Diabetes and Oral Care

One of the most alarming of all health diseases is diabetes, and precisely those already affected are more susceptible to dental problems. Studies show that "one-quarter of Canadians have diabetes or pre-diabetes and therefore are vulnerable to infections and must be especially vigilant about their oral health." But how does diabetes influence oral health? The answer is, this disease affects your whole body, including your mouth, and risk is high when your blood sugar level is poorly controlled.

The connection between Diabetes and Oral Health

Diabetes at an uncontrolled level impairs white blood cells, which are the primary defense shields for the mouth and, of course, the entire system. It can also narrow the blood vessels of gums leading to the reduced blood supply and increased rate of infection inside the mouth.

Another factor is- high blood glucose levels cause dehydration and drying of mouth due to decreased production of saliva. Dry mouth enhances the formation of plaque and tartar and a wide range of gum diseases.

Similarly, the other way around is – poor oral health can further worsen the health implications associated with diabetes and can potentially give rise to a wide range of health complications. Gum infections and tooth diseases might increase blood sugar levels and delay the control process.

Different types of Tooth Infections that might Trigger diabetes

Cavities: 

Different types of bacteria already reside in your mouth and are in the constant lookout to feed on starchy and sugary substrates. These bacterial reactions release a sticky film of plaque that settles around your teeth. People with diabetes are more likely to have tooth decay due to an increased supply of sugar on which bacteria can feast.

Gingivitis: 

It's a gum disease that might occur due to the body's inability to combat infections. The gum tissue and bone supporting the teeth are severely infected, eventually leading to the build-up of bacterial plaques, which pile up in the gum line as calcium deposits or tartar. If not treated in the early stages, it ultimately leads to tooth loss (periodontitis).

Some more symptoms that you must watch out for include bleeding gums after brushing or eating, bad breath, toothache, dryness, burning, and ulcers lasting longer inside the mouth

Holistic Oral Care- How?

If you have diabetes, then by now, you know that you are likely to develop tooth problems. So why delay? Go for a holistic oral care regimen after taking advice from a dentist.

We offer you some simple solutions here that you can follow daily.

• Manage diabetes by monitoring your blood sugar level and follow your doctor's advice most scrupulously.

• Practise oral hygiene with healthy habits. Brush your teeth twice a day, floss between teeth, clean your tongue daily and remove dentures.
  

• Rinse your mouth with a medicated fungicide or anti-bacterial lotion.
  

• Avoid chewing tobacco and smoking cigarettes for the best results

These simple precautions have also been suggested in The Surgeon General's Report on Oral Health that states- "good oral health is integral to general health. So be sure to brush and floss properly and see your dentist for regular checkups."

We, too, advise you to go for regular dental checkups to rule out any oral problems. The earlier you know, the quicker you heal. The most important thing here is to keep a check on your blood sugar level to ensure proper oral health.

Acid Reflux Disease

Acid Reflux Disease: Symptoms, Causes, Diagnosis and Treatment

Overview of Acid Reflux

Acid reflux disease in medical terms called Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD). It is a condition wherein the stomach acid gurgles up to the esophagus. This results in terrible discomfort in the body like the burning of stomach and chest, vomiting, etc.

Causes of Acid Reflux

Faulty LES: 

The Lower Esophageal Sphincter (LES) is present at the junction where the esophagus joins the stomach. It prevents the digestive juices produced inside the stomach to move into the esophagus, and it closes after food passes to the stomach. If too much pressure is exerted on this muscle, it stops functioning normally and is unable to block the acids.

Hiatal Hernia: 

It is a condition wherein the upper portion of the stomach that joins the esophagus moves towards the chest through the hiatus (opening in the diaphragm). It paves the way for the acids to rise to the throat very easily.

Pregnancy: 

During the third trimester, the baby grows considerably big enough to put pressure on the stomach, which then presses the LES. Women become prone to acidity during this time.

Peptic Ulcers: 

Ulcers inside the stomach hamper the digestion process, which leads to the piling of digestive enzymes inside the body, and they rise to the esophagus.

Eating Habits, Medicines, and Lifestyle: 

Eating large meals, lack of exercise, consuming too many beverages, excessive smoking and drinking are responsible for acid reflux disease. Pain killers, NSAIDs, aspirin, and calcium-based tablets also cause acidity.

Symptoms and Health Risks

• Problems in digestion give rise to stomach pain. 
  

• When acid rises, it can also cause chest pain.
  

• The terrible burning sensation inside the stomach (heartburn) and chest
  

• Bloating, vomiting, dizziness, and nausea
  

• Regurgitation occurs in which bitter-tasting stomach content and harsh acids come to throat and mouth.
  

• Hiccups and incessant burping due to indigestion
  

• Difficulty in swallowing food known as dysphagia 
  

• Anemia, weight loss and black stool

Diagnostic procedures

Your doctors can confirm that you have acid reflux by listening to the symptoms you tell him/her during the checkup. Diagnostic tests are performed only under a chronic condition wherein you have stomach ulcers, asthma, difficulty in swallowing food, or experiencing black stool and weight loss.

Endoscopy: 

It is performed to diagnose abnormalities in the esophagus and stomach with the help of an endoscope. Barrett's esophagus (cancer in the esophagus) can be diagnosed through endoscopy.
Barium X-ray: To get a clear view of the structure of the esophagus, the patient is asked to swallow barium followed by an X-ray.

Esophageal Manometry: 

Your nose is numbed, and a tube is passed through the nose that reaches the esophagus, till the stomach. It can detect abnormality in the esophagus and the sphincter as well.

Acid Test with pH: 

24-hour esophageal pH test is performed with the help of a catheter passed through the nose. Every time acid rises, the sensor attached to the end of the catheter is stimulated, and the frequency is noted down.

Treatment for Acid Reflux Disease

Lifestyle modifications and GERD diet:

You need to bring about changes in your eating habits. Your doctor will recommend a GERD diet. It eliminates acid, causing foods and substitutes with foods rich in proteins, omega-3 fatty acids, and vitamins. Eat small meals at an interval of 2-3 hours, exercise regularly, and stay away from smoking, drinking, etc.

Medicines:

Antacids are still conventional medicine for getting instant relief from acidity. However, for long term relief, doctors prescribe histamine (H2) antagonists because histamines trigger acid production in the stomach. They are available as different combinations like cimetidine, nizatidine, famotidine, and ranitidine.

Omeprazole Treatment, aka Proton Pump Inhibitors: 

They are the most effective group of medicine used for treating acid reflux disease. It completely blocks the secretion of stomach acids by acting directly on the cells.

Acid Reflux Surgery:

It is the last option of treatment for GERD. The surgery is known as fundoplication is performed to increase the pressure and strengthen the sphincter (LES) so that it gets back to normal function.

When to consult a doctor 

Please consult your doctor whenever you observe the symptoms we have mentioned in the content above. Your doctor will further take care of what to do next.

Acid reflux is not a big problem. It can be treated entirely with medicines and by incorporating healthy eating habits.

 

Alternative treatments for high blood pressure

The ideal blood pressure for good health is at or below 120/80 mmHg. Hypertension or high blood pressure is a condition wherein the systolic pressure (numerator) is higher than 160, and the diastolic pressure (denominator) is 100 or above. The rise in blood pressure may be due to hereditary or acquired from several reasons like stress, addiction to alcohol, obesity, and unhealthy eating habits. Medication helps to normalize blood pressure; nevertheless, there are various alternative treatments to check further rise. 

Lowing High BP through Supplements 

Supplements for hypertension are available in the form of capsules and pills, and you can have them as recommended by your physician. Alpha-linolenic acid (ALA) occurs in soybean, flaxseeds, walnuts, and green leafy vegetables. 

Omega-3 fatty acid supplements (EPA-eicosapentaenoic acid and DHA- docosahexaenoic acid) can moderately reduce blood pressure and are derived mostly from sardines, cod liver oil salmon, tofu, and walnut. 

Another excellent supplement for an antihypertensive drug is Co-enzyme Q10, found in whole grains, fish, organ meats viz. liver, kidney, and heart. 

High blood pressure can also be controlled by taking amino acid supplements, like L-arginine and L-taurine. However, their efficiency is still a question, and studies show that they can manage only for a short duration. 

Several herbal supplements are also available for controlling high blood pressure. In Indian Ayurveda, high blood pressure is attributed to a person’s “dosha” or body type. At the same time, traditional Chinese medicines consider problems in the “circulation of vital energy” of the body for a rise in blood pressure. However, both these traditional treatments make use of herbs to heal the body. Rauwolfia serpentine (snakeroot) and Crataegus monogyna (Hawthorn) are sometimes used as alternatives to medicines. While hawthorn is effective in controlling anxiety, Rauwolfia contains alkaloids that bring about a positive impact on nerve impulses and blood flow. 

Nevertheless, there are several restrictions on using these drugs, so we recommend taking the doctor’s advice before initiating anything. 

Garlic supplements must be consumed only after consulting with a doctor, despite having incredible anti-cholesterol properties. This is because garlic interacts with many prescription drugs and leads to blood thinning. Cocoa is a natural source of polyphenols that exhibit antioxidant and anti-inflammatory properties. The phenols have a positive impact on heart health, and therefore doctors say that a certain amount of cocoa supplements is beneficial for the body. 

Modulation in Diet to Control Rise in BP

The highly popular DASH (Dietary Approaches to Stop Hypertension) diet is quite successful in checking the rise in blood pressure beyond normal. It lists down low-fat dairy foods, complex carbs, fruits and vegetables, grains, nuts, and other healthy foods that improve heart health and lower blood pressure. It restricts the intake of saturated fats, cholesterol-rich foods (red meat and sweets), and simple carbohydrates. An important aspect of this diet is limiting sodium to 2400 mg per day.

The need to supplement minerals in the daily diet must also be taken into consideration. Doctors recommend the inclusion of foods rich in calcium, potassium, and magnesium to maintain the ratio of systolic and diastolic pressure. Apart from these, one should also stop drinking alcohol, which dramatically spikes up blood pressure.

Physical Activities to Maintain Blood Pressure 

This is one of the best alternatives for medicines. People who always have problems with ups and downs in blood pressure must be physically active. This implies a complete improvement of health and mind through exercise and meditation. Therapeutic yoga dealing with various postures and breathing techniques brings about a holistic improvement in the body. At the same time, mild aerobic activities like light jogging and walking are effective in bringing down high blood pressure. 

Since the most notorious causes behind the rise in blood pressure are stress and tension, one should join stress management and meditation classes to heal the body—this way; people learn how to control emotions and stabilize the mind. Worth to note, acupuncture also works wonders on enhancing heart health. All these non-pharmacological methods are excellent techniques to control hypertension and high blood pressure.

All in all, these alternative treatments have considerable help in fighting high blood pressure and different types of health complications associated with it.

Check with your doctor if you can safely consume them and then strive to give yourself a healthy life.

Ten lifestyle changes that prevent heartburn 

Are you suffering from too much acidity, indigestion, and heartburn inside your stomach? If these problems are taking a toll on your health, then you need to make specific changes in your lifestyle to get relief eventually. We explain them over here.

1.Avoid Acid Generating foods 

you must avoid foods that generate Acid and cause heartburn at any cost. Citrus fruits (lemon, cranberry, orange, etc.), spicy food items, meat, processed foods are a big NO for you. You should also control your sweet cravings for brownies, doughnuts, chocolates, etc.

2.Don’t Sleep Immediately After Eating

Your food needs time to move down your digestive tract and, therefore, do not lie down or sleep immediately after eating. Walk around your room or indulge in any kind of mild activity for at least half an hour. This will aid the digestion process.

3.Stop Sleeping on Stomach

What happens when you sleep on your stomach? Your body weight puts pressure on the lower esophageal sphincter (LES). As a result, the contents of the stomach get pushed up to the esophagus, which increases the chances of heartburn and acidity. Therefore, sleep on your back and place your head on a pillow.

4.Avoid Smoking and Drinking

Smoking tobacco deteriorates your health. The nicotine content relaxes the sphincter muscle of the esophagus as a result, you become more prone to acidity, indigestion, and heartburn. Drinking alcohol and carbonated drinks have a similar effect on your health.

5.Avoid too many Beverages

Hot tea and coffee do no good to acidity because caffeine simply stimulates it. If you have heartburn problems, then you must cut down your tea and coffee cuppas. Substitute with ginger root tea, green tea, lemongrass tea, etc.

6.Control Weight Gain 

When your abdominal fat increases, it automatically exerts pressure on your esophagus. The fat doesn’t do it directly; instead, it pushes up the gastric juices to the esophagus, due to which you become prone to frequent heartburn.  

7.Wear Light and Comfortable Clothes

Wearing tight clothes for a long time increases your body’s internal as well as external heat. Avoid wearing nylon clothing and tight clothes, belts if you regularly suffer from heartburn. Instead, wear loose cotton clothing as much as possible.

8.Change your Eating Habits 

If you are having a large portion of meals in one go, then stop doing that. Your stomach secretes more Acid to digest the food, which in turn gives rise to acidity problems. So we insist you eat a small portion of food every 2-3 hours. However, make sure you eat healthily.

9.Have Cold Water

Coldwater gives you immediate relief. People who suffer from indigestion and acidity problems are advised to drink cold water frequently. Make sure you have at least 5-6 glasses of cold water in a day. Or else stick to normal temperature water.

10.Check Your Medicines 

You may not be aware that the medicines you are taking regularly are interfering with your digestion process and causing the heartburn. If you are taking NSAIDs, blood pressure medicines, calcium, iron and potassium tablets, painkillers, etc., you should consult with your doctor to find the best remedy.

Incorporate these lifestyle modifications for a month or more to notice a substantial improvement in your health. Heartburn and other digestion problems will disappear for sure.


 

TMT or stress test

 What is a stress test?

The stress test is a test that determines the capacity of your heart to tolerate maximum stress before it shows any abnormality.

There are four types of stress tests, and they are as follows:

1.Treadmill Test: TMT test stands for the Treadmill test. It is also connoted as an exercise stress test and exercise tolerance test. TMT is a medical diagnostic procedure that is done to ensure if your heart is receiving enough oxygen and blood flow during highly strenuous physical activities. 

We will explain to you the details of TMT in this article.

1.Adenosine Stress Test: This test is specially meant for people who are incapable of physical activities like walking, running, exercising, etc. because of the problems such as arthritis. The person is given adenosine, which makes the heart respond as if the person is exercising so that he/she can detect how the heart is responding to stress. Sometimes this test is combined with walking on the treadmill at low speed for more accurate results. Adenosine may cause mild breathlessness while conducting the test. 

2.Stress echocardiogram: This technique implies ultrasound imaging and draws a graphic outline (echocardiogram) of the heart's movement. It clearly shows the pumping action of the heart under stress, including the blood flow. You will either be asked to exercise or give a pill like dobutamine to record your heart's activity. 

3.Nuclear stress test: As the name suggests, in this test, a radioactive substance (such as thallium or sestamibi) will be injected into the body. A special camera will scan the heart and depict the movement of the substance inside the body during rest and exercise. Thus the part of the heart that's not functioning properly can be diagnosed.
Now let's get back to TMT.

Why is TMT (Treadmill test) advised? 

The test is mainly performed to know your heart's health or whether you are prone to heart disease. It's advised because of the following reasons. 

• It can estimate if you are at the risk of developing heart disease, like high cholesterol, even if you don't have symptoms. 
  

• To test your ability to tolerate the exercise while suffering from too much fatigue and shortness of breath.
  

• It's capable of assessing the effectiveness of undergoing heart disease treatment.
  

• To confirm coronary artery disease (CAD), narrowing of arteries, heart valve problems (stenosis), etc. 
  

• To detect some irregular heartbeats caused due to exercise.
  

• You can freely exercise if you have diabetes or any kind of heart disease or after bypass surgery or angioplasty

How to Prepare for the Treadmill Test? 

You must consult your doctor to ensure that you can continue or stop any kind of medication you are taking on the day of the test. This includes pain killers, steroids, and sexual stimulants, also.

Your doctor will advise you not to smoke or drink before 3 hours of the test. Your stomach should be empty. Secondly, you will also be asked to exclude chocolates, tea, coffee, aerated drinks, and other types of caffeine-rich beverages. 

What is done during the procedure?

• The doctor or the technician places electrodes like sticky patches on your chest and a gel for conducting electrical impulses. These electrodes are attached to an ECG monitor to record the electrical activity of your heart.
  

• Your doctor will conduct several ECGs before you start the exercise to perform a comparative study.
  Once this is done, you will start walking on a treadmill or ride an exercise bicycle. You will be advised to increase the speed gradually. 
  

• Your heart rate will be monitored with an electrocardiogram (ECG), and blood pressure readings will also be taken.
  

• You will be asked to exercise until you reach the target heart rate.

However, your doctor will stop the test if he observes a drop in blood pressure, irregular heartbeats, and coldness in the skin. Also, if you experience dizziness, fainting, tiredness, pain in legs, or chest pain, the test will be stopped.

What to expect after the treadmill test?

You can return to normal activities after a certain period after the test. Your doctor will advise you to rest until your heartbeat returns to normal. The results are subject to vary from person to person and are dependent upon your health condition. Secondly, the abnormalities will also get detected based on how you perform the test. Your doctor may take a few hours to prepare a detailed report.

Risks involved in the treadmill test

• Low blood pressure might lead to dizziness or fatigue.
  

• Since you have exercised, you might experience irregular heartbeat (arrhythmia) after the test. Tell your doctor if it doesn't go away despite rest.

There's no harm in undergoing a TMT to rule out any underlying heart implications.

Estrogen Replacement Therapy

Estrogen Replacement Therap

What is estrogen replacement therapy?

Estrogen is the female sex hormone, and it plays a significant role in the menstrual cycle and reproduction. Estrogen replacement therapy (ERT) is a medical procedure wherein the hormone is externally administered in women to elevate the estrogen levels inside the body.

Why is estrogen replacement therapy advised?

Estrogen replacement therapy is advised explicitly to post-menopausal women who are devoid of the uterus.

The therapy controls vasomotor symptoms like night sweats, hot flushes, irritability, fatigue, vaginal dryness, stress incontinence, dizziness, etc. usually prominent during perimenopause and menopause.

One of the primary reasons behind doctors advising estrogen replacement therapy is to prevent osteoporosis in menopausal women.

Estrogen replacement therapy is also applicable to women of any age group who have undergone ovary removal and have become naturally prone to bone loss.

How is estrogen replacement therapy done?

Estrogen replacement therapy can be carried out in various ways.

Point to Note: The doctor gives progestin and estrogen together for women with a uterus because estrogen alone, leads to the overgrowth of the uterine lining, making one susceptible to uterine cancer. 

Estrogen Pills: 

The dosage of the pills could be every day or 25 days each month. Women who had undergone hysterectomy can take estrogen alone, while others take a combination of estrogen and progestin pill.

Cyclic Method: 

In this method, estrogen (every day or daily for 25 days of the month) and progestin (10-14 days of the month) are taken separately.

Transdermal patch method:

A patch is applied to the abdomen's skin or buttocks for three and a half days or seven days, which is then discarded, and a new one is applied. The patch can be left at all times but cannot be exposed to direct sunlight. You can wear on while swimming or bathing but avoid while on the hot tub, sauna, or on the tanning bed. In this technique, the estrogen or estrogen-progestin combination is administered through the skin directly into the bloodstream.

Other methods: 

Estrogen cream, vaginal ring, intramuscular injections, subcutaneous implantation, and transdermal gels are used mainly to heal vaginal dryness. These methods also deliver estrogen into the bloodstream without accessing the liver.

Limitations for estrogen replacement therapy

Who should avoid it?

• Estrogen replacement therapy is strongly not allowed for
  Pregnant women

• Women with phospholipid antibodies
  

• Men/women with a history of heart stroke or high blood pressure
  

• Women with abnormal vaginal bleeding
  

• Men/women with liver problems and diseases
  

• Women with ovarian, uterine and breast cancer
  

• Men/women with blood clots
  

• Smokers
  

• Women with deep vein thrombosis

Side Effects of estrogen replacement therapy 

No doubt, there are side effects of the pills and other methods. They include nausea, dizziness, weight gain, fluid retention, bloating, breast tenderness, cramping, indigestion, vaginal discharge, etc. However, the symptoms disappear within a few days and with a change in lifestyle as suggested by doctors.

Risks for estrogen replacement therapy 

Risks and health hazards of undergoing estrogen replacement therapy depend on your age and health problems. Some common risks include an increase in chances of stroke, ovarian cancer, blood clots, gall stones, breast cancer, and dementia.

Advantages of estrogen replacement therapy

The advantages outweigh the risks of estrogen replacement therapy if you choose the appropriate doctor for the treatment.

It has been successful in many women globally, and the results are:

• Fractures in hips, wrist, and spine decrease by 50–70%, i.e., prevention of osteoporosis.
  

• The therapy reduces all the post-menopausal symptoms as explained above.
  

• Spinal bone density increases by ~5% within three years of the onset of menopause.
  

• Estrogen replacement therapy decreases the risk of heart disease when initiated early in post-menopausal years.

We suggest you consult the right doctor and explain your health conditions to him/her before he/she prescribes the therapy. Your health condition will considerably improve with a year only if you are taking the dose correctly.

What is the Right Way to Brush

How to Brush or What is the Right Way to Brush

Do you know that one of the main reasons behind becoming susceptible to dental problems is not following the correct technique of brushing? Yes, we all ignore it many times, in a rush of the moment, we brush haphazardly and then quickly wash our mouth, sometimes even forgetting to clean the tongue. We advise you to stop doing this. 

Brushing takes only 2 minutes, and at this time, you can pamper your teeth the most. So how do you do that? We explain it to you over here.

Correct Techniques for Brushing

1. Squeeze the right amount of toothpaste in your bristles and make sure you do not overload it. Too much paste will fill your mouth, and you either tend to swallow or spit it out.
2. Dentists always insist on following a circular and vertical motion of brushing. Do not brush your teeth roughly and horizontally. Follow a uniform pattern, i.e., up and down and in circles.
3. Focus on the four zones of your teeth viz. left, right, top, and bottom. Follow the same motion as explained in point 2 for cleaning these four zones and dedicate at least 15 seconds for each.
4. Brushing the back of your teeth is a bit tricky. Hold your brush at 90 degrees angle to your lips and then gently sweep it through the inner zones of your teeth (all the four zones). Use your toothbrush in back and forth motion.
5. Now clean your tongue. You can either use a tongue scraper or use your brush to clean it. Gently rub the bristles up and down on the tongue.
6. Now gargle your mouth with water and spit out until no trace of toothpaste is left behind. You can use an antibacterial mouth wash also for rinsing.

Choosing the Right Tools for Brushing

Type of Toothbrush

You can either brush your teeth manually or use an electric toothbrush. Make sure the bristles are soft and supple and are not made from animal hair. Opt for nylon bristles. However, the bristles should be sturdy enough to remove plaque from teeth.

Choice of Toothpaste

Toothpaste is customized as per the need of consumers. Generally, dentists suggest using fluoride toothpaste; nevertheless, you must seek a doctor’s advice if you are suffering from dental diseases or if your teeth are sensitive.

Different Cleaning Tools

Dental floss is a must to clean those hidden and trapped food particles and bacteria in deep recesses of your teeth where your toothbrush cannot reach. Secondly, we suggest using a tongue scraper every day to clean your tongue.

Common Mistakes to Avoid

Brushing too Often is Wrong.

If you’re brushing every time after a meal, then stop it. It would only expose the root of your tooth and tear your gums. So brush thoroughly, but only twice a day i.e., morning and night.

Sticking to the same toothbrush for long is Unhygienic.

The American Dental Association recommends getting a new brush every three or four months, or even sooner if the bristles look frayed.

Neglecting the Inner Surface of Tooth

If the inner side of your teeth is stained, then you are neglecting them. Take care of the rear portion equally as the frontal facade of your teeth.

Follow the techniques we have explained here and avoid the mistakes to get squeaky clean teeth. Brushing your teeth is the first thing you do in the morning, so spare 2-3 minutes religiously and do it rightly.