YouCanHaveaSuccessfulImplantOutcomeifYourDiabetesisUnderControl

Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.

There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.

Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.

Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.

An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.

But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.

Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).

The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.

So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.

If you would like more information on diabetes and 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 “Dental Implants & Diabetes.”

By M. Kenneth Johnson, DMD, PA
July 19, 2021
Category: Oral Health
Tags: dental injury  
HowNottoLetaDentalInjuryRuinYourSummerVacation

After a year of lockdowns and other COVID-19 restrictions, people are itching this summer to get back out into the great outdoors. The good news is that quite a number of national and state parks are open. But there may still be some restrictions, and you might need reservations in busier parks. The key is to plan ahead—and that includes for normal contingencies like dental emergencies.

Anyone who's physically active can encounter brunt force to the face and jaws. A tumble on a hike or a mishap with a rental bike could injure your teeth and gums, sometimes severely. But if you're already prepared, you might be able to lessen the damage yourself.

Here's a guide for protecting your family's teeth during that long-awaited summer vacation.

Locate dental and medical care. If you're heading away from home, be sure you identify healthcare providers (like hospitals or emergency rooms and clinics) in close proximity to your vacation site. Be sure your list of emergency providers also includes a dentist. Besides online searches, your family dentist may also be able to make recommendations.

Wear protective mouth gear. If your vacation involves physical activity or sports participation, a mouthguard could save you a world of trouble. Mouthguards, especially custom-made and fitted by a dentist, protect the teeth, gums and jaws from sudden blows to the face. They're a must for any activity or sport with a risk of blunt force trauma to the face and jaws, and just as important as helmets, pads or other protective gear.

Know what to do for a dental injury. Outdoor activities do carry a risk for oral and dental injuries. Knowing what to do if an accident does occur can ease discomfort and may reduce long-term consequences. For example, quickly placing a knocked out tooth back into its socket (cleaned off and handled by the crown only) could save the tooth. To make dental first aid easier, here's a handy dental injury pocket guide (//www.deardoctor.com/dental-injuries/) to print and carry with you.

And regardless of the injury, it's best to see a dentist as soon as possible after an accident. Following up with a dentist is necessary to tidy up any initial first aid, or to check the extent of an injury. This post-injury dental follow-up will help reduce the chances of adverse long-term consequences to the teeth and gums.

Your family deserves to recharge after this tumultuous year with a happy and restful summer. Just be sure you're ready for a dental injury that could put a damper on your outdoor vacation.

If you would like more information about preventing or treating dental injuries, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “An Introduction to Sports Injuries & Dentistry.”

By M. Kenneth Johnson, DMD, PA
July 09, 2021
Category: Oral Health
Tags: oral hygiene  
ManagingOralHealthIsanImportantPriorityforHIV-AIDPatients

Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.

The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").

Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.

The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.

Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.

Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.

It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.

Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.

If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”

By M. Kenneth Johnson, DMD, PA
June 29, 2021
Category: Dental Procedures
Tags: celebrity smiles   retainer  
TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here. ¬†And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

By M. Kenneth Johnson, DMD, PA
June 19, 2021
Category: Oral Health
Tags: tooth pain  
Where-andHow-DoesitHurtGettingtotheSourceofToothPain

Although toothaches are common, not all tooth pain originates from the same source. But regardless of its cause, you need to take prompt action to find out and begin treatment.

Sensitive teeth, for example, usually cause a quick stab of pain when you eat or drink something hot or cold or when you bite down. If the pain lasts only a second or two, you may have a small area of decay in a tooth, a loose filling or an exposed root. The latter often occurs either because of over-aggressive brushing or periodontal (gum) disease. In both cases, the gums may have shrunk back or receded to expose the root surface.

A sharp pain when biting down may be a sign of decay or a loose filling; it could also mean you have a fractured or cracked tooth. For any of those causes, you'll need treatment to repair the problem and relieve the pain.

You may also experience a lingering tooth pain ranging from dull to sharp, or localized to one tooth or seeming to radiate from a general area, such as above the upper jaw. There are a number of possible causes, but two prominent ones are an abscess (a localized area of infection that's become inflamed) or deep decay within the pulp, the heart of a tooth.

This usually calls for a root canal treatment for the affected tooth. In this procedure we drill an access hole into the pulp and clear it of infected and dead tissue. We then fill the empty pulp chamber and root canals with a special filling and seal the access hole. Later, we bond a permanent artificial crown to the tooth to further protect it from re-infection.

Whether your pain is momentary or lingering, dull or sharp, you should see us as soon as possible to determine its cause. You should still see us even if sharp, lingering pain goes away — this could simply mean the infected nerves in the pulp have died but not the infection. The sooner you have the cause of your pain treated, the better your chances of a happy and less costly outcome.

If you would like more information on tooth pain and what to do about it, 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 “Tooth Pain? Don't Wait!





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