My Blog
By George Mui, DDS, Ltd. Gentle Dental Care
June 10, 2021
Category: Dental Procedures
Tags: dental implants  
YouCanHaveaSuccessfulImplantOutcomeifYourDiabetesisUnderControl

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.”

By George Mui, DDS, Ltd. Gentle Dental Care
June 05, 2021
Category: Oral Health
Tags: oral health   nutrition  
RefinedSugarCouldBeHarmingMoreThanYourTeeth

You've probably heard your dentist say more than once to cut back on sweets. That's good advice not only for keeping your teeth healthy, but your whole body as well.

As a carbohydrate, a macronutrient that helps supply energy to the body's cells, sugar is prevalent naturally in many foods, particularly fruits and dairy. The form of which we're most concerned, though, is refined sugar added to candy, pastries and other processed foods.

Believe it or not, three out of four of the 600,000 food items on supermarket shelves contain refined sugar, often hiding under names like "high fructose corn syrup" or "evaporated cane syrup." So-called healthy foods with labels like "low fat" or "diet" have added sugar and chemicals to replace the taste of fat they've removed.

But perhaps the biggest sugar sources in the average U.S. diet are sodas, energy drinks, and sports drinks. With the added volume of sugar in processed foods, the growing consumption of sweetened beverages has pushed the average American's sugar intake to nearly 20 teaspoons a day—more than three times the recommended daily allowance.

And right along with the increased consumption of sugar, cases of Type 2 diabetes, heart disease and other systemic diseases have likewise risen. And, yes, preventable tooth decay continues to be a problem, especially in children, with sugar a major contributing factor in the prevalence of cavities.

So, what can you do to keep your daily sugar intake within healthy bounds?

  • Check ingredient labels on packaged food for added sugar, chemicals or preservatives. If it contains sugar or "scientific"-sounding ingredients, leave it on the shelf.
  • Be wary of health claims on food packaging. "Low fat," for example, is usually an indicator of added sugar.
  • Drink water or unsweetened beverages instead of sodas, sports drinks or even juices. Doing so will vastly lower your daily intake of sugar.

A healthy diet with much less sugar and regular exercise will help you stay healthy. And with a lower risk for tooth decay, your teeth will also reap the benefits.

If you would like more information on the effects of sugar on your oral and general 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 “The Bitter Truth About Sugar.”

By George Mui, DDS, Ltd. Gentle Dental Care
May 31, 2021
Category: Oral Health
Tags: oral health  
AnEatingDisorderMayShowItselfinTheMouth

Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.

Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).

Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.

It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.

A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.

For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.

The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.

An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.

If you would like more information on eating disorders 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 “Bulimia, Anorexia & Oral Health.”

By George Mui, DDS, Ltd. Gentle Dental Care
May 26, 2021
Category: Dental Procedures
Tags: teeth whitening  
ExperienceAgaintheSmileofYourYouthThroughTeethWhitening

Picture yourself with a beautiful smile…what do you see? Besides straight and uniform teeth framed by the gums, you should also see one other thing indicative of a great smile—your teeth an attractive shade of translucent white.

But as you age your teeth can begin to dull as the enamel loses its translucency and the underlying dentin thickens and yellows. You no longer have the bright smile you once had in younger days.

But if the discoloration is mainly on the outer enamel, teeth whitening could be your answer for regaining your youthful smile. This is a procedure in which we apply a solution containing a bleaching agent (usually hydrogen peroxide) to your teeth. Aided by heat or light to activate it, the solution can temporarily whiten the enamel.

Teeth whitening isn't an exclusive treatment provided by a dentist—there are a number of retail products that enable you to bleach your teeth at home. But there are distinct advantages to having your teeth professionally whitened.

For one, we can control the level of brightness by adjusting the strength of the bleaching solution. This allows you to achieve the kind of look you want—from a more natural and subtler shade to a more dazzling color often called “Hollywood White.”

Any external teeth whitening application will fade with time, regardless of whether they're professional or DIY. But a dental office whitening may last longer due to our stronger solutions and curing techniques. And, by caring for your whitening (by avoiding tobacco and food items that stain teeth) and obtaining occasional touch-ups in our office, the shine could last for a few years.

Again, this particular whitening technique only works with outer staining and yellowing. If your discoloration originates from inside the teeth, you'll need a more invasive method. And your teeth should be reasonably healthy before undergoing whitening.

All in all, though, teeth whitening is an easy and affordable way to brighten your smile. It could help you take years off your appearance.

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 “Teeth Whitening: Brighter, Lighter, Whiter….”

By George Mui, DDS, Ltd. Gentle Dental Care
May 21, 2021
Category: Dental Procedures
Tags: veneers  
YourTeensTeethMayNotBeReadyforVeneers

Teenagers can have the same smile-disrupting tooth flaws as adults. But not all cosmetic treatments available to adults are appropriate for teenagers—at least not until they get a little older. Dental veneers fall into that category.

A veneer is a thin porcelain shell custom-made by a dental lab, and bonded by a dentist to the face of a tooth to mask chips, stains, gaps or other imperfections. Because they're less invasive than other measures, veneers are highly popular as a cosmetic dental solution. They do, however, usually require some enamel removal so that they'll appear more natural.

This enamel removal typically won't impact an adult tooth other than it permanently requires it to have veneers or other restorations after alteration. But there is a risk of damage to a teenager's tooth, which hasn't fully developed.

Adolescent teeth usually have a larger pulp chamber (filled with an intricate network of nerves and blood vessels) than adult teeth. And because the enamel and dentin layers may not yet be fully developed, the pulp is much nearer to the tooth's surface.

We must be very careful then in removing enamel and dentin for veneers or we may penetrate the pulp and risk damaging it. Alternatively, there is the possibility of no-prep veneers which are very conservative but often are unable to be done because of the need to often remove tooth structure to make the veneers look natural.

Another cosmetic problem can occur if we place veneers on a patient's teeth whose jaws and mouth structures are still growing. Eventually, the gums could recede and an unsightly gap form between the veneer and the adjacent natural tooth.

Fortunately, there are other techniques we can use to improve a tooth's appearance. Mild chipping can be repaired by bonding composite resin material to the tooth. Some forms of staining may be overcome with teeth whitening. These and other methods can address a teenager's smile appearance until their teeth are mature enough for veneers.

Whether or not a tooth is ready for veneers will depend on its level of development, something that can often be ascertained with x-rays or other diagnostic methods. And if a tooth has already undergone a root canal treatment, there isn't as much concern. In the meantime, though, it may be better for your teen to wait on veneers and try other techniques to enhance their smile.

If you would like more information on dental restoration for teenagers, 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 “Veneers for Teenagers.”





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