Osteoporosis is a major health condition affecting millions of people, mostly women over 50. The disease weakens bone strength to the point that a minor fall or even coughing can result in broken bones. And, in an effort to treat it, some patients might find themselves at higher risk of complications during invasive dental procedures.
Over the years a number of drugs have been used to slow the disease’s progression and help the bone resist fracturing. Two of the most common kinds are bisphosphonates (Fosamax) and RANKL inhibitors (Prolia). They work by eliminating certain bone cells called osteoclasts, which normally break down and eliminate older bone cells to make way for newer cells created by osteoblasts.
By reducing the osteoclast cells, older bone cells live longer, which can reduce the weakening of the bone short-term. But these older cells, which normally wouldn’t survive as long, tend to become brittle and fragile after a few years of taking these drugs.
This may even cause the bone itself to begin dying, a relatively rare condition called osteonecrosis. Besides the femur in the leg, the bone most susceptible to osteonecrosis is the jawbone. This could create complications during oral procedures like jaw surgery or tooth extractions.
For this reason, doctors recommend reevaluating the need for these types of medications after 3-5 years. Dentists further recommend, in conjunction with the physician treating osteoporosis, that a patient take a “drug holiday” from either of these two medications for several months before and after any planned oral surgery or invasive dental procedure.
If you have osteoporosis, you may also want to consider alternatives to bisphosphonates and RANKL inhibitors. New drugs like raloxifene (which may also decrease the risk of breast cancer) and teriparatide work differently than the two more common drugs and may avoid their side effects. Taking supplements of Vitamin D and calcium may also improve bone health. If your physician still recommends bisphosphonates, you might discuss newer versions of the drugs that pose less risk of osteonecrosis.
Managing osteoporosis is often a balancing act between alleviating symptoms of the disease and protecting other aspects of your health. Finding that balance may help you avoid future problems, especially to your dental health.
If you would like more information on osteoporosis and dental care, 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 “Osteoporosis Drugs & Dental Treatment.”
As with most Western countries, we in the U.S. love our carbs. While fats and proteins make an appearance in our diets, many of us go full-tilt on sugars, starches and fibers.
Regardless of what some diet gurus say, we do need these organic compounds to generate energy for our cells. But carbs can also fuel inflammation: This is a mechanism in the body that isolates and protects healthy tissues from damaged tissues or toxins. Chronic inflammation, though, contributes to systemic conditions like diabetes, heart disease and, yes, gum disease.
And it's not just a matter of too many carbs in your diet. Not all carbs are equal: Some can actually stimulate inflammation, making conditions like gum disease worse. Others, though, might actually help decrease inflammation.
So, in terms of your gum health in particular, how do you know which carbs are better for you and which are worse?
It depends on their ranking on the glycemic index, a measure of how fast the body digests a particular carbohydrate to form glucose, the blood sugar that fuels our cells. The faster the digestion (higher on the glycemic index), the more likely they'll overload the bloodstream with glucose, requiring the release of the hormone insulin to bring the levels back to normal. Continuous insulin increases ultimately lead to higher inflammation.
High glycemic foods include those with added sugar, bakery items made with white flour, white rice or mashed potatoes. But there are also carb foods low on the glycemic scale—most vegetables, greens, beans, nuts and whole grains—whose slower digestive rates avoid the big blood sugar spikes and excessive insulin—and actually hinder inflammation.
So, if you want to control inflammation, reduce your consumption of high glycemic foods like chips, French fries, cookies and similar items. Instead, eat low glycemic foods like apples, bulgur wheat products, oatmeal, and other fruits, vegetables, legumes and nuts.
In short: steer clear of processed foods with added sugar, and indulge yourself in fresh “real” food. These also have the added bonuses of minerals, vitamins and antioxidants that keep your body functioning normally. And that can also make a big difference toward keeping your gums healthy and disease-free.
If you would like more information on diet 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.”
When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.
"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."
Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!
“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”
Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.
Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.
Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.
Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.
If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”
Currently, one-third of Americans are either diabetic or have prediabetic symptoms. Caused by an imbalance in blood sugar levels, diabetes can complicate and increase the risk for other inflammatory conditions like heart disease and that includes another disease typified by inflammation: periodontal (gum) disease.
Each November, dentists join other healthcare professionals in commemorating American Diabetes Month. Besides making people aware of the widespread impact of diabetes, it's also a chance to highlight ways to manage the disease and promote better health for your body overall, including your gums.
If you have diabetes (or your doctor is concerned you may develop it), here's what you should know to keep it from harming your gum health.
Keep your diabetes under control. The adverse effects of diabetes on the body, including the gums, can be minimized through medication, good dietary habits and exercise. Because of its chronic nature, though, managing diabetes should become a permanent part of your daily life. But it's essential to keep symptoms under control to protect your gums from infection.
Practice daily oral hygiene. Gum disease can occur with anyone, not just those with diabetes. A few days without proper oral hygiene to remove bacterial plaque is all it takes to trigger an infection. So be sure you're brushing and flossing each day, as well as having routine professional dental cleanings at least every six months.
See us at the first sign of gum problems. If you notice your gums are reddened, swollen or bleeding after brushing and flossing, see us as soon as possible. If it is gum disease, the sooner we begin treatment, the less likely the infection will cause extensive damage—including tooth loss. It's also possible to have gum disease but not have any symptoms initially. That's why it's important to see us on a regular basis to check your gum health.
Keep your healthcare providers informed. Some studies seem to indicate that if you have both diabetes and gum disease, treating one condition could help improve symptoms with the other. Be sure both the dentist treating your gum disease and the physician managing your diabetes know about the other condition. It may be possible to adjust and coordinate treatment to get the most benefit for both.
Living with diabetes is a challenge, especially if you're also dealing with gum disease. Keeping your diabetes under control and caring for your teeth and gums can help make that challenge easier.
If you would like more information about protecting your dental health while managing diabetes, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Diabetes and Periodontal Disease” and “Gum Disease and Systemic Health.”
Getting a smile upgrade doesn’t necessarily require extensive dental work. You might be able to change your appearance for the better with teeth whitening.
This technique employs a bleaching solution that brightens dull enamel, the outermost layer of teeth. It isn’t a permanent fix, but if cared for properly your brighter smile could last two years or more.
Here’s what you need to know about this proven smile brightener.
Know your options. Enamel whitening is usually obtained in one of three ways: a dentist performing the procedure in-office; at home using custom trays created by a dentist; or at home with an over-the-counter whitening product. The in-office option is the most expensive—but since dentists use a stronger bleaching solution, your brighter tint may last longer and dentists can control the degree of whiteness better.
Know your preferences. That last point is important if you’re looking for a particular look. Teeth whitening can give you a dazzling “Hollywood” smile or one that’s a bit more subtle. It all depends on your lifestyle and personal preferences. Because of their advanced techniques and equipment, you may have better chances getting the look you want from your dentist rather than by doing it yourself.
Know your limitations. This type of teeth whitening won’t work if the staining originates within the teeth—for that you’ll need an invasive procedure only a dentist can perform. You’ll also want to be careful with any whitening if you have dental work like crowns, veneers or fillings: the bleaching solution won’t alter these materials’ color, which could make them stand out beside whitened natural teeth. And if you have diseased teeth and gums, those need to be treated first before any cosmetic procedures like whitening.
Teeth whitening is a great way to take years off a smile. Even if you plan to whiten your teeth at home see your dentist first for a complete examination and helpful tips on products and techniques.
If you would like more information on teeth whitening, 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 “Important Teeth Whitening Question…Answered!”
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