Dental problems in people with Diabetes - Part II

In the first part of this post, we mentioned that diabetes patients have a higher tendency for teeth loss. But besides this major dental problem, there are other hazards diabetic people ought to look after as gum cuts that take time to heal.

They usually happen because of dental dryness, which triggers the appearance of fungi. Therefore, you have to perform a very careful and patient dental brushing with the aid of a soft bristle dental brush. In addition, using mouthwash helps to fight the bacteria that form fungi in gums.

Moreover, it is indispensable that if you have diabetes to visit the dentist because of the lack of sensitivity, you may just realize you have a dental problem after a dental check-up.

Tips

• Plaque formed around teeth can be controlled with a diet that includes the daily consumption of carrots, apples, dried seeds, celery and fresh cucumber.

• For promoting saliva segregation, that helps prevent caries and mouth fungi, drink a lot of water and chew sugar free gum.

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Dental problems in people with Diabetes

Generally, diabetic people tend to focus more on the care of their levels of sugar, blood pressure and feet, but they forgot about a very important thing: Their teeth.

Some people with diabetic might “surprisingly” find they have lost their upper and/or lower frontal teeth, and they have to use dentures. This teeth loss in diabetics is actually no strange.

In fact, diabetic people are more likely to have severe teeth problems than non-diabetics due to irregular levels of insulin (the hormone that controls sugar) in blood.

It is very common that diabetes patients present caries, tartar calculi, bacterial plaque, periodontal disease or fungi infections.

Despite of following a good dental cleaning, it is unavoidable they develop dental calculi, especially in the back teeth, where it periodontal disease generally occurs.

As for caries, these are formed when diabetes is not well-controlled and the high levels of glucose in saliva promote the formation of plaque, which if it is not removed regularly becomes solid would produce chronic mouth inflammations and infections.

And periodontal disease also occurs more in patients who do not regularly control their diabetes than in those who do control their disease.

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What happens when a wisdom tooth comes up partially?

In case wisdom teeth emerge partially, and the rest of them stay submerged, the surrounding gum may get infected and inflamed. This leads to swelling of the cheek and the neck.

Becomes worse in times of stress…

This swelling, called pericornitis, tends to become acute in times of high stress when the immune system is not at its best condition, and when bacteria lie in wait for of infection the crown of the wisdom tooth.

How bacteria get into wisdom teeth

Usually at the end of the mouth, where wisdom teeth are placed, there is a gum flap that may extend over the tooth’s surface. Debris and food may get trapped inside under this gum, and this obviously leads to infection.

When wisdom teeth emerge well or bad

When the wisdom tooth emerges in good position, the flap can be trimmed, so any infection will be avoided. This procedure is called Operculectomy.

When the tooth does not emerge because there is no place for it, then it has to be extracted. A wisdom tooth extraction is done by an oral surgeon.

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What happens when you got an impacted wisdom tooth - Part I

So when going to the dentist for a wisdom tooth removal, and he/she tells you that this tooth is impacted, but what does this means and how it would affect your dental health?

Here we explain it to you easy if you didn’t catch well the idea at the dentist office…

What is an impacted wisdom tooth?

Wisdom tooth are the third molars, they are usually the most annoying of all teeth and get the most incredible forms and positions.

Here is where the problem comes, when all of our teeth have come up, there is no enough room for some “extra teeth” in the mouth. Therefore, when wisdom teeth try to emerge they get impacted under the bone, and they can not come up completely in the jaw.

What happens, then?

NO EXTRACTION. Most dentists prefer to leave these wisdom teeth alone because according to studies, an extraction would cause severe bone impaction, when actually they do rarely cause any infections neither push other teeth nor produce misalignment when left peacefully underneath the jaw.

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Valuable recommendations after a tooth extraction

After you have undergone a wisdom tooth extraction there are certain measures you have to take to ensure a successful - fast and thorough- healing of your mouth.

Do’s

• Keep the lint mildly tight in your mouth during 30 minutes
• Apply an ice bag on your swollen cheek for 20 minutes, making some pauses if it feels too cold for you during the first day, maximum two.
• Soft and liquid diet, and chew from the opposite side at least for the first 3 days.
• Sleep with two pillows
• Brush your teeth with a soft-bristle brush, trying not to reach the affected area. You can use lint or a piece of wool
• In case you bleed more than normal, pout a new dry lint in your mouth and keep it softly chewed
• If there is any complication do not hesitate in calling your dentist

Don’ts

• Do not make any physical effort. No exercises, no computer work, no reading in uncomfortable positions, and do not bend. Just relax
• Do not suck or inhale, do not make gargles or apply mouth wash
• Do not drink hot drinks during the first 24 hours
• Do not smoke or drink alcohol
• Do not chew gum

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Wisdom Teeth Surgery - Part II

How is a wisdom tooth extraction performed?

When a wisdom tooth has emerged into its expected position it can be removed in a routinary process. This is generally perfomed by a maxilofacial dentist.

The dentist injects local anesthesia just in the area where the wisdom tooth is, until that part of your mouth has got totally numb to prevent any discomfort during the extraction.

Then the doctor proceeds to pull out the wisdom tooth, which usually lasts around 15 to 20 minutes at most. After the wisdom tooth extraction, the dentist will put a piece of lint in the place where the molar was. You have to keep the lint for 30 to 45 minutes to stop the bleeding.

Generally dentists prescribe some analgesics to ease the pain after. Spill the saliva and blood, but do not rinse your mouth or do any gargles during the first hours.

The effects of anesthesia disappear after one hour. Afterwards, you will feel certain pain and discomfort that will fade away in a couple of days.

Please note: When the wisdom tooth has not totally emerged, it is called an impacted widom tooth, to extract it, it si necessary to perform a wisdom tooth surgery.

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Wisdom teeth surgery – Part I

How to prevent a wisdom tooth surgery

It is obvious that the ideal thing is avoiding reaching the maximum limit, which is a wisdom teeth surgery. And for this aim, the only way to make this possible is by visiting your dentist every six months.

This way your doctor can prevent the incidence of any impacted wisdom tooth. If this turns out to be the case, it will require wisdom teeth surgery that will have to be perfomed by a maxilofacial surgeon.

A maxilofacial surgeon is the dental specialist who is trained to perform surgeries in mouth and maxillaries. A maxilofacial specialist can extract the four wisdom teeth in just one single intervention of 30 to 60 min with minimal effects (pain and swelling).

Beware: When a wisdom teeth surgery is not performed correctly it can cause permanent problems as infections, sinusitis, and low nerve damage (the enrve that gives sensibility to the lower lip and chin).

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When is necessary to remove wisdom teeth?

Wisdom tooth removal is performed when there is no enough space for them to come out and fix in the dental cavity.

Here we mention the symptoms that tell us when exactly a wisdom tooth has to be removed, even though it has not come out completely onto the surface, before they get impacted and start giving you trouble.

Wisdom tooth symptoms

- Pain
- Dental cavity infection
- Face swelling
- Gum inflammation in the back side of the mouth

Once, you present any of these symptoms your dentist will naturally recommend you to proceed to get an extraction done in order to prevent wisdom tooth problems, as an impacted wisdom tooth may destroy a second molar.

According to the American Academy of General Dentistry, the retention of wisdom teeth is the most common disorder during development stage.

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Did you know that not everyone has wisdom teeth?

That's right, there are super lucky individuals who will never undergo the dread pain and discomfort of wisdom teeth. And why is that? Genetic reasons determine whether any or the four-set of wisdom teeth come put or not. But before you jump on your feet...these cases are not the most.

The second option is that any wisdom tooth or the four erupt and join your other teeth to perfom the chewing process.

The third option –and the most troublesome- si they get partially or totally trapped in the maxilar bone or the jaw that rproduce much more pain and discomfort than the second option, and that will require an immediate visit to your dentist.

Note: If you didn’t know, wisdom teeth are called this way becasue they appear between the ages of 18 and 25 years old, when the person has arrived to the age of “wisdom”.

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Wisdom Tooth Extraction - Part II

Advantages of not having a wisdom tooth pulled

Keeping wisdom teeth allows reaching the plentycapacity of growth and development of teeth and jaw. A wisdom tooth also can, under appropriate conditions, be transplanted to the position of a premature loss of another tooth elsewhere in the jaw.

You don't exposed yourself to the risk of a wisdom tooth surgery.

The risks and the advantages of a wisdom tooth removal must be examined.

Risks of a wisdom tooth removal

Complications of smaller importance as dental nerve damage, infection, alveolitis, trismus (difficulty to open the mouth), hemorrhage, fractures, periodontal injury, and damage ofthe adjacent tooth.

Alveolitis is the commonest complication that particularly happens to women and in the range of 25 years. Also it is seen more often in the patients who had dental indication for wisdom tooth extraction that in those who they did it by own election.

This happens in a 5% of te patients without concerning the ability or the surgical method of the chosen dentist. The damage of the nerves is rare, but it can imply paresthesia (persistent numbness) of the lip or the tongue.

Greater complications include dysesthesia (a sensation of a needle prick or something that crawls in the skin) and infections. Most of the injuries of the nerve they are cured after certain period, but some permanent injuries happen. Any damage that lasts beyond six months is probable to be permanent.

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Wisdom Tooth Extraction - Part I

A widom tooth extraction is the most common procedure dentists do. Since there is no exact way to predict what wisdom tooth will cause problems and which not, dentists are subjective when it comes to make a decision and say that, even though they do not cause to pain, they must be removed.

Since dentists are divided on this question, here we set some standards to youon the risks that exist in each one of the two options: extracting it or to leaving it if there is not wisdom tooth symptom.

Which are the risks of not removing wisdom teeth?

• One of the most common reasons is when the affected wisdom tooth pushes other teeth. Some dentists say that this can happen, but that that does not justify to clear them if they do not bother.
  

• An impacted wisdom tooth can cause to damage to the tooth or molar that is opposed to it. This is a fact, but it only occurs to a 2% of the world's population.

• Periodontal disease around the wisdom tooth. This is possible, but in young adults less of 1% have these problems. The problem must to the deficiency of good dental hygiene.
  

• Pericornitis: A wisdom tooth infection that produces the formation of abscesses, is seen more commonly in wisdom teeth. This is a reason for wisdom tooth removal.
  

• The development of mouth cysts and tumors is often mentioned, but this is very rare. The cysts often are confused with other normal characteristics in the x-rays. The tumors are in less of a percent of wisdom teeth.

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How to fix those separated teeth

One of the teeth abnormalities that calls attention the most, in people of all ages is diastema, or the gap between the upper central incisors. This empty space is normal before the permanent canine come up.

It is usual when canine erupt, this space closes in, but there is the chance this does not happen due to:

- The absence of the lateral incisors.- There is a supernumerary tooth (one extra tooth) located between the two upper central teeth. On an X-ray it is shown how this tooth impairs the two central teeth get close. - Lip frenum(frenillo) with low insertion. This can be solved with a frenum surgery or fraenum removal after the eruption of the permanent canine and the placement of a device that helps keep the incisors together until the formation of dental bone around them until the final closing.

Laughingstock smile

It is important to consider the treatment for teeth gap, not only for an esthetic reason, but also to bolster self-esteem, particularly in children and teenagers, who can be easily picked on by their classmates, which of course, has a deep psychological that can alter their academic performance.

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Mouth ulcers or aphtae: How to get rid of them. Part II

Symptoms

Before the mouth ulcer

- Tingling or burning
- Red knobs

When the ulcer appears

- Appearance of one or more small ulcers inside the lips, or cheeks, or palate (soft palate) or underneath the tongue
- White, yellow or gray cover
- Pain when eating, talking, or sleep difficulty.

Diagnosis

The doctor will ask you about your medial history and will examine your aphtous ulcers. If these ulcers repeat frequently, the doctor will look for an underlying cause as vitamin or mineral deficiency or an immune system disorder.

If the mouth ulcer can not get healed, it can be taken a small sample or biopsy to analyze the tissues under the microscope to detect cancerous cells.

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Mouth ulcers or aphtae: How to get rid of them. Part I

Part I

What are they?

Aphtaes are small, painful and superficial mouth ulcers. They usually come and do, after a brief or long period between two outbreaks. They are not contagious.
What causes them?

They cause is unknown, but some of their triggers are:

- The abnormal response of the immune system against the superficial mouth tissue.
- Genetic predisposition
- Food allergies or sensitivity to certain foods as chocolate, nuts or citric fruits.
- Mouth tissues injury (rough tooth brushing)
- Nutritional deficiencies

Risk factors

A risk factor is a something that increases the chances of contracting a disease or disorders

- Family history of aphta sufferers
- Bad absorption of nutriebnts- Ptrolognued temperature
- HIV or Aids
- Stress
- Hormonal changes in women.

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Designing perfect smiles for each sex

Once we have understood that all the phases of the restorative process are important we can focus on the design of an esthetic smile for you. We can check many fashion magazines with models with perfect smiles, but we do not have to stick to duplicating what is considered “perfect”.

The smile definitely has sexual connotations: It depends on the sex of the patient, so we have to analyze it according to that. Just by looking at the teeth (the entire mouth, actually), we can tell if it belong to a man or a woman.
For instance, a smile with dominant dental and lateral teeth, small incisors and straight angles, belong to a man.

In women, the predominant teeth are the central ones, leaving the laterals a bit relegated, and the incisors are accentuated because the angles are rounded. This is what makes women’s smile softer.

These features, proper of each sex, can not be exchanged, because the result would be a smile that does not go at all with the patient’s face.

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What we can call a perfect smile. Part I

Within esthetic dental parameters, the most important thing to understand is that teeth are not alone. They share the space with gums, lips and face. This entire environment has to be considered when deciding the size, shape and color of teeth.

For instance, when checking a dental mould we can not guess if they are teeth of a man or a woman just by looking at the teeth.

Gingival architecture

We can classify gingival architecture in:

• Esthetic patrons
• Non-esthetic patrons

The esthetic patron is the one that determine an imaginary line that connects the gingival margins of central and canine teeth, leaving the lateral teeth slightly under the line.

Small modifications (asymmetries) of this patron are sometimes acceptable, as long as the gingival margins of any tooth do not overpass this line.

When we visit the dentist because we don’t like our teeth, we sometimes can not say exactly why. For this, the dentist will make an analysis of the gingival architecture to get better result for your smile makeover.

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Fix bridges

Porcelain fix dental bridges constitute a complex treatment since not only esthetics is taken into account, but also the functionality of the bridge (bite). The neighboring teeth around the empty space are trimmed around 1.5 mm in all their sides to place a crown.
f you have a missing dental piece it means you will a bridge of three units or crowns, two for support and one that is missing. Once these pieces are collocated, the dentist applies dental cement on the pillar teeth. The most important thing is that the patient keeps a good dental cleaning.

For dental bridge placing, there have to be considered physical aspects and acknowledge of the restoring materials. Not all cases require a fix bridge. For instance, for cases when there are many dental pieces missing, this is not recommendable. They can not be placed on molars or teeth that are not in good conditions. It may be that one piece is strong to hold on to the mouth, but it is not strong enough to hold on to the others.

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Tooth extraction. Part II

Will it hurt?

Anesthesia prevents pain during the procedure, but you may feel some pain in your jaw once the effect of the anesthesia has passed.

Possible complications

- Infection
- Excessive bleeding of dental fossa.

Postoperative care

- Bite firmly but softly the dressing placed by the dentist on the fossa. This will help you reduce bleeding and will allow the formation of a blood clot in the tooth fossa.
- If the bleeding continues, replace the dressing wit a new and folded one in 20 to 30 minutes intervals. On the contrary, leave the dressing in its place from 3 to 4 hours.
- It is important not moving the blood clot off the injury. Do not spill or rinse your mouth strongly in the first 24 hours.
- Do not smoke
- Do not let food particles cover the injury.
- Do not use straws during the first 24 hours
- To ease swelling, apply an ice bag immediately after the procedure in the affected area.
- Rinse your mouth 24 hours after the surgery using a solution of ½ teaspoon (8 ounces) of warm water.
- Keep on brushing and using dental floss between your teeth, this will help preventing infection in the tooth extraction place.
- Have a soft or liquid diet during the first 24 hours.
- Avoid hassle during the first 24 hours after surgery. In the first and second day after the surgery just perform limited activities.

Result
During the first 24 hours after the dental extraction it is normal having some bleeding and swelling. The initial healing period normally takes from 1 to 2 weeks. New dental tissues will grow inwards the gums, bone and fossa.

Having a slack tooth can lead to push aside the other teeth, biting inadequately or biting difficulty. Your dentist may try restoring the area with a dental implant, fix bridge or fake denture.

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Tooth extraction. Part I

Body parts envolved
 Teeth
 Gums
 Jaw bones

Reasons for a dental extraction
Although many teeth can be saved with modern dental techniques, some still have to be extracted. Teeth extractions can de necessary in these situations:

- Teeth is too damaged or with cavities to be saved by endodontia.
- The tooth’s nerve is infected.
- The tooth is preventing the normal dental growth.
- The tooth is loose because of a periodontal disease.
- Loss of support bone, gums or tissues

Risk factors due to complications during the procedure
- Smoking
- Blood or heart disease.
- High blood pressure
- Alcoholism
- Bad nutrition
- Use of medication without medical prescription (tell your dentist of any medication or supplement you have been taking in the last month).

What to expect

Before the procedure
- Mouth radiography
- Blood and urine test

During the procedure
General or local anestesia

The procedure
If the tooth is damaged, the dentist will remove the gum and the bone tissues to unveil the tooth. Using forceps, the dentist will hold the tooth and will make it twist smoothly forwards and backwards. This action releases the tooth of the alveolar bone and breaks the ligaments that attach the tooth on its place. The tooth is pulled off, and a blood clot is formed in the empty space. The dentist will put a dressing on it, and occasionally he/she will make some stitches on the gum borders.

After the procedure
It is analyzed the extirpated tissues, bone and blood.

How much it lasts?
Around 20 minutes. More time for damaged teeth.

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Fake teeth or dentures

What dentures are?

Dentures replace missing teeth and surrounding tissues in the forms of a removable dental device of acrylic resin or of a metal combination.

What are the types of fake dentures?

There are four types of fake teeth:

Complete: Replaces all teeth and surrounding dental tissues.

Partial: This type of dentures acts like a dental bridge, since it fills the empty space between the teeth and the missing teeth.

Conventional: Conventional dentures allows a recovering time (generally from 4 to 8 weeks) after the extraction of all teeth before placing fake teeth.

Immediate: This does not allow a healing time after teeth extraction. Dentures are immediately placed in the mouth. Additional adjustments may be needed as long as the healing advances.

Fake teeth care

- Take out your dentures everyday and brush it gently with a special toothbrush and toothpaste for dentures.

- If the prosthesis has holding clips, clean them in and out carefully.

- Avoid the use of abrasive cleaners and hot water because this can seriously harm it.

- If partial dentures are in their place, take them out before brushing the natural teeth.

- Once fake teeth are clean, dip it into cleaning solution or water and keep them in safe place.

- Visit your dentist every 6 months for a dental cleaning.

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