Diabetes and Your Teeth!

  

  

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According to the U.S. Centers for Disease Control and Prevention, diabetes affects nearly 24 million people in the United States. The Academy of General Dentistry (AGD) encourages those with diabetes to pay extra attention to their oral health. Studies have shown that those with diabetes are more susceptible to the development of oral infections and periodontal (gum) disease than those who do not have diabetes. In addition, oral infections tend to be more severe in people with diabetes than in those who do not have the condition.

Because diabetes reduces the body's resistance to infection, the gums are at risk for gingivitis, an inflammation usually caused by the presence of bacteria in plaque. Plaque is the sticky film that accumulates on teeth both above and below the gum line.

"Without regular dental checkups, gum disease may result if gingivitis is left untreated. Gingivitis also can cause inflammation and destruction of tissues surrounding and supporting teeth. To prevent problems with bacterial infections in the mouth, a dentist may prescribe antibiotics, medicated mouthrinses, and more frequent cleanings for a patient with diabetes.

The established connection between oral health and systemic health suggests that diet and exercise may be the most important change that people with diabetes can make to improve their quality of life and oral health. People with diabetes should be sure that their medical and dental care providers are aware of their medical history and periodontal status. To keep teeth and gums strong, people with diabetes should be aware of their blood sugar levels and have their triglycerides and cholesterol levels checked on a regular basis, as these factors may have a direct correlation with their risk for gum disease.

People with diabetes who do not have good control over their blood sugar levels tend to have more oral health problems.  If your blood sugar is not under control, talk with both your dentist and physician about the possibility of receiving dental treatment beyond routine checkups and cleanings.

It is recommended that patients with diabetes schedule their dental appointments for the morning hours, because blood glucose levels tend to be under better control at that time of day. Patients should eat and take their medications as directed prior to a dental appointment.

Healthy Halloween Facts

  

  

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More than 90 percent of children will go trick or treating this year and return home with bags full of sugary candy that can turn anyone's mouth into a nightmare.

Since childhood obesity is becoming a problem, it might be a good idea to keep the candy consumption under control this year.

Childhood obesity has more than tripled in the past 30 years.
    In 1980 age group 6 to 11 years increased from 6.5% to 19.6% in 2008.
    During the same time span 12 to 19 years increased from 5.0% to 18.1%. Therefore, Halloween is not the time to have high caloric, sugary sweets around the house for anytime snacking.


Healthy Halloween Snacks Suggestions:
  Single-serving boxes of cereal
  Single-serving packets of microwave popcorn
  Cheese sticks
  Pretzels
  granola or breakfast bars
  Cheese and cracker packages
  Packages of trail mix
   Ginger snaps
  Graham crackers
  Vanilla wafers
  100 calorie snack packs

Non-Food Halloween treats
  plastic rings
  pencils
  stickers
  erasers
  Mouse pads
  Inexpensive flash drives
  Temporary tattoos

Monitor your children’s intake, and only allow eating in moderation. A good rule of thumb is “Never stock your house with your absolute favorite candy... You know who will eat most of it”!

The below list should help you if you must do candy:

  Best chocolate miniature: 3 musketeer’s mini. (24 calories, < 1 gram of fat)
  Worst chocolate miniature: butterfingers mini. (45 calories, 2 grams of fat)

  Best fruity candy: fun size lemon heads. (50 calories, o grams of fat for 10 pieces)
  Worst fruity candy: starburst fruit chews (204 calories, 4 grams of fat for 10 pieces)

  Best full size candy: York peppermint patty. (140 calories, 2.5 g fat)
  Worst full size candy: Snickers (280 calories, 14g fat) packed with peanuts and calories too!

  Best Halloween specialty candy: peeps pumpkins. (16 calories, 0 g fat)
  Worst Halloween specialty candy: Reese’s peanut butter pumpkins. (170 calories, 10g fat)

   Best overall pick: tootsie Carmel apple pop (60 calories, 0.5g fat). They last a long time and you won't need seconds or thirds.

Sleep Apnea

  

  

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   A good night’s sleep has the power to restore the body and enliven the mind. For the 18 million Americans who experience symptoms of sleep apnea, a good night’s sleep also has the power to save their lives. Obstructive sleep apnea is a serious, life-threatening disorder that is characterized as a series of episodes in which a person stops breathing for 10 seconds or longer during sleep, according to the Academy of General Dentistry (AGD). 

   So, how would someone know if he or she had sleep apnea? Snoring is a major indicator, but not all symptoms are so obvious—and audible. A dentist can detect the less evident symptoms of sleep apnea through a candid conversation with a patient, in conjunction with an exam, about the patient’s recent pains or discomforts. A dentist may suspect a patient suffers from sleep apnea if the patient complains about lethargy, morning headaches, or dry mouth (typically caused by open mouth breathing during sleep).

   Dentists are often the first professional to become aware of a potential problem since they are usually in contact with their patients more frequently than are physicians. Dentists will send patients with symptoms of sleep apnea to a sleep medicine specialist who will assess the patient’s conditions. If a patient is diagnosed with the disorder, he or she may return to the dentist to receive treatment.

   Treatment options for sleep apnea vary depending on the severity of the disorder. An individual with mild sleep apnea may need to make behavioral changes such as altering the sleeping position, losing weight, or quitting smoking, as well as wearing a dental appliance during sleep. A dental appliance for sleep apnea, which looks similar to an athletic mouthguard, repositions the jaw and tongue to improve airflow.

   “Like any appliance they do require some adjustment and a commitment on the part of the patient, but they are typically as easy to wear as most retainers or other removable dental appliances”. Treatment for severe cases of sleep apnea requires more aggressive management, which may include the use of a continuous positive airway pressure (CPAP) system—a device that delivers air through a small mask and applies constant pressure to keep the air way open—or surgery.

   Most dentists have undergone special training for the treatment of sleep apnea and are very skilled in its management using behavioral modification and dental appliances, but a confirmed diagnosis from a sleep medicine specialist is required before any treatment can be administered. Because sleep apnea can be a silent condition, it can go undiagnosed for many years. It is important to keep an open and honest dialog with health care professionals to ensure that conditions such as sleep apnea can be identified and properly treated.

What are the symptoms of sleep apnea?

People with sleep apnea usually do not remember waking up during the night. Indications of the problem may include:

• Morning headaches

• Excessive daytime sleepiness

• Irritability and impaired mental or emotional functioning

• Excessive snoring, choking, or gasping during sleep

• Insomnia

• Awakening with a dry mouth or sore throat

If you have any questions or concerns about dental problems or just want useful information, don’t forget to  “Ask Dr. Pierson” at pdastaff@gmail.com. Your question may be the next blog!

Dentist suggest "5 reasons to keep your teeth and gums healthy"

  

  

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1. Risk of heart disease

Be heart smart. According to the American Heart Association, periodontal infections are linked to heart disease — the leading cause of death in the U.S. Gum disease is caused by plaque buildup and affects 75 percent of American adults. Here's how it affects your ticker: when bacteria from infected gums dislodge, it can enter the bloodstream, attach to blood vessels and increase clot formations. Clots decrease the blood supply flow to the heart and can increase your chances of, you guessed it, heart attack.

2. Danger of diabetes

Nothing's sweet about this connection. As we've mentioned, poor oral care can cause bacteria to enter the bloodstream. This can activate our immune cells. These activated cells produce inflammatory biological signals called cytokines that have a destructive effect throughout the entire body. In the pancreas, the cells responsible for insulin production can be damaged or destroyed by chronic high levels of cytokines. Once this happens, watch out. It may induce Type 2 diabetes — even in otherwise healthy individuals with no other risk factors for diabetes.

3. Cancer threat for men?

Research published recently in The Lancet Oncology, a leading general medical journal, found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. In fact, researchers uncovered that men with periodontal disease may be 49 percent more likely to develop kidney cancer, 54 percent more likely to develop pancreatic cancer,  and 30 percent are more likely to develop blood cancers. “Previous research has suggested a potential link between gum disease and other conditions such as heart disease, diabetes and rheumatoid arthritis,” says Dr. Susan Karabin, President of the American Academy of Periodontology (AAP). “This study should prompt men to be particularly mindful of their teeth and gums now that gum disease may play a role in the onset of cancer.”

4. Chronic bad breath

People shying away from you? Periodontal disease is a leading cause of bad breath. Advanced forms of periodontal disease typically result in serious damage to the bone that holds your teeth in place. As this bone damage occurs, deep spaces form between the teeth and gums. These pockets provide an ideal location for bacteria. In many cases it is waste products coming from the bacteria that reside in these periodontal pockets — pockets which are often so deep that a person cannot effectively cleanse them. This is the cause of a person's bad breath.

5. Your teeth are your smile

Let's get back to where this all started: your mouth. Remember you are what you eat! Gum disease is a widespread problem that is associated with swelling, bleeding, pain, redness of the gums — and the eventual loss of teeth. We all want a healthy smile, yet gum disease, a sign of oral neglect, is the most prevalent disease Americans suffer from. And it doesn't discriminate. While the risks grow as we age, people at all ages are afflicted. The worst part? It's entirely preventable!

If you have questions or concerns about any dental problem, or just want useful information, dont forget to "Ask Dr. Pierson!"

14 Tips to reduce Bad breath

  

  

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1. Brush your teeth and rinse your mouth thoroughly after every meal to remove food particle from the mouth.

2. When you are brushing your teeth, also brush your tongue. The tongue is covered with thousands of tiny hairs that can trap bacteria.

3. Have regular check-ups with your dentist to rule out gum disease and to correct any faulty restorations, overhanging fillings or leaking crowns, all of which can trap food in the mouth.

4. Chew sugarless gum or suck on sugarless lozenges to increase the flow of saliva.

5. If your mouth is dry, drink plenty of water. Try swooshing it around in your mouth for at least twenty seconds to loosen any food particles the bacteria can feed upon.

6. Avoid breath mints and mouthwashes that contain alcohol. Instead of helping, they can make things worse. They only temporarily cover the smell and tend to dry the mouth, creating a more favorable environment for bacteria.

7. Snacking on vegetables such as raw celery or carrots can keep plaque from forming.

8. If you are going to an important meeting or on a big date, avoid foods that can cause bad breath, such as onions and garlic.

9. Avoid alcohol and caffeine consumption, which can dry the mouth.

10. Quit smoking. Tar and nicotine can build up on the surface of the teeth, tongue and cheeks. It can also dry the mouth and inhibit saliva flow.

11. Chlorophyll is a natural breath freshener and is found in leafy green vegetables like parsley.

12. A few drops of peppermint or tea tree oil can be applied to the tongue or toothbrush to help freshen the breath. In addition to its refreshing nature, their antibacterial properties will kill the bacteria found in the mouth.

13. Baking soda has a long history of being used to maintain good oral health and for fighting bad breath.

14. A mixture of 50% hydrogen peroxide and 50% water can be swooshed around in the mouth and used as a mouthwash. Hydrogen peroxide can kill many of the bacteria that can cause bad breath.

5 Healthy Foods that ruin your teeth!

  

  

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  We all have heard a million times about what candy and soda can do to your teeth. From this information most of us have made the decision to "eat healthier" but are the choices we are making truly healthy. 
 
 We all know vitamin C is health and we will tend to eat fruits and vegetables rich in vitamin C. However, one of the worst things you can eat is grapefruit. Yes grapefruit.

 
 Grapefruit.

     This citrus fruit is high in the antioxidant vitamin C and filling fiber. But grapefruit is extremely acidic. If you eat it very often, it can cause erosion, also Dr Pierson warns against the enamel-eroding habit of sucking on another acidic citrus fruit: lemons.

 
Dried Fruits.

     Although raisins, prunes and dried apricots are antioxidant-rich ways to curb your sweet tooth, they're not good for your oral health. "They're sticky and extremely concentrated in sugar. When dried fruits get stuck in the crevices between your teeth, the sugars keep acid production going, which erodes enamel and causes decay.
 
 Whole Grain Bread.

     Sugar is the worst offender when it comes to oral health, "But people forget that carbohydrates break down into sugars too." That means that even healthy whole grains feed bacteria in your mouth, which causes acid production and encourages the growth of cavity-causing plaque.

 Popcorn.

     This is a healthy food that won't hurt your teeth right? Well yes and no! Although the butter-drenched tubs you munch at the movies aren't health food, air-popped popcorn is a healthy snack. It's a whole grain that provides cholesterol-lowering fiber; plus, it's a high-density food, which means it fills you up for few calories. So what's the problem? The husks of the kernels can easily get stuck between your teeth and cause infection, and uncooked kernels can actually crack your teeth. We treat about 2 patients per month with a popcorn husk stuck between their teeth and gums. 

 
 Sports Drinks.

    You've heard that soda is harmful to your teeth, but you may be surprised to learn that sports drinks are too. In one recent study, when researchers from the Iowa College of Dentistry exposed healthy teeth to juice, soda and sports drinks for 25 hours, the teeth had the greatest loss of enamel after being exposed to sports drinks.
 
 You vowed to be healthier, work out, and be active so how can I utilize the benefits of a sports drink?  Use a drinking straw or simply drink water.

Why Do I Snore?

  

  

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Why Do I Snore?

 
It is estimated that 30 million adults snore on a regular basis.
 
The severity of snoring varies. It can be a mild nuisance, or a symptom of a more serious, problem called sleep apnea. Snoring can cause excessive daytime sleepiness, memory impairment, morning headache, poor work performance and loss of sexual drive. (Now I have your attention!)
 
While snoring itself is not life threatening, it can interfere with a good night's sleep for you, and anyone around you. Scientific studies have found that people within an earshot of snorers lose up to a 2 hour of sleep a night because of the nuisance.

Silent Nite Snore Appliance

Dr. Melvin K. Pierson, DDS, FAGD, FADI is playing a key role in the treatment of certain sleep disorders, including snoring and sleep apnea. Why? Because “A good night's sleep has the power to restore the body and enliven the mind.”
 
Dr. Pierson will complete an initial consultation to determine the problem by asking several questions, reviewing  airway blockage, and taking  jaw measurements.  Once the initial consultation is completed, Dr. Pierson may consult with a physician or a sleep clinic to have a sleep study performed.
 
Snoring is caused by vibration at the back of the throat, and dental appliances help to minimize or eliminate the problem. For basic snorers, an oral appliance can provide relief because it repositions the jaw and tongue. The appliance helps breathing become less labored, giving a person more room to breath quietly.

For those with sleep apnea, (a much more serious condition), Dr. Pierson refers patients to a sleep clinic for a sleep study test. Some of these patients will need a CPAP Machine while others may be treated with a specific sleep appliance. People with sleep apnea do not get enough oxygen during sleep, and breathing actually stops for a short period of time.

patient wearing a CPAP

If you snore, or want to reduce the symptoms of snoring, Dr. Pierson recommends losing weight, quitting smoking, reducing alcohol consumption, and a visit to the dentist for a snore appliance.

Why do dental patients wait?

  

  

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I’ve been a practicing dentist for over 18 years. Yet, I find myself always asking “Why do patients wait?” Some of it, I do understand. Maybe fear, maybe money, maybe for no reason at all. Nevertheless, why wait?

I have had several patients call or email the office for an emergency visit. We usually get them in the office the same day. Our office philosophy is “if you have a problem today, and call today, let’s try to see you today”.  At that emergency visit, I ask the patient, “What made you call the office today”? The most common answer is pain. Then I’ll do a little more investigating. I’ll ask how long have you been in pain? Now here is where it gets interesting. Some patients will say the pain started last night, or it started a few days ago. I’ll then ask, has this pain ever been there before? 95% of the times, these questions are answered YES! So back to my original question, why do patients wait?

To really answer this question, let’s stop all this talk about teeth, dentistry, emergency visits,

money and fear. Let’s talk cars. You bring your car to the mechanic for simple oil change. During the simple oil change, the mechanic says, you need your belts and hoses changed. If you don’t fix them soon, they will cause big, expensive problems. Do you have him change it at that time, or do you wait?  Do you wait because of money or fear he may find something else?  Most people will have the belts and hoses changed at that time. Why? Because most people don’t want to breakdown on the side of the road with a problem they were already warned about.

Now back to dentistry, you have a routine dental checkup, and the dentist tells you have a deep cavity, and it will cause you problems if it is not fixed in the near future. What do you do? Do you wait, or have it fixed? Do you wait because of money, fear or both? Most people choose to wait, and this is what turns into a dental emergency. Car problems won’t fix themselves, and neither will dental problems. Waiting only increases the cost (of both the car and the teeth). Waiting also increases the fear of both. A breakdown at night on I-95, needing a tow and being stuck for hours, is just as bad as a breakdown of a tooth, and needing an emergency repair in the middle of the night. Both problems could have been avoided “by taking care of the problem when you know there is a problem”.

One last interesting fact is according to ask.com “the average time an American keeps a car is 4 to 5 years”, when your teeth are supposed to last a lifetime! Don’t wait, it will only get worse!

Need more dental infomation, ask Dr. Pierson!

Beware of Teeth Whitening!

  

  

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This weekend, one of my staff members (one of my hygienist) attended the Philadelphia Home and Garden Show. While there, her and her mother (who is also a Dental Hygiene Instructor at a Local College) saw a booth performing teeth whitening. Of course these two very well dentally educated ladies approached the booth. There was a person in the booth performing teeth whitening. These two ladies decided to ask a few questions about the procedure, and these questions were things the general public may or may not have known. Questions like: What type of dental training do you have? How do you know if a patient has gum disease or periodontal disease? What would you do if a person had tooth sensitivity after the procedure? What about cavities or abfraction?

Some of the answers may or may not surprise you. This person (at the home and garden show) claimed to be a dental hygienist, but his answers were very un-hygienist like. When he was asked, “How would you know if a patient had gum or periodontal disease?” He answered “by just looking at the patient’s teeth and gums”. This is absolutely incorrect information. Any dental professional would know that “you can’t diagnose gum disease by visual examination only. You need a combination of things like x-rays, and the most important instrument for diagnosing gum disease, “the periodontal probe”. The periodontal probe is a measuring tool, to measure the pockets around each and every tooth. It measures in millimeters (mm) with 3 mm or less is considered “healthy”. Unhealthy or various stages of periodontal (gum) disease depends on the measurements. 4-6mm is moderate, and greater than 7mm is severe. X-rays show the level of bone support or in this case, the lack of it. Gum Disease ATTACKS the bone around the teeth. That’s why severe cases of gum disease cause teeth to become loose. This is why it takes all 3 tools (visual, x-rays, and the periodontal probe) to make the diagnosis of periodontal disease.

Another big question was “What would you do if a person had tooth sensitivity after the procedure?” He (the home and garden hygienist) would recommend you to “just visit your dentist”. Isn’t that interesting? This company can perform a dental tooth whitening procedures during a home and garden show yet they are untrained on how to resolve any problems that may arise from the procedure.

Do yourselves a huge favor! Only get tooth whitening procedures from a dentist. Why? Because if any problem arise, the dentist knows what has been prescribed and how much of it that has been used. In the case of the teeth whitening at the home and garden show, this company will be long gone by the time you would normally visit your dentist and how would your dentist know what type of whitening material that was used? How would your dentist know how much was used? What moderation? What duration? Now imagine trying to track down this company to find out the answers to these questions? Talk about things that make you go hmmmm!

If you have any dental questions, don’t forget to “Ask Dr. Pierson!”

Cap (Crown) Replacement

  

  

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Dr. Pierson, I was recently with a friend who told me that she needed to have a crown replaced for no other reason except that it was 5 years old. It did not require root canal prior to placement and has caused her no difficulty. Is this a common practice?

This is an excellent question? Crowns by today’s standard have a life expectancy of at least 5 years. In most cases, the crowns last far beyond that expectation. It is NOT a common practice to replace a crown, the only reason being “its 5 years old”. However, there can be a number of reasons as to why the crown is being recommended for replacement:

1. Esthetics.   Does the crown still look good? One of the primary materials used to make a crown is porcelain. Porcelain is a “color fast” material (meaning it is resistant to color change). Natural teeth, on the other hand are NOT color fast, as they fade in color as we get older. Most patients think “the crown has changed colors and does not match the color of their natural teeth”.  It’s really the other way around. So if the color of the crown is not the same color as the natural teeth, this may warrant a crown change.

2. Marginal Wear.   Crown margins are the area of the crown that comes in contact with the tooth and surrounding gingiva (gums). Marginal wear looks unrealistic because if the crown has a metal substructure, the metal shows around the crown. If the crown has no metal substructure there will be a void between the crown and natural tooth. Most patients do not pick this up until pointed out by the dentist or hygienist. Marginal wear may also lead to tooth decay.  In the below photograph, the middle tooth has marginal wear.                    

3. Excessive Wear.    Dental crowns can wear out, especially in those cases where a person has a habit of bruxism (clenching and grinding their teeth). A dentist will sometimes detect a small hole on the chewing surface of a dental crown in that area where it makes contact with an opposing tooth (meaning a tooth that touches on the crown when you bite). Since the seal of the crown has now been lost, your dentist will probably recommend a new crown.

4. Tooth Decay.     A simple rule of thumb, “crowns cannot decay but teeth can”! If dental plaque is allowed to accumulate on a tooth in the area where the crown and tooth meet, (the area of marginal wear) tooth decay can and usually does start. In some cases, your dentist must remove the crown in order to remove the decay. This is the worst case scenario, and this will also require a crown replacement.

If you have any other dental concerns or questions, don’t forget to “Ask Dr. Pierson”!