Dr. Maneesh Rai, Dentist, Bhopal

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Medical Conditions

Can Medical Conditions effect Oral Health

Can Medication Have an Effect on My Oral Health?
Yes, medications can have oral side effects — dry mouth being the most common. Be sure to tell your dentist about any medications that you're taking, even medicines that you purchase without a prescription.

These are the types of medications that will often produce dry mouth:

  • Antihistamines
  • Decongestants
  • Pain Killers
  • Diuretics
  • High Blood Pressure Medications
  • Antidepressants

Other medications may cause abnormal bleeding when brushing or flossing, inflamed or ulcerated tissues, mouth burning, numbness or tingling, movement disorders and taste alteration. If you experience any of these symptoms, consult your dentist or physician.

   

Diabetes and Oral Health

 

Is There a Link Between Gum Disease and Diabetes?
New research is suggesting a link between gum disease and diabetes. While it's established that people with diabetes are more prone to developing gum disease, this new research implies that chronic gum disease may be a risk factor for diabetes.

How does this happen? Gum disease can cause bacteria to enter the bloodstream and activate cells that produce inflammatory biological signals that have a destructive effect throughout the body. In the pancreas, the cells responsible for insulin (blood sugar) can be damaged or destroyed. Once this happens, it may trigger Type 2 diabetes — even in a healthy individual with no other risk factors for diabetes.

If I Have Diabetes, Am I at Risk for Dental Problems?
If your blood glucose levels are poorly controlled, you are more likely to develop gum disease and lose more teeth than non-diabetics. Like all infections, gum disease can be a factor in causing blood sugar to rise and make diabetes harder to control.

Other oral problems linked to diabetes include: thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness, ulcers, infections and cavities.

How Can I Help Prevent Dental Problems Associated with Diabetes?
First and foremost, control your blood glucose level. Then, take good care of your teeth and gums, along with regular checkups every six months. To control thrush, a fungal infection, maintain good diabetic control, avoid smoking and, if you wear them, remove and clean dentures daily. Good blood glucose control can also help prevent or relieve dry mouth caused by diabetes.

What Can I Expect at My Checkup? Should I Tell My Dentist About My Diabetes?
People with diabetes have special needs and your dentist is equipped to meet those with your help. Keep your dentist informed of any changes in your condition and any medication you might be taking. Postpone any non-emergency dental procedures if your blood sugar is not in good control.

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Heart Disease and Oral Health

 

Is There a Link Between Gum Disease and Heart Disease?
Overall the data indicates that chronic gum disease may contribute to the development of heart disease, the nation's leading cause of death in both men and women.

How does this happen? Gum disease is a bacterial infection that can affect conditions outside your mouth. In heart disease, one theory is that gum disease can cause bacteria to enter the bloodstream where they attach to the fatty deposits in the heart blood vessels. This condition can cause blood clots and may lead to heart attacks.

The Surgeon General's Report on Oral Health states that good oral health is integral to general health. So be sure to brush and floss properly and see your dentist for regular checkups.

If I Have Heart Disease, Are There Special Requirements to Maintain Proper Oral Health?
To maintain the best oral health, you should:

  • Establish and maintain a healthy mouth. This means brushing and flossing daily and visiting your dentist regularly.
  • Make sure your dentist knows you have a heart problem.
  • Carefully follow your physician's and dentist's instructions, and use prescription medications, such as antibiotics, as directed.

Am I at Risk if Dental Procedures Are Performed?
If you have certain preexisting heart conditions, you may be at risk for developing bacterial endocarditis — an infection of the heart's inner lining or the valves. Anytime there is bleeding in the mouth, certain oral bacteria can enter the blood stream and may settle on abnormal heart valves or tissue weakened by an existing heart problem or heart condition. In these cases, the infection can damage or even destroy heart valves or tissue.

There are precautions you need to take if you have any of the following conditions:

  • Artificial (prosthetic) heart valves
  • A history of endocarditis
  • Congenital heart or heart valve defects
  • Heart valves damaged (scarred) by conditions such as rheumatic fever
  • Mitral valve prolapse with a murmur
  • Hypertrophic cardiomyopathy

Be sure to tell your dentist if you have a heart condition, and what, if any, medications you are taking for it. Your dentist will record important health information in your record and coordinate treatment with your physician.

Dry Mouth (Xerostomia)

 

What Is Dry Mouth?
Dry mouth means you don't have enough saliva, or spit, to keep your mouth moist. Everyone has a dry mouth once in a while, especially if you're nervous, upset or under stress. But if you have a dry mouth all or most of the time, it can be uncomfortable and can lead to more serious health problems or indicate that a more serious medical condition may exist. That's because saliva does more than just keep the mouth wet-it helps digest food, protects teeth from decay, prevents infection by controlling bacteria in the mouth, and makes it possible for you to chew and swallow.

There are several reasons that the glands that produce saliva, called the salivary glands, might not function properly. These include:

  • Side effects of some medications — Over 400 medicines can cause dry mouth, including antihistamines, decongestants, pain killers, diuretics and medicines for high blood pressure and depression.
  • Disease — Diseases that affect the salivary glands, such as diabetes, Hodgkin's, Parkinson's disease, HIV/AIDS and Sjogren's syndrome, may lead to dry mouth.
  • Radiation therapy — The salivary glands can be damaged if your head or neck are exposed to radiation during cancer treatment. The loss of saliva can be total or partial, permanent or temporary.
  • Chemotherapy — Drugs used to treat cancer can make saliva thicker, or "ropey," causing your mouth to feel dry.
  • Menopause — Changing hormone levels affect the salivary glands, often leaving menopausal and post-menopausal women with a persistent feeling of dry mouth.
  • Smoking — Many pipe, cigar and heavy cigarette smokers experience dry mouth.

How Do I Know if I Have Dry Mouth?
Everyone's mouth feels dry from time to time. It's when this feeling doesn't go away that you may have a problem with saliva production. Symptoms of dry mouth include:

  • A sticky, dry feeling in your mouth
  • Trouble swallowing
  • A burning sensation on your tongue
  • A dry feeling in your throat
  • Cracked lips
  • Reduced ability to taste things or a metallic taste in your mouth
  • Mouth sores
  • Frequent bad breath
  • Difficulty chewing/speaking

How Is Dry Mouth Treated?
The only permanent way to cure dry mouth is to treat its cause. If your dry mouth is the result of medication, your doctor might change your prescription or your dosage. If your salivary glands are not working properly but still produce some saliva, your doctor might give you a medicine that helps the glands work better.

If the cause of your dry mouth cannot be eliminated, or until it can be, you can restore moisture to your mouth a number of different ways. Your dentist may recommend mouth moisturizers, such as a saliva substitute. Rinsing with mouthwashes specially formulated to help dry mouth may also bring relief. You can also:

  • Sip water or sugarless drinks often
  • Avoid drinks with caffeine, such as coffee, tea and some sodas, which can cause the mouth to dry out
  • Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow (if some salivary gland function exists)
  • Don't use tobacco or alcohol, which dry out the mouth
  • Be aware that spicy or salty foods can cause pain in a dry mouth
  • Use a humidifier at night.

Dental Problems associated with AIDS

What Is HIV/AIDS?
HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus is passed from one person to another through blood-to-blood contact (blood transfusions, HIV-infected needles) and sexual contact. In addition, an infected pregnant woman can pass HIV to her baby during pregnancy or delivery, as well as through breast-feeding.

AIDS (acquired immunodeficiency syndrome) occurs when the HIV infection has weakened one's immune system to the point that it has difficulty fighting off certain illnesses and infections. "Opportunistic" infections also occur, taking the opportunity a weakened immune system gives to cause illness.

How Do I Know if I Have HIV/AIDS?
Dental problems such as sore bleeding gums, herpes sores in the mouth, and fungal and candida (yeast) infections may be among the first signs of AIDS. However, you should not assume you are infected if you have any of these symptoms as these occur in the general population as well. The only way to determine whether you are infected is to be tested for HIV infection. Consult with your physician or other healthcare professional.

A positive HIV test result does not mean that you have AIDS. AIDS is a medical diagnosis made by a doctor based on specific criteria. You also cannot rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV do not have any symptoms at all for many years.

The following may be warning signs of infection with HIV:

  • Rapid weight loss
  • Dry cough
  • Recurring fever or profuse night sweats
  • Profound and unexplained fatigue
  • Swollen lymph glands in the armpits, groin or neck
  • Diarrhea that lasts for more than a week
  • White spots or unusual blemishes on the tongue, in the mouth or in the throat
  • Pneumonia
  • Red, brown, pink or purplish blotches on or under the skin or inside the mouth, nose or eyelids
  • Memory loss, depression and other neurological disorders

How Do I Prevent HIV/AIDS?
HIV transmission can occur when blood, semen, vaginal fluid, or breast milk from an infected person enters your body. The best way to prevent HIV is to avoid activities that allow the virus to enter your body. For more information on HIV/AIDS prevention, consult with a physician or other healthcare professional.


Can I Get HIV at the Dentist's Office?
Due to the nature of dental treatment, many people fear that HIV may be transmitted during treatment. Universal precautions are recommended between each and every patient to prevent the transmission of HIV and other infectious diseases.

These precautions require dentists to wear gloves, facemasks and to sterilize all handpieces (drills) and other dental instruments for every patient, using specific sterilization procedures. Generally after each patient visit, gloves are discarded, hands are washed and a new pair of gloves is used for the next patient.

If you are anxious, spending a few minutes asking your dentist any questions you may have about health and safety precautions can put your mind at ease.

How Is HIV/AIDS Treated?
Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or treat some of the illnesses associated with AIDS. As with other diseases, early detection offers more options for treatment.

Eating Disorders and Oral Health

What Oral Health Problems Are Associated with Eating Disorders?
Anorexia and bulimia can damage your teeth in several ways.

A bulimic individual engages in a cycle of binge eating and vomiting. The stomach acids in the vomit pass through the mouth and can erode tooth enamel, causing cavities, discoloration and tooth loss.

Since teeth appear worn and yellow, a dentist may be the first to notice signs of this eating disorder. Cosmetic dentistry can help correct deteriorated tooth enamel.

In anorexia, semi-starvation deprives the body of the nutrients it needs. Osteoporosis can develop, weakening the bones in the jaw that support teeth, leading to tooth loss.

In both diseases, it is critical to treat the underlying causes that lead to anorexia and bulimia as well as the dental complications resulting from them. While a dentist can correct the deteriorated tooth enamel, he or she cannot treat the actual eating disorder. Should you have an eating disorder - or think you might - talk to your physician.

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