Dental Health

EARLY DETECTION OF ORAL CANCER

What does the dentist look for?

During your routine exam, the dentist will observe your lips, cheek linings, tongue, and other soft tissues of the mouth for any abnormal appearances such as:

Red or white patches
Easily bleeding or non healing sores
Thick or hard areas or a lump
Rough or crusted areas
Numbness and/or pain
Changes in the way the teeth fit together when biting down

What are the common Risk Factors leading to Oral Cancer?

Many of the risk factors leading to oral cancer are those which a patient can control and/or avoid. These risk factors are: smoking, chewing tobacco, heavy drinking, and prolonged exposure to the sun (related to lip cancer).

Other risk factors include: infection from the human papilloma virus(HPV), and a low fruit and vegetable diet.

How is oral cancer diagnosed?

The dentist doesn’t provide the patient with a diagnosis of cancer on the initial examination appointment. But what the dentist will be able to do is use certain guidelines provided by the American Dental Association to check for signs of cancer. What usually happens is this:

If a suspicious looking area or unusual growth is found, the dentists may provide minimal therapy and re-evaluate the area in 1-2 weeks. The questionable area may heal within that time frame.
If no healing is apparent the patient may be scheduled for a tissue biopsy appointment and/or referred to an oral surgeon/oral pathologist for a second opinion.
The patient and the dentist can discuss options that may be causing the abnormal tissue changes and together they will determine what the best alternative for the patient.

PREGNANCY & ORAL HEALTH

During pregnancy, the body’s hormone levels rise considerably. Gingivitis is common during the second to eighth months of pregnancy and may cause red, puffy or tender gums that tend to bleed when you brush. This is an elevated response to plaque and is caused by an increased level of progesterone in your system.
Sometimes overgrowths of gum tissue, called “pregnancy tumors,” appear during the second trimester. These growth, related to excess plaque, bleed easily & are usually found between the teeth. They are red, raw-looking, with a mulberry-like surface and are usually surgically removed after the birth. Studies indicate that pregnant women who have severe periodontal (gum) disease may be at increased risk for pre-term delivery, (Premature Babies), which in turn increases the risk of having a low-birth weight baby. During pregnancy it is crucial that Mothers-to-be have excellent oral hygiene and see the dentist/hygienist for more frequent cleanings during the second trimester or early third trimester to help avoid problems.
Note: Some dental insurance companies offer additional hygiene coverage for cleanings during pregnancy. Contact your individual insurance plan for details.

A HEALTHY MOUTH MEANS A HEALTHY BODY!

MIGRAINE HEADACHES
Many people suffer from migraine headaches for various trigger reasons.

The following are several such triggers:
1. Stress & Poor Posture
2. Strenuous Exercise
3. Warm Weather & Strong Scents
4. Smoking & Caffeine
5. Tight Hair Accessories
6. Aged Cheese & Red Wine
7. Nitrates/Nitrites found in cold cut meats
8. Grinding/Bruxism Habits

Sometimes in conjunction with medications, the majority of the triggers above may be controlled by just changing habits and diet considerations. However, bruxism habits of grinding and clinching are a little more difficult to control.

Dentists can fabricate dental mouth guard appliances that will open the bite and relieve the muscle tension in the TMJ (Jaw Joint) area. Because the pressure eases up, many people not only find relief of jaw pain but also a lower frequency and intensity of headaches.

Of course we would encourage patients to be evaluated by their primary care physician and/or chiropractor to address their migraines, but if you suffer from frequent headaches and believe you grind or clinch your teeth, see your dentist soon to determine if an mouth guard may be a plausible solution for you.

Thrush

Thrush-Angular Cheilitis

Thrush (Angular Cheilitis) is an inflammatory lesion at the corner of the mouth, and often occurs on both sides at the same time. In severe cases, the splits can bleed when the mouth is opened and shallow ulcers or a crust may form.

Although the cause of the condition is unknown, the sores of angular cheilitis may become infected by a fungus called Candida albicans (thrush), or other microorganisms.

Angular cheilitis is common in the elderly population due to a lack of vertical dimension from the loss of teeth, thus allowing for over-closure of the mouth.

Less severe cases occur when it is quite cold and chapped lips develop. This lesser form mostly happens to young children/teenagers.

Treatment

Angular cheilitis can be caused by bacteria, but is more commonly a fungal infection. It is not always appropriate to treat the infection with Vaseline or lip balm. This increases the moisture level and can lead to spreading the infection. If a lesion doesn’t improve after 1-2 weeks then moisturizers may not work.

Treatment would then include antifungal and antibiotic medication, vitamins, and dentures for a person without teeth.

If you suspect you have angular cheilitis, contact your dentist for treatment.

Fungul Infection of the mouth: Candidiasis – “Thrush Mouth”

Thrush mouth is a yeast infection that causes white patches in the mouth and on the tongue. It is most common in babies and older adults, but it can occur at any age.

You get thrush mouth when a yeast called Candida, normally found on the body, grows out of control. Candida causes thrush mouth because the immune system is not strong enough to control the growth of the yeast. Some people get thrush mouth when they take certain medicines, such as antibiotics or inhaled corticosteroids. People who have health problems, such as diabetes or HIV, are also more likely to get thrush mouth.

Thrush mouth is treated with a topical antifungal medicine such as Nystatin liquid. For adults a prescription for an antifungal pill may be provided.

How can you manage thrush mouth?

Babies: Clean bottle nipples and pacifiers regularly using hot water. Clean your nipples with medicine, such as Nystatin, if you breast-feed your baby. Breast-feeding mothers and babies can pass a yeast infection back and forth. Dry your nipples and apply lanolin lotion after breast-feeding.

Denture Patients: Be sure to clean your mouth and dentures every night. Soak them overnight in a denture cleaner that you buy at the store. Rinse your dentures well after soaking them.

Cystic Fibrosis

Cystic fibrosis is a disease that causes mucus in the body to become thick and sticky. This paste-like mucus builds up and causes problems in many of the body's organs, especially the lungs and the pancreas. Cystic fibrosis is a genetic disorder. A child must inherit a specific gene from both parents to get cystic fibrosis.

People who have cystic fibrosis can have serious breathing problems and lung disease. They can also have problems with nutrition, digestion, growth, and development. There is no cure for cystic fibrosis and the disease generally gets worse over time.

Treatment is different for everyone but usually involves a combination of medicines (Bronchodilators, Mucolytics, and Dnase) and home treatment. Home treatments include getting rid of mucus, eating healthy foods, and exercising to help prevent infections and complications.

Patients with cystic fibrosis should always bring their emergency inhalers during dental visits and they should try to schedule dental appointments at a time of day when they are less congested and airway is clearer.

Smokeless Tobacco/Oral Cancer

Oral cancer may develop in any part of the mouth. Risk factors for oral cancer include smoking or chewing tobacco and excessive use of alcohol. It is important to check regularly for symptoms of oral cancer. The following guidelines can help you prevent oral cancer:

Don't use tobacco in any form.
Drink alcohol only in moderation.
Get dental checkups

Oral Cancer - When to Call a Doctor

Call your doctor if you have one or more of the following symptoms longer than 2 weeks without explanation:

A sore in your mouth that bleeds easily and does not heal.
A lump or thickening in your cheek that you can feel with your tongue.
A white or red patch on your gums, your tongue, or the lining of your mouth.
A sore throat or a feeling that something is caught in your throat.
Unexplained difficulty chewing, swallowing, or moving your jaw or tongue.
Numbness in your tongue or other areas of your mouth.
Swelling in your jaw that makes your dentures fit poorly or causes discomfort.

If you don't want this to be you...then please don't chew!

Osteoporosis & Osteonecrosis

Osteoporosis is a serious condition wear there is thinning of the bones resulting in tremendous pain with fractures. Risk factors include aging, being female, low body weight, low sex hormones such as during menopause, smoking, and some medications. There are no symptoms of this bone disease until you fracture a bone. Prevention and treatment of osteoporosis include calcium and vitamin D, regular exercise, and osteoporosis medications, if needed.

Biophosphonate medications such as Aredia, Fosamax, Actonel, and Zometa used to treat patients with osteoporosis or hypercalcemia have been linked in some rare cases to cause poor bone healing and bone necrosis - Osteonecrosis (deterioration of bone).

If your medical physician prescribes a biophosphonate medication, please inform your dentist. Most cases of osteonecrosis of the jaw have been diagnosed following dental tooth extractions or other invasive dental treatments of patients using biophosphonates.

If you are currently taking biophosphonates, if possible, avoid invasive dental procedures.

** Therefore it is usually recommended that you complete dental surgery before beginning biophosphonate therapy.

Patients should be evaluated by their primary care physician to address their changing or altering any medications.

Periodontal Disease

Gingivitis, also generally called gum disease or periodontal disease, describes the events that begin with bacterial growth in your mouth and may end with tooth loss due to destruction of the tissue that surrounds your teeth.

What's the Difference Between Gingivitis and Periodontitis?

Gingivitis usually precedes periodontitis. However, it is important to know that not all gingivitis leads to periodontitis.

In the early stage of gingivitis, bacteria in plaque build up, causing the gums to become inflamed (red and swollen) and often easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.

When gingivitis is left untreated, it can advance to periodontitis. In a person with periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and can become infected.

Toxins or poisons – produced by the bacteria in plaque as well as the body's "good" enzymes involved in fighting infections – start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become looser, and tooth loss occurs. Gum disease, in fact, is the leading cause of tooth loss in adults.

What Causes Periodontal Disease?

Plaque is the primary cause of periodontal disease. However, other factors can contribute to gum disease. These include:

Bad habits such as smoking make it harder for gum tissue to repair itself.
Poor oral hygiene habits such as not brushing and flossing on a daily basis make it easier for gingivitis to develop.
Hormonal changes such as those occurring during pregnancy, puberty, menopause, and monthly menstruation -- make gums more sensitive, which makes it easier for gingivitis to develop.
Illnesses may affect the condition of your gums. This includes diseases such as cancer or HIV that interfere with the immune system. Because diabetes affects the body's ability to use blood sugar, patients with this disease are at higher risk of developing infections, including periodontal disease.
Medications can affect oral health because some lessen the flow of saliva, which has a protective effect on teeth and gums. Drugs, such as the anticonvulsant medication Dilantin and the anti-angina drug Procardia and Adalat, can cause abnormal growth of gum tissue.
Family history of dental disease can be a contributing factor for the development of gingivitis.

Symptoms of Periodontal Disease

Periodontal disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. The symptoms of periodontal disease are often subtle, but there are warning signs. These include:

Gums that bleed during and after tooth brushing
Red, swollen, or tender gums
Persistent bad breath or bad taste in the mouth
Receding gums
Formation of deep pockets between teeth and gums
Loose or shifting teeth
Changes in the way teeth fit together upon biting down, or in the fit of partial dentures.

Periodontal disease is treatable and can be controlled or maintained with the proper diagnosis and care. Contact our office at (254) 699-7002 to set up your dental exam.

Sinus Infection Toothache

A sinus infection toothache can come from a maxillary sinus infection. The maxillary sinuses are just above the upper molar teeth. The roots of the upper molars and premolars extend to and sometimes touch the floor of the maxillary sinus. When pressure builds up in the sinus from inflammation or infection, the tooth roots near the sinus floor may receive this pressure sensation and this pain can be confused with dental pain.

A sinus infection toothache can confuse a dentist, especially if one of the upper back teeth has a very large filling or existing tooth decay. This is why many patients with sinus problems sometimes have multiple root canals. Sinus infections are difficult to treat and need longer periods of time on antibiotics than normal infections.

Your primary care physician is the one who will diagnose and treat your sinus infection. If you have acute sinusitis (duration of less than 4 weeks), you will be referred to your physician because a dentist cannot treat sinusitis when there are no dental symptoms.

Chronic sinusitis — which lasts greater than 12 weeks is best managed by a MEDICAL doctor. If your dentist decides to treat the sinusitis to rule this infection out as the source of the dental pain, the treatment needs to focus on facilitating drainage and treating the infection.

Most sinus infections are due to viral infections and can be treated with decongestants because they will reduce tissue swelling and allow drainage. Antihistamines are of benefit if there is an allergic component.

H1N1 Influenza (Swine Flu)

The H1N1 Influenza was originally called Swine Flu because the virus that causes the illness came to humans from pigs. The virus contains genes from swine and bird, as well as human flu viruses. While researchers are still debating on what the virus should be called, generally most people know it as the H1N1 Swine Flu Virus.

The symptoms of H1N1 are very much like regular flu symptoms, and include fever, cough, runny nose, sore throat, body aches, headache, chills, fatigue, diarrhea and vomiting. Swine Flu can also stimulate neurologic conditions in children, such as seizures, as well as changes in behavior and mental status.

High risk groups include:

pregnant women
young children
the elderly
persons with cardiovascular conditions (except high blood pressure)
persons with liver and kidney problems
persons with sickle cell disease and diabetes
people who are “immune suppressed” (part of the immune system is missing or defective, which affects the body’s ability to fight infections)

To prevent the spread of the virus, please be sure to cover your mouth when you sneeze. Also, do not share make-up or eating utensils, and always wash your hands after using the restroom and before and after eating.

If you have been diagnosed with Swine Flu, postpone your dental appointments for at least two weeks to keep from spreading the virus.

Epilepsy

The term epilepsy describes a collection of disorders identified by chronic seizures. Seizures are caused by abnormal and spontaneous electrical activity in the brain.

Seizures are more common in childhood. At least 4% of kids will have at least one seizure by age 15.

Although some epileptic cases have no known cause (idiopathic epilepsy)… head trauma, developmental abnormalities, brain tumors/cancer, hypoglycemia, and drug withdrawal are all common causes for epileptic seizures.

Seizure patients are usually on long-term drug therapy to control the episodes. The most common medications prescribed are Dilantin, Tegretol, and Depakote. These anti-seizure medications tend to have side effects that include DRY MOUTH (xerostomia), OVER GROWTH OF GUM TISSUE, & they may increase the chance for GUM INFECTIONS.

Patient’s with epilepsy need to inform their dentist so that proper management of periodontal gum tissues can occur. If the negative side effects of your medication cause your dental health to be compromised, your dentist may recommend that you discuss your medications and dosages with your primary care physician. This would allow both doctors to work together to keep you in optimal health.