Posts for: April, 2017
Thanks to treatments like chemotherapy and radiation, your chances of surviving cancer are greater than ever. These treatments, however, often produce unwelcome side effects. Treating throat or oral cancer, for example, could damage your mouth's salivary glands or bone.
Saliva is essential to oral health, providing antibodies to curb the growth of disease-causing bacteria and neutralizing acid, which can erode enamel. But salivary glands damaged during cancer treatment may not be able to produce enough saliva. The resulting “dry mouth” creates an environment conducive to bacterial growth and elevated acid levels.
You can help reduce the effects of dry mouth during your treatment (and after, if the damage is permanent) by drinking more water or by using substances that stimulate saliva. Cutting back on acidic foods and beverages will also help lower your mouth's acidity. And be sure to keep up daily oral hygiene and regular dental visits.
The more ominous threat to oral health during cancer treatment, though, is osteoradionecrosis. This occurs when radiation targets specific areas of bone. The bone can lose blood supply and living cellular tissue, which inhibit its ability to heal or replenish itself. If this occurs in the jawbone of teeth that may be lost, the bone tissue could be adversely affected during healing.
Depending on your treatment needs, your risk for osteoradionecrosis might be unavoidable if teeth are to be lost. It's important we discuss that risk because it could impact future dental treatment. In the worst case, before cancer treatment, we may not be able to save affected teeth and your restorative options might be limited.
If your risk of osteoradionecrosis is minimal, though, we may be able to restore any resulting damaged or missing teeth with a wide range of options like dental implants or crowns before or after your cancer treatment.
As with other aspects of health, taking care of your teeth and gums while undergoing cancer treatment can be challenging; some problems may be unavoidable. But with a proper dental treatment plan during and after chemotherapy and radiation, we can minimize those problems and help to eventually restore your smile.
If you suspect you have periodontal (gum) disease, it's important to get a correct diagnosis and begin treatment as soon as possible. The sooner you begin treatment the better the long-term outcome.
Gum disease is a bacterial infection that's most often triggered by plaque, a thin film of food particles on tooth surfaces. Plaque buildup most often occurs when a person doesn't practice effective oral hygiene: daily brushing and flossing and professional cleanings at least twice a year.
The most common type of gum disease, gingivitis, can begin within days of not brushing and flossing. It won't always show itself, but you can have symptoms like swollen, red or bleeding gums, as well as bad taste and breath. You could also develop painful abscesses, which are localized pockets of infection within the gums.
If we don't stop the disease it will eventually weaken the gum attachment to the teeth, bone loss will occur and form deep pockets of infection between the teeth and bone. There's only one way to stop it: remove the offending plaque from all tooth surfaces, particularly below the gum line.
We usually remove plaque and calculus (hardened plaque deposits) manually with special hand instruments called scalers. If the plaque and calculus have extended deeper, we may need to perform another procedure called root planing in which we shave or “plane” the plaque and calculus (tartar) from the root surfaces.
In many cases of early gum disease, your family dentist can perform plaque removal. If, however, your gum disease is more extensive, they may refer you to a periodontist, a specialist in the treatment and care of gums. Periodontists are trained and experienced in treating a full range of gum infections with advanced techniques, including gum surgery.
You can also see a periodontist on your own for treatment or for a second opinion — you don't necessarily need a referral order. If you have a systemic disease like diabetes it's highly advisable you see a periodontist first if you suspect gum disease.
If you think you might have gum disease, don't wait: the longer you do the more advanced and destructive the disease can become. Getting an early start on treatment is the best way to keep the treatment simple and keep gum disease from causing major harm to your teeth and gums.
If you would like more information on the diagnosis and treatment of 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 “When to See a Periodontist.”
The Health Policy Institute, part of the American Dental Association, recently conducted a survey of around 15,000 people across the U.S., asking them about problems with their teeth and gums. Three issues in particular stood out, each affecting about one-third of those surveyed.
Here are those top 3 dental problems that plague Americans and what to do about them.
Tooth Pain. As with other parts of the body, tooth or mouth pain is a sign of something wrong — in some instances ignoring it could lead to tooth loss. Because there are a number of possible pain sources like tooth decay or periodontal (gum) disease, anyone with tooth pain should see a dentist for an examination to pinpoint the actual cause. That will determine what kind of treatment will remedy the problem and stop the pain.
Difficulty with Chewing. For 31% in the ADA survey, chewing food was a difficult and often painful task. The consequences go well beyond the mouth: with less chewing efficiency a person may be unable to eat certain foods that supply his or her body with essential nutrients. Like tooth pain, there are a number of possible causes: cracked or deeply decayed teeth, enamel erosion or recessed gums that have exposed sensitive tooth layers, or poorly fitted dentures. Finding and then treating the cause of the difficulty could help restore chewing ability.
Dry Mouth. The most prevalent dental issue in the survey was chronic dry mouth. It's more than simply being thirsty: chronic dry mouth usually stems from inadequate saliva flow. It's often caused by some systemic diseases or as a side effect to a prescription drug. Saliva helps neutralize decay-causing acid and supplies antibodies to fight infection. Without sufficient flow a person is more susceptible to diseases like tooth decay and periodontal (gum) disease. Changing medications or using products to increase saliva could help prevent these dental problems.
So, have you experienced symptoms for any these common oral health problems? If you have, be sure you see your dentist as soon as possible for diagnosis and treatment.
If you have periodontal (gum) disease, it's important for you to know its effects aren't limited to your mouth. A number of studies demonstrate gum disease can affect the rest of your body — and what may be going on elsewhere could likewise stimulate gum disease.
Here are 3 diseases or conditions that seem to share a link with gum disease.
Diabetes. This chronic disease results from the body's inability to interact properly with insulin, the hormone necessary for turning glucose (sugar) into energy, or producing enough of it. There's clear evidence that having diabetes increases your risk of gum disease and vice-versa. If you have diabetes, it's important that you keep it under control for your gum's sake as much as for your overall health.
Cardiovascular disease. Like diabetes, this group of heart and blood vessel diseases has a related characteristic with gum disease: inflammation. This natural function of the immune system limits tissue damage caused by disease or injury. But in both CVD and gum disease, inflammation can become chronic and itself cause damage. Further, some types of bacteria associated with gum disease can contribute to a higher risk of CVD. Minimizing gum disease occurrence with good oral hygiene could positively impact your risk of CVD.
Pregnancy. While certainly not a disease, pregnancy does trigger hormonal changes in the mother that in turn could elevate her risk of gum disease, particularly pregnancy gingivitis. Not only does this pose problems for the mother's teeth and gums, some studies connect gum disease to the increased possibility of early, pre-term birth. A sharper focus on dental care during pregnancy not only benefits the mother but may also be important for the health of the baby.
These aren't the only conditions that can be affected by gum disease: others like osteoporosis, respiratory disease or rheumatoid arthritis also share links with the disease. If you have any systemic condition like these, it pays to be extra vigilant in preventing and treating gum disease.
If you would like more information on periodontal (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.”
Although techniques for treating periodontal (gum) disease can vary, they all boil down to one objective: remove the bacterial plaque and calculus (hardened plaque deposits) that cause the infection. The initial treatment usually involves two techniques known as scaling and root planing.
Scaling uses hand instruments, ultrasonic equipment or a combination of both to manually remove plaque and calculus from the tooth and root surfaces. Root planing takes it a step further by minutely “shaving” infected material from the root surfaces. While more invasive techniques (including surgery) may be needed, scaling and root planing are the first line of treatment for any recent diagnosis of gum disease.
In recent years, an adaptation to these treatments has emerged using the Nd: YAG laser. The laser uses a particular crystal that’s adaptable for many different types of surgery. In the case of gum disease, it’s been found as effective as traditional methods for removing the infected linings of periodontal pockets. Voids created by detaching gum tissues as bone loss occurs, enlarge the small natural gap between the teeth and gums, which fill with pus and other infected matter. Removing the diseased lining from these pockets reduces bacteria below the gum line and speeds healing.
Periodontal laser therapy may have one advantage over traditional treatments: less tissue damage and swelling, and hence reduced post-treatment discomfort. While some research seems to confirm this, more controlled studies are needed to render a verdict on this claim.
Regardless of whether you undergo traditional scaling and root planing or a laser alternative, the aim is the same — to bring the disease under control by removing plaque and calculus and reestablishing good daily oral hygiene practices. Stopping gum disease as soon as possible will help ensure you’ll have healthy teeth and gums for a long time.
If you would like more information on treatments for periodontal (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 “Lasers versus Traditional Cleanings for Treating Gum Disease.”