Dr. McKibben's Blog

What is periodontal disease? Periodontal (gum) disease may result from gingivitis, an inflammation of the gums usually caused by the presence of bacteria in plaque or biofilm.  Bacterial biofilm is the sticky film that accumulates on teeth both above and below the gum line. Periodontal disease may result if the bacterial biofilm is not removed or disturbed below the gum line by a dental professional on a regular basis.  Periodontal disease causes inflammation and destruction of tissues surrounding and supporting teeth, gums (gingival), bone and fibers which hold the gums to the teeth.

A number of factors increase the probability of developing periodontal disease including diabetes, smoking, poor oral hygiene, diet, and genetic makeup; and it is the primary cause of tooth loss in adults.

How are periodontal disease an diabetes related? It is estimated that 12 to 14 million people, or one-third of the population in the United States, have diabetes, but only one-half of these individuals are diagnosed.

Studies have shown that diabetics are more susceptible to the development of oral infections and periodontal disease than those  who do not have diabetes.  Oral infections tend to be more severe in diabetic patients than non-diabetic patients.  And, diabetics who do not have good control over their blood sugar levels tend to have more oral health problems.  These infections occur more often after puberty and in aging patients.

What types of problems could I experience? Diabetics may experience diminished salivary flow and burning mouth or tongue.  Dry mouth (xerostomia) also may develop, causing an increased incidence of decay.  Gum recession has been found to occur more frequently and more extensively in moderate and poorly controlled diabetics patients because the bacterial biofilm (plaque) responds differently, creating more harmful proteins.  To prevent problems with bacterial infections in the mouth, the dentist may prescribe antibiotics, medicated mouth rinses, and more frequent cleanings.

How can you stay healthy? Make sure to take extra good care of your mouth and have dental infections treated immediately.  Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease.

Diet and exercise may be the most important changes that diabetics can make to improve their quality of life and their oral health. Diabetic patients should be sure both their medical and dental care providers are aware of their medical history and periodontal status.  To keep teeth and gums strong, diabetic patients should be aware of their blood sugar levels in addition to having their triglycerides and cholesterol levels checked on a regular basis. These may have a direct correlation on your chances of developing periodontal disease.

What is the best time to receive dental care? If your blood sugar is not under control, talk with both your dentist and physician about receiving elective dental care.  Dental procedures should be as short and stress free as possible. Also make morning appointments because blood glucose levels tend to be under better control at this time of day.

If you have a scheduled appointment, eat and take your medications as directed. See your dentist on a regular basis, keep him or her informed of your health status, and keep your mouth in good health.

Grim news about the global financial crisis dominates headlines daily.  Consumer confidence is at its lowest point in history.  Even if your monthly income has not recently changed, you are probably looking at your household budget, trying to decide where you can cut back in personal expenses.  It only makes sense to prioritize spending and cut back on the things that just are not necessary right now.

Personal Reflection: All of us have ongoing expenses that we can certainly reduce or perhaps go without.  We want the item or service, but do we really need it?  On the other hand, there are things that we need but we don’t really want. In these hard times it is certainly easy to rationalize that you can’t afford something  you actually need if it isn’t something that is high on your emotional priority list.  Often health care falls into that category.  You need it but you don’t necessarily want it, and it is moved down the priority list when it comes to monthly spending.

Making Good Choices: Making the decision to reduce or eliminate health care in the short term during lean financial times can have long term repercussions.  There are very few procedures in dentistry that are preventive (or elective) or that can be delayed.  Often the public has considered regular hygiene visits (teeth cleaning), resin sealants, examinations and xrays as procedures that are preventive in nature and not totally necessary.  Nothing could be further from the truth.  Delaying any needed procedure, including a hygiene visit, will lead to more dental disease.   A delay in needed therapy will result in dental treatment that is more extensive, more expensive, and with a poorer prognosis. Often it leads to the loss of the tooth entirely.

90% of the dental diseases that we diagnose have no symptoms for the patient.  The decision to not treat the disease until you feel it can be a costly mistake.  Taking care of it now will be the most conservative treatment option, with the least expense and the best prognosis.

The doctor and your hygienist make a recommendation for the frequency of your dental cleanings based on your level of periodontal disease and your ability to control the bacterial levels in your mouth, as well as your medical conditions.  This is necessary to control or eliminate the dental disease process.  Every patient is different, therefore every patient’s frequency rate for cleaning and examination will vary.

The decision to spread out your regular dental visits for the sake of saving money in the monthly household budget may not be a wise choice.  It would be the equivalent of a diabetic deciding to take insulin every other day, or a high blood pressure patient deciding to skip his medication twice a week for the sake of saving money.  Could that decision create an unstable medical condition for the patient?  You bet!  The decision to delay or skip regular dental visits or needed treatment will create an unstable dental situation as well.

We Want To Help: We are dedicated to assisting our patients in achieving and maintaining excellent oral and systemic health.  We know that means not only providing the services necessary but also the information and education necessary for our patients to make good decisions about their care.  We know that also means working with each patient individually to find a way to comfortably afford treatment.  Let us help you with your questions and considerations during this unusual economy.

Invest In Yourself: The troubled financial times leave few places for an individual to securely invest their time and money.  While Wall Street is seemingly in a state of disarray, the financial institutions are lacking credibility and real estate investments have become unpredictable, your continued good health becomes your best investment.