Posts for tag: oral health
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.
While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.
To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.
That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.
If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.
These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.
If you would like more information on caring for your child's teeth, 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 “Saving New Permanent Teeth after Injury.”
More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.
E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.
The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.
According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.
Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.
These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.
If you're the principal caregiver for an older person, you may have already faced age-related health challenges with them. Good preventive care, however, can ease the impact of health problems. This is especially true for their teeth and gums: with your support you're loved one can have fewer dental problems and enjoy better health overall.
Here are a number of things you should focus on to protect an older person's dental health.
Hygiene difficulties. With increased risk of arthritis and similar joint problems, older people may find brushing and flossing more difficult. You can help by modifying their toothbrush handles with a tennis ball or bicycle grip for an easier hold, or switch them to an electric toothbrush. A water flosser, a device that uses a pressurized water spray to remove plaque, may also be easier for them to use than thread flossing.
Dry mouth. Xerostomia, chronic dry mouth, is more prevalent among older populations. Dry mouth can cause more than discomfort—with less acid-neutralizing saliva available in the mouth, the risk for dental diseases like tooth decay or periodontal (gum) disease can soar. To improve their saliva flow, talk with their doctors about alternative medications that cause less dry mouth; and encourage your loved one to drink more water and use products that help boost saliva flow.
Dentures. If your older person wears dentures, be sure these appliances are being cleaned and maintained daily to maximize their function and reduce disease-causing bacteria. You should also have their dentures fit-tested regularly—chronic jawbone loss, something dentures can't prevent, can loosen denture fit over time. Their dentures may need to be relined or eventually replaced to ensure continuing proper fit and function.
Osteoporosis. This common disease in older people weakens bone structure. It's often treated with bisphosphonates, a class of drugs that while slowing the effects of osteoporosis can cause complications after certain dental procedures. It's a good idea, then, for an older person to undergo any needed dental work before they go on osteoporosis medication.
Keep alert also for any signs of dental disease like unusual spots on the teeth or swollen or bleeding gums. Visiting the dentist for these and regular dental cleanings, checkups and oral cancer screenings could prevent many teeth and gum problems.
If you would like more information on senior dental care, 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 “Aging & Dental Health.”
The American Diabetes Association has declared November National Diabetes Month. If you or a loved one has diabetes, you may already know that diabetes puts you at greater risk for gum disease. Let's look at four must-know facts about diabetes and gum disease.
#1. Gum disease is an acknowledged complication of diabetes.
High levels of blood sugar can interfere with your mouth's ability to fight infection, making you more susceptible to gum disease. People with poorly controlled diabetes may have more severe gum disease and may ultimately lose more teeth due to gum disease—in fact, one in five people who have lost all their teeth have diabetes.
#2. Gum disease makes diabetes harder to control.
Diabetes and gum disease are a two-way street when it comes to adverse health effects. Not only does diabetes increase the risk of gum disease, but gum disease can make diabetes harder to manage. Infections such as gum disease can cause blood sugar levels to rise. This is because chronic inflammation can throw the body's immune system into overdrive, which affects blood sugar levels. Since higher blood sugar weakens the body's ability to fight infection, untreated gum disease may raise the risk of complications from diabetes.
#3. You can do a lot to take charge of your health.
If you have diabetes and gum disease, you may feel as if you've been hit with a double whammy. While it's true that having both conditions means you are tasked with managing two chronic diseases, there is a lot you can do to take care of your health. Do your best to control blood sugar by taking prescribed medications, following a balanced diet, and exercising. In addition, pay special attention to your oral healthcare routine at home: Brushing your teeth twice a day and flossing once a day can go a long way in preserving good oral health.
#4. Preventing and managing gum disease should be a team effort.
We can work together to prevent, treat, and control periodontal disease. Come in for regular professional dental cleanings and checkups so we can monitor the health of your teeth and gums and provide specialized treatment such as deep cleanings when necessary. Diligent dental care can improve your oral health and help control your diabetes.
Remember, we're on your team. Let us know if there have been changes in your diabetes, your medication, or your oral health. If you have questions about diabetes and your oral health, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”