with hidden wiring.  You have probably seen a retainer-type of wiring the back of the lower front teeth to prevent teeth from moving after braces. That’s what your dentist can do for your loose teeth.    In some select cases the loose teeth can be splinted together with crowns.

Scaling and root planing. This is a type of deep cleaning procedure that can treat and help to reverse gum disease.

Medications or mouth rinses. These can help infected gums to heal and combat bacteria in the mouth.

Surgery. The aim will be to remove inflamed gum tissue and bone that has been damaged by gum disease.

Bone grafts. These can help to rebuild bone lost to gum disease.

Soft tissue grafts. Also known as gum grafts, these can prevent further gum or tooth loss in people with gum disease.

Dental appliances, such as bite splints. These can reduce damage from grinding and may help the mouth to heal after dental surgery.

Treatment for diabetes. Appropriate treatment is important for dental health.

So, if you have loose teeth or suspect you might be prone to have them, see your dentist as soon as possible.  As the old saying goes, “A stitch in time saves nine.”  What we dentists can also say, “Splint your teeth in time, you will be fine.”

If you would like more information about loose teeth, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Diabetes Leads to Gum Disease; Gum Disease leads to Diabetes | Alhambra Dentist

Poorly controlled diabetic patients are at risk for numerous oral complications, such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing.

Diabetes mellitus (diabetes) is a common chronic disease of abnormal carbohydrate, fat, and protein metabolism that affects an estimated 20 million people in the United States, of whom about one third are undiagnosed. There are two major forms recognized, type-1 and type-2. Both are characterized by inappropriately high blood sugar levels (hyperglycemia). In type-1 diabetes, the patient cannot produce the hormone insulin, while in type-2 diabetes the patient produces insulin, but it is not used properly. An estimated 90% of diabetic patients suffer from type-2 disease. The causes of diabetes are multiple and both genetic and environmental factors contribute to its development. The genetic predisposition for type-2 diabetes is very strong and numerous environmental factors such as diet, lack of exercise, and being overweight are known to also increase one’s risk for diabetes. Diabetes is a dangerous disease which affects the entire body and diabetic patients are at increased risk for heart disease, hypertension, stroke, kidney failure, blindness, neuropathy, and infection when compared to nondiabetic patients. Diabetic patients also have impaired healing when compared to healthy individuals. This is in part due to the dysfunction of certain white blood cells that fight infection.

The most common test used to diagnose diabetes is the fasting blood glucose. This test measures the glucose levels at a specific moment in time (normal is 80-110 mg/dl). In managing diabetes, the goal is to normalize blood glucose levels. It is generally accepted that by maintaining normalized blood glucose levels, one may delay or even prevent some of the complications associated with diabetes. Measures to manage diabetes include behavioral modification (proper diet, exercise) and drug therapies (oral hypoglycemic, insulin replacement). The choice of therapy prescribed takes into consideration the type and severity of the disease present and patient compliance. The physician may request the patient to keep a log of their daily blood glucose measurements to better assess therapeutic success. Another commonly obtained test is the hemoglobin A1c (HbA1c), which is a surrogate marker used to assess blood glucose levels over an extended period (2-3 months). This test provides the physician with a good picture of the patient’s glucose levels over time.

Oral changes are evident in poorly managed diabetics. These patients are at risk for numerous oral complications, such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing. None of these complications are unique to diabetes. However, their presence may serve as an early clue to the possible presence of diabetes, prompting your dentist to perform or request further testing.

Periodontal disease is a commonly observed dental problem for patients with diabetes. It is similar to the periodontal disease encountered among nondiabetic patients. However, as a consequence of the impaired immunity and healing associated with diabetes, it may be more severe and progress more rapidly. The potential for these changes points to the need for periodic professional evaluation and treatment.

In conclusion, we can summarize the above by citing the American Dental Association, which states that those with diabetes are more at risk for getting periodontal disease; and those with periodontal disease are more likely to contract diabetes. Good hygiene and regular visits to the dentist will lower our risk for gum disease, as well as diabetes and other diseases. Keeping your blood sugar level within the normal range by proper diet and exercise will keep your body healthy and lower the risk of gum disease.

(This column is partly based on statements of the American Academy of Oral Medicine.)

If you would like more information about diabetes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Maintaining Good Health by Taking Care of Your Toothbrush | Alhambra Dentist

Most dentists agree you should change your toothbrush at least every two to three months. According to a recent report, “20 Things You Should Throw Away For Better Health” by TIME (1/30, Jones), a toothbrush is one of these things. The American Dental Association (ADA) spokesman, Ruchi Sohota, was quoted to say, “Toothbrush bristles start to fray after two months and should be replaced by three months”.

After daily wear, a toothbrush can get worn and become less effective in cleaning teeth and gums. Bacteria, germs and fungus can flourish in between the bristles. Putting a wet toothbrush in an enclosed case can cause mold to grow on it. Let your toothbrush dry before putting it a case.

It is very important to change your toothbrush after you have had a cold, flu, mouth infections, cold sores, and sore throat. This will help you from re-infecting yourself and others. Even if you are not sick, bacteria and fungus can still grow on your toothbrush.

Always rinse, shake any excess moisture, and air dry your toothbrush after you brush your teeth. Also try to keep your toothbrush away from any flushing commode because of germs that may travel with any aerosols.

Taking care of your tooth brush can help you have a healthier 2018!

If you would like more information about toothbrushes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

10 Fun Facts About Toothbrushes | Alhambra Dentist

1. When selecting your toothbrush, look for the ADA seal.

The ADA Seal of Acceptance is the gold standard for toothbrush quality. It’s how you’ll know an independent body of scientific experts, the ADA Council on Scientific Affairs, has evaluated your toothbrush to make sure bristles won’t fall out with normal use, the handle will stay strong and the toothbrush will help reduce your risk for cavities and gum disease.

2. The toothbrush is 5,000 years old.

In various forms, that is. Ancient civilizations used a “chew stick,” a thin twig with a frayed end, to remove food from their teeth. Over time, toothbrushes evolved and were made from bone, wood or ivory handles and stiff bristles of hogs, boar or other animals. The modern nylon-bristled toothbrush we use today was invented in 1938.

3. The first mass-produced toothbrush was invented in prison.

In 1770, an Englishman named William Addis was jailed for inciting a riot. He saw fellow prisoners using a rag covered in soot or salt to clean their teeth. Addis saved an animal bone from dinner and received bristles from a guard. Accounts state he bored tiny holes into the bone, inserted the bristles and sealed them with glue. After his release, he modified his prototype, started a company and manufactured his toothbrush. That company, Wisdom Toothbrushes, still exists in the United Kingdom today.

4. Manual or powered? Your teeth don’t care, if you do it right.

In the manual and powered toothbrush debate, it’s a wash. You just need to brush twice a day for two minutes with a fluoride toothpaste. Both types of toothbrushes can effectively and thoroughly clean your teeth. It all depends on which one you prefer. People who find it difficult to use a manual toothbrush may find a powered toothbrush more comfortable. Talk to your dentist about which kind is best for you. If you do decide to use a powered toothbrush, you must hold it with your fingers, like how you would hold a flute. Don’t hold it in the palm of your hand. Palming your power toothbrush is likely to cause excessive pressure on your teeth and gums.

5. There is no “correct” order for brushing and flossing.

Brushing before flossing, flossing before brushing – it doesn’t matter to your teeth, as long as you do both. However, be very careful not to cut your gums when you floss. Over-zealous flossing can cause spaces (dark triangles) to form between your teeth as well as gum recession.

6. Toothbrushes like to be left out in the open.

Cleaning your toothbrush is easy: rinse it with tap water to remove any remaining toothpaste and debris. Store it upright and allow it to air dry. If you store your toothbrush with other toothbrushes, make sure they are separated to prevent cross contamination. And do not routinely cover toothbrushes or store them in closed containers. A moist environment such as a closed container is more conducive to the growth of unwanted bacteria than the open air.

7. Lifespan = 3-4 Months

Make sure to replace your toothbrush every three to four months, or sooner if the bristles are frayed. A worn toothbrush won’t do as good of a job cleaning your teeth.

8. When it comes to choosing a brush, go soft.

Whether you use a manual or powered toothbrush, choose a soft-bristled brush. Firm or even medium-strength bristles may cause damage to your gums and enamel. When brushing your teeth, don’t scrub vigorously – only brush hard enough to clean the film off your teeth.

9. Remember: 2 minutes, 2 times a day.

Four minutes a day goes a long way for your dental health. Put the time in each day to keep your smile healthy and keep up this twice-a-day habit.

10. Sharing is caring, but not for toothbrushes.

Sharing a toothbrush can mean you’re also sharing germs and bacteria. This could be a particular concern if you have a cold or flu to spread, or you have a condition that leaves your immune system compromised.

If you would like more information about toothbrushes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Acetaminophen (Tylenol) and Ibuprofen (Advil) in Combination Better than One or the Other | Alhambra Dentist

For mild to moderate pain after surgery, patients are asked to take over-the-counter (OTC) pills. There are basically two kinds of OTC pills – one is represented by pain pills such as Tylenol and is called acetaminophen, the other is represented by Advil and is called ibuprofen.

For quite some time now many doctors have advised their patients to take both acetaminophen and ibuprofen together, in the belief that taken together brings about more relief from pain than just taking one kind. However, it has not been strongly established that this is true. An article reviewing various studies involving a total of 1909 patients published in the September issue of the Journal of the American Dental Association has concluded that taking acetaminophen (e.g., Tylenol) in combination with ibuprofen (Motrin or Advil) would be better for dental post-operative pain than taking only one or the other. In other words, if you take a Tylenol at the same time you taken an Advil, you would have better relief from pain from dental surgery than if you took just Tylenol or just Advil.

According to the author, Ferne Kraglund, D.D.S., these two kinds of over-the-counter pain pills “are widely available and inexpensive, with a well-established reputation for safety and efficacy” (effectiveness). This review of a number of very strident scientific studies, called randomized clinical trials, involving these 1909 patients showed that the combination of these two drugs effectively lowers pain intensity and decreases the need for higher dosage or the addition of other supplementary drugs.

Of course, you should only use these over-the-counter drugs at the direction of your dentist to make sure that it is safe and effective. Just as importantly, you need to be instructed by your dentist as to how much and under what circumstances you should take or not take these drugs.

The FDA recommends certain limits as to strength and daily dosage of these drugs. For example, each tablet of acetaminophen should contain no more than 325 milligrams, and the maximum dosage should not exceed 4000 mg per day. It is critical you follow your dentist’s instruction and contact them with any unusual reactions.

 

Bleachorexia: Excessive Teeth Whitening | Alhambra Dentist

Excessive, unsupervised teeth whitening, dubbed “Bleachorexia,” may lead to receding gums and oversensivity, according to a news segment on Good Morning America.  This TV program cited Dr. Laurence Rifkin who treated five-time World Boxing Council champion Mia St. John for “bleachorexia.” St. John “constantly” bleached her teeth to the point her dentist warned her that her teeth might turn to “mush.”  A good thing can become a bad thing, if overdone, said Dr. Rifkin. For that reason some dentists have coined a new term, “Bleachorexia,” to describe excessive, or obsessive preoccupation with teeth whitening.

Also interviewed on this show was Dr. Jen Ashton who quoted the position of the American Dental Association (ADA) with regard to teeth whitening. Dr. Ashton stated that teeth whitening should only be done after consultation and examination with your dentist.  Especially if you already have crowns, fillings or veneers on your teeth, you should be treated under the supervision of your dentist. The ADA warned that there is not enough evidence to support long-term, unsupervised and/or repeated use of bleaching products.  

When consulting with your dentist, it would be important to have the front teeth examined to determine whether there are fillings, crowns or veneers and their relative condition.  Should “leaky fillings” be replaced first to prevent bleaching agents from leaking through to the nerve? Would dark fillings be bleached as white as the teeth? Would these darker fillings be even more obvious when the teeth become whiter?  Crowns and fillings do not whiten. Would there be a contrast problem? Are the gums in good shape? If not, can inflamed gums be irritated and can they become painful if exposed to bleaching agents? These are the many questions to ask your dentist before you allow bleaching agents to be applied to your teeth.

The following is the ADA statement on teeth whitening:

“The ADA recommends that if you choose to use a bleaching product, you should only do so after consultation with a dentist. This is especially important for patients with many fillings, crowns, and extremely dark stains. A thorough oral examination, performed by a licensed dentist, is essential to determine if bleaching is an appropriate course of treatment. The dentist and patient together can determine the most appropriate treatment. The dentist may then advise the patient and supervise the use of bleaching agents within the context of a comprehensive, appropriately sequenced treatment plan … Patients should be cautioned that not enough information is available to support unsupervised long-term and/or repeated use of bleaching products.”

Nothing can be gained by bypassing your dentist and hygienist when you consider improving your teeth and your dental health by means not recommended by the ADA.

If you would like more information about teeth whitening, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.