Archives for July 2013

Dental Implants When You Have Diabetes

July 16, 2013 by iowasmiles

I am thinking about getting dental implants. My concern is that I have diabetes and that there would be a complication. Please help.

Thank you.

Deb

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Dear Deb,

Dental implants work fine with patients who suffer from diabetes as long as the diabetes is in check and under control. If it is not under control complications can arise. During the 1980’s dental implants first came into existence. They became a great alternative in providing jaw and mouth stability while preventing jawbone re-absorption that is caused when teeth are missing. Over time, dental implants have only gotten better and their success rate is very high. Research now shows that there is only about a 6% rate of dental implant failure with patients with diabetes. And most of those patients did not have their diabetes under control and/or had been smokers.

When under control, the success rate for dental implants with a diabetic patient is very high. However, extra precautions should be taken with all diabetic patients and they should have an adequate screening and their health history made known to the dentist. Metabolic control for diabetic patients should be at an appropriate level before implant surgery and control must be maintained throughout the healing process. Infection is always a concern. So it is recommended that diabetic patients have a 10 day supply of antibiotics beginning on the day of surgery. If a diabetic patient smokes, it is also recommended that he/she stop several days before surgery to reduce the possibility of implant failure.

This post was provided by Elgin dentist Dr. Steve Sirin.

Post Dental Work Numbness

July 16, 2013 by iowasmiles

About a week ago the teeth in the lower left part of my jaw were prepped for a dental bridge. Subsequently, my lower lip is still numb. I’m a little concerned. Please explain if you can.

Thanks very much.

Cheryl P.

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Dear Cheryl,

In truth when a dentist gives an injection to numb an area they never know exactly where the anesthetic is going or where it will settle in the mouth. It is a more general area that is being numbed and they cannot control its exact location. Also, to slightly complicate this, patients are all wired differently. So their nerves do not match up patient by patent. That is why the injection is in a more general area. Sometimes during this injection a patient may experience an electric shock, if the dentist hits a “bulls eye” and delivers the anesthetic directly to the nerve. However, most do not. If the tip of the needle actually touches the nerve, it can cause a bit of a trauma to the nerve and a persistent numbing or altered sensation (paresthesia) of the tongue and lip area.

It is rare but patients can experience nerve damage during this simple dental procedure while only receiving a local anesthetic. How long it lasts depends on the extent of the damage to the nerve. A slight bruising of the nerve will heal in a few days. If the nerve is punctured, it can last a month, or sometimes as long as a year. If the nerve is severed, the damage could be permanent.

This doesn’t occur too often as the result of a simple injection. The more common cause of nerve damage is from the extraction of a wisdom tooth, where the roots of the tooth lie very close to this nerve, which can result in serious bruising or severing of the nerve.

Since this numbness has been more than a few hours, I would certainly recommend a follow up visit and check up with your dentist. That is assuming that this “numbness” that you refer to is an absolute complete lack of sensation in your lip. If you have a tingling sensation in your lip, that’s an indication that the nerve is healing and you just need to be patient until the healing is complete.

This post was provided by Elgin dentist Dr. Steve Sirin. Learn more about Dr. Sirin’s approach to dentistry.

Gray Tooth

July 16, 2013 by iowasmiles

I have never had a cavity, but last year my dentist pointed out that I have a gray tooth. He didn’t explain if I needed a filling, root canal or simple whitening. He never explained what that meant or what I should do. After the appointment I suffered great anxiety and couldn’t bring myself to go back. My fear is that the gray tooth is dead. What can I do?

Thank you.

Jean

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Dear Jean,

When a tooth turns gray it is often a sign of a dying nerve. Yet clearly your dentist was unsure if it was a cavity or something more serious. In fact the x-ray was not definitive to the dentist. With tooth trauma or dental decay a tooth can die. And it can happen for no apparent reason. Usually there is a pain associated with a dying tooth and one might experience sensitivity and possible pain when this situation arises. Yet if there is no pain or sensitivity occurring, most likely the nerve of the tooth has already died. Individual teeth can die from a heavy biting or clenching force which causes the blood supply to the nerve to become reduced causing death to a tooth. It is hard to know if a tooth is dying especially if there is no pain. There would be no trigger to alert a patient. And yet there may be a dead nerve tissue. However, graying is always a possible indicator. Doing nothing allows the deteriorating tissue to be feasted upon by bacteria which will definitely trigger an infection.

We strongly recommend that you set an appointment for your dentist to take another x-ray to see if the tooth is in fact gray. If your new dentist is also uncertain then we recommend that you schedule an appointment with an Endodontist. An Endodontist has more specialized schooling in these matters and their focus is root canal treatments and nerves. They also have better equipment and apply different techniques that will be able to better ascertain if the tooth is dead.

This post was provided by Elgin dentist Dr. Steve Sirin.

Does Professional Teeth Whitening Really Work?

July 1, 2013 by iowasmiles

I have considered getting my teeth whitened by my local dentist. But my concern is that it doesn’t really work for long term and I will be out my money. I have tried the over the counter whitening strips, but they didn’t work for long and I’ve read they can damage the tooth enamel.

I am wondering if professional whitening really works and if so, what is the cost?

Thanks very much.

Pete in Des Moines

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Dear Pete,

The truth is that dental whitening done by a professional is highly effective and can help your teeth regain their original luster. You are also right about strips damaging enamel. They will if used a lot.

The over-the-counter strips can be useful and help with a few degrees of whiteness. However, the change is only temporary and they would need to be used continuously to maintain that whiteness; thus leading to the tooth enamel damage you mentioned.

The real difference between the whitening strips bought at the local drug store and the bleaching found at your local dentist is simply the level of bleach intensity and concentration. The professional products are much stronger than the stuff found at your local store. It’s like comparing aspirin and morphine.

If the bleaching is done professionally the teeth will usually remain white for many years to come. In fact they typically never go back to the color when first treated. Yet with our western diets of processed foods, sodas and other culprits, we suggest every few years to get a touch up to maintain that healthy white luster, but we suggest that only if you notice any darkening. The maintenance is not expensive.

Professionally there are usually two types of whitening approaches. The first kind of teeth whitening is immediate and takes place in the dental office. The visit to the office will last about two hours and the process involves applying the bleaching material to your teeth, placing a light to activate the bleach then simply waiting the approximate two hours for results. Afterwards, your teeth will jump several degrees within the white spectrum. So whatever tooth color or stains you walked into the dental office with will be transformed to a white sheen after those couple of hours. Please note that this process usually runs a couple hundred dollars.

The second option for teeth whitening is for the dental office to design bleach trays specifically for your teeth and then for you to bleach your teeth at home. This procedure works just as well yet it is much more involved and takes longer, yet costs far less.

We always encourage patients to consult with their dentists to see which option will work for them. Your dentist will assess your teeth to make certain, before you move forward, that either option is the right choice for you.

This post was provided by Elgin dentist Dr. Steve Sirin. Learn more about Teeth Whitening.