Category Archives: Diabetes

Diabetes and Your Oral Health

Child and mom looking at eachotherIt is estimated that up to 20 million people have diabetes, but only two-thirds of these individuals are diagnosed.  Studies have shown that diabetics are more susceptible to the development of oral infections and periodontal (gum) disease than those who do not have diabetes.  This relationship causes great concern because serious gum disease may have the potential to affect blood sugar control and contribute to the progression of diabetes.  That’s why it’s important for people with diabetes to visit Dr. Marinic on a regular basis and to keep him up to date on the status of the diabetic’s oral and overall health.

How are gum disease and diabetes related?Tooth erosion

Because diabetes reduces the body’s resistance to infection, the gums are at risk for gingivitis, a reversible form of gum disease usually caused by the presence of bacteria.  These bacteria produce toxins that create a sticky film that accumulates on teeth, both above and below the gum line, leading to inflammation.  If left untreated, gingivitis can progress to periodontitis, an irreversible destruction of the tissues that surround and support the teeth.

ThrushWhat other problems are associated with diabetes?

Other oral problems associated with diabetes include thrush (candidiasis), an infection caused by a fungus that grows in the mouth, and dry mouth, which can cause soreness, ulcers, infections, and cavities.  To prevent problems with bacterial infections in the mouth, Dr. Marinic may prescribe antibiotics, medicated mouth rinses and more frequent cleanings.

How can I stay healthy?

ToothpasteBrush your teeth with an antimicrobial toothpaste containing fluoride and rinse with antimicrobial mouthwash at least two times a day.  People with diabetes who receive good dental care and have good insulin control typically have a better chance of avoiding gum disease.

To improve their quality of life and their oralTesting for diabetes health, people with diabetes need to pay close attention to diet and exercise. People with diabetes should be sure that both their medical and dental care providers are aware of their medical history and periodontal status.

To keep teeth and gums strong, those with diabetes should be aware of their blood sugar levels in addition to having their triglycerides and cholesterol levels checked on a regular basis.

What is the best time to receive dental care?

Waking upIf your blood sugar is not under control, talk with both Dr. Marinic and physician about receiving elective dental care.  Types of dental procedures and appointment length are dependent on the level of diabetic control.  Try to schedule morning appointments because blood glucose levels tend to be more stable at this time of day.  If you have a scheduled appointment, eat and take your medications as directed.  See Dr. Marinic on a regular basis and keep him informed of your health status,

Xylitol – A Popular Sugar Free Substitute

XylitolXylitol is a sugar alcohol sweetener that is found in birch tree bark, beets, corncobs, raspberries, mushrooms, and other natural sources.  Its sweetness is equal to that of sugar, but it has about 40 percent fewer calories, making it a popular sugar-free substitute.  Xylitol not only cuts calories, it also cuts cavities!

How does xylitol prevent cavities?

Xylitol helps prevent Streptococcus mutans, the primary bacterium associated with dental caries, from attaching to teeth and tissues in the mouth.  Xylitol cannot be metabolized by bacteria; as a result, the process that creates harmful, enamel-eating acids is drastically slowed.  Regular use of xylitol has been shown to help reduce dental plaque – the first stage of cavity development, tartar formation, and tooth staining – and promote better oral health.

How often must I use xylitol for it to be effective?Xylitol gum

Xylitol is a natural and convenient way to supplement daily dental care.  Xylitol gum or mints used three to five times daily (for a total intake of 5 grams) is considered optimal.  Because frequency and duration of exposure is important, gum should be chewed for approximately five minutes and mints should be allowed to dissolve.  Dentists who recommend using xylitol immediately after meals and snacks to help reduce plaque, do so to inhibit adhesion of bacteria to the teeth, and reduce contact time of sugar on teeth.

Has xylitol been evaluated for safety?

Yes. Human consumption of xylitol has been confirmed for safety by a number of agencies, including the U.S. Food and Drug Administration, the World Health Organization’s Joint Expert DogCommittee on Food Additives, and the European Union’s Scientific Committee on Food.  Pet owners should note, however, that xylitol is harmful to dogs.  To prevent xylitol poisoning, dog owners should be aware of products that contain xylitol as a sweetener, and keep those products out of the reach of their dogs.

What products contain xylitol and how do I find them?

Products containing xylitol have been available in the United States for a Xylitol sweetnernumber of years, but only recently have its use become main stream.  Today, xylitol can be readily found in chewing gums, toothpastes, mouthwashes and other oral care products, candies, and some pharmaceuticals.  On food labels, xylitol is classified broadly as a carbohydrate and more narrowly as a polyol.  To learn more about xylitol products, talk to Dr. Marinic.

Fluoride Treatments – Are They Really Necessary?

Water and faucetFluoride is a natural mineral that is found in various concentrations in soil and drinking water.

Why is fluoride important?

Every day, a tooth’s enamel (the outer layer that makes a tooth hard) has minerals both added to it (remineralization) and removed from it (demineralization).  During Tooth anatomyremineralization, minerals such as fluoride, calcium, and phosphate are added to the enamel layer via foods and drinks that contain these minerals.  Minerals are lost (demineralization) when acids—from bacteria in the mouth and certain foods and drinks – attack the enamel.  Tooth decay results when the enamel loses more minerals than it receives.

How does fluoride prevent tooth decay?

Fluoride helps to prevent tooth decay by making the tooth more resistant to acid attacks.  Fluoride also helps to speed remineralization of erupted teeth in both children and adults.

Where is fluoride found?

Fluoride toothpasteAlthough some foods, such as seafood and certain teas, naturally contain fluoride, the primary source of fluoride is drinking water.  Tap water in most cities in the United States contains fluoride.  Some, but not all, bottled waters contain fluoride.  Fluoride also can be applied directly to teeth through toothpastes and mouth rinses that contain fluoride.  You can buy these products at most pharmacies and grocery stores.

Dr. Marinic and/or his hygienist can also apply fluoride directly to your teeth in the form of a gel, foam, or varnish.  These products contain a much higher level of fluoride than toothpastes and mouth rinses.

When should fluoride use begin?

Infants and children between the ages of 6 months and 16 years shouldInfant smiling receive fluoride.  Their primary teeth and permanent teeth develop during these ages, so the stronger their enamel is, the better.  Because most children receive their first permanent teeth at around age 6, the Centers for Disease Control and Prevention recommends prescribing fluoride supplements for children between the ages of 6 and 16 who are at high risk for dental caries and whose community water source is less than optimal.  In areas that have minimal fluoride in the water, fluoride supplementation may begin earlier.

Although fluoride is an immediate concern for children and adolescents, adults also can benefit from fluoride.  Topical fluoride – including toothpastes, mouth rinses, and fluoride treatments – is as important for fighting tooth decay in adults as it is for strengthening the teeth of children.

When is additional fluoride necessary?

Additional fluoride treatment can benefit children and adults with certain oral conditions, including dry mouth, gum disease, and cavities.  Dry mouth makes an individual more prone to tooth decay because the decreased saliva production makes it harder to wash away food particles and thus decrease the cavity-causing acids.  Gum disease can expose more of the tooth and tooth roots to bacteria, increasing the chance of tooth decay.  Patients who have many cavities and develop new ones each year may benefit from additional fluoride treatment.

Additional fluoride might also be appropriate for patients with crowns, bridges, and braces, as the portion of the tooth that isn’t covered by a crown, bridge, or brace may be at greater risk for tooth decay.  To find out if you and/or your children are receiving enough fluoride or should consider fluoride treatment or supplements, ask Dr. Marinic.  He may prescribe fluoride supplements (in liquid or pill form) or offer suggestions for increasing the amount of fluoride you receive.

Is Everything OK in Your Mouth?

Dorothy cleaningRegular dental exams not only help decrease your risk of oral diseases, such as cavities and gum (periodontal) disease, but may also help to diagnose other, sometimes life-threatening, medical conditions.  Dr. Marinic is an important part of your health care team.  He is able to assess your overall oral health and may recognize symptoms of serious diseases, including diabetes and cancer, which often manifest as signs and symptoms inside your mouth.  There are many diseases with oral manifestations that, in many cases, may first present in the mouth.

Diabetes

More than 25 million people in the United States suffer from diabetes. Diabetes is associated with high levels of blood sugar and is known to lower resistancGum diseasee to infection and increase the chance of the following:

  • Gum disease, including gums that bleed easily or are tender and swollen
  • Tooth decay
  • Taste impairment
  • Inflammatory skin disease
  • Persistent bad breath
  • Changes in teeth position

Additionally, patients with diabetes (especially those with dentures) are more likely to experience oral fungal infections, including thrush (oral candidiasis).

Oral cancer

During your regularly scheduled dental check up, Dr. Marinic will also search for signs of oral cancer.  Oral indicators of cancer include:Oral cancer

  • Sores that bleed easily or do not heal
  • Crusted, rough areas of skin
  • Lumps or thick hard spots
  • Red, brown, or white patches
  • Changes in the lymph nodes or other tissues around the mouth and neck
  • Tenderness or pain, numbness inside the mouth
  • Changes in the way the teeth fit together

While Dr. Marinic will check all his patients for these signs and symptoms, patients with a history of smoking, using smokeless tobacco, or drinking heavily are at an increased risk for developing oral cancer.

Eating disorders

Eating disorderEating disorders, including anorexia nervosa and bulimia nervosa, physically damage both your oral and overall health.  These disorders, which include patterns of insufficient food intake or excessive food intake with purging, can rob the body of much needed vitamins and minerals.  These vitamin and mineral deficiencies can present themselves orally.   Without proper nutrition, the gums can lose their healthy pink color and become increasingly soft and tender, bleeding easily.

Additionally, disorders that involve excessive vomiting, such as bulimia, can cause discoloration and erosion of the teeth through constant contact with stomach acid. Those with eating disorders may also experience:

  • Swollen salivary glands
  • Dry mouth
  • Thin, sensitive teeth
  • Loss of tooth enamel

Alcohol use disorders

Alcohol use disorders affect more than 17 million adults in the United StatesAlcoholic beverages alone.  In addition to causing irreparable social and medical problems, alcohol use disorders can severely impact your oral health.  Dentists treating patients with alcohol abuse problems may observe the following signs and symptoms:

  • Tooth decay
  • Tooth erosion
  • Moderate to severe gingivitis (gum disease)
  • Gum irregularities
  • Poor dental hygiene

Be proactive about your oral health

Diseases that negatively impact your general health also can damage your teeth, gums, and mouth.  Regularly scheduled dental exams allow Dr. Marinic to detect or monitor these diseases and recommend treatment.  Patients should inform Dr. Marinic about all medical conditions they have or medicines they are taking, which may affect their oral health.  Remember, maintaining a healthy body includes taking care of your oral health.