We’ve come a long way since the early 1980s when we first identified the HIV virus. Although approximately 35 million people worldwide (including a million Americans) now have the virus, many are living relatively long and normal lives thanks to advanced antiretroviral drugs.
Still, HIV patients must remain vigilant about their health, especially their oral health. In fact, problems with the teeth, gums and other oral structures could be a sign the virus has or is moving into the full disease stage, acquired immunodeficiency syndrome (AIDS). That’s why you or a loved one with the virus should maintain regular dental checkups or see your dentist when you notice any oral abnormalities.
One of the most common conditions among HIV-positive patients is a fungal infection called candidiasis (or “thrush”). It may appear first as deep cracks at the corners of the mouth and then appear on the tongue and roof of the mouth as red lesions. The infection may also cause creamy, white patches that leave a reddened or bleeding surface when wiped.
HIV-positive patients may also suffer from reduced salivary flow. Because saliva helps neutralize excess mouth acid after we eat as well as limit bacterial growth, its absence significantly increases the risk of dental disease. One of the most prominent for HIV-positive patients is periodontal (gum) disease, a bacterial infection normally caused by dental plaque.
While gum disease is prevalent among people in general, one particular form is of grave concern to HIV-positive patients. Necrotizing ulcerative periodontitis (NUP) is characterized by spontaneous gum bleeding, ulcerations and a foul odor. The disease itself can cause loosening and eventually loss of teeth, but it’s also notable as a sign of a patient’s deteriorating immune system. The patient should not only undergo dental treatment (including antibiotics), but also see their primary care physician for updates in treating and managing their overall symptoms.
Above all, HIV-positive patients must be extra diligent about oral hygiene, including daily brushing and flossing. Your dentist may also recommend other measures like saliva stimulators or chlorhexidine mouthrinses to reduce the growth of disease-causing bacteria. Together, you should be able to reduce the effects of HIV-induced teeth and gum problems for a healthier mouth and better quality of life.
If you would like more information on oral care for HIV-AIDS patients, 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 “HIV-AIDS & Oral Health.”
November is National Diabetes Month—a good time to look at the connection between diabetes and oral health. While it’s important for everyone to take care of their teeth and gums, it may be especially important for people with diabetes.
People whose diabetes is not well controlled have a higher risk of infections in the mouth, especially gum disease, also called periodontal disease. Advanced periodontal disease is the number one cause of tooth loss among adults. Not only does diabetes put you at risk of oral health problems, it goes both ways. Periodontal disease can lead to higher blood sugar levels in people with diabetes and may increase the risk of complications such as heart and kidney problems.
But here’s some good news: People who take good care of their teeth and gums may have better blood sugar levels and, conversely, better blood sugar levels generally result in better gum health. Many people successfully avoid complications of diabetes by taking good care of themselves, including their teeth and gums. Here are some things you can do to help control your diabetes:
- Eat right, exercise and watch your weight for better blood sugar control.
- Keep up with your oral hygiene routine at home.
- Schedule regular dental visits and cleanings.
Better oral health combined with better blood sugar control will reduce your risk of complications from diabetes. Your dental care team can help you maintain the best oral health for better diabetes control.
When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.
"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."
Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!
“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”
Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.
Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.
Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.
Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.
If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”
Ongoing jaw pain can be disruptive to your entire life: it can make eating, sleeping, and talking difficult. If you have been experiencing jaw pain and aren't sure why, it's time to make an appointment with Dr. Robert Hoffmaster, your dentist in York, PA, to find out if you have TMJ. You may have heard of this term but aren't sure what it means. This is a great place to start to learn more about TMJ.
What is TMJ?
TMJ is short for temporomandibular joint, which is the area of the jaw that moves when you talk and chew. It's also the area that is affected by poor alignment or degradation of the joint's cushioning tissues. Prior trauma to the jaw, such as from a car or sports-related accident, may also cause TMJ to develop. Its symptoms include a clicking or popping sensation during jaw movements, pain and tenderness in the immediate area, or "referred" pain in the neck, shoulder, or ear. TMJ may also be referred to as TMJD or TMD, with the 'D' standing for "dysfunction." TMJ is a common problem seen by your York dentist; it's estimated that over 10 million Americans deal with some form of it.
Treating TMJ with medication
The first step in treating your TMJ is to contact Dr. Hoffmaster, who has extensive experience and training in diagnosis and management of TMJ. A regimen of anti-inflammatory medicine can be extremely helpful in keeping the associated pain under control. Muscle relaxants may also be effective for TMJ symptoms, but they need to be used on a short-term basis with strict adherence to a schedule to avoid adverse side effects. Antidepressant medications have also shown to be useful in helping to relax the jaw and reduce pain.
Other ways to treat TMJ
Your York dentist may recommend that you wear an appliance, also called an orthotic or a splint, in your mouth during sleep to help hold your jaw in the proper position. Many people see significant relief from wearing these devices. Surgical procedures, such as joint replacement or steroid insertion, are typically only recommended if the conservative treatments listed above fail to bring any relief.
For sympathetic and experienced care of TMJ, contact Dr. Hoffmaster's office in York, PA for an evaluation.
There are a variety of methods for treating periodontal (gum) disease depending on its severity — from routine office cleanings to periodontal surgery. But the goal behind all of them remains the same: remove bacterial plaque and calculus (tartar), the root cause for gum disease, from all tooth and gum surfaces.
The traditional method for doing this is called scaling in which we use special hand instruments (scalers) to mechanically remove plaque and calculus. Scaling and a similar procedure called root planing (the root surfaces are “planed” smooth of plaque to aid tissue reattachment) require quite a bit of skill and experience. They're also time-consuming: full treatment can take several sessions, depending on how extensive the infection has spread.
In recent years, we've also seen a new method emerge for removing plaque: lasers. Commonly used in other aspects of healthcare, lasers utilize a focused beam of light to destroy and remove diseased or unhealthy tissue while, according to studies and firsthand accounts, minimizing healthy tissue destruction to a better degree than traditional techniques. Procedure and healing times are likewise reduced.
Because of these beneficial characteristics, we are seeing their use in gum disease treatment, especially for removing diseased and inflamed tissues below the gum line and decreasing sub-gingival (“below the gums”) bacteria.
Dentists who have used lasers in this way do report less tissue damage, bleeding and post-treatment discomfort than traditional treatments. But because research is just beginning, there's not enough evidence to say laser treatment is preferably better than conventional treatment for gum disease.
At this point, lasers can be an effective addition to conventional gum disease treatment for certain people, especially those in the early stages of the disease. As we continue to study this technology, though, the day may come when lasers are the preferred way to stop gum disease from ruining your dental health.
If you would like more information on treating gum disease, 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”
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