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How Dr Joffe Helped a Patient with Diabetes Reclaim Her Smile

reclaim your smile

A patient with diabetes takes on her oral health to overcome adversity, tooth loss and periodontal disease so she can reclaim a strong, confident and natural-looking smile

At Hyde Park Dental Care we take your smile very seriously and have helped a multitude of patients gain beautiful, healthy and natural-looking smiles that can last a lifetime. We are proud to showcase one of these success stories to you, so you can have a better understanding of the treatments we use and the results we can achieve.

The issue…

Nicole, a 26-year-old female, initially visited our dental practice in 2011 seeing our principal dentist Dr Brian Joffe. Upon inspection, Nicole’s main dental concerns comprised of:

  1. Gums bleeding easily
  2. Red, swollen and tender gums
  3. She had either bad breath or a persistent bad taste in the mouth
  4. Her upper and lower front teeth were loose and the upper front teeth were splayed in front of her lower lip

These are all indicators of a much larger problem, and Dr Joffe decided to undertake a thorough assessment of her oral health to ensure nothing sinister was at play.

The diagnosis…

Upon hearing Nicole’s concerns, Dr Joffe conducted a thorough dental examination to determine the cause of her oral health issues. His comprehensive examinations typically include:

  1. A medical history – a patient has Type 1 Diabetes since 1997 and has high blood pressure.
  2. An overall examination of her mouth – patient suffered severe periodontal (gum) disease on her front teeth

Patients suffering from Type 1 Diabetes are more prone to periodontal (gum) disease since the body of a diabetic is typically more prone to infection. This was important information and gave Dr Joffe what he needed to understand and fully acknowledge Nicole’s condition.

The recommendations…

After comprehensive discussions with Nicole, in which all her questions were answered, the following treatment recommendations were made:

  1. Full mouth x-rays to assess levels of bone loss due to gum disease and tooth decay
  2. Deep scale and polish to remove plaque and tartar deposits
  3. Oral hygiene instruction that included brushing twice a day with fluoride toothpaste using a soft brush, flossing daily to clean between the teeth and hard to reach areas in order to remove all plaque on and between her teeth and near to the gum line. A daily mouthwash was also recommended.
  4. Monitoring and control of her blood sugar levels.
  5. That she continue taking the medication prescribed by her medical practitioner.

Because Nicole suffered from a severe periodontal disease, it was important for us to gain a second opinion from a periodontist whose recommendations were then discussed and agreed upon with her.

The prognosis…

What we learned from the subsequent report from the periodontist was that the prognosis of her 4 upper and 4 lower incisor teeth was hopeless and that the only treatment for these teeth that would benefit Nicole was extraction.

after-extractions

With Nicole’s consent, Dr Joffe safely extracted her upper and lower incisors, after which an immediate upper and lower partial denture (plate) was fitted. To ensure her confidence and self-esteem, Dr Joffe made sure that at no point was Nicole left without front teeth.

dentures-applied

The partial dentures (as seen above) that we fitted were only a short to medium term solution, and Nicole found them bulky and sometimes uncomfortable. They also did not help her gum tissue or remaining teeth, as food debris and plaque would often become trapped under them. Nicole, therefore, decided to seek a better and healthier long-term solution.

The solution…

In 2012, Nicole decided she would prefer dental implants as a substitute for her missing teeth. After consulting with her and discussing her decision in great detail, 4 dental implants (2 uppers and 2 lower) were placed at the position of the lateral incisor teeth.

implants-without-dentures

implants-with-dentures

After 4-6 months the implants fused with the bone, offering a durable and strong tooth root alternative, and soon thereafter the upper and lower porcelain bridges were fitted onto the implants – completing her smile.

the-finished-smile

Nicole finally had a long-term solution to her dental problems. Her new teeth are now comfortable and feel the same as her natural teeth. She can smile with confidence, bite into an apple without pain and her food tastes better without the denture and active gum disease.

Further discussion…

Type 1 Diabetes is a disease which results in the body destroying its own insulin-producing cells in the pancreas. The pancreas is then not able to produce insulin. People with this condition require daily insulin therapy to survive. Currently, this requires injections, but newer modalities are currently being researched and tested.

The long-term complications of diabetes are largely related to changes in large and small blood vessels which increase the risk of:

  • Heart disease and stroke
  • Foot ulceration, gangrene and lower limb amputation
  • Kidney failure
  • Eyesight impairment
  • Gingivitis (reversible gum disease) and periodontal disease (irreversible gum disease)

Those who suffer from diabetes are more prone to contracting dental illness and disease. Dental problems associated with diabetes include:

  • Gum disease
  • Slow healing after extractions or oral surgery
  • Infections of the mouth including fungal infection such as thrush
  • Dry mouth and taste impairment

If a patient’s diabetes is poorly controlled and if their blood sugar levels remain high, their gum problems are likely to become worse. Uncontrolled gum disease causes damage to the bone supporting the teeth and will ultimately cause one to lose teeth and bone density. This problem is compounded in people who also smoke.

If you have diabetes, it is important to take care of your dental health as well as your overall health. Controlling dental problems associated with diabetes can be achieved by:

  1. Excellent oral hygiene that includes careful cleaning of the teeth to remove plaque, with the aid of tooth brushing, flossing and mouthwash.
  2. Good control of your blood sugar levels.
  3. Being a non-smoker
  4. Regular dental appointments to monitor the health of your gums and to remove plaque and tartar buildup.
  5. Notify your dentist of any change in your health status and/or medication.

To discover more about what we at Hyde Park Dental Care in Sydney can do for you, or if you would like to book an appointment, please do not hesitate to contact us.

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  • 02 9267 9526
  • Suite 10, Lower Level,
    Hyde Park Square,
    227 Elizabeth Street,

    Sydney, NSW, 2000

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