Issuu

issue Nov ‘23

Generations of Smiles Oral Health Means Better Health At Every Age and Every Stage

Dentists & Doctors Working Together in Diabetes Care

Quality care from sea to shining sea.

Diabetes and Oral Health Link Is No Laughing Matter Question: How is your mouth not like Las Vegas? Answer: What happens in your mouth, does not stay in your mouth. So, I’m not going to quit my day job as a dentist to become a standup comedian, but shedding light on the link between oral health and overall health is no laughing matter. Take diabetes (please). Gum disease can lead to infections in the mouth that cause blood sugar levels to rise, which can cause or aggravate1 diabetes. At the same time, uncontrolled diabetes can increase2 a person’s risk of developing gum disease. Gum disease can lead to diabetes. Diabetes can lead to gum disease. This vicious cycle calls for a team-based approach, with doctors and dentists partnered in the Mouth-Body Connection®. In fact, Dr. Lulu Tang, one of my colleagues out of Las Vegas, told me about a young patient who came in for a chipped tooth and learned he had some potential warning signs for diabetes. After seeing Dr. Tang, the patient began seeking diabetes treatment with his doctor. After five weeks of diet and exercise, the patient managed to bring his blood sugar down to almost normal levels. So, no, the connection between diabetes and oral health is no laughing matter... But did you hear about the guy whose dentist discussed diabetes with him? He thought her approach to care was pretty sweet.

Until next time,

Dr. Carolyn Ghazal, DDS

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Keep smiling! It makes others feel good!

Contents Discussing Diabetes from the Dentist Chair Meet Lulu Tang, DDS and learn how she’s helping patients in more ways than one with open dialogues on diabetes.

page 06

Wisdom Teeth: How Oral Surgery Helped A Patient Manage Her Diabetes Doubtful your dentist can help you manage diabetes? We’ll see about that!

page 10

Tips for Good Oral Health in Children With Diabetes If your child is diagnosed with diabetes, here’s what you need to know about oral health.

page 12

Send Smiles to Guatemala: Love Coffee, Love People Your daily coffee can make a difference in more than just your morning by impacting access to oral health care in Guatemala.

page 14

Smile Stories Serving over 2,600 patients across the country in one day? That’s the beauty of Smile Generation Serve Day.

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Discussing Diabetes FROM THE DENTIST CHAIR

Born in a refugee camp in Thailand, Lulu Tang, DMD, understands the tension and anxiety surrounding access to basic care. She was only a year old when her family moved to Portland, Ore. – and to a childhood marked by poverty. So, when Smile Generation®trusted dentists began to roll out technology that links oral and overall health, Sahara Modern Dentistry’s Dr. Tang jumped at the chance to help bridge the care gap for her lower-income Central Las Vegas patients.

"Thinking back, I wonder, What if my dentist could have done more?" -Dr. Tang said. Her practice and many others across the country have been answering that question in innovative ways, integrating basic medical services into their dental practices, and even incorporating on-site medical providers, who are able to address issues that affect her patients most,

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including diabetes prevention and management.

"Having diabetes increases your risk of periodontal disease2, and periodontal disease can lead to elevated blood sugar “Many people can’t afford to take the time off of work for both doctor levels, which can visits and dental visits,” Dr. Tang said. “Integrating basic medical services exacerbate diabetes,” Dental practices like hers now offer A1c tests, which measure a person’s blood sugar over three months to monitor diabetes. They may also offer active matrix metalloproteinase (aMMP-8) which is both a marker of gum disease and of diabetes.

during dental visits would have helped my own family.”

This unique collaboration between dentists and doctors in diabetes care comes at a time when a growing body of evidence1 points to a connection between diabetes complications and oral health.

Dr. Tang said. “And because diabetes can complicate3 the healing process after surgery, when someone with diabetes comes in for oral surgery, the doctor always requests a report on the patient’s blood sugar. This may save patients’ health, and potentially their lives.

Nearly 20% of the 37 million people4 who have diabetes don't know they have the disease. In her own practice, Dr. Tang has been the first to discuss diabetes and prediabetes with patients, connecting them to in-house medical providers who can provide treatment in a true collaborative partnership. Dr. Tang said she is proud that dentistry is playing a larger role in whole-person health.

healthcare in Las Vegas,” she said. “The fact that we are open later and on weekends means that people don’t have to ask for time off.…So, if we can discuss diabetes during their dental appointments, it’s possible to get them connected to medical care earlier to manage or even prevent them from developing the disease.” The result, she hopes, will be a patient population better equipped to take control of their own health. “It is amazing how powerful the dentist can be in the healthcare team for patients,” she said. “And it is so easy and seamless. You can get so much information about a patient from just a five-minute test in the dental chair.”

“There is a great disparity in

Shailyn Smith, 25, of Las Vegas, Nevada, says her journey to better health began with her teeth. Diagnosed with diabetes more than a year ago, Smith had been taking weight loss medication to help control her blood sugar levels. Unfortunately, her diabetes wasn’t as well managed as she wanted it to be, and she did not feel she was getting the care she needed from her primary care physician. Then, she went to the dentist. Before scheduling a wisdom teeth extraction, Lulu Tang, DMD, offered to perform an A1c test, a simple fingerprick test to measure Smith’s average blood sugar levels over the past three months. Though the numbers came back higher than she’d hoped, Smith said she was delighted. “I was so happy. I love everyone at Sahara Dentistry, and they referred me to a doctor at Queensridge who I love too,” she said.

Under the care of her new dentistdoctor health care team, Smith has been able to bring her blood sugar levels down below the diabetic range, and is on a new medication that is helping her get closer to her weight loss goals. “What I love is that they’re all up-todate on my information,” she said.

“Whether I go to the doctor or the dentist, they have access to the same charts, so I don’t have to remember everything every time I go in for an appointment. They can just look it up.” Smith’s story is a powerful example of how potent a dentist-doctor team can be in addressing the Mouth-Body Connection®. “I’ve been trying to tell my mom and my sister, you really need to go to my dentist. She’s great,” Smith said. “I wish I could go there for my eye appointments, too.”

Oral health children T I P S

WITH

DIABETES

hen a child is diagnosed with diabetes, parents need to be aware that their child is at higher risk for oral health problems such as gum disease.1 Bacteria cause early gum disease by forming plaque in the mouth. However, the nature and intensity of the body’s inflammatory response to bacteria in people with diabetes is different than in people without, according to the American Diabetes Association. Diabetes can reduce the amount of saliva that the mouth produces, leading to a condition called dry mouth or xerostomia. Saliva protects against dryness, helping

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keep bacteria and food particles from building up. On the other hand, diabetes can increase the amount of glucose in saliva, causing more bacteria to grow and more plaque to accumulate.2 Untreated, early gum disease can progress to periodontitis, resulting in tooth loss and impacting other aspects of health.3 If your child has diabetes, it’s important to take measures to reduce the risk of gum disease and partner with your family dentist in managing oral health.

1. Take your child for a visit to the dentist twice a year. 2. Make sure to tell your dentist if your child has diabetes. It helps them tailor care like recommending regular cleanings or treatments for a healthier, happier smile. 3. Inform the dentist of any changes in your child’s health or medication to help ensure optimal oral care. 4. Ensure your child brushes twice daily for two minutes using fluoride toothpaste. Additionally, encourage daily flossing to prevent plaque buildup and consider alternatives like interdental devices if needed.

5. Let the dentist know of any oral issues your child experiences, such as bleeding gums, bad breath, or soreness. 4 6. Schedule your child’s dental visit in the morning when their body's natural cortisol levels are higher. Cortisol raises blood sugar levels. In a child with diabetes, low blood sugar can cause shakiness, dizziness, sweating, hunger, headaches, and more. 7. Make sure your child eats a meal and takes their regular medication before a dental appointment to maintain a stable blood sugar level during the visit.

Send Smiles to Guatemala Buy a bag. Give a smile. What if your morning coffee had the power to cross borders and change lives? Now it can.

Buy a limited-edition, mediumroast 10oz. bag (or several) of certified organic and fair trade, non-GMO coffee lovingly created by 182 female Guatemalan coffee producers, featuring notes of orange, mango, banana and dark chocolate. All proceeds go to support Smile Generation’s nonprofit partner, the Pacific Dental Services Foundation (PDSF) and its International Dentistry Program. The PDSF is a 501 (c) (3) charitable organization whose mission is creating opportunities to serve through improving oral health care locally, nationally and internationally.

Love People, Love Coffee Access to care, oral health literacy, and lack of local dental professionals are urgent challenges in Guatemala. There is only one licensed dentist per 100,000 people with a daily diet heavy in sugar and light on oral health. With 54 percent of Guatemala’s population living in poverty and 13 percent in extreme conditions, dental disease is a tremendous problem in this country of over 16 million people. The PDSF Clinical Dental in Xenacoj, Guatemala provides 100% free oral health care to residents, some who travel long distances for the opportunity to be seen. A Force-for-Good Trifecta To help bring awareness to the clinic’s important work, the PDSF has partnered with Asociación Barillense de Agricultores (ASOBAGRI), a nonprofit, all-female coffee producer co-op known for its high-quality coffee and Sir Owlvericks Coffee, a woman-owned roaster in California. By purchasing this coffee, you allow the PDSF to continue to provide vital oral health care to the underserved Guatemalan population while also empowering female coffee producers and entrepreneurs to defeat the cycle of poverty.

Middle: Proud Co-owners of Owlvericks Amy Tang and husband Anthony Wong, Anaheim CA Bottom: Michael Le & Rachel Peters PDS Foundation Team, Irvine CA

The power to make a difference is in your hands ... and coffee mug.

BUY NOW

Buy a bag. Give a smile. Indulge in a rich cup of fresh Owlvericks coffee and send love to Guatemala. Your purchase will go directly towards providing dental care for someone in need. Love coffee. Love people.

Smile

Smile Generation Serve Day Smile Generation Serve Day is an annual day of service and part of a nationwide campaign of giving that focuses on providing donated dental care to underserved patients. On August 19, Smile Generation-trusted offices across the country joined forces to make an impact in their communities for the 13th annual Smile Generation Serve Day. Together, they provided care to over 2,600 patients!

Healthie Happ Generations of Smiles A Smile Generation Magazine

LET'S DO THIS AGAIN! The Smile Generation exists to connect you with trusted dentists in your area and to offer education on the critical link between oral and overall health. We’d love to know what you think of our magazine.

DROP US A NOTE!

Sources Diabetes and Oral Health Link Is No Laughing Matter 1. https://diabetes.org/healthy-living/medication-treatments/diabetesgum-disease-risk#:~:text=If%20you%20develop%20gum%20 disease,against%20gum%20disease%20and%20inflammation 2. https://www.niddk.nih.gov/health-information/diabetes/overview/ preventing-problems/gum-disease-dental-problems

Discussing Diabetes from the Dentist Chair 1. https://pubmed.ncbi.nlm.nih.gov/33850074/ 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10048655/ 3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9538860/ 4. https://www.cdc.gov/diabetes/library/spotlights/diabetes-facts-stats. html#:~:text=Key%20findings%20include%3A,t%20know%20they%20 have%20it

Tips for Good Oral Health in Children With Diabetes 1. Oral Manifestations of Type I Diabetes Mellitus in Pediatric Patients,” International Journal of Applied Dental Sciences, https://www.oraljournal.com/pdf/2022/ vol8issue2/PartA/8-2-4-949.pdf 2. “Oral Health Implications and Dental Management of Diabetic Children,” International Journal of Clinical Pediatric Dentistry, https://pubmed.ncbi.nlm.nih. gov/36865714/ 3. “Gum Disease,” Juvenile Diabetes Research Foundation UK, https://jdrf.org.uk/knowledge-support/guide-to-type1-complications/gum-disease-type-1-diabetes/ 4. “Diabetes and Oral Health,” American Diabetes Association, http://diabetes.org/diabetes/keeping-yourmouth-healthy

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