Last year, over 1.5 million people heard the words no one wants to hear: “You have cancer.” While only a small portion of those — about three percent — were diagnosed with oral cancer, their survival rate isn’t as good as with other types of cancers: 58% five years after diagnosis.
Here, then, are some things you should know about this deadly disease.
Oral cancer is an “equal opportunity” disease. People from all walks and stations of life experience oral cancer. The disease has caused the untimely deaths of Ulysses S. Grant, Babe Ruth and George Harrison, one of the original Beatles. However, you don’t have to be prominent or famous to acquire oral cancer: it can strike anyone at any age, especially people 40 years and older.
Oral cancer is difficult to detect early. Oral cancer usually appears as a small, scaly-shaped sore known as a squamous cell carcinoma. Appearing in the lining of the mouth, lips, tongue or back of the throat, the early stages often resemble other benign conditions such as cold or canker sores, so they’re easily overlooked in the early stages. To increase your chances of an early diagnosis, you should see your dentist about any mouth sore that doesn’t heal in two to three weeks; it’s also advisable to undergo a specific oral cancer screening during your regular dental checkups.
Tobacco and heavy alcohol use are strongly linked to oral cancer. Tobacco smokers are five to nine times more likely to develop oral cancer while snuff or chewing tobacco users are roughly four times more likely than non-tobacco users. People who are moderate to heavy drinkers are three to nine times more likely to develop oral cancer than non-drinkers.
You can reduce your risk for oral cancer. Besides quitting tobacco use and moderating your alcohol consumption, there are other things you can do to reduce cancer risk: a nutritious diet rich in fresh fruits and vegetables; limited sun exposure with adequate sunscreen protection and clothing; and safe sexual practices to avoid contracting Human Papilloma Virus (HPV16), strongly linked to oral cancer. And above all, practice effective, daily oral hygiene with regular dental cleanings and checkups.
If you would like more information on prevention and treatment of oral cancer, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Cancer.”
Sometimes dental conditions point to health problems beyond the teeth and gums. An astute dentist may even be able to discern that a person’s oral problems actually arise from issues with their emotional well-being.Â In fact, a visit to the dentist could uncover the presence of two of the most prominent eating disorders, bulimia nervosa or anorexia nervosa.
Here are 3 signs dentists look for that may indicate an eating disorder.
Dental Erosion. Ninety percent of patients with bulimia and twenty percent with anorexia have some form of enamel erosion. This occurs because stomach acid — which can soften and erode enamel — enters the mouth during self-induced vomiting (purging), a prominent behavior with bulimics and somewhat with anorexics. This erosion looks different from other causes because the tongue rests against the back of the bottom teeth during vomiting, shielding them from much of the stomach acid. As a result, erosion is usually more severe on the upper front teeth, particularly on the tongue side and biting edges.
Enlarged Salivary Glands. A person induces vomiting during purging by using their fingers or other objects. This irritates soft tissues in the back of the throat like the salivary glands and causes them to swell. A dentist or hygienist may notice redness on the inside of the throat or puffiness on the outside of the face just below the ears.
Over-Aggressive Brushing. Bulimics are acutely aware of their appearance and often practice diligent hygiene habits. This includes brushing the teeth, especially after a purging episode. In doing so they may become too aggressive and, coupled with brushing right after purging when the minerals in enamel are softened, cause even greater erosion.
Uncovering a family member’s eating disorder can be stressful for all involved. In the long run, it’s best to seek out professional help and guidance — a good place to start is the National Eating Disorders Association (www.nationaleatingdisorders.org). While you’re seeking help, you can also minimize dental damage by encouraging the person to rinse with water (or a little baking soda) after purging to neutralize any acid in the mouth, as well as avoid brushing for an hour.
If you would like more information on the effect of eating disorders on oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bulimia, Anorexia & Oral Health.”
The American Dental Hygiene Association has designated October as National Dental Hygiene Month. Good dental hygiene is the best weapon against your mouth’s number one enemy: dental plaque.
Plaque, a sticky biofilm that forms on your teeth, is an accumulation of bacteria, other microorganisms, food debris, and other unpleasant components. It can make your teeth feel fuzzy or slimy. And worse, the bacteria in plaque can lead to tooth decay and gum disease.
The best way to keep plaque at bay is by brushing your teeth twice a day and flossing once a day. But even though you can remove much of the plaque in your mouth with a toothbrush and dental floss, there are nooks and crannies that are hard to access with these basic oral hygiene tools.
Staying on top of dental plaque is an ongoing challenge. Immediately after teeth are cleaned, plaque starts to form again. And the longer plaque stays on teeth, the thicker it grows. Minerals in saliva become incorporated into the biofilm. As plaque takes on more minerals, it becomes calcified. This is when it hardens into calculus, or tartar. At this stage, tooth-brushing and flossing cannot disrupt the hardened layer of buildup, sometimes visible as yellow or brown deposits around the gum line.
This is why it’s important to schedule regular professional dental cleanings. At the dental office, we have special tools to remove tartar and get at those hard-to-reach places that your toothbrush and floss may have missed. If you have questions about dental hygiene, plaque control or another oral health issue, we are happy to talk with you. We are your partners in fighting plaque for a bright, healthy smile!
Read more about the topic in the Dear Doctor magazine article “Plaque Disclosing Agents.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Accidents happen, especially to teenagers involved with sports or similar activities. In an instant they can lose one or more teeth and permanently alter their smile.
Fortunately we can restore a teenager’s lost teeth, but often not immediately as a permanent restoration with a dental implant requires maturity of their jaw structure. Our focus then turns to the age of the patient and the condition of the underlying bone. A future dental implant, your best choice for tooth replacement, depends on bone for support, but also the age of the patient as it relates to jaw development.
There are a couple of ways an accidental tooth loss can harm supporting bone: first and foremost, the impact of the accident itself can damage the bony socket. To find out for sure we may need to perform a cone beam scan, a type of x-ray that allows us to view the area three-dimensionally. If we do find damage, we can attempt to repair the socket through bone grafting.
Bone can also suffer from the long-term absence of a tooth. Bone has a growth cycle in which older cells dissolve and new ones form to take their place. The force generated by teeth when we eat or chew helps stimulate this growth. Without stimulation, as with a missing tooth, the bone may not grow at a healthy rate. In time, it could lose some of its volume and density and not be able to support an implant.
Installing an implant right after tooth loss could help avoid this situation. Bone has a natural affinity with the titanium post imbedded in the jaw and will naturally grow and adhere to it. But we can’t place an implant with a teenager. This is because the jaw is still developing so an implant would gradually become misaligned as the jaw grows. It’s best to install an implant later after full jaw development in early adulthood.
Today, we can place a bone graft in the empty socket right after tooth loss. The graft serves as a scaffold for bone cells to grow on and will help keep the bone volume at a healthy level until we can install an implant.
Timing is everything in restoring a teenager’s accidental tooth loss. But with coordination and care for the supporting bone, a teenager can eventually enter their adult years with their smile intact.
If you would like more information on restoring your teenager’s smile after tooth loss, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”
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