Posts for: August, 2013
According to a recent study from the National Cancer Institute, a branch of the National Institutes of Health, the incidence of cancer is dropping and the survival rate is increasing. In general, the outlook for patients undergoing treatment for the disease is getting better and better. Unfortunately, it's possible that some essential lifesaving treatments, like chemotherapy and radiation, can adversely affect your oral health. If you (or a loved one) need cancer treatment, however, there are some things you should know that can help minimize the possible complications and side effects.
- Chemotherapy and radiation are effective cancer treatments, but they may cause oral health problems. These therapies work by attacking cancer cells, but they can also damage healthy cells, including those in the salivary glands and the lining of the mouth. Common symptoms may include a dry mouth or uncomfortable mouth sores. Cancer patients may also be at higher risk for dental disease, especially tooth decay.
- Prevention is the best way to minimize these problems. It's important to have a complete dental evaluation before cancer treatment begins. Side effects often result when the mouth isn't healthy prior to the start of therapy — so if there's time for necessary dental treatment beforehand, it can be beneficial in the long run.
- Taking good care of the mouth is crucial at this time. During cancer treatment, proper brushing is more important than ever. A fluoride gel or antibacterial rinse may be prescribed to help prevent tooth decay. Prescription medications are sometimes recommended to alleviate dry mouth, but drinking plenty of water, chewing xylitol-containing gum, or using a soothing rinse of salt, water and baking soda can help too.
- A team approach is essential for the best care. This includes coordination between dentists and oncologists (cancer specialists), and sharing information about prescription and non-prescription drugs, medical histories and treatment plans.
- It's vital to understand and follow medical recommendations. This means not only getting the necessary treatments and taking prescribed medications, but also learning to recognize the warning signs of potential problems. With the support of our office, your oncologist, and caring family and friends, we can make cancer treatment as comfortable as possible and help obtain the best outcome.
If you would like more information about cancer treatment and oral health, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Oral Health During Cancer Treatment.”
No one wants to hear the word “cancer.” But thanks to advances in detection and treatment, the disease increasingly can be stopped in its earliest stages when it's most treatable and outcomes are most favorable. Oral cancer accounts for a relatively small 3% of cancers in men and 2% in women, but early detection rates are lagging. Our office screens for oral cancer as part of your regular checkups. Knowing some of the signs and symptoms can help you monitor as well.
The main areas where oral carcinomas (cancers) occur are:
- the tongue (most common location, particularly the sides and on the floor of the mouth),
- the lip (especially the lower one),
- the oral cavity (the mouth), and
- the pharynx (back of mouth and throat).
Most oral cancers are preceded by surface changes (lesions) of the oral membranes. In the “precancerous” stage, white or red patches start forming and a non-healing ulcer may appear. The most common locations on the tongue for this to occur are on the sides and underneath on the floor of the mouth. Lip cancers typically develop on the lower lip, usually in people with a history of sun exposure. There has often been prior damage at the site such as scaling and crusting.
Be aware that oral cancers can be mistaken for cold and canker sores, ulcers, minor infections, and even irritations caused by biting or certain types of food. If lesions don't heal within two or three weeks, there's a higher likelihood that they are cancerous.
An in-office examination includes the following:
- visual inspection of face, lips, neck and mouth;
- inspection of sides and underneath of tongue and floor of mouth using gauze to gently manipulate the tongue;
- palpation of the floor of the mouth, sides of neck and glands to detect unusual lumps; and
- an “open wide and say ‘Aah’” examination of the back of your throat.
There are some risk factors for oral cancer that can't be controlled, such as a family history, age and race. But awareness, monitoring for potential signs and seeking prompt attention are always key ingredients in protecting your oral health!
If you would like more information about oral cancer detection, 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.”
In a healthy tooth, a coating of enamel protects the crown — the part above the gum line — and a layer of cementum protects the tooth root below the gum line. Enamel and cementum are inert (nonliving) substances that do not respond to stimuli such as heat or cold; however, dentin, the living tissue below them, does. Dentin contains numerous microscopic tubules that readily transmit stimuli toward the nerve-filled center of the tooth (pulp tissue). Loss of protective enamel or cementum leaves dentin exposed to all sorts of stimuli in the oral environment, which can trigger “dentinal hypersensitivity” — anything from a mild twinge to shooting pain.
Fortunately, there are many options for treating hypersensitivity. The key to selecting the most appropriate one(s) is determining the cause(s). Some of the more common reasons for sensitivity due to dentin exposure include:
- Enamel erosion caused by an “acid attack” related to external (extrinsic) causes — i.e., consumption of acidic beverages/food — or internal causes — i.e., regurgitation of stomach acids due to gastroesophageal reflux disease [GERD] or the eating disorder bulimia
- Using an overly abrasive brush or toothpaste, brushing incorrectly or too frequently, or brushing too soon after an “acid attack” — all of which can result in a loss of enamel
- Tooth decay (dental caries or cavities)
- Tooth fracture or chipping: tooth grinding (bruxism) is a common cause
- Worn fillings
- Gum recession, due to age or improper tooth brushing, that exposes the tooth root
- Gum disease, which can result in gum recession
Sensitivity can also occur following a procedure like treating a cavity. Normally it subsides within a couple of weeks or so but if it continues there may be another underlying cause.
Whatever the source(s) of your discomfort, our office can get to the bottom of it and recommend an effective course of treatment that meets your personal needs!
If you would like more information about tooth sensitivity, 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 “Sensitive Teeth.”
While she was pregnant with her son Camden Jack Cutler, 25-year-old Kristin Cavallari noticed an odd occurrence in her bathroom sink: “Every time I floss, my sink looks like I murdered somebody!” the actress and reality-TV personality exclaimed. Should we be concerned that something wicked is going on with the star of Laguna Beach and The Hills?
Before you call in the authorities, ask a periodontist: He or she will tell you that there's actually no mystery here. What Cavallari noticed is, in fact, a fairly common symptom of “pregnancy gingivitis,” a condition that affects many expectant moms in the second to eighth month of pregnancy. But why does it occur at this time?
First — just the facts: You may already know that gingivitis is the medical name for an early stage of gum disease. Its symptoms may include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. Fundamentally, gum disease is caused by the buildup of harmful bacteria, or plaque, on the teeth at the gum line — but it's important to remember that, while hundreds of types of bacteria live in the mouth, only a few are harmful. A change in the environment inside the mouth — like inadequate oral hygiene, to use one example — can cause the harmful types to flourish.
But in this case, the culprit isn't necessarily poor hygiene — instead, blame it on the natural hormonal changes that take place in expectant moms. As levels of some female hormones (estrogen and/or progesterone) rise during pregnancy, changes occur in the blood vessels in the gums, which cause them to be more susceptible to the effects of bacterial toxins. The bacteria produce toxic chemicals, which in turn bring on the symptoms of gingivitis — including painful and inflamed gums that may bleed heavily when flossed.
Is pregnancy gingivits a cause for concern? Perhaps — but the condition is generally quite treatable. If you've noticed symptoms like Kristen's, the first thing you should do it consult our office. We can advise you on a variety of treatments designed to relieve the inflammation in your gums and prevent the harmful bacteria from proliferating. Of course, your oral health (and your overall health) are prime concerns during pregnancy — so don't hesitate to seek medical help if it's needed!
How did things work out with Kristen? She maintained an effective oral hygiene routine, delivered a healthy baby — and recently appeared on the cover of Dear Doctor magazine, as the winner of the “Best Celebrity Smile” contest for 2012. And looking at her smile, it's no mystery why she won.
If you would like more information about pregnancy gingivitis, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Expectant Mothers” and “Kristen Cavallari.”