Summer 2009
Volume 18
No. 3

In This Issue

Protect Your Smile! Be a Periodontal Disease Detective!

If you enjoy watching crime shows on television, then you have probably noticed that police detectives often use clues to solve a mystery. In a similar way, you and your dentist can investigate your teeth and gums to provide clues about your oral health. In this article, you’ll learn about the warning signs of gum disease and oral infections. With early detection and treatment, you can avoid serious complications and keep your teeth healthy!

People with diabetes must take extra care to protect their teeth and gums.
This is because people with diabetes are more likely to experience infections in their mouth which lead to tooth decay. And since diabetes also hampers the body’s healing process, getting rid of these gum infections once they start can be very difficult. What makes this even more troublesome is that you may not feel any pain or have obvious symptoms in the early stages of the disease.

Periodontal disease is triggered by bacteria in your mouth.
Periodontal disease (also known as gum disease) is an infection of gum tissues. It starts with bacteria that build up in the sticky plaque on and between your teeth. The early stage of gum disease is called gingivitis, and is usually reversible with regular brushing and flossing. If gingivitis isn’t treated and reversed, the disease worsens causing a more serious condition called periodontitis. With periodontitis, your gums and the bones that hold your teeth in place can suffer serious damage leading to unavoidable tooth loss.

Infections in your mouth affect more than just your teeth and gums.
Having inflamed and bleeding gums and losing teeth are just the tip of the iceberg. Gum disease affects other parts of your body too. Serious gum disease may make it more difficult to control your blood sugar. Just like any other infection in your body, gum disease puts stress on your system. This triggers glucose (sugar) to be released from your liver which raises your blood sugar level.

Find out if problems are lurking inside your mouth.
Bacteria and plaque could be building up inside your mouth. That’s why it’s important to brush and floss your teeth daily and see your dentist for regular checkups. Follow the steps in the Better Care at Home article found in this newsletter to keep your mouth healthy - and protect your smile!

From the desk of Nurse Lorraine - Better Care at Home: 6 Simple Steps for Healthy Teeth and Gums

Dear Friend,
Here’s an alarming fact - almost one-third of all people with diabetes have severe periodontal (gum) disease. Protecting your teeth by visiting your dentist regularly is just part of the answer. There are a few simple things that you can do at home too.

Here are six simple steps for healthier teeth and gums:

  1. Keep your blood sugar under good control. Keep your A1c less than 7% as recommended by the American Diabetes Association. Talk to your doctor if your blood sugar is above your target range.
  2. Stop smoking or chewing tobacco. Tobacco use is one of the biggest risk factors in the development and progression of periodontal disease.
  3. Brush your teeth and gums after every meal.
    • Use a small-headed, soft bristled toothbrush after meals and snacks to remove bacteria and plaque that can cause periodontal disease.
    • Use antibacterial fluoride toothpaste and mouthwash as recommended by your dentist.
    • Change your toothbrush at least every three months.
    • If you wear false teeth (dentures) clean them daily. Your dentures can get dirty and create problems such as bad breath or infection. Your dentist can recommend a good denture cleanser. Interesting Tip: Ask your dentist about cleaning your dentures in a microwave to kill bacteria.
  4. Use dental floss every day.
    • There are different types of floss: waxed, un-waxed, and flavored. Your dentist may suggest you use small dental brushes if you have large spaces between your teeth to remove plaque and food.
  5. Check your teeth and gums frequently. If you find any of the problems listed below, contact your dentist immediately. You may have periodontal disease.
    • Red, puffy gums that bleed when you brush your teeth.
    • Gums that are pulled away from your teeth.
    • Loose teeth.
    • Pus (infection) between your teeth and gums.
    • Bad breath that lasts longer than a few days.
    • A change in how your partials or dentures fit.
  6. Get a dental checkup and cleaning every six months.
    7. Sincerely, Lorraine Farrar, MSN, RN, APN, BC-ADM, CDE Director, Education and Wellness

Ask Sandy

By Sandy Gaskins, RN, CDE
Sandy Gaskins, AmMed Direct’s Registered Nurse and Certified Diabetes Educator
addresses some of the common myths people with diabetes have about smoking.

Question: Why should I care about periodontal (gum) disease?

Answer: Researchers have found that people with gum disease are almost twice as likely to suffer from cardiovascular disease. There are several theories that try to explain the link between gum disease and cardiovascular disease. One possibility is that bacteria present in gum disease enter the bloodstream and cause small blood clots to form in the arteries of the heart. These blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to a heart attack.

Another idea is that inflammation caused by gum disease may contribute to buildup of fatty plaque inside the heart arteries. This plaque may block the heart arteries and also cause a heart attack.

Gum disease can affect other parts of the body too. A recent study suggests a link between gum disease and stroke. The study found that people with periodontal disease had a greater risk of having a stroke; specifically, people who had lost some or all of their teeth, and those who had lost a lot of the bone that normally holds their teeth in place.

The good news is that intensive treatment of gum disease may reduce your risk of developing heart disease.

For Healthy Gums and Healthy Body information or for a referral to a periodontist (a specialist in gum disease) call 1-800-FLOSS-EM or visit the American Academy of Periodontology’s web site at www.perio.org.

Source: American Academy of Peridontology

WHAT OUR CUSTOMERS ARE SAYING

"I have been on insulin since 1995 and on pills before that. I am most pleased with the service from your company."
—Dorothy V. of Enfield, CT

"After the wonderful and professional treatment AmMed Direct has shown me, I referred my 45 year old son (who was diagnosed with diabetes years before me.) He is now a faithful member of AmMed Direct."
—Odessa M. of Chandler, AZ

"Thank you for everything. I never have to worry about running out of my medications. They are always on time, every time. You are always so nice and very helpful every time I call. You really do make things easy."
—Kinley G. of Grimsley, TN

"I was so sick from my diabetes, but now that I have joined the Better Care Program I am staying within my target range and feeling great!"
—Audrey W. of Fort Worth, TX

Have You Heard about the AmMed HomeCare Pharmacy?

Have you ever driven to your local pharmacy only to find a mile-long line to pick up your prescriptions? Waiting in line can make tired feet ache and put extra strain on your back. Plus if you’re not feeling well, standing in long lines can really wear you out.

Switch to the HomeCare Pharmacy and just say “No!” to standing in long lines! In addition to providing your diabetes test supplies, we also offer a full-service pharmacy. We can ship your prescription medications directly to your front door! Here are just a few more reasons why our customers love the HomeCare Pharmacy:

  • Get your medications delivered right to your door! That’s right, we deliver your medications to your front door and shipping is absolutely free!
  • Saves you money by eliminating costly trips to the pharmacy.
  • Convenient refills of your prescriptions over the phone using our toll free number.
  • Coordination of your refills with your doctor.
  • Free insurance claim filing – we take care of all the paperwork for you!
  • Personal refill reminders so you never run out of your medications again!
  • Guaranteed for purity and accurate dosage… the same FDA approved medications as your local pharmacy delivered right to your door!

Better Care at Your Dentist’s Office

Having diabetes puts you at much higher risk for problems with your gums and teeth. That’s why it is important for you to have regular dental check-ups. Your dentist can do a thorough exam and suggest treatment if needed. At each appointment, be sure to also talk to your dentist about your blood sugar levels and your overall diabetes care program.

Get Ready, Get Set, Go...to Your Appointment! To make the most of each visit, set aside some time to prepare in advance. Simply follow the steps below to get cleaner, healthier teeth.

  1. Get ready…
    • Call your dentist. Schedule an appointment to get your teeth professionally cleaned if you have not seen your dentist in the last 6 months.
    • Write down your appointment information in the spaces provided below.
      • I have an appointment with Dr.___________________________________
      • Date__________________ Time of appointment ____________________
      • The office phone number is _____________________________________
    • Tear out this page. Put it in a place where you will be sure to take it with you on the day of your appointment.
  2. Get set…
    • Before your visit, write down any questions you want to ask. Here are some suggested questions you may consider: My Questions:
      • How can I improve my dental health? ____________________________________
      • Do I have any signs of gingivitis or periodontitis? ____________________________________
      • Are my gums bleeding or inflamed? ____________________________________
    • Make a list of all the pills you take. Include the name and dose of all herbal supplements, prescription and over-the-counter medications. You may just want to bring all of your medications in the bottle with you to your visit.
    • These are the medications I am currently taking: ____________________________________ ________________________________________________________________________
  3. Go...
    • Eat your usual meal before going to see the dentist. If you take insulin or an oral diabetes medication that can cause hypoglycemia (low blood sugar) a morning dental visit after breakfast is best, unless your dentist instructs you differently.
    • Take your usual medications unless your dentist tells you to change your diabetes medication schedule.
    • Stick to your normal meal plan after dental work. If you have trouble chewing, you may need to eat soft foods or liquids until your mouth feels better.
    • Be sure to tell your dentist:
      • You have been diagnosed with diabetes.
      • Your last A1c result. Bring your blood sugar log book.
      • About any change in your health history since your last visit.
      • If you are having trouble taking care of your teeth and gums.
      Together you may be able to find a solution to your problem.
    • Make sure you understand how to take care of your teeth.

Fun Food Facts - Tip of the day

By Ken Jenkins, RD, LDN, CDE
Cutting boards are one of the most commonly used kitchen utensils that can cause cross contamination in foods. After preparing raw beef, poultry or seafood, you should wash your cutting board before using it to prepare ready-to-eat foods like fruits and vegetables.

(Ken is a Certified Diabetes Educator at AmMed Direct. Ken has two bachelor's degrees; one in Exercise Physiology and another in Nutrition. )

From the Better Care BookschenTM - Cooking with Ken

Cheddar Onion Chicken

Ingredients:

  • 4 (3 oz.) chicken breasts (skinless, boneless)
  • 1/4 cup fat free margarine
  • 4 tablespoons Worcestershire sauce
  • 1 can (2.5 oz.) cheddar onion rings (crushed)
  • non-stick cooking spray

To Prepare:

To Prepare: Flatten each breast, season to taste. Combine margarine and Worcestershire sauce. Dredge chicken in margarine mixture, then crushed onion rings. Place on baking pan and spray with nonstick cooking spray. Top with any remaining margarine mixture. Bake at 350º for 20 minutes or until tender.

Yield:

  • 4 servings
  • serving size: 1 chicken breast

Nutrition:

  • 240 Calories
  • 1 g Saturated Fat
  • 432 mg Sodium
  • 29 g Protein
  • 17 g Carbohydrate
  • 73 mg Cholesterol
  • 1 g Fiber

Recipe recommended by our Better Care ChefTM

Meal Planning from the Better Care Bookschen

  • 1 (3 oz.) Cheddar Onion Chicken Breast (1 carb serving)
  • 6 oz. baked sweet potato (2 carb servings)
  • 1/2 cup of broccoli
  • 1/4 cup of diced tomatoes and peppers (green and yellow) place on top of broccoli
  • 1 baseball size orange (1 carb serving)
  • 1 tablespoon reduced fat margarine
  • water or non-calorie (diet) drink