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Home > Archive > Lupus Support > September 2006 > Dental prevention in the Lupus Patient
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Dental prevention in the Lupus Patient
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| Your mileage may vary. This is a handout I used for patients who were
newly diagnosed. Again, any treatment plan should be in consulation
with your physician.
Dental Concerns and Lupus
Meticulous mouth hygiene should be emphasized at all times, in lupus
patients. The mouth is a breeding ground for bacteria; mouth ulcers
can get painfully infected, causing eating to be difficult. Remember,
lupus directly affects a person’s immune system, reducing the ability
to prevent and fight infection. Also, many of the drugs used to treat
lupus suppress the immune system, leaving you, the lupus patient, even
more prone to infection.
Communication, self-examination, and prevention are the keys to
controlling lupus dental problems. Keeping both your lupus doctor
and dentist informed about all medication, you are taking, dosage, and
the side affects, is of utmost importance. Since lupus immune system
causes slow healing, regular dental check-ups need to be every 2 to 6
months for prevention of dental problems.
Steroid medications are a particular concern, with dental surgeries
and procedures, in which they cover up infections. Your lupus doctor
may need to change the dosage of any steroid medications, and begin
prophylactic (preventive) antibiotics, before ANY dental procedures.
Lupus heart disease (the kind that affects the valves of the heart),
is another concern, and should be watched carefully by your doctor.
Check up, after dental surgery, need to be more frequent, for the
lupus patient. Frequency and extended over a longer period of time,
will allow the dentist to catch any new develops, fast.
Get into the habit of regular self-examination of your mouth, every
week. Periodontal disease, which causes the greatest amount of tooth
loss in adults and affects almost everyone, usually does not cause
pain and may not give warning until significant gum tissue breakdown
has occurred.
Periodontal disease is a group of inflammatory conditions which affect
the gums (gingiva) and supporting bone around each tooth. The most
common periodontal disorders are gingivitis (inflammation of the
gingiva or gums) and periodontitis (inflammation affecting the bone
under the gingiva). Lupus patients need to report any of the following
to their dentist:
1. Bleeding Gums: Gingiva, which bleeds on eating or brushing
teeth, or bleeds without any obvious cause.
2. Swollen Gums: Enlarged gingiva, which is not bound tightly
around each tooth.
3. Red Gums: Gingiva, which is red in color. Dark colored gingiva
due to naturally occurring melanin (the substance which colors the
gums) is not an indication of inflammation.
4. Sensitive Gums: Gingiva, which is painful to brushing.
Untreated gingivitis can progress into the tissues under the gingiva
and cause the bone, which supports the teeth to become weakened and
reabsorb.
Periodontitis dental disease also causes bone loss and will eventually
lead to loosening or loss of teeth. It is usually painless and may
have the same signs and symptoms as gingivitis.
Prevention is the best treatment for dental disease. The only way to
prevent periodontal disease is by effective tooth brushing techniques.
Putting toothpaste on a toothbrush and swishing the brush around your
mouth for 15 to 30 seconds once or twice a day is not effective tooth
brushing. Tooth brushing must clean all five surfaces of each tooth,
taking about three full minutes to cover the entire mouth, twice
daily. Plaque which causes dental caries (cavities) and periodontal
disease accumulates on all tooth surfaces and must be removed daily.
The most critical area of the tooth to clean is next to the gingiva or
gums. Use a soft bristle toothbrush, over lapping the tooth and gum
area, as you brush. Any areas of gingival sensitivity, tooth
sensitivity, or gingival bleeding require effective brushing or the
sensitivity and bleeding will get worse. The area between the teeth
cannot be cleaned by a toothbrush, so the use of dental floss, dental
tape, rubber tips, special interproximal) brushes and stimulators will
help remove the dental plaque deposits between each tooth.
Mouth Sores and any red or irritated areas should also be reported to
your lupus doctor and dentist. Approximately 25% of lupus patients
have these kinds of oral problems, which are usually accompanied by a
skin irritation or facial rash. Oral problems in lupus are also found
on the lips and on the tissue inside the cheeks or jaw area. If you
have any active oral problems, do not use denture powder or denture
paste to hold in removable dentures. If toothpaste irritates the
mouth, then baking soda and water should be substituted for
toothpaste. Mouth sores usually appear when the lupus disease is
active. Secondary Sjögren’s Syndrome can be associated with lupus
producing increased dental decay, due to lack of enough saliva.
Certain foods can also cause mouth ulcers, in lupus patients. This is
very individualized, so if you notice certain foods irritating the
mouth tissue, avoid them. A soft diet, during mouth sore / ulcer
breakouts, is recommended, to prevent any damage to the already
irritated mouth sores / ulcers.
Gargling with saline solutions (salt and warm water), 2- 4 times a
day, may help heal the mouth sores / ulcers. Dental problems are
common in lupus, and you should postpone all dental work during a
lupus flare or outbreak of mouth sores / ulcers. If you must see a
dentist while experiencing a recurrence of lupus mouth ulcers, inform
your dentist before the exam.
Steroid mouthwashes or Peridex prescribed by your physician can
provide some pain relief and healing for mouth sores / ulcers.
Salivert is useful for dry mouth. Other medications may be ordered if
your case is severe. Antimalarial drugs, such as Plaquenil, may
provide some healing for mouth lesions. Plaquenil has also been found
to relieve skin inflammation, hair loss, fatigue, and joint pains. The
treating method varies from doctor to doctor.
Researchers still do not now what causes lupus, including the lupus
mouth ulcers. More research is needed to determine the best forms of
therapy for this common lupus symptom
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| janers 2006-09-07, 9:34 pm |
| Thank you so much Chattie Patti
janers
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|
| On Thu, 7 Sep 2006 19:49:41 -0400, "janers" <rojakort@bright.net>
wrote:
>Thank you so much Chattie Patti
>
>janers
>
>
You are most welcome. I just changed computers and now that I am not
working I have time to go through alot of old work files. If I find
anything else of use I will forward them on. Sure miss working.
Never thought I would say that.
Patti
| |
| janers 2006-09-09, 4:29 pm |
| Oh man me too Patti
I loved my job nursing and miss it a lot. The patients you took care of the
families and boy the friends you established. Memories are never forgotten.
make you want to cry a little don't it?
I have a nursing reunion the 16th and I am looking forward to it and seeing
my friends I made for a life time
janers
| |
|
| I had been nursing since age 19, and worked for 26 yrs till last
summer.
I went back for my bsn, then went back for my Nurse Practitioner.
I always knew I would never make it till 60 but I was hoping for 55,
missed the cutoff by 10 yrs. I still keep thinking that I can return.
I went on disability in 1989 for 2 yrs when I had both hips replaced,
and managed to get back to work. It was funny when I called SSA to
tell then I was going back to work. The person who helped me hadnt
had anyone do that and didnt know what to do.
It was right after I went back to work that I was diagnosed with
Lupus. I worked thorugh all of it, except when I was in the hosp.
which was alot that first yr. Ive since had another hip replacement
and need both of them again. Plus more surgeries thatn I care to list
or you care to know. I did get my disability this time with relative
ease considering what I went through last time. I had to get a lawyer
last time. This time I did it on my own.
Ok, enough sob for this am. Tennis is on and I do love the us open.
Patti
On Sat, 9 Sep 2006 09:40:06 -0400, "janers" <rojakort@bright.net>
wrote:
>Oh man me too Patti
>I loved my job nursing and miss it a lot. The patients you took care of the
>families and boy the friends you established. Memories are never forgotten.
>make you want to cry a little don't it?
>
>I have a nursing reunion the 16th and I am looking forward to it and seeing
>my friends I made for a life time
>
>janers
>
>
| |
|
| PS, I got off on a tangent and forgot the real reason I replied, enjoy
the reunion. I hope you have a wonderful time.
Patti
On Sat, 9 Sep 2006 09:40:06 -0400, "janers" <rojakort@bright.net>
wrote:
>Oh man me too Patti
>I loved my job nursing and miss it a lot. The patients you took care of the
>families and boy the friends you established. Memories are never forgotten.
>make you want to cry a little don't it?
>
>I have a nursing reunion the 16th and I am looking forward to it and seeing
>my friends I made for a life time
>
>janers
>
>
| |
|
| Good info, thanks.
I had a very savvy dentist in 1998 that referred me to a
Rheumatologist, said he was sure I had lupus, lost 3 teeth and had lots
of cavities, $3,000 later the teeth were much better, it had only been
2 years between dental visits, so now I go 2 times a year.
I also have Sjogrene's, I do feel like a slave to dental hygiene,
brushing and flossing several times a day and lots of swishing and
rinsing.
Zinn
patti wrote:
> Your mileage may vary. This is a handout I used for patients who were
> newly diagnosed. Again, any treatment plan should be in consulation
> with your physician.
>
> Dental Concerns and Lupus
> Meticulous mouth hygiene should be emphasized at all times, in lupus
> patients. The mouth is a breeding ground for bacteria; mouth ulcers
> can get painfully infected, causing eating to be difficult. Remember,
> lupus directly affects a person's immune system, reducing the ability
> to prevent and fight infection. Also, many of the drugs used to treat
> lupus suppress the immune system, leaving you, the lupus patient, even
> more prone to infection.
> Communication, self-examination, and prevention are the keys to
> controlling lupus dental problems. Keeping both your lupus doctor
> and dentist informed about all medication, you are taking, dosage, and
> the side affects, is of utmost importance. Since lupus immune system
> causes slow healing, regular dental check-ups need to be every 2 to 6
> months for prevention of dental problems.
> Steroid medications are a particular concern, with dental surgeries
> and procedures, in which they cover up infections. Your lupus doctor
> may need to change the dosage of any steroid medications, and begin
> prophylactic (preventive) antibiotics, before ANY dental procedures.
> Lupus heart disease (the kind that affects the valves of the heart),
> is another concern, and should be watched carefully by your doctor.
> Check up, after dental surgery, need to be more frequent, for the
> lupus patient. Frequency and extended over a longer period of time,
> will allow the dentist to catch any new develops, fast.
> Get into the habit of regular self-examination of your mouth, every
> week. Periodontal disease, which causes the greatest amount of tooth
> loss in adults and affects almost everyone, usually does not cause
> pain and may not give warning until significant gum tissue breakdown
> has occurred.
> Periodontal disease is a group of inflammatory conditions which affect
> the gums (gingiva) and supporting bone around each tooth. The most
> common periodontal disorders are gingivitis (inflammation of the
> gingiva or gums) and periodontitis (inflammation affecting the bone
> under the gingiva). Lupus patients need to report any of the following
> to their dentist:
> 1. Bleeding Gums: Gingiva, which bleeds on eating or brushing
> teeth, or bleeds without any obvious cause.
> 2. Swollen Gums: Enlarged gingiva, which is not bound tightly
> around each tooth.
> 3. Red Gums: Gingiva, which is red in color. Dark colored gingiva
> due to naturally occurring melanin (the substance which colors the
> gums) is not an indication of inflammation.
> 4. Sensitive Gums: Gingiva, which is painful to brushing.
> Untreated gingivitis can progress into the tissues under the gingiva
> and cause the bone, which supports the teeth to become weakened and
> reabsorb.
> Periodontitis dental disease also causes bone loss and will eventually
> lead to loosening or loss of teeth. It is usually painless and may
> have the same signs and symptoms as gingivitis.
> Prevention is the best treatment for dental disease. The only way to
> prevent periodontal disease is by effective tooth brushing techniques.
> Putting toothpaste on a toothbrush and swishing the brush around your
> mouth for 15 to 30 seconds once or twice a day is not effective tooth
> brushing. Tooth brushing must clean all five surfaces of each tooth,
> taking about three full minutes to cover the entire mouth, twice
> daily. Plaque which causes dental caries (cavities) and periodontal
> disease accumulates on all tooth surfaces and must be removed daily.
> The most critical area of the tooth to clean is next to the gingiva or
> gums. Use a soft bristle toothbrush, over lapping the tooth and gum
> area, as you brush. Any areas of gingival sensitivity, tooth
> sensitivity, or gingival bleeding require effective brushing or the
> sensitivity and bleeding will get worse. The area between the teeth
> cannot be cleaned by a toothbrush, so the use of dental floss, dental
> tape, rubber tips, special interproximal) brushes and stimulators will
> help remove the dental plaque deposits between each tooth.
> Mouth Sores and any red or irritated areas should also be reported to
> your lupus doctor and dentist. Approximately 25% of lupus patients
> have these kinds of oral problems, which are usually accompanied by a
> skin irritation or facial rash. Oral problems in lupus are also found
> on the lips and on the tissue inside the cheeks or jaw area. If you
> have any active oral problems, do not use denture powder or denture
> paste to hold in removable dentures. If toothpaste irritates the
> mouth, then baking soda and water should be substituted for
> toothpaste. Mouth sores usually appear when the lupus disease is
> active. Secondary Sj=F6gren's Syndrome can be associated with lupus
> producing increased dental decay, due to lack of enough saliva.
> Certain foods can also cause mouth ulcers, in lupus patients. This is
> very individualized, so if you notice certain foods irritating the
> mouth tissue, avoid them. A soft diet, during mouth sore / ulcer
> breakouts, is recommended, to prevent any damage to the already
> irritated mouth sores / ulcers.
> Gargling with saline solutions (salt and warm water), 2- 4 times a
> day, may help heal the mouth sores / ulcers. Dental problems are
> common in lupus, and you should postpone all dental work during a
> lupus flare or outbreak of mouth sores / ulcers. If you must see a
> dentist while experiencing a recurrence of lupus mouth ulcers, inform
> your dentist before the exam.
> Steroid mouthwashes or Peridex prescribed by your physician can
> provide some pain relief and healing for mouth sores / ulcers.
> Salivert is useful for dry mouth. Other medications may be ordered if
> your case is severe. Antimalarial drugs, such as Plaquenil, may
> provide some healing for mouth lesions. Plaquenil has also been found
> to relieve skin inflammation, hair loss, fatigue, and joint pains. The
> treating method varies from doctor to doctor.
> Researchers still do not now what causes lupus, including the lupus
> mouth ulcers. More research is needed to determine the best forms of
> therapy for this common lupus symptom
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