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People who have diabetes are usually familiar with many of the other health risks they face, including damage to the nerves, eyes, heart, and kidneys. But did you know that if you have diabetes you also have a much greater chance of developing gum disease? It's true, and like other diseases related to diabetes, the risk potential severity of gum disease is directly related to how well blood sugar is controlled.

The Causes

In diabetics, there are two primary mechanisms that increase the risk of developing gum disease, also called periodontal disease:

• Bacterial growth: Bacteria love sugar including the glucose found in blood and bodily fluids. Elevated levels of sugar in saliva can provide a very hospitable environment for bacterial growth. The risk may be elevated if your gums bleed.
• Circulatory changes: In diabetes, the blood vessels become thick, making it more difficult for blood to carry oxygen to the gums and to carry away harmful waste products. This decrease in circulation can weaken the mouth's natural resistance to decay. If you smoke, circulation can become even more compromised, significantly increasing your risk of periodontal disease.

Preventing Gum Disease

If you're diabetic, the number-one key to preventing gum disease is to make sure you do all you can to keep your blood sugar under control. In fact, studies show diabetics who have excellent control of their blood sugar levels have no more risk for gum disease than those who don't have diabetes. Here are some other tips to keep your gums healthy:

• Floss your teeth gently, curving the floss so it can gently reach just below your gum line to remove plaque and food particles. Rinse your mouth when you're done flossing.
• Use a soft-bristle brush to brush teeth twice daily, using small circular motions. Avoid pressing too hard on tooth surfaces.
• Brush your tongue gently to remove germs that can hide there.
• Use an anti-bacterial mouthwash to kill germs that are hard to reach.
• Keep track of how well your blood sugar is controlled and let Dr. Jerry Martin know at each visit.
• Be aware that having diabetes may mean it takes you longer to heal after undergoing oral surgery.

Most importantly, be sure to visit our Granite Bay office for regular checkups and tell Dr. Jerry Martin about your diabetes so you can be sure to get the care you need. Follow these steps, and you can enjoy healthy teeth and gums for years to come.

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Dr. Jerry Martin can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Granite Bay office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

When you chip a tooth badly, it can be a very nerve-wracking situation. Dr. Jerry Martin and our team want to provide you with some information that can help if you ever suffer a chipped or broken tooth. The most common ways people break their teeth are by biting down on something hard, getting hit in the mouth, falling down, or developing cavities that weaken the tooth and allow it to be broken easily. There are a few things you can do if you find yourself in this situation, however.

First, we recommend that you investigate whether the tooth is partially chipped or completely broken. Unless you are experiencing a lot of pain or bleeding, this should not be treated as an emergency. You may call our office and we will try to schedule an appointment with you as soon as possible. Once we have evaluated the tooth during your appointment, we can start to treat it. For minor chips or cracks, we may simply smooth out the area or fill in the space so the crack doesn’t spread.

If your teeth show severe damage such as a serious break, split tooth, split root, or a decay-induced break, Dr. Jerry Martin may need to take more time to fix the problem. If you need emergency dental care because a tooth has fallen out, call our practice immediately to schedule an appointment for that day. If you’re waiting for an emergency appointment, you can rinse your mouth with warm salt water and apply slight pressure to the area to stop the bleeding. We recommend using an ice pack to reduce swelling, but do not take any aspirin because that may increase the bleeding.

If your tooth has completely fallen out of the socket, hold it by the crown and rinse it under running water. Do not let the tooth become dry; instead, place it in salt water or milk until you get to our office. Dr. Jerry Martin will determine whether the broken tooth can be salvaged or will need to be completely replaced.

We know how upsetting it can be to chip or break a tooth, which is why we want to guide you through this process. Most chipped teeth are usually just cosmetic problems, fortunately, but we know that dental emergencies can come up rather suddenly. Be sure to schedule an appointment at our Granite Bay office as soon as an emergency situation occurs.

That ache in your head may stem from your jaw. If your jaw falls out of alignment, you could have temporomandibular joint disorder, or TMD.

It's not clear what causes TMD. Obesity may factor in. Stress and pressure on the jaw may also contribute. A misaligned bite (that is, where your upper and lower teeth don't fit together when you close your mouth) may cause TMD symptoms, too.

TMD can affect your life and your health by making it painful to eat and hard to sleep. Some people find the nagging pain difficult to bear.

Symptoms of TMD include:

• Recurring headaches with no other cause
• Pain along and behind your ears
• Pain in your cheeks or lower face
• Clicking noises when you talk or chew
• Tired or sore jaw muscles after eating
• Limited jaw movement

If you experience the symptoms listed here, make an appointment with our office. We’ll take an X-ray to look at your bite, and determine if TMD could be the culprit. If you have TMD we can offer a number of treatments, including:

• Relaxation and stress reduction techniques
• Pain reduction recommendations, which might involve visualization or medication
• Jaw joint exercises that can help reduce stress and improve your alignment

Left untreated, TMD headaches and other symptoms can become quite severe. If you suffer the symptoms of TMD, you do not have to live in pain. Make an appointment at our Granite Bay office to learn how we can reduce your pain and restore comfort to your life.