With college, a full-time job and an upcoming wedding to plan, Brooke Vitense had the hectic life of an average young woman in her twenties. But a chance discovery one morning would completely upend her normal life.
That morning Brook noticed white spots on the underside of her tongue while brushing her teeth. Not long after, she pointed out the spots to her dentist during her regular dental checkup. He recommended having the spots biopsied, just to be safe. She needed a wisdom tooth removed, so she scheduled the biopsy with her oral surgeon to coincide with the tooth extraction.
She soon forgot about the biopsy — until her dentist contacted her about the results. The lesions were pre-cancerous: he recommended she have them and a portion of her tongue removed surgically as soon as possible.
She underwent the procedure, but that wasn't the end of her ordeal. The follow-up pathology report indicated cancerous cells in the tissue excised during the procedure. To ensure elimination of any remaining cancerous cells they would need to remove more of her tongue as well as the lymph nodes from her neck.
Brooke survived her cancer experience and has since resumed her life. Her story, though, highlights some important facts about oral cancer.
Oral cancer is life-threatening. Although cases of oral cancer are rarer than other types of malignancies, the survival rate is low (50%). This is because lesions or other abnormalities are often dismissed as simple sores. Like any cancer, the earlier it's detected and treated, the better the chances for survival.
Anyone of any age can develop oral cancer. While most cases occur in older adults, young and otherwise healthy people like Brooke are not immune. It's important for everyone to make healthy lifestyle choices (good oral hygiene and nutrition, moderate alcohol use and avoidance of tobacco) and see a dentist whenever you see an abnormal sore or spot in your mouth.
Regular dental checkups are crucial for early detection. Had Brooke not seen her dentist soon after discovering the spots on her tongue, her survivability could have been drastically lower. Regular dental visits (and cancer screenings if you're at high risk) could mean all the difference in the world.
If you would like more information on the signs and treatment of oral cancer, please contact us or schedule an appointment for a consultation. You can watch Brooke's interview by visiting How a Routine Dental Visit Saved My Life
“No man is an island….” So wrote the poet John Donne four centuries ago. And while he meant the unity of humanity, the metaphor could equally apply to the interdependence of the various parts of the human body, including the mouth. According to recent scientific research, your mouth isn’t an “island” either.
Much of this research has focused on periodontal (gum) disease, an infection most often caused by bacterial plaque that triggers inflammation in the gum tissues. Although an important part of the body’s defenses, if the inflammation becomes chronic it can damage the gums and weaken their attachment to the teeth. Supporting bone may also deteriorate leading eventually to tooth loss.
Avoiding that outcome is good reason alone for treating and controlling gum disease. But there’s another reason—the possible effect the infection may have on the rest of the body, especially if you have one or more systemic health issues. It may be possible for bacteria to enter the bloodstream through the diseased gum tissues to affect other parts of the body or possibly make other inflammatory conditions worse.
One such condition is diabetes, a disease which affects nearly one person in ten. Normally the hormone insulin helps turn dietary sugars into energy for the body’s cells. But with diabetes either the body doesn’t produce enough insulin or the available insulin can’t metabolize sugar effectively. The disease can cause or complicate many other serious health situations.
There appears to be some links between diabetes and gum disease, including that they both fuel chronic inflammation. This may explain why diabetics with uncontrolled gum disease also often have poor blood sugar levels. Conversely, diabetics often have an exaggerated inflammatory response to gum disease bacteria compared to someone without diabetes.
The good news, though, is that bringing systemic diseases like diabetes under control may have a positive effect on the treatment of gum disease. It may also mean that properly treating gum disease could also help you manage not only diabetes, but also other conditions like cardiovascular disease, osteoporosis, or rheumatoid arthritis. Taking care of your teeth and gums may not only bring greater health to your mouth, but to the rest of your body as well.
If you would like more information on treating dental diseases like gum disease, 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 “Good Oral Health Leads to Better Health Overall.”
Porcelain veneers are excellent for restoring otherwise sound teeth that are stained, chipped or slightly misaligned. But the question for many is, are they long-lasting?
Just as the term is used in building construction, a dental veneer is a thin covering of material that’s bonded to the outside of a tooth to conceal blemishes. Very thin layers of dental porcelain (a form of hardened glass colored to match a patient’s natural teeth) are created by a dental lab technician to achieve the preferred shape and size of the patient’s tooth. Unlike crowns or other restorations, veneers require very little tooth preparation to accommodate them.
As to their longevity: if cared for properly, a veneer could last for twenty years or more. While the veneer itself isn’t subject to the effects of dental disease, the tooth and the gums that support it are. Shrinking gum tissues as a result of periodontal (gum) disease, for example, could have a negative effect on the veneered tooth and subsequently the veneer. It’s important, then, that you properly practice daily brushing and flossing, along with keeping up regular office cleanings and checkups.
There’s one other important consideration: while porcelain veneers can withstand normal biting forces, if they’re subjected beyond their tolerance they could shatter. You should be careful not to subject your veneered teeth to an abnormal biting force, such as biting down on an extremely hard object. If you tend to grind your teeth at night, wearing a night guard can minimize the force created from the grinding.
It’s possible to repair and re-bond a loose or slightly chipped veneer. In some cases, though, severe damage may require a replacement. Still, by using common sense about what you bite down on and taking proper care of your teeth and gums, you can minimize the chances of damage and enjoy many years of a more attractive smile.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers: How Long will Your Porcelain Veneers Last?.”
We've known for a long time that fluoride strengthens tooth enamel against decay. We've also learned that fluoride consumption early in life pays later dividends with healthier teeth.
But while fluoride has generally proven safe, too much ingested by young children could cause enamel fluorosis. This condition produces a mottled or streaked appearance in teeth ranging from faint white patches to darker, pitted staining. Fluorosis doesn't harm teeth, but it does make them less attractive.
To prevent this, it may be necessary with your dentist's help to monitor your infant's or young child's fluoride intake and keep it in check. That will depend in large part on where you live, as well as your child's hygiene and eating habits.
Like three-quarters of public water systems, your local utility may be adding fluoride to your drinking water. The amount is governed by federal guidelines, which currently recommend fluoride amounts of no more than 0.70 parts per million of water. The fluoride levels in your water could have an impact on your child's total fluoride intake. You can find out for sure how much fluoride is present in your water by contacting your water utility company.
Another major fluoride source is toothpaste and other hygiene products. You can control your child's fluoride exposure by limiting the amount of toothpaste on their brush. Children under two only need a “smear,” while those between two and six need only a pea-sized amount.
Processed foods can contain fluoride if fluoridated water was used in their production. In this case, replace as much of the processed food items in your family's diet as you can with fresh fruits, vegetables and other foods.
Along this line, if you have an infant you want to pay particular attention to feeding formula, especially the powdered form you mix with water. If you're concerned about the amount of fluoride in your water consider other infant feeding options. Besides breast-feeding in lieu of formula, you can also use ready-to-feed pre-mixed with water (usually lower in fluoride) or mix powdered formula with bottled water specifically labeled “de-ionized,” “purified,”Â “demineralized,” or “distilled.”
This can be a lot to keep up with but your dentist can advise you. Fluoride is still a potent weapon against tooth decay and a safeguard on your child's current and future dental health.
If you would like more information on the relationship between fluoride and your child's dental 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 “Tooth Development and Infant Formula.”
Periodontal (gum) disease causes more than simple gum swelling—this bacterial infection can harm and destroy your teeth’s supporting structures, including the bone. Its aggressiveness sometimes requires equally aggressive treatment.
Gum disease usually begins with dental plaque, a thin film of bacteria and food particles on tooth and gum surfaces. Without proper oral hygiene plaque builds up with large populations of bacteria that can trigger an infection.
The growth of this disease is often “silent,” meaning it may initially show no symptoms. If it does, it will normally be reddened, swollen and/or bleeding gums, and sometimes pain. A loose tooth is often a late sign the disease has severely damaged the gum ligaments and supporting bone, making tooth loss a distinct possibility.
If you’re diagnosed with gum disease, there is one primary treatment strategy—remove all detected plaque and calculus (tartar) from tooth and gum surfaces. This can take several sessions because as the gums begin responding to treatment and are less inflamed, more plaque and calculus may be discovered.
Plaque removal can involve various techniques depending on the depth of the infection within the gums. For surfaces above or just below the gum line, we often use a technique called scaling: manually removing plaque and calculus with specialized instruments called scalers. If the infection has progressed well below the gum line we may also use root planing, a technique for “shaving” plaque from root surfaces.
Once infection reaches these deeper levels it’s often difficult to access. Getting to it may require a surgical procedure known as flap surgery. We make incisions in the gums to form what looks like the flap of an envelope. By retracting this “flap” we can then access the root area of the tooth. After thoroughly cleansing the area of infection, we can do regenerative procedures to regain lost attachment. Then we suture the flap of gum tissue back into place.
Whatever its stage of development, it’s important to begin treatment of gum disease as soon as it’s detected. The earlier we can arrest its spread, the less likely we’ll need to employ these more invasive procedures. If you see any signs of gum disease as mentioned before, contact us as soon as possible for a full examination.
If you would like more information on preventing and treating gum disease, 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 “Treating Difficult Areas of Periodontal Disease.”
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