The more severe form of gum disease is called periodontitis. When you reach this stage, your gums begin to pull away from your teeth. Pockets form between your teeth and gums. These fill with germs and pus, and deepen. When this happens, you may need gum surgery to save your teeth. If nothing is done, the infection goes on to destroy the bone around your teeth. The teeth may start to move or get loose. Your teeth may fall out or need to be pulled.
For the nearly 24 million Americans that have diabetes, many may be surprised to learn about an unexpected complication associated with this condition. Research shows that there is an increased prevalence of gum disease among those with diabetes, adding serious gum disease to the list of other complications associated with diabetes, such as heart disease, stroke and kidney disease.
Emerging research also suggests that the relationship between serious gum disease and diabetes is two-way. Not only are people with diabetes more susceptible to serious gum disease, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes. Research suggests that people with diabetes are at higher risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease). People with diabetes are at an increased risk for serious gum disease because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums.
The Surgeon General's Report on Oral Health states that good oral health is integral to general health. So be sure to brush and floss properly and see your dentist for regular checkups.
If your blood glucose levels are poorly controlled, you are more likely to develop serious gum disease and lose more teeth than non-diabetics. Like all infections, serious gum disease may be a factor in causing blood sugar to rise and may make diabetes harder to control.
Other oral problems associated to diabetes include: thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness, ulcers, infections and cavities.
First and foremost, control your blood glucose level. Then, take good care of your teeth and gums, along with regular checkups every six months. To control thrush, a fungal infection, maintain good diabetic control, avoid smoking and, if you wear them, remove and clean dentures daily. Good blood glucose control can also help prevent or relieve dry mouth caused by diabetes.
People with diabetes have special needs and your dentist and hygienist are equipped to meet those needs - with your help. Keep your dentist and hygienist informed of any changes in your condition and any medication you might be taking. Postpone any non-emergency dental procedures if your blood sugar is not in good control.
Breast cancer patients, individuals at risk for osteoporosis, and individuals undergoing certain types of bone cancer therapies often take drugs that contain bisphosphonates. These drugs may place patients at risk for developing osteonecrosis of the jaws (a rotting of the jaw bones), according to the May/June issue of General Dentistry.
Bisphosphonates are a family of drugs used to prevent and treat osteoporosis, multiple myeloma, Paget's disease (bone cancers), and bone metastasis from other cancers. These drugs can bond to bone surfaces and prevent osteoclasts (cells that breakdown bone) from doing their job.
Healthy bones constantly rebuild themselves. The jawbones have rapid cell turnover and can fail to heal properly in patients taking any of the bisphosphonate drugs.
Patients taking the drugs need to be aware of the possibility of complications from dental surgery or extractions. These drugs linger in the bone indefinitely and may upset the cell balance in how the jaws regenerate and remove unhealthy bone.
An example is a women who received bisphosphonate therapy intravenously to treat metastic cancer. She then developed osteonecrosis in her upper and lower jaws following tooth removal. This type of osteonecrosis has been occuring since the advent of these drugs.
At this time osteonecrosis as a result of bisphosphonate therapy has no treatment.
Patients who are taking these drugs should inform their dentist to prevent complications from dental surgical procedures.
It is strongly recommended that patients scheduled to receive bisphosphonate therapy should visit a dentist or an oral surgeon so problematic teeth can be treated prior to the start of therapy.
Widespread use of bisphosphonates to prevent or treat early osteoporosis in relatively young women and the likelihood of long term use is a cause for concern.
How bisphosphonates interfere with healing after dental surgery is still unclear and further research will be needed. It is imperative that the public understands there is no present treatment or cure for this problem.
Reduced saliva flow that results in a dry mouth is a common problem among older adults. It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.
Some of the common problems associated with dry mouth include a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages. Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive decay can occur.
Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.
Dry mouth is a potential side effect of numerous medications (prescribed and over-the-counter). Among them are antihistamines, decongestants, painkillers, high blood pressure medications, muscle relaxants, drugs for urinary incontinence, Parkinson's disease medications, antidepressants and many others. Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection.
Without the cleansing effects of saliva, tooth decay and other oral health problems become more common. Patients using oral inhalers for asthma often develop oral candidiasis, an oral fungal infection, and are encouraged to rinse their mouths with water after using the inhaler.
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