Dentist - Chicago
220-222 W. Huron, Suite 4002
Chicago, IL 60654
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Posts for: January, 2014

By Reuben D. Collins, DDS
January 28, 2014
Category: Oral Health
DiabetesandGumDiseaseWhatstheConnection

The increasing rates of obesity and diabetes in Americans have been getting a lot of attention lately. Most people know that the two are clearly linked. But did you know there's also strong evidence of a link between diabetes and gum disease?

Both diabetes and periodontal (gum) disease are chronic inflammatory conditions. That means they are disorders that develop over time (chronic), and are characterized by problems with a function of the immune system (inflammation). In diabetes, problems with the hormone insulin lead to abnormal levels of sugar in the blood. This can bring about a number of complications which, if not treated, may result in kidney failure, coma and even death. In many people, however, it's a condition that can be managed with drugs and lifestyle changes.

You may not think of gum disease (periodontitis) as a serious illness. But here's something you should know: If you have diabetes, having gum disease is a risk factor for worsening control of blood glucose levels, and may also increase the risk of complications. Likewise, having diabetes puts you at greater risk for developing more severe forms of periodontal disease.

What is gum disease? It's actually a group of diseases caused by many types of bacteria in the mouth, which affect the tissues around the teeth. Initially, it often causes swelling and redness of the gum tissue. Left untreated, it may result in bone loss, abscess formation, and ultimately the loss of teeth. But its ill effects aren't limited to your mouth.

Periodontal inflammation is associated with a higher systemic (whole-body) inflammatory state. That means it may increase your risk for cardiovascular diseases like heart attack and stroke, and adverse pregnancy outcomes — as well as complicating the management of blood-sugar levels in diabetics.

Now, here's the good news: Treatment of periodontal disease which reduces inflammation has a beneficial impact on the inflammatory status of the whole body. For people who have both diabetes and periodontal disease, that means that periodontal therapy can lead to improved blood sugar control.

How do you know if you have periodontal disease? Bleeding gums and bad breath are both possible symptoms, as are redness and soreness of the gum tissues. But these warning signs may be masked by any number of other factors — or may not be noticed at all.

The sure-fire way to diagnose and treat periodontal disease is by getting regular dental checkups, followed by specialized periodontal treatment when necessary. If you presently have diabetes, or may be at risk for developing the disease, those check-ups and treatments are even more important.

If you have concerns about diabetes and gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Diabetes & Periodontal Disease” and “Understanding Gum (Periodontal) Disease.”


AlthoughChallengingSmileZoneImplantscanAppearBeautifullyLife-Like

Dental implants have quickly become the restoration of choice for two basic reasons: they effectively restore the lost function of missing teeth and simultaneously rejuvenate the smile with their life-like appearance.

Achieving a life-like appearance, however, isn’t always a simple matter. A restoration in what we dentists call the “Smile Zone” (the upper front area that displays both teeth and the gum line when you smile) requires careful planning and technique to ensure they appear as life-like as possible.

Our first concern is whether there’s enough bone to fully anchor an implant. Bone is a living, dynamic tissue that goes through cycles of dissolving (resorption) and growth. The normal forces of biting and chewing transmit through healthy teeth and stimulate growth in the bone. When the teeth are missing and no longer transmit this pressure, the bone will eventually resorb only and not grow.

Adjacent teeth could also be affected with bone loss if the extraction was difficult and a bone graft was not placed into the extraction socket to preserve bone. This not only puts adjacent teeth at risk of gum and bone loss but can also have implications for the final smile appearance. This bone also supports the triangular tissue between teeth known as papillae which give teeth their arched appearance. If the bone isn’t adequate, there’s less hope that the papillae will regenerate.

With these concerns it’s very important to consider how the implant and crown emerges from the gums in the Smile Zone. Recent developments in implant design are helping in this regard. The design change of the top of the implant re-orients the gum tissues in relation to the implant from vertical to horizontal, which dentists call “platform switching.” This provides greater stabilization where bone mass is limited, and helps create a more aesthetically pleasing result. There are also other techniques, such as surgical tissue grafting of the papillae that can further enhance the final appearance.

Although creating a natural, life-like appearance in the Smile Zone is difficult, it’s not impossible. It’s important first to undergo a complete dental examination and profile, where we can advise you on your best options to achieve a beautiful smile.

If you would like more information on the relation of implants to the aesthetics of your smile, 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 “Implant Aesthetics.”


By Reuben D. Collins, DDS
January 16, 2014
Category: Oral Health
Tags: oral health  
ALinkBetweenDentalHealth-AndMentalHealth

A substantial amount of research has recently pointed up the connection between oral health and systemic (whole-body) health. But recently, one study went a step further: It seems to show that having certain dental-health issues in middle age — for example, tooth loss and gum disease — could signal a deterioration in cognitive function.

Study author Gary Slade, a professor at the University of North Carolina at Chapel Hill, summed it up: “We were interested to see if people with poor dental health had relatively poorer cognitive function, which is a technical term for how well people do with memory and with managing words and numbers,” he said in an interview with U.S. News and World Report. “What we found was that for every extra tooth that a person had lost or had removed, cognitive function went down a bit. The same was true [for] patients with severe gum disease.”

Does this mean that losing teeth is a little like losing brain cells? Not really, because it isn’t clear which condition occurred first… or even if one caused the other. For example, it could be that a poor diet is responsible for both poor dental health and a decline in cognitive ability; on the other hand, there could be a genetic link between both conditions. Or, it could simply mean that people with cognitive difficulties don’t take good care of their teeth.

Still, the association is intriguing — especially because it echoes some previous studies, which indicate that systemic inflammation could be a major cause of both problems. What’s the oral-systemic connection? No one is exactly sure yet, but research suggests a relationship between periodontal disease and other diseases such as heart disease, stroke and diabetes. The common link may be bacteria: The same microorganisms that cause problems in the mouth might be able to spread through the body, producing a low-grade inflammation — one that’s waiting for the right conditions to burst into fire.

So, should you rush out and grab everything off the drugstore’s oral health products shelf? Well, we wouldn’t necessarily go that far… but here’s a more sensible suggestion: Take good care of your teeth and gums. Both tooth decay and periodontal disease can cause a number of problems with your health — yet both can be treated effectively… and they’re largely preventable!

If you haven’t visited our office in a while, why not come in for an exam? When you do, ask us what’s the best way to keep your smile looking great and feeling clean and healthy. Our goal is to help you maintain proper oral hygiene — for life. If you would like more information about oral health and systemic diseases, call our office for a consultation. You can learn more in the Dear Doctor magazine article “The Link Between Heart & Gum Diseases.”


By Reuben D. Collins, DDS
January 08, 2014
Category: Dental Procedures
WhatyoucandotoReduceComplicationsAfterGumSurgery

Today's periodontal (gum) surgical procedures are less painful and have fewer complications than ever before. Nevertheless, the best outcome still depends on how well you care for yourself as you recuperate. Here are some things you can do after surgery to lessen its effect.

In the first twenty-four hours after surgery, your primary objective is to prevent swelling, the major source of post-operative discomfort. You can accomplish this by applying an ice or cold pack to the outside of your face in the area of the surgery. It's best to alternate five minutes on and off with the pack for the outside, and ice chips, cold water or ice cream inside your mouth as often as possible. Your aim is to surround the surgical site with cold as much as you can with the five-minute on and off strategy.

You should eat only foods that are cold and soft (Jell-O™, applesauce, yogurt, ice cream, etc.), to help ease any swelling. The next day switch to hotter foods like soup, mashed potatoes or buttered pasta, as well as hot, salt water rinses as often as convenient. Avoid crumbly foods like chips, cookies or popcorn for a few days to help keep the incision site particle-free.

We typically prescribe a number of medications during recuperation: analgesics (usually of the aspirin or ibuprofen family) for swelling and pain, and antibiotics and antibacterial rinses to inhibit bacterial growth. Be sure to follow directions with each prescribed medication, taking the correct dosage and for the specified duration.

There is a possibility of post-operative bleeding — but don't panic. You should first attempt to locate the bleeding area, clean it, and then apply gentle pressure with moist, sterile gauze for ten to fifteen minutes. If the bleeding doesn't stop, give us a call.

You should keep the wound site as clean as possible to help avoid infection. However, don't brush, floss or rinse during the first twenty-four hours to avoid bleeding, and limit hygiene activities to antibacterial mouthrinses like chlorhexidine near the wound site for several days to weeks. During the first few days to a week after surgery avoid activities like strenuous exercise, drinking alcohol, sucking through a straw, or blowing up a balloon, as these can also increase your risk for bleeding. You should also avoid tobacco products during this time as these can inhibit the healing process. Each surgery is different and you should make sure you follow the specific instructions your surgeon will provide for you.

Taking these precautions will help keep discomfort and complications to a minimum. They will also help you recover quickly so that you can get back to your normal life.

If you would like more information on periodontal surgery and what to expect, 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 “Instructions Following Periodontal Surgery.”