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Serving Las Vegas and Henderson, Nevada since 1999.

Diabetes (also called diabetes mellitus) is a chronic systemic disease which affects your body’s ability to process sugars in your food. As a result, a diabetic patient will have a high blood glucose (sugar) level which can cause a host of issues including problems with your eyes, nerves, kidneys, and heart. Diabetes can also lower your resistance to infection and can slow the healing process. Diabetes can also affect your oral health in many different ways.

Fast Facts About Diabetes

-Diabetes is a long-term condition that causes high blood sugar levels.

-Diabetes currently affects over 371 million people worldwide and is expected to affect over 550 million by the year 2030. In the United States, a new case of diabetes is diagnosed once every 30 seconds and more than 1.9 million new cases are diagnosed each year.

Types Of Diabetes

-Type 1 Diabetes – In this type, the body does not produce insulin. About 10% of all diabetes cases are type 1.

-Type 2 Diabetes – In this type, the body does not produce enough insulin for proper function. About 90% of all cases of diabetes worldwide are of this type.

-Gestational Diabetes – In this type, pregnant females are affected

Common Diabetes Symptoms

1) Frequent need to urinate (polyuria)

2) Intense thirst (polydipsia) and hunger (polyphagia)

3) Unexpalined weight gain

4) Unusual weight loss

5) Fatigue (tiredness)

6) Cuts and bruises that do not heal

7) Male sexual dysfunction

8) Numbness and tingling in hands and feet

-If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life with little to no complications.

-Type 2 patients need to eat healthily, be physically active, and test their blood glucose. They may also need to take oral medication, and/or insulin to control blood glucose levels.

-As the risk of cardiovascular disease is much higher for a diabetic, it is crucial that blood pressure and cholesterol levels are monitored regularly.

-As smoking might have a serious effect on cardiovascular health, diabetics should stop smoking.

-Hypoglycemia – low blood glucose – can have a bad effect on the patient.

-Hyperglycemia – high blood glucose – can also have a bad effect on the patient.

How Is Your Dental Health Affected By Diabetes?

-Periodontal Disease. Diabetes reduces the body’s resistance to infection, diabetics have an increased risk for developing gingivitis (earliest and most treatable form of periodontal disease), an inflammation usually caused by the presence of bacteria in plaque. Plaque is the sticky film that accumulates on teeth both above and below the gum line. Without regular dental check-ups, periodontal disease may progress if left untreated. It also can cause inflammation and destruction of tissues surrounding and supporting teeth, gums, bone and fibers that hold the gums to the teeth. Research has shown that treating periodontal disease in people with diabetes can help improve blood sugar control.

-Burning Mouth SyndromeBurning mouth syndrome is a chronic burning in the mouth without an obvious cause. The discomfort can affect your tongue, gums, lips, inside of your cheeks, roof of your mouth or widespread areas of your oral cavity. Burning mouth syndrome appears suddenly and can be severe, as if you burned your mouth.

-Fungal infections (such as thrush and oral candidiasis). Since diabetes weakens your immune system, you may be prone to developing fungal infections. Symptoms include painful sores and difficulty swallowing. If you develop a fungal infection, it is important to see your dentist as soon as possible.

-Dry mouth (xerostomia). Uncontrolled diabetes can decrease salivary flow, which can result in dry mouth. Dry mouth can further lead to soreness, oral ulcers, oral infections, and increased incidence of tooth decay.

-Infection and delayed healing. People with uncontrolled diabetes do not heal quickly after oral surgery or other dental procedures because blood flow to the treatment site can be impaired.

Dental Care Tips For Diabetic Patients

-Maintain Good Blood Sugar Levels.

-Keep your healthcare team informed including your dentist.

-See your dentist regularly for dental hygiene visits as well as oral examinations. It is recommended that you visit your dentist and hygienist at least every 6 months. For many diabetic patients, it is advised that they go on a more frequent schedule to maintain proper oral health.

-Brush and Floss Daily. This is to prevent plaque build up and keep periodontal disease away. In fact, it is recommended that diabetic patients brush following every meal to ensure good dental hygiene.

-Denture wearers should remove their dentures and clean them daily. Do not sleep in them.

-If you smoke, talk to your doctor about ways to quit.

-Maintain regular visits to your diabetes doctor to ensure there are no conflicts between dental treatment and your general treatment.

-Remember that healing may take longer in people with diabetes. Follow your dentist‘s post-treatment instructions closely.

-Patients with diabetes with orthodontic appliances should contact their orthodontist immediately if a wire or bracket results in a cut to their tongue or mouth.

Conclusion

Diabetes can be a scary diagnosis but with proper monitoring and care it does not have to be. A well controlled diabetic can leave a very normal life and stay healthy for a long, long time. Dental care should never be compromised even for healthy individuals.

 

Thyroid disease makes it difficult for the body to produce and regulate the normal amount of important hormones. Thyroid disease is quite difficult to diagnose and it can have a ripple effect throughout the body throwing systems out of balance. Approximately 30 million Americans have thyroid disease ( more than half of them undiagnosed). Subtle changes in thyroid function can have a significant impact on our health. Women’s risk of developing thyroid problems is seven times that of men. A family history of thyroid problems and increasing age affect the chances of a woman developing thyroid problems. A woman has almost a one-in-five chance of facing some type of thyroid disease in her lifetime. The question we ask…Does thyroid disease also affect dental health? Read below to find out….

Possible Dental Health Symptoms Of Thyroid Disease

-Increased risk of periodontal disease. Thyroid conditions may inhibit the body’s ability to heal wounds. This can be quite dangerous for dental health as our gum tissues are constantly in a state of rebuilding and repair. If the gum tissue is in a weakened state it becomes more prone to infection than healthy gum tissues. With an increased risk of periodontal disease also comes an increased risk for diabetes and cardiovascular disease (heart disease and stroke). It is believed that oral bacteria passes into the bloodstream which can then attach to fatty plaques leading to clot formations. It has been shown in research that stroke victims are more likely to have an oral infection present vs. those who have not suffered from a stroke.

-Enlarged Tongue. This is also called Macroglossia. This can be a common symptom of thyroid disease sufferers. The swollen or enlarged tongue can make it difficult to perform simple activities like talking, eating, and swallowing. Sleep patterns can also be disrupted as those suffering from macroglossia may also find it difficult to fall asleep as the tongue can block the airway and wake the person with a gasp for air. Sleep deprivation can lead to its own disorders including mental fatigue and early development of Alzheimer’s disease.

-Dry Mouth (Xerostomia). Saliva acts as a buffer for our teeth and gums. The saliva constantly washes and coats our mouth maintaining a delicate balance. If salivary flow is reduced it can lead to increased tooth decay. Saliva also adds nutrients to our teeth keeping them strong to defend against attack by oral bacteria.

-Burning Mouth Syndrome. This is a condition that causes a burning pain in the mouth and tongue.

-Change In Taste Sensation. This is also referred to as Dysgeusia. Thyroid disease may cause your sense of taste to become distorted or just change over time. This may make healthy eating difficult which  leads to a decreased quality of health.

-Accelerated Dental Eruption. This pertains to children with thyroid disease. It is possible for teeth to erupt earlier and faster than normal creating an issue in proper development for those children.

Thyroid Disease Conclusion

Thyroid disease must be accurately diagnosed with blood work, usually by an endocrinologist.  The endocrinologist will monitor the disease, and update changes to thyroid medications to help them to maintain patient’s oral health. Due to the manifestation of oral signs, the dentist may be the first to suspect a serious thyroid disease disorder and play a key role in early diagnosis. If you notice any of these changes speak to your dentist and medical doctor.  Be proactive in your dental and overall health care.

Menopause can be a time of tremendous anxiety for many women. As their bodies change and hormone levels rise and fall during menopause, there can be some unforeseen consequences. Many women only notice the outward changes that occur to their bodies but fail to look internally especially the changes that can occur in the mouth. These changes are quite natural but being informed can help you stay one step ahead and keep healthy through this time of change.

What Are Some Of The Potential Oral Changes With Menopause Onset?

-Xerostomia (Dry Mouth). As a woman’s estrogen levels decrease it can lead to a drier mouth. Saliva is nature’s way of keeping our mouth clean and hydrated. Without sufficient amounts of saliva our teeth become more susceptible to tooth decay and periodontal infections. Dry mouth can also come from many medications (prescriptions or over the counter) that are commonly prescribed as we get older.

-Menopausal Gingivostomatitis. This can occur to a very small percentage of women but can be very damaging. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red are hallmarks of this condition. Estrogen supplements are usually able to help to relieve these symptoms.

-Bone Density Changes. The decrease in estrogen that occurs with menopause also puts women at greater risk for loss of bone density. Loss of bone in the jaw area can lead to tooth loss. Gum recession can also be a sign of bone loss in the jawbone. Receding gums also expose more of the tooth surface to potential tooth decay by exposing more areas of the tooth to the acids in the mouth. Gingival grafting may be necessary to cover the receding areas.

-Change In Taste. This is especially true for salty, peppery or sour.

-Burning Mouth Syndrome. This can affect the tongue, gum tissues, lips, and possibly the tissues inside the cheeks of the mouth. The burning mouth sensation generally occurs from changes in taste and the sensory nerves in the mouth. It can also be caused as a result of dry mouth, poor nutrition, and even allergic reactions to food or drug. If you note any of these symptoms contact your dentist immediately for help in relieving the discomfort.

-Eating Disorders. Nutritional changes can occur from a woman’s change in her own body self image. These changes can lead to poor nutrition and improper eating habits. These changes can make our teeth more susceptiple to teeth damage.

How To Avoid Menopause Dental Issues?

-Maintain Good Oral Hygiene. This should include brushing 2x per day, flossing, and rinsing with an antibacterial rinse. This should also include regular dental visits for routine examinations and professional cleanings.

-Eat Properly. Maintaining good nutrition will help not only your oral health but your overall health as well.

-Salivary Supplements. These supplements can keep the oral tissues moist and make your mouth feel better throughout the day.

-Estrogen Supplements. While a controversial topic for many, the lowered estrogen levels are a main reason for the periodontal issues that arise going thru menopause.

Menopause Conclusion

Maintaining a healthy oral environment improves the quality of our lives especially as we get older. It is important for a woman to be aware of the changes happening in her body and to make the simple changes to keep on a healthy lifestyle path.

Almost one third of all Americans diagnosed with cancer each year will develop oral health issues. Patients who undergo life saving treatments for various cancers are usually unaware they may develop painful and debilitating conditions following their cancer treatment. A thorough dental examination is a critical step in maintaining their overall health throughout cancer treatment. This includes examination prior to, during, and after cancer treatments. Untreated oral disease can also complicate cancer treatment. The dentists role in patient management can be beneficial to the patient beyond their oral cavity.

Cancer can be treated or slowed down with proper treatments like, chemotherapy and radiation therapy. The type of treatment can be very effective but also can have very debilitating or even painful side effects that can can affect other parts of your body. These can include your mouth, teeth, gums, oral tissues and salivary glands. Being aware of these possible cancer treatment side effects can help patients reduce and manage them with help from physicians and dentists alike.

How can your oral health be affected by cancer?

Chemotherapy and radiation therapy treatment for cancer can have oral side effects. This varies depending on the type of cancer and the aggressiveness of the treatment. Those side effects can display

American Cancer Society

American Cancer Society

themselves in different ways:

-Dry Mouth (Xerostomia). Salivary production and flow are affected because the salivary glands can be affected during treatments for cancer.

-Tooth Decay. This can happen very rapidly due to the dry mouth condition.

-Burning Mouth Syndrome. There might be a painful or burning feeling in the mouth, tongue and gums. This also occurs from the reduction in salivary flow.

-Erosion of teeth due to high acid in the mouth following reflux and vomiting

-Stiffness in jaws..

-Problems with eating, speaking, and swallowing.

-Alteration of taste sensation. Your ability to taste properly will decrease..

-Gum inflammation and swelling, Periodontal disease can develop.

-The immune system is weakened.

In order to manage all the side effects from cancer, your dentist can make you recommendations to keep your mouth comfortable and healthy.

Dental Examination Before Treatment of Cancer

A pretreatment dental examination can identify potential issues and help educate the patient about the importance of maintaining good oral care. This examination can be completed by a your local or by a hospital based dentist. The evaluation includes a thorough examination of hard and soft tissues It will also include x-rays to detect trauma and possible sources of infection. Before cancer treatment begins, the dentist can also do the following:

-Removal of orthodontic bands if highly stomatotoxic chemotherapy is planned or if the bands will be in the field of radiation.

-Evaluate comfort and fit of dentures and oral appliances.

-Any teeth that need to be removed or have large fillings, crowns, should be performed at least two weeks prior to the beginning of radiation therapy to allow for proper healing, and at least 7-10 days before myelosuppressive cancer chemotherapy starts.

-For adults receiving head/neck radiation, removing teeth that may pose a problem in the future. The jaw bone , after being exposed to radiation does not heal properly following trauma, a simple removal of a tooth can result in bone death (osteonecrosis) which can destroy large areas of jaw bone. If you receive head and neck radiation you will need to take extreme precaution to avoid needing extractions for the rest of your lifetime.

-For children, consider extracting highly mobile primary teeth and teeth that are expected to fall out during the cancer treatment window.

-Instruct patients on the maintenance of proper oral hygiene, nutrition, the use of fluoride gel, rinses, dry mouth products, and the need to avoid tobacco and alcohol use.

During the examination, the patient will also learn about home care to protect oral tissues and minimize oral complications. The dentist or hygienist will instruct the patient on special brushing and flossing techniques, mouth rinses, and other approaches to keep the mouth as moist and clean as possible to reduce the risk of infection and pain.

Oral Care during Treatment

Even with examinations before cancer treatment, regular oral exams and care are necessary during cancer treatment. Good communication and planning between physician and dentist can reduce the Dental Carerisks of oral complications and maximize the efficacy of dental and supportive care. Specific oral health symptoms to remember when treating patients undergoing chemotherapy or radiation include the following:

Symptoms can include:

-A sticky, dry feeling in the mouth.

-Trouble chewing, swallowing, tasting or speaking due to dryness in oral cavity.

-A burning feeling in the mouth.

-A dry feeling in the throat and tongue.

-Dry,Cracked lips.

-Mouth sores.

-A fungal infection in the mouth or at the corners of the lips, like oral candidiasis.

Chemotherapy Issues

-Fever of unknown origin may be linked to an oral infection.

-Have the patient schedule appointments carefully. Patients should be seen when blood counts will be at safe levels.

-Conduct blood work 24 hours before dental treatment to determine whether the patient’s platelet count, clotting factors, and absolute neutrophil count are at adequate levels to prevent hemorrhage and infection.

-If the patient has a central venous catheter, careful consideration should be given to implementing the American Heart Association (AHA) prophylactic antibiotic regimen before any dental work.

Radiation Therapy Issues

-Treat infections. Ulcerations and dry, friable tissues are easily infected.

-Nutrition.Instruct the patient on the importance of healthy eating to maintain nutritional status, emphasizing the need to avoid foods that irritate sore tissues or cause dental decay.

-Show patients exercises to reduce tightening of mouth muscles,( trismus). Fibrosis of the tissue may occur if the chewing muscles are in the direct field of radiation. Ask your dentist to teach you how to exercise and stretch these muscles properly to avoid or alleviate the symptoms.

Follow up Dental care

Patients may continue their regular dental care schedule once all complications from chemotherapy have subsided and blood counts have recovered.

Once radiation therapy has been completed and acute oral complications have subsided, the patient should be evaluated by a dentist every four to eight weeks for the first six months. After that the dentist can decide the schedule the patient needs based on findings.

Post Cancer Treatment

Head and neck radiation therapy can cause oral complications that continue or emerge long after treatment has been completed. Although cancer patients may no longer be under an oncologist’s care at that time, what they learn about oral health during their treatment will affect how they deal with subsequent complications. Patients receiving radiation therapy need to know about its risks:

-High dose radiation treatment carries a lifelong risk of osteonecrosis, xerostomia and dental cavities

-Because of the risk of osteonecrosis, people who have received radiation should avoid invasive surgical procedures (including extractions) that involve irradiated bone

-Radiation to the head and neck may permanently reduce the quantity and quality of normal saliva. Daily fluoride application, good nutrition and maintaining proper oral hygiene are very important.

-Radiation can change oral tissues. Dentures may need to be remade or relined after treatment is completed and the tissues have become stable. Some patients are never able to wear dentures following cancer treatment again because of friable tissues and xerostomia

-A dentist should closely observe children who have received radiation to craniofacial and dental structures. They want to ensure that abnormal craniofacial growth and skeletal development does not occur.

Cancer can be a very debilitating disease in many areas. But if planned accordingly before cancer treatment, we can limit those issues together and face them head on to create the scenario for the best possible outcome from cancer.