IS THERE A CONNECTION BETWEEN DIABETES AND ORAL HEALTH???

         Diabetes mellitus is a metabolic disorder characterized by hyperglycemia caused by absolute relative deficiency of insulin.                                                                                                   

•   Diabetes is a predominant health problem today.  

•   Diabetes can hit at any age

•   If not checked, it may be very dangerous

•  Consult a specialist & get it treated immediately.

TYPES:

•   Type 1 - less common -10% - usually younger than 30 yrs

•   Type 2 - most common - 90% - usually obese and older

•   Gestational : which occur in 5-7% of all pregnancies and results in loss of fetus.

   

DIABETES ALSO CAUSES:

• Heart disease

• Nerve damage

• Kidney diseases

• Eye damage

• Oral health complications

DIABETES DIAGNOSIS IN DENTAL HOSPITAL:

• Most common type of diabetes is type 2

• Dentist should be able to recognize diabetic symptoms  and interpret screening tests.

• However, referral to physician for definitive diagnosis and treatment is important.

DIABETES AND ORAL HEALTH PROBLEMS:

TOOTH DECAY :

      

•  The high levels of sugar in your saliva caused by type 2 diabetes also can increase your           risk of cavities.

•   If you ate candy all day, you are at greater risk for tooth decay.

•    A lack of saliva due to diabetes also raise your risk of tooth decay.

PERIODONTAL DISEASES LIKE:                                                                                                         

   Bleeding gums:

• When you have high blood sugar from diabetes, your saliva around your gums has more sugars in it.

• This helps harmful germs and plaque grow. plaque irritates your gums and can lead to gum disease.

• Gum disease make your gums bleed.

             

   Tooth sensitivity:

•   As diseased gums pull away from the teeth, the cementum layer on the roots is readily           worn away, leaving the underlying dentin exposed, and sensitive teeth result.

             

      Recession of gums:

•  Diabetes that is not controlled well leads to higher blood sugar levels in the mouth  fluids.

•  This promotes the growth of bacteria that can cause gum recession.

             

  Bad breath ( Halitosis ):

   

•   High blood sugar levels provides food for bacteria in the mouth and leads to the build up     of dental plaque.

•  If plaque is not removed effectively which also causes halitosis.

  Swollen gums:

•   Diabetes reduces your ability to fight bacteria. If you don't remove plaque with regular brushing and flossing, it will harden under your gum line into a substance called dental calculus.

•    The longer plaque and calculus remain on your teeth, the more they irritate the part of your gums around the base of your teeth, called gingiva.

•     In time, your gums become swollen leading to GINGIVITIS.

                                                                                                                        

   Loose teeth:  

•  If left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support your teeth.

•  Periodontitis causes your gums and jawbone to pull away from your teeth, which in turn causes your teeth to loosen and possibly fall out.                                                                                                                                 

                                                                                    

 SALIVARY GLAND DYSFUNCTION (DRY MOUTH): 

      

•      Dry mouth or xerostomia, occurs when a person's salivary glands produce enough saliva        to keep the mouth moist.

•      Dry mouth can be a symptom of diabetes and also a side effect of the medication that             treats diabetes.

FUNGAL INFECTIONS:

•   It is caused by an overgrowth of the yeast, Candida albicans, which occur naturally in the mouth.

•   Some conditions caused by diabetes such as high glucose in saliva, poor resistance to infection and dry mouth (low saliva levels) can contribute to oral thrush.

LICHEN PLANUS & LICHENOID  REACTIONS( INFLAMMATORY SKIN DISEASE):

INFECTION AND DELAYED WOUND HEALING:

•  Many people who have diabetes also have problems with immune system activation.

•  The number of immune fighter cells sent to heal wounds, and their ability to take action, is often reduced.

•   If your immune system can't function properly, wound healing is slower and your risk of infection is higher.

• People with uncontrolled diabetes may develop poor circulation .

• As circulation slows down, blood moves more slowly, which makes it more difficult for the body to deliver nutrients to wounds.

• As a result, the injuries heal slowly, or may not heal at all.

DENTURE - SORE MOUTH & CHANGES IN THE TONGUE(CHRONIIC FISSURED                                                                                                                                                      TONGUE):

•  The fungus thrives on the high glucose levels in the saliva of people with uncontrolled diabetes.

•   Wearing dentures (especially that worn constantly) can also lead to fungal infections.

•  Oral candidiasis in the form of candida associated denture stomatitis, is a common disease in a large percentage of denture wearers.

 ALTERED IMMUNE AND INFLAMMATORY RESPONSES:

• As type 2 diabetes starts to develop, the body becomes less sensitive to insulin and the resulting insulin resistance also leads to inflammation.

• A vicious cycle can result, with more inflammation causing more insulin resistance and vice versa.

ORAL NEUROPATHIES:

 Burning mouth syndrome:

  Burning mouth syndrome has been attributed secondarily to diabetes, poor glycemic control and diabetic neuropathy.

Temperomandibular joint dysfunction:

•   Diabetes has an inflammatory response which can make the impact of gum disease much stronger.

•    As inflammation persists and worsens with the onslaught of these conditions, the TMJs can be affected.

  Depapillation of the tongue:

• Complete or patchy atrophy of the tongue papilla, resulting in the appearance of a ''bald'' tongue, is also more common in diabetic patients.

• Generalized atrophy of the papilla of the tongue has been attributed to nutritional deficiencies.

DENTIST INSTRUCTIONS PRIOR TO DENTAL VISIT:

• Patient should eat normal meals before appointment and take their medication.

• Take a morning appointment.

• Inform the dentist about any insulin reaction when they first occur.

• After dental appointment patient should keep his / her eating  routine and medications.

• They should keep good oral hygiene and restrict to dentist's instruction to prevent infection and impaired wound healing, dry socket, and osteomyelitis from happening.

IN CASE OF ACUTE INFECTION:

• Antibiotic prophylaxis for patient after dental procedure is not required unless patient suffer from infection and / or systemic symptoms of infection( lymphadenopathy, fever).

• In case of patient with infection , patient's insulin dosage should be altered with consultation, and infection is treated locally.

Insulin dosage guidelines:

• Oral hypoglycemic controlled patients: may require insulin, consult with physician.

• Insulin controlled patients: may need increase insulin dosage, consult with physician

         Patient with brittle diabetes (fluctuating, too high and too low) and patient receiving high dose of insulin:  

•          culture is taken from infected area for antibiotic sensitivity.

•          culture is sent to testing, and antibiotic therapy is initiated with penicillin or its                       alternatives   in case of allergies.

•          if patient condition did not response to medication, antibiotic is selected from test                   result and  therapy is initiated.

In all cases, infection should be treated locally with:

• Incision and drainage

• Root canal treatment or extraction

• Antibiotics

DENTAL MANAGEMENT:

• Analgesia: avoid aspirin and NSAIDs in patient taking sulfonylureas, because it can worsen the hypoglycemia.

• Antibiotics: antibiotic prophylaxis is not required unless there is an infection or brittle diabetes.

• Anesthesia: usual dose. however, in patient with cardiac symptoms, limit dose to 2 cartridge containing 1:100,000 epinephrine.

• Blood pressure : monitor blood pressure, because diabetes is associated with hypertension.

If you have ''DENTAL PROBLEMS'' contact us @

GUMS AND TEETH LASER AND DENTAL IMPLANT CENTER @

                                     Perumbakkam Main Road,

                         Medavakkam, chennai- 100

                         Land mark: Behind MSM food court

                         Perumbakkam.

                         Mail Id: care@gumsandteeth.in

Also check us out at :www.gumsand teeth.in

                 

ARE YOU IN KETO DIET??IS IT RELATED TO ORAL HEALTH??

           Keto diet is an increasingly popular low - carbohydrate, high fat diet . 

•   It restricts the intake of carbohydrates, which puts your body into a state of ketosis - where burning fat instead of glucose causes you to lose weight .

•  For some people keto is not a diet, It is a life style.

               

                                             

 

        While this can help you reduce the pounds, it also produces three ketones as a result :

•          ACETOACETATE

•          BETA-HYDROXYBUTYRATE

•          ACETONE

       The latter, Acetone is what may be concerning to your dentist.

(Acetone cannot be used for energy storage, It is released from the       body through lungs and urination which leads to bad breath )

                                                  

      Is it anyway related to oral health? let's discuss... Before that...

 BENEFITS OF KETO DIET :

• It helps you in killing your appetite ( for food - lovers )

• Lowers high blood pressure

• It can even cure diseases such as Diabetes, Cancer, Epilepsy and Alzheimer's disease. 

• Helps in increasing good cholesterol.  

                                          

EFFECTS OF KETO DIET ON ORAL HEALTH :

      Dentists prefer ketogenic diet because..,

      1.Decreases the risk of gum disease :

•  The reduction or total stoppage of sugar intake will surely help in making your gums healthy and strong.

•  Gums are the roots of teeth so; the teeth will become automatically healthy when the gums are strong and disease free. 

                                                

HEALTHY GUMS AND TEETH

    2.Reduce plaque formation :

•  Positive effect of keto diet is that it can reduce the plaque buildup in the mouth. Plaque basically forms through the accumulation of tartar and bacteria on your teeth and gums.

•  People who follow keto diet cut down the amount of carbohydrates intake. Carbohydrates are mainly responsible for building the plaque.

• Low carb means low sugar level; which ultimately reduces plaque buildup.

                                                 

PLAQUE ASSOCIATED 
AND
PLAQUE FREE TEETH

   3.Destroy the cavities :

• Cavities are formed due to presence of sugar in the oral cavity. These sugars demineralize the tooth structure and make them weak.

•  Keto diet doesn't include any sugary intake which stops the cavity formation in the mouth.

                                                  

 4.Reduction of phytic acid :

•  Low mineral diet can be really dangerous. Mineral deficiencies can cause :  

                               *Hair fall 

                              *Development of disease 

                              *Worsening conditions of your teeth

• Many foods you consume contain phytic acid. It can absorb all the minerals which are necessary for the growth and maintenance of the body. Since keto diet is low on the carb and does not have phytic acid so you can be safe from dental problems.

                                               

•  Hence, Ketogenic diet can be the most preferable measure for you to have a great smile.

                                                             

HOW DOES IT AFFECTS YOUR ORAL HEALTH 

   

        Though it has positive effects on oral health, It has some extent of negative impact too...

                                         

                                                                   

   1.Saliva acidity and dry mouth :

  

          In keto diet, you can't maintain a balance of all the elements which your body ultimately needs. Because you are not consuming a balanced diet, your internal PH becomes more acidic.

                                                       

           When your saliva is acidic, dry mouth is an issue. Saliva fights off germs and protects the tissues from harm. Both the acidity and dryness will cause oral issues that your dentist will need to address.

                                              

   2. Bad breath ( keto breath ) :

• One of the most common negative impacts of the keto diet is the foul smelling breath (metallic nature of the odor) .

•  Some say it smells like nail polish remover.

• This happens with the majority of people who starts following the keto diet.

                                        
                                                          HALITOSIS (BAD BREATH )

   You must be wondering why that happens ?

•  As you begin the ketogenic diet, your body starts burning fat instead of carbohydrates. This mainly happens due to high intake of fats. 

• Ketones are some chemicals that are present in your body. But, their high development generates a distinct taste and odor in your mouth.

                                             

•  It is the temporary side effect when your body is not yet using all the ketones the liver is producing.

•  The bad breath will gradually reduce when your body fully adapts to this new diet.

• It starts using these ketones to fuel the muscles and brain.

                                                    

        But what to do till then? how to handle this bad breath?

  METHODS OF REDUCING KETOGENIC BAD BREATH :

   1.  Increase water consumption :

• Drink as much water as u can to flush ketones and acetones from your body through urination.

•  Water will help in constantly reducing the level of ketones through which your breath can be improved.

                                                          

2.Focus on your oral hygiene :                

•   Brush after every meal

•   Floss regularly

•   Use an alcohol free mouthwash and a tongue scraper daily

                                    

                         

                            

                    

  3.Chew mints and gums :

•   Mints and chewing gums can mask your bad breath and prevent it from coming out of your mouth. 

                                           

•  Ensure to choose sugar-free gums and mints in order to stick to your diet plan.

                                                 

• Infuse pleasant-smelling herbs in water or tea. Herbs such as cloves, cinnamon, mint and fennel are natural breath fresheners. 

                                                

              

  4.Slightly decrease protein intake :                           

•  Proteins are the main source of energy in a low - carbs keto diet. But eating too much protein can worsen the situation.

• Your body produces ammonia on burning proteins. High quantity ammonia will make your breath foul.

5. Take it slow :

• Gradually cut carbs out of your diet rather than cut them out drastically. By doing this, it gives your body time to adjust to the change and not release as many ketones at once.

• Give yourself time to adapt to keto diet.

6.Keep stress levels down :

• De - stress yourself . stress not only reduces the flow of saliva, but it also slows digestion of proteins.

• Anxiety can also cause acid -reflux which leads to bad breath.

• Finding ways to de - stress is important when starting a new diet.

                    

                                                

•     While keto breath may be embarrassing , it may be a great way to achieve and maintain overall health.

•     Bad breath is short - lived and will go away on its own. If you really can't stand keto breath, you may need to consider a diet with a different nutritional balance.

     Why should you talk to your dentist before starting keto :

•  The food you eat is an important part of your oral hygiene regimen. If you are changing your diet, it is beneficial to talk to your dentist first.

•  When you have any concerns about your oral health, it is time to speak with a dentist.

     Takeaway points :

           

        Keto diets are a great short - term diet option for healthy people.

You must check with your physician to make sure your body can handle being put into ketosis. Your teeth will not suffer the most damage, but your breath might.

       Give us every detail about your diet's limitations and indulgences so together we can make a positive impact on your dental health for years to come.

       So, the keto diet can benefit as well as harm your oral health. however the limitations can be controlled so ; keto diet is majorly considered good for the teeth and mouth.

      

  To know more about " GETTING RID OF BAD BREATH AND GUMS

 RELATED ISSUES " contact us @ GUMS AND TEETH LASER AND

 DENTAL IMPLANT CENTER @ 

         ADDRESS   :     Perumbakkam main road,

                                       Medavakkam,

                                       Chennai -100

   LANDMARK   :      Behind MSM food court

                                       Perumbakkam.

           MAIL ID   :      care@gumsandteeth.in

Also check us out at www.gumsandteeth.in

 

        

YES...DENTAL FEAR IS REAL

 DENTAL PHOBIA:

      Dental phobia is defined as an unpleasant mental, emotional, or physiologic sensation derived from a specific dental related stimulus.

  Fear of the dentist is a common phenomenon and is universally recognized.

REASONS FOR DENTAL FEAR:

Reasons for dental fear is complex and  multi factorial                               

   

           Dental fear may appear at any age.                                                                                                             

           Patients younger than 40 yrs of age are more fearful than those who are over 40.

           No differences among socioeconomic groups or racial / ethnic groups have been demonstrated.

           Females are more fearful than males.

•   Previous bad experience

•   Heard of bad experiences from family or friends.

•   History of abuse

•   Uncaring dentist

•   Post -traumatic stress

DIFFERENT PHOBIAS RELATED TO DENTISTRY:

1.Fear of unknown

       It is a phenomenon in which the patients do not wish to accept or meet with anything unfamiliar in terms of any situation.

HOW TO OVERCOME:

In such patients first visit counseling and tell show do technique is advised.

2.Fear of dental procedures

3.Sensitive gag reflex

   People with a sensitive gag reflex may loathe (dislike) the part of the dentist's visit where those tabs are put in the mouth for the dental X-ray.

   These days, newer dentist offices offer panoramic X-rays.

4.Fear of loud noise                                                                                                                                         

     Dental tools can be really loud, and the noise can stir up fear in some people.                                                                                   

                                  

  HOW TO OVERCOME:                                                                                                                                     

Wear earplugs                                                                                                

                                                                                                  

Noise cancelling head plugs to block out sound                                          

                                                                                                                                     

5.Feeling uncomfortable lying back in a dentists chair                                                                                  

  Some people may be uncomfortable with something as simple as lying back in the dentist's chair, due to a bad back or some control issues.                                                                                                  

 

HOW TO  OVERCOME:                                                                                                                            

A simple remedy may be for the dentist to only put the patient half-back so that it's more comfortable or can provide with supporting pillows.                                                                                                        

6.Unable to breath through nose                                                                                                                    

Mouth breathers have phobia that they wont be able to breathe during their dental treatment.                                                                                                                                                                                                    

  HOW TO OVERCOME:                                                                                                                              

 Nasal strips to help them breathe                                                                                                             

 Nitrous oxide to relax the patient.                                                                                                                         

7.Fear due to previous bad experiences                                                                                                                       

Change in fear perception with age:                                                                                                          

• The expression and intensity of child's fear varies with emotions, illness and age. 

• Sleepy child shows more fear and irritation than widely awake child.

• Physically healthy child respond more actively than child who is week.

• Mentally alert child respond more intelligently and rapidly than mentally retarded individual.

2-3 Years:

• Right time to introduce child to dentistry.

• Less afraid of new people and surroundings.

• Appropriate time to begin any preventive procedures.

3-4 Years:

• Fear of separation and abandonment prevails in this age group.

• They think and feel that dentistry is a mode of punishment.

• It is advised to allow parents in the operatory during dental treatment

4 years:

•  The peak of definite fears is reached 

 4-6 years:

•  There is gradual decline in the earliest fears, due to     

•  Realization that there is nothing to fear

• Adult guidance

7 Years:

• Child tries to resolve real fears.

• Family support is important in understanding and overcoming his fears

8-14 Years:

• Learns to tolerate unpleasant situation and has marked desire to be obedient.

Teenage:

• Become concerned about their appearance

• Dentist as motivation for seeking dental attention can use this interest in cosmetic effect.

Chronic fear leads to

•        Tiredness
•        Difficulty in sleeping and bad dreams
•        Restlessness
•        Loss of appetite
•        Avoidance of tension producing stimulation

Delivery of care to the fearful patient:

Distraction:

Music is a common distraction technique for use in the dental office.

Some dentists provide individual headsets that allow patients to select the music of their choice.

Relaxation:

Deep breathing exercises help to reduce this unwanted stress and consist of as little as 2 to 4 minutes of breathing deeply in , holding the breath and then exhaling completely. 

Hypnosis:

Hypnosis is a guided, self-controlled state of mind in which concentration and focus are directed inward.

Pharmacologic intervention:

•        Conscious sedation
•        Deep sedation
•        General anesthesia

Tips to remove the dental phobia:

• You should discuss your fears with your dentist therefore, he/she will determine the best ways to prevent your uneasiness and feel more  comfortable.

• If the dentist doesn't handle your fear seriously, you should go to another dentist.

• You should actively participate with your dentist, explaining all the possible outcome on every sage of the procedure therefore, you will avoid nervousness or fear . because you will be much prepared for the results.

• Dentist frequently ask the patient for permission to continue.

• Dentist give  the opportunity to the patient to stop the procedure at any time the patient feels uncomfortable ( if for an reason they need to stop, raise your left hand)

• Dentist make time for breaks as requested.

To overcome DENTAL PHOBIA Contact us @

GUMS AND TEETH LASER AND DENTAL IMPLANT CENTER @

   ADDRESS      :      Perumbakkam Main Road,   

                                 Medavakkam,Chennai-100

 LANDMARK   :    Behind MSM food court

                                 Perumbakkam.

                              

  MAIL ID        :   care@gumsandteeth.in

Also check us out at www.gumsandteeth.in