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Prospect Street News & Advice
Diabetes is on the rise, it's estimated that there are 415 million adults aged 20-79 with diabetes worldwide, including 193 million who are undiagnosed. A further 318 million adults are estimated to have impaired glucose intolerance which puts them at high risk of developing the disease.
What Does This Mean For Your Teeth?
High levels of sugar in your blood and the inability to control the level of sugar can lead to severe gum disease if not effectively treated.
Severe gum disease was associated with significantly higher levels of HbA1C (a blood test that measures your glucose control) in people and there appears to be a direct relationship between diabetes and gum disease.
Why You Should Have Your Gums Checked
If you think you could have diabetes, make an appointment to get your gums checked. People with diabetes have a higher chance of getting gum disease, which can lead to tooth loss and may make your diabetes harder to control. The earlier you seek help, the better the outcome will be.
What Are The Symptoms Of Gum Disease?
- Bleeding from your gums or blood in the sink after you brush your teeth
- Bad taste
- Longer looking teeth
- Loose teeth
- Spaces getting bigger between teeth
- Calculus or Tartar between teeth
- Red or swollen gums
I Don't Have Any Of These Signs, Can I Still Get Gum Disease?
Gum disease may also be present and get worse with no apparent signs. Especially if you smoke, so even if you don't think you have gum disease now, you should have regular check-ups as part of managing your diabetes. Your dentist should be able to pick up early signs of gum disease.
How Can I Prevent Gum Disease?
You should clean your teeth and gums twice daily at home for a minimum of 2 minutes. Also cleaning in-between the teeth daily is important and your dentist or hygienist will be able to show you how to do this.
Take the below questionnaire to see if you could be at risk of diabetes and therefore gum disease.
Turns out snacking between meals is pretty bad for our teeth. Around a third of adults have obvious cavities and it could all be down to our habits changing, mostly eating between meals.
A recent report provided by Wrigley’s Oral Health Care Programme revealed that most respondents snack a least once a day between meals (82%) and almost half (48%) enjoy two snacks or more per day.
Overall adult oral health has improved over the last 40 years with over 60% of adults aged 55 and over having more than 21 natural teeth, compared to around 30% in 1978 (figures from Adult Dental Health Survey 2009).
There is however more you can do to stop these cavities forming, chewing sugar free gum after meals and snacks can help lower the acidity in your mouth, which is one of the main causes of tooth decay.
When dietary sugars are consumed acid begins to be produced and so the pH in your mouth falls (low pH is more acidic eg the pH of lemon juice is 2.4) and further destruction of tooth tissue will occur. If sugars are consumed frequently throughout the day then damage occurs often and your saliva will not have a chance to repair the damage before the next wave starts. Gradual loss of mineral tissue from teeth leads to breakdown and the development of a cavity (i.e., tooth decay)
This diagram shows the intake of sugar compared to the acidity levels found in your mouth after eating. Without the time to balance back out your teeth are continually subjected to a barrage of acid, breaking down the tooth.
Wisdom teeth generally erupt from the age of 18 onwards and can be the bane of many patients existence but when do they need treating and what do you need to do to take care of them?
The main cause of issues regarding wisdom teeth is a lack of space for them to erupt fully into the dental arch and as a result they can often become wedged against the adjacent teeth or become stuck halfway out of the gum.
When a tooth is partially erupted the overlying gum can become a trap for food and debris which can cause localised inflammation resulting in a condition known as pericoronitis. This results in swelling of the soft tissues around the wisdom tooth which causes an aching sensation which can be felt along the jaw and down the neck. This is managed clinically by cleaning under the inflamed tissues and washing out any debris with an antiseptic agent. If you suffer from recurrent issues with pericoronitis with long term solution is to remove the offending wisdom tooth however occasionally patients can suffer a single episode of pain which does not recur and does not need any further treatment. The best way to avoid this issue is to clean carefully around any wisdom teeth when brushing but one can still have issues even if the area is carefully maintained.
Impacted Wisdom Teeth
Wisdom teeth can also become wedged into the adjacent tooth which creates an area for plaque and food to stagnate which can put both the wisdom tooth and the adjacent tooth at risk of decay. If this is the case in your mouth the area will need careful monitoring at check ups and if there is any sign of decay the best course of action is to extract the wisdom tooth to prevent further damage to the tooth next door. The best way to avoid decay of the teeth is to minimise the sugar in your diet as well as keeping the area as clean as possible
The final issue patients can suffer with as a result of troublesome wisdom teeth is trauma to your cheek due to the positioning of the erupting tooth- this is generally more of any issue for upper wisdom teeth and can be very uncomfortable. If this is the case the dentist can try to smooth off the points of the tooth but if this doesn’t resolve your issues the wisdom tooth can be removed
If you have a cavity in a tooth or a filling that is leaking you need to have a new filling but what are the different materials available and what’s the difference between them.
Amalgam- this is the traditional ‘silver’ fillings that were the mainstay of dentistry in the past but is used less and less today as other materials improve and begin to surpass amalgam. It is generally the most inexpensive material for restoring teeth and requires the least time to place however it does have downsides. The primary issue patients have with amalgam is its appearance as it is much darker than natural tooth as thus can be quite unsightly and as such it is not used for fillings on front teeth but is suitable for back teeth. From a clinical point of view the main issue with dental amalgam is the higher rate at which teeth with amalgam filling chip and break. This is because amalgam expands slightly as it fills and does not ‘stick’ to the tooth around it and thus often acts like a wedge which eventually causes the tooth around it to break. Some patients also express concern about the material as it does contain a small quantity of mercury however it has been in use and has been studied for 150 years and there is no evidence of any harm coming from its usage- the only cases where its use is prohibited is for pregnant patients and this is merely as a precaution.
Composite- Composite is the technical term for ‘white fillings’ and is increasingly becoming the standard filling material used by dentists to restore teeth. In the past this material was not as strong as silver fillings and had a tendency to become worn and discoloured over time however due to advances in technology these problems have largely been resolved to the point that there is increasing evidence that a well-placed composite filling lasts longer than an amalgam restoration. The big advantage of white fillings is that they look natural and can give a far more attractive finish than silver fillings however they also help to hold teeth together and prevent teeth fracturing by bonding to the tooth around the filling. This means that if there is a tooth that is vulnerable to shattering or a tooth which is beginning to crumble around an old filling it is often prudent to place a composite filling rather than a silver filling. This bonding does have one drawback which is that white fillings can only be placed where the tooth can be kept dry as it is impossible to bond to wet surfaces predictably. As a result any fillings that are under the gum line or in areas which are hard to get to such as wisdom teeth may be off limits to white fillings.
Inlays/ Onlays- This class of restorations are custom made in a laboratory by a technician to fit over or in a cavity in a tooth and are the strongest restorative material. This makes them well suited to patients who have a tendency to wear down or break teeth and fillings or excellent for restoring large cavities that are too big to repair with conventional fillings. They are generally made from high impact porcelain and are made to look like your natural tooth. They are still occasionally made from gold if the restoration extends slightly under the gum line but generally due to advances in the strength of porcelains and in the quality of our cements onlays and inlays will be made in porcelain to look like a natural tooth.
If you ever require any treatment your dentist will always go through with you what your options are and give you any information about what materials are suitable for your case and what the specific advantages and disadvantages might but generally due to advances in the strength of porcelains and in the quality of our cements onlays and inlays will be made in porcelain to look like a natural tooth.