Tuesday, February 2, 2010

Toothy Tuesdays: Why do you care?

So, for this week's Toothy Tuesdays we will not be talking about teeth!

Before we see any patients, we have to ask a million questions that most patients glaze over and don't always reveal the answers to because they don't think they are important. Questions about past surgeries, any and all medications you are taking, personal and family history of diabetes, acid reflux disease; the list we use here at the DSchool is probably more in depth than most doctors' offices. And many will just say no, no, no thinking that it just doesn't matter for the dentist to know. It does!! So, how does diabetes affect my teeth or high blood pressure affect you drilling on a tooth?
Here are the top things we will ask you and why we care:

Diabetes: Ok, so this is major. I'm hoping that if you have Diabetes (Type 1 or 2) then you have learned enough about controlling it that you know how this affects you and your dental health. First of all, control your diabetes! Please! If you have meds for this, then take them. Uncontrolled diabetes really affects your healing time from any sort of infection or wound. Even a little irritation to your gums can turn into a big deal if your body is not able to bring the right healing factors to the site of injury. And then the infection can very easily enter into the blood stream and turn into a major infection spreading elsewhere since you're body just can't control it. If you go to the dentist with uncontrolled diabetes or an extremely high blood sugar level, they probably won't treat you that day and instead send you to your doctor to get that under control.

Blood pressure: One of the things we use almost every time you come to the dentist is Local Anesthesia, the lovely injection that makes treatment painless for you. One of the ingredients in most of these is epinephrine. Epi is added for a variety of reasons; one is that it provides a local effect in the blood vessels of gums that leads to less bleeding when we have to nick them for one reason or another. If you already have high blood pressure, putting more epinephrine into your system, mixed with the rise of blood pressure due to anxiety can send your heart into overdrive.

Pregnancy: We need to know if you are pregnant so that we can take extra precautions and avoid the laughing gas. You need to know that if you are pregnant you can expect to see changes in your gums. They might get puffier or more red. True story: Jamie's B's mom was told by her dentist that little B was in the oven.

Medications: One of the number one side effects of the most common medications is a dry mouth. Hopefully we're starting to stress enough how important a wet mouth is in keeping bacteria and cavities at bay. So know that if you are taking a daily medication and starting to experience dry mouth, the med is probably the cause and you should make sure to sip water and use fluoride. Sugarfree gum is also helpful. Many people forget to include birth control and vitamins/supplements. If a dentist prescribes an antibiotic he or she should inform you that this medication will render your birth control ineffective!

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