Your teeth can take decades of daily biting and chewing and not miss a beat. But they do have a nemesis, dental disease, which can easily get the upper hand. As a result, millions of people lose teeth each year to tooth decay and periodontal (gum) disease.
But while both the living tissue that makes up teeth and gums are susceptible to bacterial attack, the non-living materials in a life-like dental implant are impervious to disease. That being the case, you would think your implants wouldn't need as much hygiene as your other teeth.
But they still do. True, implants in themselves aren't affected by infection, but the bone and other tissues that support them can become diseased. This often happens with advanced cases of gum disease.
There is, in fact, a particular form of gum infection associated with implants called peri-implantitis ("peri"—around; "it is"—inflammation), which occurs in the gums around an implant. Once it starts, peri-implantitis can advance at a rapid pace.
This is because implants don't have the gum attachment of real teeth, which can fight and slow the advance of a gum infection. Because an implant doesn't have this attachment, any infection around it continues virtually unimpeded. If the bone supporting an implant becomes infected, it can weaken to the point that the implant fails.
But this dire scenario can be avoided with continuing hygiene and maintenance of the gum tissues surrounding the implant. You should brush and floss every day around implants to remove dental plaque, the bacterial film most responsible for dental disease, just as you do with natural teeth.
It's also important to keep up regular dental visits for cleanings to remove lingering plaque and tartar (hardened plaque). Your dentist may also notice and clean away any residual cement from the restoration, which can also cause gum inflammation.
And, you should promptly see your dentist if you notice any telltale signs of a gum infection, such as swelling, redness or bleeding, especially around implants. The quicker we diagnose and treat a case of gum disease, particularly peri-implantitis, the less likely it will endanger your implant.
Half of adults over age 30, and an astounding 70% over 65, have had some form of periodontal (gum) disease. Unchecked, a bacterial gum infection can spread into the supporting bone and destroy attachments between the teeth and gums. Because of its rapidity and aggressiveness, gum disease is the number one cause of tooth loss among adults.
But there may be even more harm caused by gum disease beyond losing teeth: There's growing evidence gum disease may worsen other diseases like diabetes, heart disease or rheumatoid arthritis. Patients with gum disease are also more likely to suffer from one or more of these systemic conditions.
The link between gum disease and these other diseases appears to be inflammation. When tissue becomes injured or diseased, swelling (inflammation) occurs to isolate these tissues from the rest of the body. Under normal circumstances, this is a critical defense mechanism to protect the body overall.
But this response is a temporary measure—if it becomes chronic, it can actually damage the tissues it's trying to protect. This often happens with gum disease as inflammation can't overcome the gum infection, and both sides settle into a kind of trench warfare. The same story plays out with other diseases with an inflammatory response. And if the body is waging war with a gum infection, it can worsen these other conditions.
It's important then to take care of your gums and the rest of the body to minimize chronic inflammation. You can help prevent a gum infection by brushing and flossing every day and getting your teeth cleaned professionally at least every six months. You should also see your dentist if you notice swollen, reddened or bleeding gums, often the first signs of gum disease.
It can also benefit your gums if you're addressing other inflammatory issues in your body. Besides regular medical care, you can reduce your risk for other systemic diseases by eating a healthy diet, keeping your weight at an optimum level and avoiding smoking.
The individual parts of your body aren't isolated islands: Diseases that affect one can eventually affect all. By preventing or treating gum disease as early as possible, you'll also help reduce the effects of other systemic diseases.
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.”
If you're a fan of former NFL player and current host of Good Morning America Michael Strahan, then you're well aware of his unique smile feature—a noticeable gap between his front teeth. So far, Strahan has nixed any dental work to correct the gap, often saying it was part of "who I am."
But if you follow him on Twitter, you may have been shocked by a video he posted on March 30th of him sitting in a dentist's chair. Calling it a "moment fifty years in the making," Strahan said, "Let's do it." After some brief video shots of a dental procedure, Strahan revealed a new gapless smile.
But some of his Twitter fans weren't buying it—given the timing, they sniffed an elaborate April Fool's Day ruse. It turns out their spider senses were on target: Strahan appeared once again after the video with his signature gap still intact, grinning over the reaction to his successful prank.
The uproar from his practical joke is all the more hilarious because Strahan has let it be known he's truly comfortable with his smile "imperfection." But it also took him awhile to reach that point of acceptance, a well-known struggle for many people. On the one hand, they want to fix their dental flaws and improve their smile. But then again, they're hesitant to part with the little "imperfections" that make them unique.
If that's you, here are some tips to help you better navigate what best to do about improving your smile.
See a cosmetic dentist. A cosmetic dentist is singularly focused on smile enhancement, and particularly in helping patients decide what changes they want or need. If you're looking for such a dentist, seek recommendations from friends and family who've changed their smiles in ways you find appealing.
Get a "smile analysis." Before considering specific cosmetic measures, it's best to first get the bigger picture through an examination called a "smile analysis." Besides identifying the defects in your smile, a cosmetic dentist will use the analysis to gauge the effect any proposed improvements may have on your overall facial appearance.
Embrace reality. A skilled cosmetic dentist will also evaluate your overall oral health and assess how any cosmetic procedures might impact it. This might change your expectations if it whittles down the list of enhancement possibilities, but it may help determine what you can do to get the best improved smile possible.
A great cosmetic dentist will work diligently with you to achieve a new smile that's uniquely you. Even if, like Michael Strahan, you decide to keep a trademark "imperfection," there may still be room for other enhancements that will change your appearance for the better.
There are great health benefits to eating better, including for your teeth and gums. But to determine your ideal diet, you'll have to come to terms with carbohydrates, the sugars, fiber and starches found in plants or dairy products that convert to glucose after digestion.
Carbohydrates (also known as carbs) are important because the glucose created from them supplies energy and regulates metabolism in the body's cells. But they can also create elevated spikes of glucose in the bloodstream that can cause chronic inflammation. Besides conditions like diabetes or heart disease, chronic inflammation also increases your risk of periodontal (gum) disease, a bacterial infection arising from dental plaque.
Many concerned about this effect choose either to severely restrict carbs in their diet or cut them out altogether. But these hardline approaches deprive you of the benefits of carbs in maintaining good health. There's a better way—and it starts with understanding that not all carbs are the same. And, one difference in particular can help you properly manage them in your diet.
Here's the key: Different carbs convert to glucose at different digestive rates of speed measured on a scale known as the glycemic index. Carbs that digest faster (and are more apt to cause glucose spikes in the bloodstream) are known as high glycemic. Those which are slower are known as low glycemic.
Your basic strategy then to avoid blood glucose spikes is to eat more low glycemic foods and less high glycemic. Foods low on the glycemic index contain complex, unrefined carbohydrates like most vegetables, greens, legumes, nuts or whole grains. High glycemic foods tend to be processed or refined with added sugar like pastries, white rice, or mashed potatoes.
Low glycemic foods also tend to have higher amounts of minerals and nutrients necessary for healthy mouths and bodies. And fresh vegetables in particular often contain high amounts of fiber, which slows down the digestion of the accompanying carbohydrates.
Eating mainly low glycemic foods can provide you the right kinds of carbs needed to keep your body healthy while avoiding glucose spikes that lead to inflammation. You're also much less likely to experience gum disease and maintain a healthy mouth.
If you would like more information on nutrition 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 “Carbohydrates Linked to Gum Disease.”
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