Diabetes and Periodontal Disease
It's important for your dentist to know if you have diabetes, and how you're controlling it. Good control of your diabetes affects your oral health as well as your overall health.
Diabetics tend to be less resistant to infection than non-diabetics, have more fragile bones, and take longer to heal after an operation.
An oral infection can make diabetes worse, which makes the infection worse, which makes the diabetes worse - and so on into a major medical problem.
Diabetics develop severe gum disease more often, too, especially over the age of 40. Once gum inflammation - gingivitis - sets in, it can erupt into periodontal disease or even infection in the jaw. In undiagnosed or uncontrolled diabetics, this could mean tooth loss.
How to hang on to your teeth?
Practice preventive dentistry and follow the medication, diet, and meal schedules recommended by your physician. This, with balanced rest and exercise, will bolster your resistance to disease, including oral infections and cavities.
If you're taking insulin injections, you may want to schedule appointments around your medication times. The stress of an examination or procedure can change the way your body uses insulin. Your dentist will want to be prepared to help you in case you have a reaction. And let him or her know if you are taking any other medications. Drug interactions can be serious.
You may want to have your gums examined (and have a dental cleaning) by a dental hygienist more often than twice a year - just to make sure nothing suspicious gets started.
And on the home front, good dental hygiene - controlling plaque, the invisible bacterial film that undermines teeth - is crucial. Home care rules to live by: brush at least twice a day and floss at least once a day. The more, the better.
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Periodontal Regeneration Dentistry Treatment
Periodontal regeneration means restoring the bone and supporting tissues adjacent to teeth with advanced bone loss. Frequently, periodontal regeneration treatment will prolong the use of the involved teeth. A periodontist or dentist will diagnose the problem by taking a careful medical and dental history.
The tissues adjacent to the teeth will be gently probed with a calibrated, ruler-like instrument. These measurements, together with a dental X-ray, will help determine the appropriate treatment for the involved teeth.
There are many regenerative techniques and methods. Bone purchased from bone banks has been used effectively as a regenerative material for over 30 years. This bone is procured from healthy individuals, is carefully processed, and has been proven safe. Treatment consists of carefully moving the gum tissue away from the involved teeth and removing tarter (calculus) deposits from the root surfaces.
The bony defect is gently filled with the bone bank material (allogenic bone) or other synthetic materials. The gums are then replaced around the neck of the teeth with small sutures. The sutures are removed within five to seven days, and gentle tooth brushing can resume.
Synthetic bone substitutes have been developed to simulate natural bone. These materials are safe, and may help support the involved teeth. Such substitutes are implanted through periodontal surgery. Recently, cow bone, which is carefully prepared, sterilized, and safe, has been used to repair defects next to teeth. This bone is porous, allowing bone from the patient to grow into the pores. New technologies have developed porcine (pig) proteins, which, when painted onto teeth, allow for natural regeneration of tooth cementum and bone. These materials have demonstrated early promising clinical results.
The use of barrier membranes to protect and isolate bony defects has been used for over 15 years. These are made from synthetic, non-dissolvable materials, dissolvable materials, or bovine collagen (cow collagen). Membranes are frequently used either with synthetic graft materials or with bone purchased from bone banks. Recently, proteins have been joined to synthetic bone.
This material enhances cell attachment to root surfaces and may provide an effective method for periodontal regeneration. In the future, proteins that stimulate bone formation and enhance formation of new root cementum will make periodontal regeneration a simple, effective method to save teeth with advanced disease.
The materials discussed above have been published in dental journals, are safe, and generally result in tooth retention with bone fill of the treated bony defects. Articles relating to periodontal regeneration can be researched from PubMed using the following key words: "periodontal," "regeneration," "allogenic bone," "synthetic bone grafting," and "barrier membranes."
By William Becker, DDS