Archive for the ‘Oral Conditions’ Category

I asked Helen, a patient of mine in her late 70’s who regularly reads my “Ask The Gentle Dentist” column what she would like to see in my June Ask the Dentist column.  She thought it would be a good idea for me to write an article on the Periodontal Disease / Gum Disease.  This was inspired because a friend of hers was recently diagnosed with adult onset diabetes and Periodontal and Gum Disease.  I posted an article some time ago on the co-relationship between Periodontal and Gum Disease and other systemic diseases like diabetes and heart disease.  Smoking, high cholesterol, high blood pressure and Periodontal Disease / Gum Disease all create inflammation in the body and are potential agents that can cause heart disease.

There is accumulating evidence and data that shows that the bacteria that causes Periodontal Disease / Gum Disease gets into the blood system creating chronic inflammation.  This chronic inflammation activates a protein called C-Reactive Protein into the blood eventually creating a higher risk of stroke, heart attacks by hardening of the arteries (atherosclerosis) in coronary (heart) and carotid arteries.

Diabetes is a growing problem that now affects over 7% of Americans and is still on the rise.  In fact, in the 1980s there were 5 million people diagnosed and now there are over 23 million. About 30% of diabetics are not even diagnosed. The most common reason why there is such a rapid rise in the incidence is because of the sedentary lifestyle that Americans are living.  Fast foods, high sugar drinks, lack of exercise has created an obese population. In fact the CDC states that over 26% of Americans are obese (120% of normal body weight)!!   Obviously watching diet and exercise can go a long way to a better, healthier body.

What is diabetes?  Insulin is a naturally occurring hormone made naturally in the body.  When carbohydrates are eaten the body rapidly breaks it down to simple sugars which are rapidly absorbed into the blood stream.  Insulin is then released in response to the high levels of blood sugar.  Insulin allows the sugars to penetrate into the cells of the body when it is needed.  Diabetes is therefore the inability of the cells to absorb the blood sugar due to a lack of this insulin

There are three types of diabetes:

• Type 1 is where the body’s immune system actually destroys the cells that make insulin.  This is genetic in nature and is usually diagnosed at an early age. It is also the most severe form of diabetes.
• Type 2 is also known as adult onset diabetes.  In this situation the body doesn’t create enough insulin.  90-95% of diabetics are type 2, but this number is rising at an alarming rate.
• Gestational diabetes develops during pregnancy, but after birth the body rebounds back to health.

Diabetics are at risk for blindness, Stroke, amputation of toes and legs, Heart attack, numbness, kidney failure, early death, and Periodontal Disease / Gum Disease. A well controlled diabetic who exercises and eats properly has the same risk of these problems as a healthy individual.  It is therefore important to take medicines along with diet and exercise to live a somewhat normal life.

Periodontal (gum) disease is described as a bacterial infection and inflammation of the bone and soft tissues that hold the teeth into the jaw.  This infection usually is not painful or sometimes not easily seen without a proper diagnosis by your dentist.  The bone around you teeth that is dissolved from the disease will never come back but with proper treatments the bone level can stabilize.

You know you have Periodontal Disease / Gum Diseaseif you have bad breath, your gums bleed when brushing or flossing and/or your teeth are loose and shift around.    Since it is usually not painful (like most chronic diseases) you may have Periodontal Disease / Gum Disease and not even know about it.

Periodontal Disease / Gum Disease is considered to have a bidirectional relationship with diabetes.  In other words diabetes affects the severity and complications of Periodontal Disease / Gum Disease and the periodontal disease affects diabetes and the ability to control blood sugar levels.  The National Diabetic Association states this and research supports this claim.

The bottom line is that if you or a loved one has been diagnosed with diabetes you are at risk for Periodontal Disease / Gum Disease.  If you have a difficult time in regulating your blood sugar then a periodontal evaluation is critical so that you not only can save your teeth, but potentially save your life.

Do me a favor and mention this article to your physician so that they can also be informed and team up with dentist’s to combat this serious problem.

For more information on this please visit the American Heart Association www.AmericanHeart.org website.

If you have questions or comments you can email me at DrAntolak@TheGentleDentist.com or phone us at (586)247-3500

If you have diabetes and desire a free dental consultation please give us a call.  Our dental office is located in Shelby Township, Michigan (Macomb County) at 22 Mile and Hayes.

Snoring: Causes and Treatment options to help with this Social Problem

During a recent Boy Scout outing my son Matthew and I went to Muskegon to sleep on the World War II submarine USS Silversides.  This is quite an experience spending the night on such a vessel.   I have such an appreciation for what the men who served in the war did for our country some 65 years ago and the sacrifices they gave.  If you are in the area take some time to explore this great piece of history.

During the night sleeping in a confined setting with others I experienced what many have to deal with every night—SNORING!!!  I had quite a sleepless night sleeping next to a man who snored after every breath.   I gave him my business card and told him that I can help him with a snoring appliance that I will later describe.  It became apparent to me what I needed to write my monthly article on.  There are a few observations I made here that I think snorers need to hear and appreciate.

Those who snore without a stoppage of breathing are usually not affected by their actions.   Even though there is nothing they can consciously do about their actions it remains an obtrusive act to others.   Even with the use of ear plugs the sound can penetrate and keep others awake.

This act of snoring can lead to embarrassment and feeling of hopelessness to those who snore.

Being married to one who snores can have a effect on the marriage because it keeps the other spouse up at night creating resentment and exhaustion for them.  Many partners of snorers decide to sleep in separate rooms, and the resulting lack of bedtime chatting and physical intimacy can lead to a strained relationship. The person who snores often becomes isolated and frustrated about a problem they seemingly have no control over.

Negative Physical Consequences of heavy snoring and sleep apnea:

Deep snoring can lead to a more physically serious problem called sleep apnea. Sleep apnea is when one stops breathing during one of the snoring cycles.  As one goes into a deeper level of sleep the muscles in the back of the throat get more relaxed and eventually close off the airway.  They will eventually gasp for air after a 10-15 second episode of not breathing because the brain senses a decrease in blood oxygen.  During this oxygen deprivation the body produces a surge of adrenaline deposited into the blood stream which raises blood pressure and gets the heart to pump harder.  The person can develop systemic problems like diabetes, chronic fatigue, high blood pressure and a whole host of other problems from this potentially serious problem.

Causes of snoring out of our control:

• Heredity – A narrow throat, a cleft palate, enlarged adenoids and other physical attributes which contribute to snoring can be hereditary.
• Being middle-aged or beyond – As you age, your throat becomes narrower, and the muscle tone in your throat decreases.
• Being male - Men have narrower air passages than women and are more likely to snore.
• Allergies, asthma, a cold, or sinus infections – Blocked airways make inhalation difficult and create a vacuum in the throat, leading to snoring.

Remedies:

• Lose weight – Losing weight is often a very effective cure for mild to moderate snoring. Even a little bit of weight loss can reduce fatty tissue in the back of the throat and decrease snoring.
• Sleep on your side – If you sleep on your back and snore mildly, sleeping on your side might cure your snoring altogether.
• Elevate your head – Try elevating the head of your bed four inches, which may make breathing easier and encourage your tongue and jaw to move forward. Sleep without a pillow (or with a specially designed pillow) to make sure your neck muscles are not crimped.
• Avoid certain foods, alcohol and medications before bed – Alcohol and certain medications increase relaxation of throat and tongue muscles, which makes snoring more likely. Sleeping pills or tranquilizers may help you sleep, but they will also relax your muscles and increase the chance of snoring. High-fat milk products or soy milk products cause mucus to build up in the throat which can lead to snoring as well.
• Clear your nasal passages – Having a stuffy nose makes inhalation difficult and creates a vacuum in your throat, which in turn leads to snoring. Nasal decongestants or nasal strips may help you breathe more easily while sleeping. Antihistamines can help with allergies, but will relax throat muscles and cause snoring.

If these remedies don’t  help then you could be a candidate for an acrylic oral appliance that we make which keeps the lower jaw pushed forward and thereby opening the soft palate and keeping the tongue in a more forward position.  This is an effective approach to snoring cessation and will also help with those relationships that have been effected by this condition.

Dr. Antolak practices comprehensive, implant and cosmetic dentistry in Shelby Township, Michigan.  To contact the office call (586)247-3500 or email at DrAntolak@TheGentleDentist.com.

The effects of cancer treatment on the mouth can be quite severe!

Most people realize the side effects of radiation and chemotherapy which are hair loss and nausea, but 1 out of 3 people develop problems with the mouth during and even after treatment.  These complications such as dry mouth or life threatening infections may interfere with cancer treatment or diminish the quality of living and eating. It is therefore important to have a qualified dentist as part of the oncology team who can manage and prep the patient’s mouth in anticipation of these complications.  This preoperative care for the cancer treatment is a vital part in a comprehensive approach to overall patient comfort and satisfaction.

Cancer treatment kills fast growing cells and saliva producing cells are one of the fast growing types.  As a result, cancer patients can have extremely dry mouths eliminating the lubrication, re-mineralization, and healing enzyme properties of saliva.

Dental cavities, infection of the soft tissues, periodontal disease and other dental diseases are exacerbated and made worse when saliva is either reduced or eliminated.  Therefore it is critical to involve your qualified dentist to treat decay with fillings, treat periodontal disease, extract hopeless teeth and either remake or reline poorly fitting dentures.

If at all possible your first dental visit should be at least 1 month before cancer treatment begins to give the treating dentist enough time to complete treatment.  Once the cancer treatment begins it is too late to have the dental work done because the bodies healing capacity and ability to fight off infections is greatly reduced if not stopped.

Since the mouth is full of disease causing bacteria any potential dental problem that can be foreseen should be treated immediately with enough time to heal completely (around 14 days) before cancer treatment is started.  Open wounds, infected teeth and the like can be seeds to serious problems.  Any elective oral surgery such as implant placement should be postponed until after cancer treatment is completed.  Soft plastic trays can be used to hold fluoride to prevent tooth decay.  These are to be used during the night to re-mineralize the teeth.

The diagnosis of cancer is devastating for everyone involved and there are both emotional and physical aspects that must be dealt with right away.  Involving the dentist as part of your care isn’t usually considered, but is critical.  Since time is of the essence, being told to wait a week for a dental appointment isn’t acceptable to me.  If your dentist isn’t willing to either alter his/her schedule or come in on their day off you may want to contact our office for an immediate appointment.  For more information on what a patient should do before, during and after cancer treatment you can call our office at (586) 247-3500 for a free reprinted brochure from the National Institute of Health.  You can also visit their website at Http://www.nidcr.nih.gov/OralHealth/cancertreatment

Even if you have questions about this topic or if you or a loved one is to be starting cancer therapy you can call me or visit the office to discuss your questions.

If you are involved with a cancer support group and would like to have me speak to them about oral care before, during and after cancer therapy you can email me at DrAntolak@TheGentleDentist.com.

I am also available to talk with support groups or even patients who are about to begin cancer treatment.