Posts for: June, 2021
Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.
The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").
Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.
The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.
Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.
Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.
It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.
Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.
If you would like more information on dental care and HIV-AIDS, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “HIV-AIDS & Oral Health.”
Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.
There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.
Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.
Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.
An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.
But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.
Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).
The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.
So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.
If you would like more information on diabetes and dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants & Diabetes.”
After a year of lockdowns and other COVID-19 restrictions, people are itching this summer to get back out into the great outdoors. The good news is that quite a number of national and state parks are open. But there may still be some restrictions, and you might need reservations in busier parks. The key is to plan ahead—and that includes for normal contingencies like dental emergencies.
Anyone who's physically active can encounter brunt force to the face and jaws. A tumble on a hike or a mishap with a rental bike could injure your teeth and gums, sometimes severely. But if you're already prepared, you might be able to lessen the damage yourself.
Here's a guide for protecting your family's teeth during that long-awaited summer vacation.
Locate dental and medical care. If you're heading away from home, be sure you identify healthcare providers (like hospitals or emergency rooms and clinics) in close proximity to your vacation site. Be sure your list of emergency providers also includes a dentist. Besides online searches, your family dentist may also be able to make recommendations.
Wear protective mouth gear. If your vacation involves physical activity or sports participation, a mouthguard could save you a world of trouble. Mouthguards, especially custom-made and fitted by a dentist, protect the teeth, gums and jaws from sudden blows to the face. They're a must for any activity or sport with a risk of blunt force trauma to the face and jaws, and just as important as helmets, pads or other protective gear.
Know what to do for a dental injury. Outdoor activities do carry a risk for oral and dental injuries. Knowing what to do if an accident does occur can ease discomfort and may reduce long-term consequences. For example, quickly placing a knocked out tooth back into its socket (cleaned off and handled by the crown only) could save the tooth. To make dental first aid easier, here's a handy dental injury pocket guide (//www.deardoctor.com/dental-injuries/) to print and carry with you.
And regardless of the injury, it's best to see a dentist as soon as possible after an accident. Following up with a dentist is necessary to tidy up any initial first aid, or to check the extent of an injury. This post-injury dental follow-up will help reduce the chances of adverse long-term consequences to the teeth and gums.
Your family deserves to recharge after this tumultuous year with a happy and restful summer. Just be sure you're ready for a dental injury that could put a damper on your outdoor vacation.
If you would like more information about preventing or treating dental injuries, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “An Introduction to Sports Injuries & Dentistry.”