Diabetes is a chronic inflammatory group of diseases that affects your body’s ability to process sugar. If you have diabetes, you are more prone to infections, so it is extremely important that you maintain good oral health through a combination of home care and professional dental visits.
There is some evidence that “acetone breath” might be an early sign of diabetes—your physician or dentist may notice this at a check-up.
If your child has Type 1 diabetes (diabetes mellitus) he or she is considered to be at higher risk for dental decay (cavities) than the general population. One possible reason for this is having to give sugar or juice for overnight glycemic (sugar) control and not cleaning your child’s teeth afterward.
One study found children with Type 1 Diabetes had higher plaque indexes and higher gingival indexes than children without diabetes. This may indicate that gum problems in diabetics begin at an earlier age than previously thought.
As you get older, gum problems are called gum disease or periodontal disease. (This is an example of being more likely to develop infections because periodontal disease is caused by bacterial toxins that inflame and irritate your gums.)
Gum disease can make it harder for you to control your blood sugar levels. Uncontrolled blood sugar increases your risk of complications such as heart issues or kidney problems. At the same time, your blood sugar levels and diabetes make it harder for your body to heal itself, making it harder for your gums to heal from the effects of gum disease.
You can learn more about how diabetes affects your mouth here:
The best way to avoid the problems of gum disease is to never develop them in the first place. Your dentist can help you with this by removing hard deposits that trap bacteria near your gums—deposits that you can’t remove with your toothbrush and dental floss. Some insurances allow an extra cleaning each year if you are diabetic—if so, you may want to take advantage of it and have the third one at regularly spaced intervals (usually every 4 months instead of every 6 months). Your dental office can check if this is the case for you and advise if you or your child would benefit from the extra cleaning. If you do not have a dentist, we invite you to join our office by calling 440-960-1940.
Dr. Jennifer Robb is a general dentist who sees children and adults at her office located at 1612 Cooper Foster Park Rd., Lorain, OH 44053. Phone: 440-960-1940
A lot happens in your child’s mouth from infancy to early adulthood. Not surprisingly, it’s the most active period for development of teeth, gums and jaw structure. Our primary goal as care providers is to keep that development on track.
One of our main concerns, therefore, is to protect their teeth as much as possible from tooth decay. This includes their primary (“baby”) teeth: although your child will eventually lose them, a premature loss of a primary tooth to decay could cause the incoming permanent tooth to erupt out of proper position. And we of course want to protect permanent teeth from decay during these developmental years as well.
That’s why we may recommend applying topical fluoride to your child’s teeth. A naturally occurring chemical, fluoride helps strengthen the mineral content of enamel. While fluoride can help prevent tooth decay all through life, it’s especially important to enamel during this growth period.
Although your child may be receiving fluoride through toothpaste or drinking water, in that form it first passes through the digestive system into the bloodstream and then to the teeth. A topical application is more direct and allows greater absorption into the enamel.
We’ll typically apply fluoride in a gel, foam or varnish form right after a professional cleaning. The fluoride is a much higher dose than what your child may encounter in toothpaste and although not dangerous it can cause temporary vomiting, headache or stomach pain if accidentally swallowed. That’s why we take extra precautions such as a mouth tray (similar to a mouth guard) to catch excess solution.
The benefits, though, outweigh this risk of unpleasant side effects, especially for children six years or older. Several studies over the years with thousands of young patients have shown an average 28% reduction in decayed, missing or filled teeth in children who received a fluoride application.
Topical fluoride, along with a comprehensive dental care program, can make a big difference in your child’s dental care. Not only is it possible for them to enjoy healthier teeth and gums now, but it could also help ensure their future dental health.
If you would like more information on topical fluoride and other dental disease prevention measures, 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 “Fluoride Gels Reduce Decay.”
Do you dislike the color of your teeth? Perhaps so much so that you avoid having your picture taken or don’t smile very often in real life. If so, you should be aware that you do have options to change the color of your teeth (or even the shape of your teeth).
If you like the shape of your teeth and only feel that the color is off, you can try whitening your teeth (sometimes called bleaching your teeth). There are several ways to do this, but doing it through your dental office is your best bet because your dentist can buy different materials than just what is available on store shelves.
Some whitening trays come preloaded with material and are used in a similar fashion to the ones you can buy at the store. Once you’ve used the tray, you throw it out. The plus side is that it’s ready to go with little fuss, but the down side is you have to keep buying the entire product as you want to touch up—and they often come in a multiple pack with more or less than you may need.
Your dentist can also make custom whitening trays for you that fit to your teeth. With these, you load the material into the tray, wear it, then take it out and clean the used material out of it and store it so it is ready to use the next time. With care, these trays can last a long time, so the only thing you will have to buy is the material to put in the trays.
Your dentist can also do whitening in-office. This type of whitening usually shows the fastest results, but because we have to keep your lips and cheeks away from the whitening material, your teeth dry out during the procedure. As your saliva rewets your teeth, the teeth often appear darker. (Think of putting a pair of jeans in your washer. When you take them out to put them into the dryer they often look darker than they do when they are dry and ready to wear.) You may think your teeth look really great just after the procedure and feel like the color fades a bit within a day or so (and be disappointed), so some people opt to do the custom tray take home whitening after their in office whitening to try to keep the lighter tooth color.
For all whitening, we are constrained by the underlying color of your teeth—so if you have naturally dark gray teeth, you may never achieve the “paper white” color or be able to pass the “tissue test” one commercial uses to hawk its product, with tooth whitening alone.
If the whitening doesn’t get your teeth light enough for your taste or if you also don’t like the shape of your teeth, you can move into cosmetic dentistry to achieve the smile of your dreams. Cosmetic dentistry can be as simple as bonding material over the visible part of your tooth or as complex as having the dental lab make crowns, caps, or veneers for your teeth. The color and shape are more controllable with lab made options. Crowns go all the way around your tooth. Veneers are like a fake fingernail that is bonded to the side of your tooth that is visible when you smile. In many cases, your dentist can take impressions and have the dental lab wax up a cosmetic model that will give you an idea of what is possible for your smile. (There may be a charge for this.) Another option would be a removable cosmetic device such as a Snap On Smile that fits over your own teeth. The Snap On Smile product also allows you to eat with it in, while some other ones are for looks only and eating with them is not recommended.
So if you’re not happy with the color of your teeth, start exploring the options with your dentist. If you do not have a dentist, Dr. Robb would be happy to examine your mouth and discuss which options would work best for you. You can learn more about many of these dental procedures in the patient education section of Dr. Robb’s website at www.drjrobb.com
Dr. Jennifer Robb is a general dentist with an office at 1612 Cooper Foster Park Rd., Lorain, OH 44053. Call 440-960-1940 to reserve your appointment!
Fluoride is a naturally occurring mineral that is absorbed by your teeth as they are forming. It can also help prevent tooth decay by re-mineralizing and strengthening your tooth enamel. Fluoride helps reduce the chance of cavities. I often call it “vitamins for your teeth” to explain it to child patients.
Fluoride is added to most city water. Well water levels vary. Most bottled waters do not contain fluoride. If your water supply does not have fluoride, you may want to talk to your dentist about a fluoride supplement. You can also switch to a bottled water that contains fluoride or use a fluoride gel or rinse at home.
Fluoride is in toothpaste: Pediatric dentists recommend fluoride toothpaste be used for all children. Use a tiny smear for children less than 3 years old and a pea size amount for 3 years and up. Do not rinse after brushing for better fluoride effect. Prescription toothpastes with higher fluoride levels are available for those who tend to get many cavities.
In the dental office, fluoride is available as a liquid (similar to mouthwash), gel, foam, or varnish. No matter what type, it is applied directly to your teeth. For use outside the dental office, rinses and gels are available over the counter. Prescription types are also available with a prescription from your dentist. We’ll talk a bit about these later in this article.
Though you may be tempted to think “if some fluoride is good, more fluoride is better”, too much fluoride during tooth development can cause a condition called fluorosis (a pattern that looks like spots develops on the teeth). Swallowing too much fluoride at one time can cause tummy upset.
Fluoride Varnish is available at the dental office. It is applied with a small brush and hardens when saliva contacts it. It is well tolerated by infants and young children and has a prolonged therapeutic effect because it stays in contact with the teeth for several hours (if directions are followed). It is recommended to have it applied every 3 months by a dental professional starting with presence of the first tooth. Realistically, our expectation is once every 6 months –and some kids will only get it once a year because parents go with “what insurance covers” or never because they don’t take kids to a dentist until around age 4.
Fluoride foams and gels are available at the dental office. Gels are also available for home use. In the dental office, the foam or gel is placed into a disposable tray and placed over the teeth for 1 to 4 minutes (depending on the type of fluoride). You can spit or suction your mouth out afterward, but for best results, you should not eat, drink, or rinse your mouth for 30 minutes afterward. Gels for home use can be placed into a custom made tray or just brushed on your teeth. As with the ones used in the office, it is recommended that you not eat, drink, or rinse your mouth for about 30 minutes after applying the fluoride gel to your teeth.
Fluoride rinses seem to be rarely used as a fluoride treatment in the dental office these days. (When they were used, they tended to have the advantage of allowing the person to rinse their mouth after the treatment.) Off the shelf (also called over the counter) fluoride rinses have a lower level of fluoride than toothpastes. Because of the lower amount, the effect of these rinses is somewhat limited. Kids under age 6 have a limited ability to rinse and spit which could lead to too much fluoride being swallowed, so these rinses are not recommended until a child can reliably rinse and spit.
Fluoride Supplements are usually only used if your child routinely drinks water that is not fluoridated and are usually not needed until 6 months old at the earliest.
In the end, though most dentists recommend fluoride treatments, whether or not you, or your child, get them is a decision you should make with your or your child’s dentist based on each unique situation.You can learn more about Fluoride by clicking on the word link in this sentence in order to make your informed decision!
Dr. Jennifer Robb is a general dentist who sees children and adults at her office located at 1612 Cooper Foster Park Rd., Lorain, OH 44053. Call 440-960-1940 to reserve your seat! www.drjrobb.com www.facebook.com/drjenniferrobb
There's more to your dental visit than preventing or treating teeth or gum problems. We're also on the lookout for a number of potential soft tissue problems that could occur in or around your mouth.
Here are 4 examples of such problems we can detect and help you manage.
Lumps. Whenever you accidentally bite the inside of your mouth, the wound you create forms a protective layer of hard collagen. Unfortunately, the “callous” can rise higher than the surrounding cheek surface and easily get in the way of your teeth again. With successive bites and more scar tissue you'll soon notice a prominent lump. Although not a health danger, it becomes annoying with each successive bite. We can surgically remove the lump and flatten out the mouth surface.
Canker sores. Known as aphthous ulcers, these round sores with a yellow-gray center and a red “halo” can break out on the inside cheeks, tongue or back of the throat. Unless they don't heal within a couple of weeks or seem to be increasing in frequency, they're nothing to worry about. They can, however, cause a burning or stinging sensation. We can reduce this discomfort and speed healing with over-the-counter ointments or prescription options like topical or injected steroids.
Cracked mouth corners. Also known as perleche (from the French lecher, meaning “to lick”), your mouth corners can become dry and irritated and you may begin licking them to soothe the discomfort. Accumulated saliva can trigger a yeast infection, which can spread to other parts of your mouth. We can usually prevent this by prescribing antifungal ointments, and a steroid ointment to control inflammation.
Mouth rash. Peri-oral dermatitis is a red, scaly rash that appears around the outside of the mouth. Because it's often mistaken for acne or other conditions, it's often treated with topical steroids. This actually suppresses the skin's normal healing effects and can actually make the rash worse. The best way to treat it is to stop using any kind of ointment or cream and use only mild soap to wash the area. We can also prescribe antibiotics to help speed the healing process.
If you would like more information on these and other soft tissue problems, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Lumps and Bumps in the Mouth,” “Mouth Sores,” and “Cracked Corners of the Mouth.”
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