Diabetes and Your Smile

By Laura Martin, Case Western Reserve University School of Dental Medicine

Did you know that 29.1 million people living in the United States have diabetes? That’s 9.3% of the population. Approximately 1.7 million new cases are diagnosed each year—and 8.1 million people living with diabetes don’t even know they have it.

Diabetes affects your body’s ability to process sugar. All food you eat is turned to sugar and used for energy.

- In Type I diabetes, the body doesn’t make enough insulin, a hormone that carries sugar from your blood to the cells that need it for energy.

-In Type II diabetes, the body stops responding to insulin. Both cases result in high blood sugar levels, which can cause problems with your eyes, nerves, kidneys, heart and other parts of your body.

So what does this have to do with that smile of yours — and how can you protect it? First, it’s important to understand the signs of diabetes and the roles they play in your mouth.

The Symptoms of Untreated Diabetes

The warning signs of diabetes affect every part of your body. After a blood test, you may be told by a doctor that you have high blood sugar. You may feel excessively thirsty or have to urinate a lot. Weight loss and fatigue are other common symptoms. Diabetes can also cause you to lose consciousness if your blood sugar falls too low.

If diabetes is left untreated, it can take a toll on your mouth as well.

Here's how:

*You may have less saliva, causing your mouth to feel dry. (Dry mouth is also caused by certain   medications.)
*Because saliva protects your teeth, you’re also at a higher risk of cavities.
*Gums may become inflamed and bleed often (gingivitis).
*You may have problems tasting food.
*You may experience delayed wound healing.
*You may be susceptible to infections inside of your mouth.
*For children with diabetes, teeth may erupt at an age earlier than is typical.

Why People with Diabetes Are More Prone to Periodontal (Gum) Disease

All people have more tiny bacteria living in their mouth now than there are people on this planet. If they make their home in your gums, you can end up with periodontal disease. This chronic, inflammatory disease can destroy your gums, all the tissues holding your teeth and even your bones.

Periodontal disease is the most common dental disease affecting those living with diabetes, affecting nearly 22% of those diagnosed. Especially with increasing age, poor blood sugar control increases the risk for gum problems.  In fact, people with diabetes are at a higher risk for gum problems because of poor blood sugar control. As with all infections, serious gum disease may cause blood sugar to rise. This makes diabetes harder to control because you are more susceptible to infections and are less able to fight the bacteria invading the gums.

How Your Dentist Can Help You Fight Diabetes

Regular dental visits are important. Research suggests that treating gum disease can help improve blood sugar control in patients living with diabetes, decreasing the progression of the disease. Practicing good oral hygiene and having professional deep cleanings done by your dentist can help to lower your HbA1c. (This is a lab test that shows your average level of blood sugar over the previous three months. It indicates how well you are controlling your diabetes.)

Your Diabetes Dental Health Action Plan

Teamwork involving self-care and professional care from your dentist will be beneficial in keeping your healthy smile as well as potentially slowing progression of diabetes.

Here are  things you can do to for optimal wellness:

*Control your blood sugar levels by using your diabetes-related medications as directed.
* Changing to a healthier diet and exercising more can help. Good blood sugar control will also help your body fight any bacterial or fungal infections in your mouth and help relieve dry mouth caused by diabetes.
*Avoid smoking.
*If you wear any type of denture, clean it each day.
*Make sure to brush twice a day with a soft brush and floss correctly daily.
*See your dentist for regular checkups.

This artical first appeared in mouthhealthy.org

Healthy Habits Adults Over 60

Brush and Floss Daily

Brushing and flossing your teeth is just as important for you as it is for your grandchildren. Even though it may have been years since you've had a cavity, your risk of cavities increases with age. One of the reasons is dry mouth—a common side effect of many prescription medications.

Brush your teeth twice a day with fluoride toothpaste. Choose a toothbrush with soft bristles and a small head to get to those hard to reach areas. Replace your toothbrush every three or four months, or sooner if the bristles becomes frayed. If you have arthritis or other condition that limits movement, try an electric toothbrush.

Clean between teeth daily with floss. If floss is too difficult to work with, try a floss pick or tiny brushes made specifically to clean between teeth.

When you’re buying oral care products, look for the ADA Seal of Acceptance. The ADA Seal has been around since 1931, and when you see it on a package you can trust that the product is safe and does what the manufacturer advertises.


Clean Dentures Daily 
Bacteria stick to your teeth and also to full or partial dentures. If you wear dentures, remember to clean them on a daily basis with cleaners made specifically for dentures. Do not use toothpastes for natural teeth or household cleaners, which are too abrasive and can damage dentures that can be expensive to replace.
Take your dentures out of your mouth for at least four hours every 24 hours to keep the lining of your mouth healthy. It’s best to remove your full or partial dentures at night. Your dentist will provide you with instructions about how long your dentures should be worn each day.

Visit a Dentist Regularly

Get regular dental checkups at least once a year – please do not wait until you have pain. Why? As you age, the nerves inside your teeth become smaller and less sensitive. By the time you feel pain from a cavity, it may be too late and you may lose your tooth. There are also more serious conditions that your dentist will look for, like oral cancer and gum disease, which do not always cause pain until the advanced stages of the disease. By then, it’s more difficult and costly to treat.
When you go to your dentist for a check-up bring the following information:

List of medications, including vitamins, herbal remedies, and over-the-counter medications
List of medical conditions and allergies
Information and phone numbers of all health care providers, doctors, and your previous dentist
Information about your emergency contacts, someone who can help make decisions on your behalf in the case of a medical emergency
Dental insurance or Medicaid cards
Your dentures or partials, even if you don’t wear them
Be sure to talk with your dentist about how to properly secure and dispose of any unused, unwanted or expired medications, especially if there are any children in the household. Also, take the time to talk with your children and/or grandchildren about the dangers of using prescription drugs for non-medical purposes.

If you don’t currently have a dentist, you can search for one at ADA® Find-a-Dentist™. Simply put in your address for a list of ADA member dentists near your home.

Are you over 60 or the caregiver of an older adult in need of dental care? Visit Oral Health America's Tooth Wisdom for a list of the resources available in your state.

Drink Water with Fluoride

No matter what age you are, drinking water with fluoride helps prevent tooth decay. Fluoride is nature’s cavity fighter. Many community water systems contain added fluoride, but if you prefer bottled water, check the label because some do not contain fluoride. And, some home water filters remove fluoride from the tap water. Visit the ADA Seal product search page for a list of water filters that do not remove fluoride from tap water.



                                                     

Quit Smoking

It’s never too late to quit smoking. Smoking increases problems with gum disease, tooth decay and tooth loss. It also slows down healing after dental procedures and can decrease the success rate of dental implants. Talk to your dentist about quitting. There are tobacco cessation programs, over-the counter products and prescription medications that your dentist may prescribe or recommend to help you quit for good. Smokefree.gov is another good resource to help you quit today.


this article appeared on ADA mouthhealthy.org

Removable Partial Dentures

Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases. Depending on your needs, your dentist will design a partial denture for you. A partial denture may have a metal framework and clasps that connect to your teeth, or they can have other connectors that are more natural looking. In some cases, a removable partial denture is made to attach to your natural teeth with devices called precision attachments. Precision attachments are generally more esthetic than clasps.

Crowns on your natural teeth are sometimes needed to improve the fit of a removable partial denture and they are usually required with attachments. Partial dentures with precision attachments generally cost more than those with clasps. Consult with your dentist to find out which type is right for you.

What to expect:
In the beginning, your new partial denture may feel awkward or bulky. This is normal, and you will eventually become accustomed to wearing it.

Inserting and removing the partial denture will require some practice.

Follow all instructions given by your dentist. Your denture should fit into place with relative ease. Never force the partial denture into position by biting down. This could bend or break the clasps.

Your dentist will give you specific instruction about how long the denture should be worn and when it should be removed.

Initially, you may be asked to wear your partial denture all the time. Although this may be uncomfortable at first, it's the quickest way to identify areas that may need adjustment.

If the denture puts too much pressure on a particular area, that spot will become sore. Your dentist will adjust the partial denture to fit more comfortably. After making adjustments, your dentist will probably recommend that you take the partial denture out of your mouth before going to bed and replace it in the morning.

Eating should become a more pleasant experience with dentures. Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on both sides. Avoid foods that are extremely sticky or hard. You may want to avoid chewing gum during the adjustment period.

Partial denture can also help improve your speech. If you find it difficult to pronounce certain words, practice reading out loud. Repeat the words that give you trouble. With time, you will become accustomed to speaking properly with your partial denture.

Caring for your dentures
Your dentist can recommend a denture cleaner. Look for denture cleansers with the American Dental Association Seal of Acceptance.

When cleaning a partial denture, it’s a good idea to stand over a folded towel or a sink of water just in case you accidentally drop the denture.

Do not use toothpaste since it can be too harsh for cleaning dentures.

Some people use hand soap or mild dishwashing liquid to clean their dentures, which are both acceptable. However, most household cleaners are too abrasive and should not be used for cleaning dentures.

Brush the denture each day to remove food deposits and plaque. The helps the denture from becoming permanently stained.

It's best to use a brush that is designed for cleaning dentures because it has bristles that are arranged to fit the shape of the denture. A regular, soft-bristled toothbrush is also acceptable.

Avoid using a brush with hard bristles, which can damage the denture.

Clean your dentures by thoroughly rinsing off loose food particles. Moisten the brush and apply the denture cleaner. Brush all denture surfaces gently to avoid damaging the plastic or bending the attachments.

A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. Your dentist can recommend the proper method for keeping your dentures in good shape.

Don’t chew, swallow, or gargle with denture cleansers.

Always thoroughly rinse the denture before placing it in your mouth.

Adjustments
Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a poorly fitting denture.

Dentures that do not fit properly should be adjusted by your dentist. Poorly fitting dentures can cause various problems, including sores or infections. See your dentist promptly if your denture becomes loose, and maintain your regular visits, too.

Remember: You can do serious harm to your denture and to your health by trying to adjust or repair your denture. Using a do-it-yourself kit can damage the appliance beyond repair. Glues sold over-the-counter often contain harmful chemicals and should not be used on a denture. If your denture breaks, cracks or chips, or if one of the teeth becomes loose, call your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.


Produced with the cooperation of the American College of Prosthodontists

Dentures

Dentures are removable appliances that can replace missing teeth and help restore your smile. If you’ve lost all of your natural teeth, whether from gum disease, tooth decay or injury, replacing missing teeth will benefit your appearance and your health. That’s because dentures make it easier to eat and speak better than you could without teeth—things that people often take for granted.

When you lose all of your teeth, facial muscles can sag, making you look older. Dentures can help fill out the appearance of your face and profile. They can be made to closely resemble your natural teeth so that your appearance does not change much. Dentures may even improve the look of your smile.

Types of dentures:

Conventional.
 This full removable denture is made and placed in your mouth after the remaining teeth are removed and tissues have healed, which may take several months.

Immediate.
This removable denture is inserted on the same day that the remaining teeth are removed. Your dentist will take measurements and make models of your jaw during a preliminary visit. You don’t have to be without teeth during the healing period, but may need to have the denture relined or remade after your jaw has healed.

Overdenture.
 Sometimes some of your teeth can be saved to preserve your jawbone and provide stability and support for the denture. An overdenture fits over a small number of remaining natural teeth after they have been prepared by your dentist. Implants can serve the same function, too.

New dentures may feel awkward for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place. It is not unusual to experience minor irritation or soreness. You may find that saliva flow temporarily increases. As your mouth becomes accustomed to the dentures, these problems should go away.

Follow-up appointments with the dentist are generally needed after a denture is inserted so the fit can be checked and adjusted. If any problem persists, particularly irritation or soreness, be sure to consult your dentist.

Even if you wear full dentures, you still have to practice good dental hygiene.
Brush your gums, tongue and roof of your mouth every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

Like your teeth, your dentures should be brushed daily to remove food particles and plaque. Brushing also can help keep the teeth from staining.

Rinse your dentures before brushing to remove any loose food or debris.

Use a soft bristle toothbrush and a non-abrasive cleanser to gently brush all the surfaces of the dentures so they don't get scratched.

When brushing, clean your mouth thoroughly—including your gums, cheeks, roof of your mouth and tongue to remove any plaque. This can help reduce the risk of oral irritation and bad breath.

When you’re not wearing your dentures, put them in a safe place covered in water to keep them from warping.

Occasionally, denture wearers may use adhesives. Adhesives come in many forms: creams, powders, pads/wafers, strips or liquids. If you use one of these products, read the instructions, and use them exactly as directed. Your dentist can recommend appropriate cleansers and adhesives; look for products with the ADA Seal of Acceptance. Products with the ADA Seal have been evaluated for safety and effectiveness.

If you have any questions about your dentures, or if they stop fitting well or become damaged, contact your dentist. Be sure to schedule regular dental checkups, too. The dentist will examine your mouth to see if your dentures continue to fit properly.


This article first appeared on MouthHealthy.org, an A.D.A. website.