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Another long-recognized effect of periodontitis is its role in the presence of diabetes. Glucose levels in patients with type 1 or 2 diabetes with active, advanced periodontal disease are more difficult to manage than in patients without periodontal disease. Conversely, when the diabetic state is uncontrolled, the patient is more susceptible to periodontal abscesses and rapid periodontal breakdown. |
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Tooth Loss and Non Replacement |
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The Non Replacement of missing teeth is one of the principal causes of inability to chew. Many older people, especially those with low incomes, fail to have lost teeth replaced for financial reasons. If many teeth are missing, chewing becomes more and more difficult, and malnutrition is likely to result. A related problem is the continued use of dentures that no longer fit properly. The patient either leaves the dentures out of the mouth or uses them only intermittently. Even when a partial denture fits well, the patient is at higher risk for root caries unless the denture is removed daily, and both the denture and teeth are cleaned thoroughly. |
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Dental Caries |
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Caries is generally thought of as a disease of young people because the highest incidence of new-enamel decay occurs during the first three decades of life in the enamel on the chewing surfaces and the proximal surfaces (the surface at which each tooth contacts its neighbor). However, older adults are susceptible to root caries, a condition in which decay invades the exposed roots of teeth and may result in pain, tooth fracture, abscess formation, and pulp death, requiring root canal treatment or extraction. |
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