Is there another way I can have a tooth replaced other than a bridge?
Yes. Dental implants can provide artificial teeth that look natural and feel secure. Dental implants can also be used to attach full or partial dentures. Implants, however, are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, have adequate bone to support the implant and be committed to meticulous oral hygiene and regular dental visits. If you are considering implants, a thorough evaluation by your dentist will help determine if you would be a good candidate.
What is involved in placing implants?
First, surgery is performed to place the anchor. Surgery can take up to several hours, and up to six months may be required for the bone to grow around the anchor and firmly hold it in place. Some implants require a second surgery in which a post is attached to connect the anchor to the replacement teeth. With other implants, the anchor and post are already attached and are placed at the same time.
After the gums have had several weeks to heal, the next step is begun. The artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step can take one to two months to complete.
Implant surgery can be done either in a dental office or in a hospital, depending upon a number of factors. A local or general anesthetic may be used. Usually pain medications and, when necessary, antibiotics are prescribed. Your dentist will give you instructions on diet and oral hygiene.
What information do I need to give my dentist about my diabetes?
It's important to keep your medical records up-to-date. Let your dentist know:
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What oral health problems
can be associated with diabetes?
The most common oral health problems associated with diabetes are:
What should I know about diet and tooth decay?
Your teeth are covered with plaque, a sticky film of bacteria. After you have a meal, snack or beverage that contains sugars or starches, the bacteria release acids derived from dietary sugars that attack tooth enamel. Repeated attacks can cause the enamel to break down and may eventually result in cavities.
When diabetes is not controlled properly, high glucose levels in saliva may help bacteria thrive. Brushing twice a day with fluoride toothpaste and cleaning once a day between your teeth with floss or an interdental cleaner helps remove decay-causing plaque.
Plaque that is not removed can eventually harden (calcify) into calculus, or tartar. When tartar collects above the gumline, it becomes more difficult to thoroughly brush and clean between teeth. This can create conditions that lead to chronic inflammation and infection in the mouth.
Is there a connection between diabetes and periodontal (gum) disease?
Because diabetes reduces the body's resistance to infection, the gums are among the tissues likely to be affected. Periodontal diseases are infections of the gum and bone that hold your teeth in place.
Periodontal disease is often linked to the control of diabetes. For example, patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than persons who have good control of their diabetes. It is possible to have periodontal disease and not have all of the warning signs. If you notice any of the warning signs of gum disease, see your dentist immediately.
Because of lowered resistance and a longer healing process, periodontal diseases often appear to be more frequent and more severe among persons with diabetes. That's why good maintenance of blood sugar levels, a well-balanced diet that meets your needs, good oral care at home, regular dental checkups and periodontal examinations are important.
What else can I do to help prevent oral health problems?
Preventive
oral health care, including professional cleanings at the
dental office, is important if you are to control the progression
of periodontal disease and other oral health problems. Regular
dental checkups and periodontal screenings are important for
evaluating overall dental health and for treating dental problems
in their initial
stages. Your dentist may recommend more frequent evaluations
and preventive procedures, such as teeth cleaning, to maintain
good oral health.
What should I do if my mouth frequently feels dry?
Saliva helps wash away food particles and keeps the mouth moist. Without adequate saliva, bacteria continue to colonize. Xerostomia, or dry mouth, is a common complaint among diabetic dental patients and patients undergoing radiation of the head and neck for cancer therapy. Constant dryness irritates the soft tissues in the mouth, often making them inflamed and painful. This condition greatly increases the risk of tooth decay and periodontal diseases.
Your dentist may recommend a saliva substitute that can be used for relief from dry mouth discomfort. Your dentist may also recommend rinsing with a fluoride mouthrinse or having a topical application of fluoride at home and in the dental office to help prevent rampant tooth decay. These products are sold over-the-counter at pharmacies.
Using sugarless gum, sugarless mints, taking frequent sips of water or using melting ice chips may help alleviate a dry mouth. Restricting intake of caffeine and alcohol also can help.
What other some other oral conditions that can be associated with diabetes?
Oral candidiasis, a fungal infection in the mouth, appears to occur more frequently among persons with diabetes including those who wear dentures. Your dentist may prescribe antifungal medications to treat this condition. Good oral hygiene is critical.
Lichen planus is a skin disorder that produces lesions in the mouth. A more severe type of Lichen planus involves painful ulcers that erode surface tissue. Although there is no permanent cure, your dentist may prescribe a topical anesthetic or other medication to reduce and relieve the condition.
Some diabetics have reported that their taste for sweets is diminished, although the taste impairment is usually not severe. Altered taste sensations, barely perceptible to most diabetic patients, may influence their food choices in favor of sweet tasting foods with highly refined carbohydrate content. This may worsen the diabetic patient's dental health and overall health.
Infection is a risk for the diabetic patient and can make it more difficult to control blood glucose levels. If you are having extensive oral surgery, your dentist may prescribe antibiotics to minimize the risk of infection. To help the healing process, keep your blood glucose levels under control before, during and after surgery.
What effects can smoking have on my oral health?
Use of any tobacco product can increase your risk of developing oral cancer and gum disease (periodontal disease).
Tobacco products damage your gum tissue by affecting the attachment of bone and soft tissue to your teeth. An example of the effect is receding gums. A receding gum line exposes the tooth roots and increases your risk of developing a sensitivity to hot and cold, or tooth decay in these unprotected areas.
Smoking can delay healing after a tooth extraction or other oral surgery.
Smoking also can contribute to bad breath, stains on your teeth and tongue, and a build-up of tartar on your teeth.
Are cigars a safe alternative to cigarettes?
Cigars are not a safe alternative to cigarettes. Even if you do not inhale cigar smoke, you are still at risk for oral and pharyngeal (throat) cancers.
Like cigarette smokers, cigar smokers are at increased risk for periodontal (gum) disease, a leading cause of tooth loss.
In addition to the health risks, cigar smoke (and cigarette smoke) can cause staining of the teeth and tongue as well as bad breath.
Are smokeless tobacco products safe?
Like cigars and cigarettes, smokeless tobacco products contain a variety of toxins associated with cancer. At least 28 cancer-causing chemicals have been identified in smokeless tobacco products.
Smokeless tobacco can irritate your gum tissue, causing it to recede or pull away from your teeth. Once this gum tissue recedes, the roots of your teeth are exposed, increasing your risk for tooth decay. The roots of your teeth also may become sensitive to hot and cold or other irritants, which means you could experience some discomfort when eating or drinking.
Sugars, often added to enhance the flavor of smokeless tobacco, can increase your risk for tooth decay. Smokeless tobacco also typically contains sand and grit, which can wear down your teeth.
What are some signs of oral cancer?
Signs and symptoms that could indicate oral cancer include:
Yes. Dental amalgam has been used in tooth restorations worldwide for more than 100 years. Studies have failed to find any link between amalgam restorations and any medical disorder. Amalgam continues to be a safe restorative material for dental patients.
Is it possible to have an allergic reaction to amalgam?
Only
a very small number of people are allergic to amalgam fillings.
Fewer than 100 cases have ever been reported. In these rare
instances, mercury may trigger an allergic response. Symptoms
of amalgam allergy are very similar to a typical skin allergy.
Often patients who are truly allergic to amalgam have a medical
or family history of allergies to metals. If there is a confirmed
allergy, another restorative material will be used.
Is it true that dental amalgams have been banned in other countries?
No. Erroneous news reporting has confused restrictions in a few countries with outright bans. Dentists around the world are using dental amalgams (silver fillings) to restore teeth that have dental decay. Studies have not shown a link between dental amalgam and any medical disorder.
Is there a filling material that matches tooth color?
Yes. Composite resins are tooth-colored, plastic materials (made of glass and resin) that are used both as fillings and to repair defects in the teeth. Because they are tooth-colored, it is difficult to distinguish them from natural teeth. Composites are often used on the front teeth where a natural appearance is important. They can be used on the back teeth as well depending on the location and extent of the tooth decay. Composite resins are usually more costly than amalgam fillings.
If my tooth doesn't hurt and my filling is still in place, why would the filling need to be replaced?
Constant pressure from chewing, grinding or clenching can cause dental fillings, or restorations, to wear away, chip or crack. Although you may not be able to tell that your filling is wearing down, your dentist can identify weaknesses in your restorations during a regular check-up.
If the seal between the tooth enamel and the restoration breaks down, food particles and decay-causing bacteria can work their way under the restoration. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to infect the dental pulp and may cause an abscess.
If the restoration is large or the recurrent decay is extensive, there may not be enough tooth structure remaining to support a replacement filling. In these cases, your dentist may need to replace the filling with a crown.
Tooth decay is a destruction of the tooth enamel. It occurs when foods containing carbohydrates (sugars and starches) such as milk, pop, raisins, cakes or candy are frequently left on the teeth. Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.
You can help prevent tooth decay by following these tips:
Aren't Cavities Just Kid's Stuff?
No. Changes that occur with aging make cavities an adult problem, too. Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. The majority of people over age 50 have tooth-root decay.
Decay around the edges, or margins, of fillings is also common to older adults. Because many older adults lacked benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.