Posts for: November, 2020
One in ten Americans has diabetes, a serious condition that may increase the development and severity of other health problems—including gum disease. Because of this latter connection, dental providers join other health professionals during November's National Diabetes Month to call attention to this chronic disease and its effect on health and well-being.
There's another health condition with a diabetes connection that isn't as well known: obstructive sleep apnea (OSA). It's also of keen interest to dental providers, as dentists are often involved in the discovery and treatment of this common sleep disorder.
OSA is the temporary blockage of the airway during sleep by the tongue or other anatomical structures. The subsequent drop in oxygen awakens the body to remove the obstruction. People with OSA may not realize they have the condition, but their bed partner can often attest to their snoring, snorting and gasping for breath during the night. Such episodes can occur several times per night, depriving the person of sufficient sleep.
Chronic OSA can contribute to the development of other health problems, among them Type 2 diabetes. It can do this first by interfering with the metabolization of glucose (blood sugar). It may also increase the body's resistance to insulin, the primary hormone regulating glucose.
Fortunately, properly managing OSA can lower your risk for diabetes, and that's where dentists may be able to help. For one thing, we dentists are often the first to notice early signs of OSA—sometimes even before our patients do.
According to the American Sleep Apnea Association, as many as 80% of the estimated 22 million Americans with OSA may not know they have it. But dentists often identify OSA indicators while examining patients: signs like an enlarged tongue or tonsils, or patients falling asleep in the exam chair. While we can't formally diagnose OSA, we often refer symptomatic patients to a sleep specialist.
Dentists also offer an alternative to the most common OSA therapy, which is continuous positive airway pressure (CPAP). This therapy employs a motorized pump that delivers pressurized air into the throat via face mask to keep the airway open during sleep. Although effective, some people find a CPAP machine noisy and uncomfortable to use.
Alternatively, dentists can provide an oral device that can often help patients with mild to moderate OSA that's worn in the mouth during sleep. Most of the various types of these appliances either reposition the lower jaw with a hinge mechanism to keep the throat open or pull the tongue away from the airway through a suction effect.
Diabetes is one part of a chain reaction that can bring unexpected challenges to your health, including to your teeth and gums. You can slow or even stop its development with proper diet, exercise and good, restful sleep. Dealing with OSA is often part of that equation—and we may be able to help.
If you would like more information about the prevention and treatment of diabetes, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Oral Appliances for Sleep Apnea.”
For over half a century now, community water systems have been adding fluoride to drinking water to help reduce the risk of tooth decay. Numerous long-term studies have demonstrated the soundness of this practice, prompting the U.S. Centers for Disease Control to call water fluoridation one of the ten most effective public health measures of the 20th Century.
In the 1960s, after years of study into the teeth-strengthening effects of fluoride, the U.S. Public Health Service recommended that drinking water utilities add fluoride at a rate of between 0.7 and 1.20 milligrams per liter (mg/L) or parts per million (ppm) of water. This recommendation held fast until 2015 when the service changed the recommendation to no more than 0.7 mg/L.
Why the change to guidelines that had been in place for over fifty years? The revision was in response to an increasing occurrence of dental fluorosis. This condition happens when the teeth absorb more fluoride than necessary, leading to discoloration of the surface enamel, creating effects like small white spots or brownish “mottling.”
Dental fluorosis is the only known health condition caused by fluoride. As such, it doesn't damage the tooth itself, and is mainly a cosmetic problem. But it can still be avoided if fluoride intake is kept at moderate levels.
The original recommendation was sound science when first introduced. Since then, though, the prevalence of fluoride in everyday life has grown, with the chemical commonly found in dental care products like toothpastes or mouthrinses, as well as many processed foods and beverages and even infant formula. Our society's overall intake of fluoride has been growing as a result.
The new recommendation came after several years of research to verify water fluoridation levels of 0.7 mg/L would still be effective in the fight against tooth decay while lowering the risk of dental fluorosis. With this adjustment, this important and safe measure for keeping your family's teeth protected against disease is safer than ever.
Although energy drinks are but a blip on the historical timeline compared to coffee or tea, they've displaced these traditional stimulants among nearly half of today's adolescents and young adults. But these sweetened “processed” drinks are also controversial among healthcare experts—particularly the effect they may have on dental health.
Besides the added sugar found in many energy drinks—a prime food source for harmful bacteria—many energy drinks and their cousins sports drinks contain significant amounts of acid. High levels of acid soften and erode tooth enamel, which can lead to tooth decay.
During one experimental study, portions of tooth enamel were subjected to a number of name-brand energy and sports beverages. Over the course of a few days, researchers recorded significant enamel loss, especially involving the energy drink samples.
Abstaining from both energy and sports drinks is a sound way to avoid enamel erosion (the best hydrator, it turns out, is simply water). But if you do wish to continue consuming these beverages, here are a few common sense precautions for reduce the risk of harm to your teeth.
Partake only at mealtimes. Among its many abilities, saliva is able to neutralize oral acid and bring the mouth to a neutral pH level within 30 minutes to an hour. But if you're sipping on high-acid beverages throughout the day, your saliva may not be able to compensate effectively. Drinking energy drinks only during a meal helps saliva do its acid-buffering job better.
Rinse with water afterwards. Rinsing with a little water after eating or drinking something acidic can help reduce the pH levels in the mouth. That's because water is by and large neutral on the acidic/alkaline scale. Because it's not adding more, rinsing with water dilutes any concentrations of acid that may still be lingering in your mouth.
Don't brush immediately. Brushing is essential to overall hygiene, but if you do it right after you eat or drink, you could be doing more harm than good. That's because elevated acid levels that naturally occur after consuming foods and beverages can temporarily soften and demineralize the surface enamel. Brushing could remove microscopic bits of softened enamel. If you wait an hour to brush, you'll be giving saliva time to “re-mineralize” your enamel.
If you would like more information on the role of beverage acid in dental disease, 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 “Think Before Your Drink.”