Early Detection of Oral Cancer in One Easy Step

Last night, Michael Douglas announced to America that he had stage 4 throat cancer, diagnosed only 3 weeks ago. Symptoms? Yes-- pain, dry throat, hoarse voice, ear pain--all which he told to many doctors, many months ago. Only after a biopsy did they determine it was stage 4 throat cancer, attributing it to previous cigarette & alcohol use. He is now undergoing radiation & chemo treatments 5 days per week for the walnut-sized tumor located under his tongue.

Pathologies in the mouth & throat tend to grow & spread fairly quickly due to the constant reproduction of cells in the oral cavity. Most aren't even visible until they are already a stage 3 or stage 4 (the worst). Even worse, the 5 year survival rate for oral cancer is only 50%.

So why is this important? Every hour of every day in America, someone dies of oral cancer. As dental providers, we now have ways to screen for early detection of oral cancer--early enough to catch at a stage 1 (the earliest) or 2. One of these screening tools is called Velscope. It is "a technology platform based on the direct visualization of human tissue fluorescence and the changes in fluorescence that occur when abnormal tissue is present"--meaning it uses a special light filter that enables us to see beneath the tissue inside your mouth, allowing us to see any abnormalities beneath the surface (see below). Being able to see beneath the suface provides us the ability to diagnose pathologies earlier, which means a greater success rate & survival rate for the patient. If an abnormality is found via Velscope, the dentist should recommend a follow-up evaluation of the area 2 weeks later. If the area is still diagnosed abnormal via Velscope, a biopsy of the area should be recommended to determine or rule out the pathology.

No apparent lesion

Irregular, dark area visible with Velscope

Biopsy-confirmed: Carcinoma in Situ (CIS)

Velscope uses a special light only--no bad tasting rinses, no brushing away of gum tissue--just a light. The dentist should be trained to diagnose abnormalities through the special filter & the entire oral cavity examination with the Velscope should take less than 2 minutes.

Did Michael Douglas see his dentist on a regular basis? I don't know. Did he have an oral cancer screening regularly? I don't know. What we do know is this...Early diagnosis is key to preventing & saving lives. So ask your dentist for a Velscope oral cancer screening at least once a year.

Unbelievable Item on Craiglist

Roger Miller’s King of the Road came to mind after I read an article about a Pennsylvania woman who put an ad on Craigslist for some used dentures. “Trailers for sale or rent, rooms to let..fifty cent”…but dentures? Really?

The story detailed how the elderly woman was on a fixed income, had medical issues & had patched her old set to the point of no repair. The ad was placed in hopes of using the used pair until a new set could be purchased. This story may sound unconventional, but unrealistic?—no.

The power of the internet is at our fingertips daily. From simple research, to purchases of all sizes, the internet seems to put everything “at arms length”….even dentistry. There are searches for providers, searches for education of dental services, even sites to bid on treatment! But remember…even though the power is at our fingertips, we must first be good stewards of the power.

Searching for a dental provider that fits you is almost like shopping for clothes. They have to fit your personality, make you feel comfortable and have the ability to create a final product you would wear. This can sometimes be a long & tedious search, so I’ve created an article titled, 10 Questions to Ask Before Choosing a Dentist. Answering these questions will help guide you in the direction of the dental provider that best fits you and your goals.

Unfortunately, the elderly lady did not have my article. No one responded to the Craigslist denture ad & the woman continues her search. The power of the internet reminds us that commodities can be purchased online by anyone. But a well-educated consumer knows that dentistry is not a commodity, but a value-driven service that is personally customized to each individual….so click here & do your research!

The Skinny on Mini's

As new technological advancements grow bigger & bigger, the results tend to be thinner & thinner. Microwaves, iPods, TVs & even hamburges have all maintained their original functions, but have shrunk quite a bit in size.

Electronics & food aren't the only advancements making waves. The dental industry has also changed with the advancement of implants--and now mini implants. Although mini dental implants (MDI's) have been around for a couple of decades, it is only in recent years they have made their mark mainstream.

Dental implants are used to replace a missing tooth/teeth or to secure a loose denture. Mini dental implants are basically a smaller version of a traditional implant, having the same components for function (screw & abutment), just in smaller form. The screw is what anchors to the bone & the abutment is placed on top of the screw to connect it to a crown, in the case of replacing a missing tooth. If a MDI is used to secure a loose denture, chances are, there will be at least 2-4 mini implants recommended. The implant screw is still anchored into the bone, but in a denture case, a special attachment is used to connect the screw to the denture. This special attachment allows the denture to snap into place for security.

Becasue MDI's are smaller and take less time to place, they are approximately half the cost of a traditional implant. And best of all, most patients have the crown & implant ,or the implants & denture placed in the same day with little to no discomfort.

In addition to providing replacement for missing teeth or security for loose dentures, both MDI's & traditional dental implants provide a way to help keep your bone. Over time, if a tooth is lost & no implant has been placed, the bone shrinks and begins to cause other problems.

So if you have a missing tooth/teeth or have loose or ill-fitting dentures, contact your dentist to see if you are a candidate for mini dental implants. Your frustrations aren't shrinking, but your bone is... so call today!

Dentistry - Key Identifier in Cancer Treatment Success

Picture any visit to the doctor resulting in a converstation about the need for cancer treatment. A myriad of questions begin to form, with the primary one asking, "what do I do now?" If this ever happens to you in the future, there are two key healthcare professionals that must immediately become your best friends...your oncologist & your dentist. Your oncologist, for obvious reasons, and your dentist to help prevent serious problems.

Chemotherapy and radiation treatments are used to kill cancer cells. But these treatments also harm and/or kill normal cells as well. Some of the side effects cause serious problems in the mouth--some serious enough to delay or stop treatment. Some of these side effects include: Dry mouth, Increase in cavities, Loss of taste, Sore gums, Increased infections, Jaw stiffness & bone changes. Because the side effects often happen when a person's mouth is not healthy, it is recommended that you see a dental professional at least 2 weeks prior to undergoing any form of radiation or chemotherapy treatment.

If you don't have a dentist, ask your oncologist for a recommendation. If you do have a dentist, contact the office to schedule a quick exam and consultation. At this visit, the dentist will check your teeth, take any necessary xrays, and show you how to care for your mouth during your treatment. Make sure the dentist can contact your oncologist for questions regarding your cancer treatment. They may also want to confer regarding any dental treatments you may need prior to starting any cancer treatment.

One of the keys to cancer treatment success is looking at your mouth on a daily basis, keeping it moist with lots of water, saliva substitutes, or sugarless candies/gum, brushing & flossing daily and contacting your dentist about any mouth problems that may occur during or after cancer treatment.

Regardless of where the cancer is located in the body, your dentist is a key part of your cancer treatment success team.

A Dish Best Served Cold

Fortunately, I'm not talking about revenge...but I am referencing the coveted all-american treat of ice cream, in honor of National Ice Cream Month! This crazy commemoration was created for us by Ronald Reagan back in 1984--(you just can't beat a president with a great sense of humor....and sweet tooth!) Like many others, I assume he probably topped his favorite flavor with, you guessed it, jelly beans. Apparently jelly beans brought him much intuition & wisdom, for he once said, "You can tell a lot about a fellow's characher by the way he eats jelly beans." (He noticed some would eat only one color, while others would eat many flavors at once.) Well, I am here to tell you that you can also tell a lot about a person's teeth by the way he/she eats jelly beans (and other candy as well).

Ever experience a burning sensation in your gums or in between teeth when eating something sweet like candy? Ever experience pain or sensitivity when eating something cold like ice cream? These symptoms are indicative that there is something unhealthy about the tooth/teeth. Depending upon the severity of the pain or sensitivity, the treatment is usually something small, common & routine, such as a filling. Recognizing these symptoms early and seeing a dental professional for treatment will eliminate the pain/sensitivity, restore the teeth back to health & help ensure you don't have any suddent toothache-style interruptions to your summer. Just remember...teeth that need treatment get worse over time, which means the treatments become bigger..as does the price.

Enjoy the hot summer days with a cold beverage, a popsicle or a cold bowl of ice cream. And if you experience any pain or sensitivity when you do, contact a dental professional. The summer's long from over, so ensure you can enjoy the rest of it with a pain-free healthy mouth.

To BP or not BP?

As the oil continues to wash closer & closer, encroaching upon the livelihood of surrounding towns, the anticipation of devastation has Gulf Coast cities low on both tourism & optimism. Military response efforts have helped defray some time & expense, helping to streamline the claims process on land & stave off the oil at sea. So how does this relate to dentistry?

Bacteria, like gushing oil, continues to multiply until something stops it or removes it. Small amounts of bacteria can be removed by a toothbrush and can die with the use of a Fluoride mouthrinse; however, small amounts of bacteria quickly multiply into large amounts of bacteria if not stopped or removed on a daily basis. The only way for bacteria to survive is to eat something nutritious—and in the mouth, nutrition comes from healthy teeth & gums.

The livelihood of a tooth is its nerve and bone. The nerve is in the middle of the tooth and it is joined to the bone at the base of the tooth. Bacteria begins eating on the outside of the tooth and migrates toward the most delicious part—the nerve. It has a great blood supply with many nutrients that keep bacteria strong & multiplying. At this point, the bacteria have eaten a hole in the tooth, are sucking the life out of the tooth by eating the nerve, and are working their way to the bone. Like the Gulf Coast communities feel the affects of the oil spill via a decrease in tourism & trade, a person’s livelihood will be affected by pain & swelling.

Dentists to the rescue! Although there is still no cure for the BP gusher, there is a cure for a person in such a condition. A dentist has the skills and tools to remove and kill the bacteria causing the acute problem so your mouth doesn’t become a “BP Situation.” The key is to see your dentist regularly so that gushers don’t continue to erupt all over your mouth.

I don’t know if BP had any foresight into the effects of their actions, but as responsible adults, we know the consequences of our own actions. If a dental professional informs you about a cavity-- in relation to BP, it means the oil is bubbling and if you don’t have it treated, it will become a gusher. If he/she suggests anything larger, (ie crown, root canal, etc), it means you already have a “BP Situation” and there is a system in place to resolve the problem. If you are told there are multiple issues throughout your mouth that need to be addressed…it means you definitely have a “BP Situation” –and in order to resolve the problem, we, as engineers will devise a plan for treatment & you, the patient, will have to join the clean-up crew.

If only BP could make it so easy…

Are Your Teeth On Acid?

Every morning, children across America hear the words, "Finish your orange juice...Now go brush your teeth!" Orange juice is good for the body, and brushing is good for the teeth, but orange juice (and other acidic beverages) immediately followed by brushing is catestrophic to teeth. Could mom be wrong after all these years?

Enamel Erosion- A number of studies have shown that beverages with a low pH (acidic) have an influence on the softening and erosion of tooth enamel. One of the studies exposed a cow tooth to an acidic soft drink for 5 minutes and reported that the tooth surface--after only 5 minutes--was 31% less hard. The study also reported that the tooth regained only 86% of its strength back after a 24hr period of time.

Dental Abrasion- Another study revealed that brushing teeth immediately after consuming acidic products accelerates enamel erosion. Once the enamel is softened by the acid, it becomes more susceptible to abrasions by toothbrush bristles.

Most people tend to sip their beverages, submersing their teeth for a total time of several minutes. So a recent study chose to immerse teeth at times of 5 seconds, 1 minute or 10 minutes in one of the following four beverages: Coca-Cola, Pepsi One, Diet Mountain Dew or Tropicana Pure Premium Low Acid Orange Juice. Micrographs showed that the appearance of the tooth enamel was altered after only 5 seconds. The altered appearance showed the noticeably softer enamel surface. Brushing with toothpaste induced even greater surface changes and caused some enamel to be brushed away.

So how much time should elapse after drinking acidic beverages before brushing can occur? Well, that has yet to be determined. What we do know is that the plaque around teeth becomes acidic within 2 minutes of drinking a beverage containing sugar and that more than 30 minutes must elapse before normal pH is restored. Until a protocol is determined, I tell my patients to swish with water after drinking an acidic beverage and wait 30 minutes before brushing.

All acidic beverages aren't bad for the body, but most are bad for the teeth if not cared for properly...so don't leave your teeth on acid--Swish, Wait, then Brush!