Tuesday, September 25, 2012

Periodontal Disease and Diabetes

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Of the 20.8 million children and adults in the United States who have diabetes, nearly one-third are unaware that they have the disease.1  Recent research has suggested that periodontitis is often associated with diabetes and might be considered one of the chronic complications of the disease. A recent study consisting of over 200 subjects examined the relationship between diabetes and periodontitis. The results of the study indicate that subjects with diabetes had a greater level of periodontitis than subjects who did not have the disease.2


Important factors to consider in assessing the periodontal status of and formulating treatment plans for patients with diabetes include their degree of metabolic control, the duration of their disease, the presence of other long-term complications of diabetes, the presence of concurrent risk factors and their general level of well-being.
Photo Source
Emphasis should be placed on the reduction of the bacteria and elimination of the biofilm, both above and below the gumline. This can be accomplished with traditional scaling and root planing in addition to excellent home care. Treatment should focus on the prevention of periodontal disease and oral inflammation, which is essential in controlling the oral complications associated with diabetes. And, because we know that bacterial challenge is a risk factor for gingivitis among even healthy, well-controlled diabetic patients, patients should be encouraged to floss regularly and brush twice daily with a toothpaste that offers anti-bacterial protection.
© Copyright 2009 Colgate-Palmolive Company
References
1. American Diabetes Association.
2. J Periodontol Mar; 76(3):418-25.
Article Source: Coglate



David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037

Telephone: 858.558.1946
info@davidkitchendds.com

Tuesday, September 18, 2012

Illustrations: How A Tooth Decays

  1. Healthy Tooth
    Healthy Tooth
    Enamel is the hard outer crystal-like layer. Dentin is the softer layer beneath the enamel. The pulp chamber contains nerves and blood vessels and is considered the living part of the tooth.
  2. White Spots
    White Spots
    Bacteria that are exposed to sugars or carbohydrates can make acid, which attacks the crystal-like substance in the tooth's outer surface. This process is known as demineralization. The first sign of this is a chalky white spot. At this stage, the decay process can be reversed. Using fluorides at home and in the dental office can help the tooth repair itself.
  3. Enamel Decay
    Enamel Decay
    Demineralization continues. Enamel starts to break down. Once the enamel surface is broken, the tooth can no longer repair itself. The cavity has to be cleaned and restored by a dentist.
  4. Dentin Decay
    Dentin Decay
    The decay reaches into the dentin where it can spread and undermine the enamel.
  5. Pulp Involvement
    Pulp Involvement
    If decay is left untreated, it will reach the tooth's pulp, which contains nerves and blood vessels. The pulp becomes infected. An abscess (swelling) or a fistula (opening to the surface of the gum) can form in the soft tissues.
*Illustrations created by Simple Steps designer Lynda Buchhalter

Article Source: Colgate

David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037
Telephone: 858.558.1946
info@davidkitchendds.com

Tuesday, September 11, 2012

What Is Debridement? An Explanation.

What Is It?
Debridement is the removal of excessive amounts of plaque and tartar from your teeth.

What It's Used For

Debridement is done on people who have heavy plaque and tartar (calculus) build-up, usually because they haven't visited a dentist in several years. The plaque and tartar accumulation on the teeth is so heavy that your dentist can't see the teeth to examine them. Before he or she can do an exam, the plaque and tartar must be removed through debridement.

Preparation

Some people who are very sensitive to pain might need local anesthesia for this procedure. Others might require some form of sedation, such as nitrous oxide. Often, people who avoid the dentist have some form of dental phobia, so anesthesia or sedation may be necessary to make them comfortable.

How It's Done

Debridement is done with a combination of hand instruments and an ultrasonic device. This device uses water and high-frequency vibrations to dislodge plaque and tartar from the teeth.

Follow-Up

Debridement is usually the first phase of comprehensive periodontal treatment. After completing the debridement, your dentist will re-evaluate your teeth to determine the appropriate course of therapy, which may involve scaling and root planing or periodontal surgery.

Risks

If your gums are inflamed they can bleed during the procedure. In some cases, you may notice that your teeth are sensitive to temperature (hot and/or cold) after debridement. This occurs when the roots of the teeth are exposed following the removal of plaque and tartar.
Infection is possible after debridement, but it is very rare.

When To Call a Professional

Call your dentist if:
  • You have bleeding that doesn't stop
  • You think the area might be infected
  • You have excessive swelling or discharge from the area
  • Lymph nodes beneath your lower jaw or in your neck become swollen

Article Source and Video Source: Colgate and the ADA [video]


David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037
Telephone: 858.558.1946
info@davidkitchendds.com


Tuesday, September 4, 2012

Bad Breath and Its Relationship To Oral Systemic Diseases


“About 75 percent of bad breath or “halitosis” is caused by the mouth itself.  Other causes include gastric problems, sinus infections or severe gum disease,” says Mark Wolff, DDS, Ph.D., director of operative dentistry at the State University of New York at Stony Brook. One of the key successes in treating bad breath is determining the cause. Once your dental professional determines what the cause is then treatment for it can then begin (1).
Bad breath can be caused by the following:
    Photo Source
  • External factors – foods such as onions and garlic, beverages like coffee and alcohol, and smoking
  • Poor oral hygiene – where plaque and food debris is left on the teeth
  • Dentures – plaque and food debris can form on dentures, which need to be cleaned daily
  • Tonsils – cryptic areas (crevices) in the tonsils can allow food debris to become lodged in the tonsil area
  • Respiratory tract infections – throat, sinus and lung infections
  • Dry mouth (Xerostomia) – can be caused by salivary gland problems, medication, mouth breathing, radiation therapy and chemotherapy

Who Should You See If You Have Bad Breath?

If you believe your diet is causing bad breath, then consult with a dietician or nutritionist who can work with you to modify your diet. If you have poor oral hygiene and are suffering from gingivitis (inflammation of the gum tissue in your mouth) or have periodontal disease (bone loss around the teeth sometimes referred to as “pyorrhea”), consult your dentist and periodontist and work with your dental hygienist to improve gingivitis and thorough oral hygiene instruction at home. The tonsils and respiratory infections will need to be followed by your physician or a specialist such as an ear, nose and throat physician or pulmonologist. A large majority of people in the United States are suffering from dry mouth due to medications they may be taking, salivary gland dysfunction and those who may be going through radiation and chemotherapy treatment for cancer therapy. Please consult your oral maxillofacial surgeon, your physician or oncologist for their professional recommendations for prescription or over-the-counter products that can alleviate dry mouth symptoms. Those patients who are diabetics, have liver or kidney conditions, and gastrointestinal disorders should see their physician, urologist or gastroenterologist for their insights on how bad breath can be reduced regarding these systemic diseases. Contact your dentist office for a recommendation of which dental or medical professional you should see for your bad breath condition.

Article Source: Colgate


David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037
Telephone: 858.558.1946
info@davidkitchendds.com