Last year, over 1.5 million people heard the words no one wants to hear: “You have cancer.” While only a small portion of those — about three percent — were diagnosed with oral cancer, their survival rate isn’t as good as with other types of cancers: 58% five years after diagnosis.
Here, then, are some things you should know about this deadly disease.
Oral cancer is an “equal opportunity” disease. People from all walks and stations of life experience oral cancer. The disease has caused the untimely deaths of Ulysses S. Grant, Babe Ruth and George Harrison, one of the original Beatles. However, you don’t have to be prominent or famous to acquire oral cancer: it can strike anyone at any age, especially people 40 years and older.
Oral cancer is difficult to detect early. Oral cancer usually appears as a small, scaly-shaped sore known as a squamous cell carcinoma. Appearing in the lining of the mouth, lips, tongue or back of the throat, the early stages often resemble other benign conditions such as cold or canker sores, so they’re easily overlooked in the early stages. To increase your chances of an early diagnosis, you should see your dentist about any mouth sore that doesn’t heal in two to three weeks; it’s also advisable to undergo a specific oral cancer screening during your regular dental checkups.
Tobacco and heavy alcohol use are strongly linked to oral cancer. Tobacco smokers are five to nine times more likely to develop oral cancer while snuff or chewing tobacco users are roughly four times more likely than non-tobacco users. People who are moderate to heavy drinkers are three to nine times more likely to develop oral cancer than non-drinkers.
You can reduce your risk for oral cancer. Besides quitting tobacco use and moderating your alcohol consumption, there are other things you can do to reduce cancer risk: a nutritious diet rich in fresh fruits and vegetables; limited sun exposure with adequate sunscreen protection and clothing; and safe sexual practices to avoid contracting Human Papilloma Virus (HPV16), strongly linked to oral cancer. And above all, practice effective, daily oral hygiene with regular dental cleanings and checkups.
If you would like more information on prevention and treatment of oral cancer, 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 “Oral Cancer.”
Before she began hosting the long-running TV competition Top Chef, Padma Lakshmi was a well-known model and successful cookbook author. (Appropriately, she is said to have been “discovered” by a modeling agent while sitting in a café in Madrid.) Yet the Indian-born beauty's striking look — at once exotic and familiar — doesn't come from any cookie-cutter mold.
So when Lakshmi had cosmetic work done on her teeth, early in her career, her dentist didn't use a cookie-cutter approach either: Instead, her smile was carefully designed, using small amounts of bonding material to brighten her teeth and to bring their shape and spacing into harmony with her facial features.
Dentistry by Design
What exactly is smile design — and what could it do for you? Essentially, it's the process of evaluating your smile in concert with the appearance of your entire face, and visualizing the changes — some dramatic and some subtle — that will make it really shine. Some aspects we consider include the face's shape, the proportion or “balance” of facial features, the complexion, eye and lip color and form, and the overall dimensions of the smile.
Based on dental aesthetics and clinical experience, we will probably have a number of suggestions to make on how you can improve your smile. Your input will also be very important; while some individuals prefer perfectly even teeth and a sparkling “Hollywood white” smile, others are looking for a result that's more in keeping with a “natural” look: slight irregularities in tooth shape, spacing, and even color.
There's no right or wrong answer here: Having a “perfect” smile means what's perfect for you, so it's very important for dentists and patients to communicate openly during the smile design process. But sometimes, words alone just aren't enough to convey the subtle dimensions of beauty.
The Trial Smile
Fortunately, it's now possible to preview your “perfect” smile using a number of different techniques. Advances in computer imaging make this the first step in previewing your new smile — you can see the changes before a single tooth is touched! Still, many people find that having a more concrete picture is helpful. The next step is to make a 3-D mock-up the proposed dental work on an actual model of your mouth. That way, you can see a physical representation of the final results — and even turn it around and hold it in your hands.
There's still one more way to really experience the difference cosmetic treatments can make without committing to a permanent change: the provisional restoration. Here, tooth-colored bonding material and other techniques are used to actually create the new smile — temporarily. This gives you time to “live with it,” and see if the proposed changes work for you. If everything goes well with the provisional work, the permanent restoration is guaranteed to please.
So if you want holiday treats, get out the cookie cutter — but if you're looking for a smile that's uniquely yours, and one that enhances your own individual appearance… call our office and ask about a smile design consultation. You can learn more in the Dear Doctor magazine articles “Great Expectations — Perceptions in Smile Design” and “Beautiful Smiles by Design.”
A critical part of effective, daily oral hygiene, flossing removes bacterial plaque from between teeth that can’t be accessed with brushing. Unfortunately, it’s often neglected — string flossing requires a bit more dexterity than brushing and can be difficult to do properly.
It can be even more difficult for people with implants or who wear orthodontic appliances. For brace wearers in particular, getting access to areas between teeth with string floss is next to impossible; the metal brackets and tension wire also have a tendency to catch and retain food debris that’s difficult to remove with brushing alone.
Water flossing, using a device called an oral irrigator, is an effective alternative that addresses many of these difficulties. First available for home use in the 1960s, an oral irrigator delivers pulsating water at high pressure through a handheld applicator that forcefully flushes material from between teeth.
There’s no question that string flossing is effective in plaque removal between teeth — but what about oral irrigators? A 2008 study looked at a group of orthodontic patients with braces who used oral irrigators and compared them with a similar group that only brushed. The study found that five times as much plaque was removed in the group using the oral irrigators as opposed to the group only brushing.
Oral irrigators may also be effective for people who’ve developed periodontal (gum) disease. In fact, oral irrigators coupled with ultra-sound devices are routinely used by dental hygienists to remove plaque and calculus (hardened plaque deposits) in periodontal patients. As with regular oral hygiene, though, it’s important for patients with gum disease to include water flossing with daily brushing (at least twice a day) and regular cleaning sessions at the dentist to ensure removal of all plaque and calculus.
If you’re interested in using an oral irrigator, be sure to consult with us at your next appointment. Not only can we recommend features to look for in equipment, but we can also instruct you on the techniques to make water flossing an effective plaque remover.
If you would like more information on water flossing, 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 “Cleaning Between Your Teeth.”
Actor Michael Douglas shocked TV audiences across the country when he announced on the David Letterman Show in 2010 that he has stage IV oral cancer. Fortunately, the cancer had not spread and his radiation and chemotherapy treatments were successful. This year, Douglas teamed up with the Oral Cancer Foundation to warn others about the dangers of the disease and the importance of early detection. In particular, he wants younger people to know that even if they don't smoke and drink a lot, as he admitted to Letterman that he did, they are still at risk.
As Douglas states in a PSA he made with the foundation, “the fastest growing segment of the people developing oral cancers are young, non smokers.” That's due to a strain of the Human Papilloma Virus known as HPV16 that can be transmitted through oral sex. So it's important to avoid risky sexual behaviors and to be screened regularly for this devastating disease that claims one life every hour in the U.S., according to the Oral Cancer Foundation.
An oral cancer screening is a simple visual and tactile exam done right here at the dental office. We will feel your neck for lumps and inspect your lips and all inside surfaces of the mouth, including the back of your throat, for any suspicious signs. If any are found, a biopsy (laboratory analysis of a tissue sample) can be ordered.
Most oral cancers are “squamous” (small scale-shaped) cell carcinomas that occur in the lining of the mouth and are often preceded by recognizable changes (lesions) of the oral membranes. White or red patches begin to form in the pre-cancerous stage, and as the cancer develops, a non-healing ulcer may appear. If you notice any such changes in your mouth, please let us know.
Michael Douglas ends his PSA with the following plea: “So please, the next time you visit your dentist or your medical doctor, ask for this simple screening. Finding oral cancer in its earliest stages may save your life.” We agree, which is why we always perform this screening during your regular dental check-up. If it's been a while since your last appointment, please come in and see us.
If you would like more information about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more about the disease in the Dear Doctor magazine article “Oral Cancer.”
Since their introduction over three decades ago, dental implants have evolved into dentistry’s premier tooth replacement choice. While their primary purpose is to replace missing teeth and rejuvenate a patient’s smile, they’re also regarded for another important benefit: they can slow or stop bone loss accelerated by the loss of teeth.
Like all living tissue, bone has a life cycle. Older bone dissolves and is absorbed by the body, a process called resorption. New bone forms and grows to replace the resorbed bone in response to stimuli occurring within the body. In the jaw, this stimulation comes from the forces the teeth receive when we bite or chew.
When a tooth is lost, however, it no longer transmits these force stimuli to the adjacent bone. This results over time in less new growth to replace resorbed bone, and the overall bone mass shrinks. In fact, about a quarter of the normal bone width will diminish in the first year alone after tooth loss. Other serious problems follow, like gum recession or chewing and speaking difficulties. A person’s appearance may also suffer, because as resorption continues unchecked, the underlying foundational bone will continue to shrink. As more teeth are lost, a decrease in the distance between the nose and chin may result causing the lower third of the face to become smaller in size.
Dental implants can interrupt this process by encouraging bone growth around the implant. Implants are made of “osseophilic” titanium, meaning the metal has a natural affinity with bone. After implantation, bone cells will begin to grow and attach to the titanium post. The enhanced growth stabilizes bone loss by providing stimulation to the bone as teeth once did, thereby maintaining bone levels and minimizing potential effects on the patient’s appearance.
Ironically, too much bone loss could make the installation of implants more difficult, since they require a minimum level of bone mass for anchorage. Receiving an implant as soon as is practical once a tooth is lost will minimize the chances of that occurring — and a better chance of improving bone health overall.
If you would like more information on how dental implants improve bone 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 “The Hidden Consequences of Losing Teeth.”
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