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Link Between Periodontal Disease and Women’s Cancer

While men are more prone to develop periodontal disease than women the CDC estimates that almost 40% of adult women in the U. S. have gum disease. Recently increased breast cancer risk and periodontal disease have been shown to be linked.  A recent study done by the State University of New York at Buffalo was conducted to determine if gum disease is associated with any other types of cancer. The study, conducted on women aged 54-86 showed that periodontal disease increased the risk of developing any type of cancer by 14%. The most commonly associated cancer was esophageal cancer, but there was also lung cancer, gallbladder cancer, melanoma (skin cancer), and breast cancer. While these findings are concerning it is still too early to completely understand the underlying correlation. More research will be required to develop this connection.

Impacted Wisdom Teeth

Impacted wisdom teeth are third molars that are trapped partially erupted or completely beneath the gums. Symptoms of impacted wisdom teeth are pain, swelling, bleeding, or bad breath. If any of these occur it may be time to go to the dentist to evaluated them.  To properly evaluate wisdom teeth your dentist will need to take a panorex x-ray to evaluate the number and placement of the third molars, and then refer you to an oral surgeon for the extraction surgery. If wisdom teeth are not removed there are a number of possible dental complications that may occur. First, is the risk of developing a periodontal infection if a tooth is only partially erupted. Food debris and plaque will still be able to migrate below the gum, but will be trapped and cause bacterial infection to occur. This can result in expensive periodontal therapy. Secondly, is the risk of damage to the second molar if the top of a third molar is trapped against it. Finally, there is the risk that the erupting third molars will cause the shifting of teeth and ruin the occlusion. The oral surgeon will first review your x-rays and give you the recommended treatment plan. You will then return to have the teeth extracted under sedation. A few days of recovery and a later appointment to remove your stitches and then everything is back to normal.

Roots-Remineralization Versus Demineralization

Teeth are in a constant struggle between remineralization and demineralization. Demineralization is the process by which cavities begin to form, while remineralization is the repair process. Unfortunately, demineralization occurs much more rapidly than remineralization, with enamel being the most resistant part of the tooth. This means that the root surface, an area especially vulnerable for the elderly is more prone to this problem. Products like fluoride varnishes, rinses, or gels are good products for remineralizing the root surface.  There are also good options for home care in chlorhexadine, xylitol gum, and toothpastes containing calcium and phosphate. Unfortunately these products do not totally prevent root cavities, so the best option is preventing demineralization initially by establishing good home care routines earlier in life before root caries risk is a factor.

Connection Between HPV and Oral Health

Oral HPV or human papilloma virus is linked to a variety of oral lesions, oral cancers, and oropharyngeal cancers. HPV is one of the most commonly transmitted sexual infections. In fact nearly all sexually active adults will be infected at some point in their lives. While tobacco linked squamous cell carcinoma is decreasing, head and neck cancer linked to HPV infection is actually increasing. It is especially worse in young adults and adolescents. Utilizing the vaccine prior to the start of sexual activity in children will help prevent infection, and an annual screening at your dentist will help diagnose an cancers.

Custom Mouthguards

A recent article in the journal Decisions in Dentistry underscores the importance of custom fit athletic mouthguards for student athletes. Statistically athletes have a 10% chance of receiving an injury to the face in a single sports season. Males are more often the recipients of dental sports injuries, and it is more likely to be the central incisors that are injured. Despite these alarming statistics mouthguard use in sports that do not require them is low. Mouthguards work by redistributing the force of a collision, so an appliance made from a sports store is going to fit more loosely and not provide the same level of protection. A custom made appliance will do the best job or redistributing those forces so that they are not transferred to the teeth where they can cause injury.

Latest and Greatest Whitening Toothpaste

Frequently in dentistry we get questions about over the counter whitening toothpastes. It is a frustrating topic for those of us in dentistry because over the counter toothpaste doesn’t whiten, it only brightens. Whitening is done by products formulated from peroxides. No over the counter product will effectively bleach better than a product obtained from your dental office. Only a dental office can sell a product with a strong enough peroxide to actually whiten. A new product is getting a lot of buzz on social media for its whitening claims. This toothpaste receives mixed reviews from users though. Many complained of canker sores which can easily be attributed to the sodium laurel sulfate in the ingredient list. It also relies on alumina to produce the clean, reduced plaque feeling they advertise. Alumina is an abrasive. Many people complained that after a few weeks of use they had terrible sensitivity issues which can be the result of an overly abrasive toothpaste. Finally, this product promotes that it is free of dangerous peroxides. Peroxide is only dangerous when consumed in high concentrations, not from merely wearing whitening trays. It is important to remember that fantastic claims from over the counter products cannot always be trusted.

Manual versus Electric Toothbrushes

The manual toothbrush that we are familiar with today is the latest incarnation of a personal hygiene tool that has been in use for centuries. The original toothbrush was a sharpened twig made of sweet smelling wood. Then in 15th century China a bone handle brush embedded with hog bristles was invented that ultimately replaced the twig. Now the electronic brush is the highest on the evolutionary ladder of  toothbrush evolution. The ADA states that a manual toothbrush is perfectly fine for those who have a good flossing and brushing technique, which unfortunately most patients do not have. The electric toothbrush action can be anywhere from 6,000 to 30,000 strokes per minute which can vastly improve the quality of brushing while leaving the gum and tooth structure safe. Most models also have a timer that helps to train the user to brush for the adequate amount of time. Electric toothbrushes are beneficial to any age patient, but particularly children and the elderly. Children are inconsistent with brushing, and the electric brush helps even out the quality of their homecare. For elderly patients who for a variety of health reasons have lost the ability to  brush well the electric brush can make up the difference. Overall the electric toothbrush is a better choice than a manual toothbrush.

Silent Night?

Approximately 90 million Americans snore. That means not only the person snoring, but their spouse and children may suffer from lack of quality sleep. Unfortunately disturbed sleep is not the only consequence of snoring. According to a UCLA School of Dentistry  study this struggle for breath contributes to high blood pressure and stroke risk. In sleep,  the muscles and soft tissue of the mouth and throat relax and decrease the airway. This will increase the velocity of air flowing through and results in vibrations which produce the noise of snoring. If this is a problem for you ask our dentists about a Silent Nite appliance. This custom fit appliance positions the lower jaw forward by using select connectors attached to the upper and lower transparent forms. The appliance has a soft inner layer that rests comfortably against the teeth and gums with a hard outer shell that resists breaking so that the appliance is comfortable yet durable. It requires two appointments for this appliance, the first to take impressions and then a second to deliver the appliance and check the fit. Silent Nite does not interfere with breathing through the mouth, and it allows slight movement of the jaw to minimize stiffness. Wearing the appliance overnight may produce a slight feeling of jaw misalignment due to the build up of lymphatic fluid in the joint, but that quickly disappears with normal function. Many insurance companies do not provide coverage for the appliance, but it is a small price to pay for the benefit of a good night sleep.

Opioid Abuse

Currently about 91 Americans die everyday due to opioid addiction. Opioids are a category of drugs that include hydrocodone, oxycodone, heroin, methadone, and fentanyl. They depress the central nervous system reducing pain sensation, providing a sedative effect, and producing euphoria. These drugs are  extremely addictive over time, and it is important to recognize this in the dental office where they are a tool for treatment. It is important to be aware of symptoms of addiction in patients. Systemic signs of opioid abuse include constricted pupils, depressed respiration, anorexia, and constipation. These are symptoms that can be readily visible to anyone in regular contact with an addict. In the dental office there are also symptoms in the mouth that can be diagnosed such as xerostomia, bruxism, and extremely poor oral hygiene. Early diagnosis can increase success in overcoming addiction. Withdrawal from opioids can be difficult, and proper treatment can sometimes require drug therapy.

Grinding vs. Clenching

When a patient presents with occlusal or incisal wear on their teeth the inevitable question is do you clench or grind your teeth? Grinding involves sliding your teeth across each other, while clenching is holding top and bottom teeth tightly together. Both conditions are called bruxism, and they present with the same symptoms. Symptoms included are as follows: headache/earache, sore jaw, jaw clicking, frequent toothaches, sensitive teeth, facial pain, worn/cracked teeth or fillings, tongue marks, or trouble sleeping.  The causes of bruxism can be stress, disorders, or malocclusion. Treatment can involve a night guard, medication for pain or muscle spasms, and exercises to manipulate the muscles. It may involve multiple treatment to get the condition under control.