While the effectiveness of chemotherapy and radiation have contributed to rising cancer survival rates, they can still have an adverse effect on the rest of the body. That includes the mouth: these treatments can damage healthy tissues like the salivary glands. The decrease in saliva flow increases the risk of tooth decay or periodontal (gum) disease.
While overcoming cancer is certainly the patient’s main health priority, it’s important for them to tend to their oral health. The best approach often involves a three-way partnership between patient, dentist and family caregivers all doing their part to keep the patient’s teeth, gums and mouth healthy during cancer treatment.
Here’s what each “partner” can do to protect a cancer patient’s oral health during treatment.
The dentist. To minimize dental disease odds, patients should enter cancer treatment with their teeth and gums in the best shape possible. Before beginning treatment, then, the dentist can assess their oral health status and recommend a treatment plan for any existing disease or condition. The dentist can also monitor a patient’s oral health during the treatment period.
The patient. Patients can do the most to protect their oral health by removing disease-causing plaque buildup with daily brushing and flossing, as well as maintaining their regular schedule of dental cleanings (if possible). They should also attempt to reduce dry mouth, a potential consequence of cancer treatment, by consuming more water and using saliva boosters like Xylitol-sweetened gums and mints. A nutritious diet is also important for protecting oral health.
The caregiver. Many cancer patients depend on family or friends to aid them during treatment. One of the best things a caregiver can do is act as a liaison between the patient and their medical and dental providers. When it comes to oral health, caregivers should be on the alert for any mouth changes including tooth pain, gum swelling or bleeding, foul breath and other signs of disease.
Focusing on oral health can be a daunting challenge for patients during their fight with cancer. But with help from their other partners, they can come out of this fight with their teeth, gums and mouth in good health.
If you would like more information on oral care during cancer treatment, 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 Health During Cancer Treatment.”
Today’s dental care has advanced leaps and bound over the last century. But these advances are tiny steps compared to what many believe may be coming in the next few decades. This optimism arises from our growing understanding of deoxyribonucleic acid (DNA), the chain-like molecule that houses the genetic instructions for the growth, function and reproduction of every cell in the body.
As researchers unlock the secrets of this vast genetic blueprint unique to each individual the possible applications from this knowledge are astounding. Here are just a few possibilities that could one day impact everyone’s oral health.
Preventing tooth decay. This rampant disease, triggered by bacteria (particularly Streptococcus mutans), can cause extensive damage in otherwise healthy teeth. There’s already some indications from the study of genomics that we may be able to stop or at least hinder this disease in its tracks. Already we’re seeing advances in gene therapy that might be able to inhibit the growth of Strep mutans and reduce its colonies in the mouth.
Growing new teeth. Composed of various layers, a natural tooth is part of a dynamic system of bone and gum ligaments that allow movement, protection and nourishment. Although dental implants are the closest and most advanced artificial approximation we now have to them, implants still can’t fully measure up to the function and capabilities of a natural tooth. But further insight into the genetic code may one day allow us to reproduce a living replacement tooth for a lost one.
Harnessing saliva for detecting disease. The impact of genomics related to the mouth could impact more than just the mouth itself. Researchers have discovered that saliva contains genetic information similar to blood, urine and other bodily fluids with markers for various disease conditions. Unlike other fluids, though, saliva is relatively easy to collect. The key is new equipment and testing protocols to take advantage of the information already available in a single drop of saliva.
These examples illustrate the range of possibilities for better health in the future: a reduction in dental disease early in life; new and better ways to restore missing teeth; and quicker ways to diagnose dangerous health conditions.
If you would like more information on new developments in 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 “The Future of Dentistry: A Sneak Preview of Your Dental Future.”
There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.
The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.
Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.
If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.
It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.
If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.
Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.
Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.
Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.
With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.
Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.
For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.
But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.
Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.
Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.
Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.
Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.
If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
Perhaps you haven’t thought of it quite this way, but saliva is one of the true wonders of the human body. This unassuming fluid performs a variety of tasks to aid digestion and help protect your mouth from disease. And you hardly notice it — except when it’s not there.
That’s the case for millions of people in America who have a chronic condition called xerostomia or “dry mouth.” This happens when the salivary glands don’t secrete enough saliva, normally two to four pints daily.
Of course, we can experience mouth dryness when we first wake up (saliva flow ebbs while we sleep), feel stressed, use tobacco, or consume alcohol and certain foods like onions or spices. It becomes a problem, though, when periods of low saliva become chronic. Without its preventive capabilities, you’ll be at much higher risk for dental diseases like tooth decay or periodontal (gum) disease.
Chronic dry mouth can occur for various reasons: systemic diseases like cancer or autoimmune deficiencies can cause it, as well as radiation or chemotherapy treatments. One of the most common causes, though, is medication, both over-the-counter and prescription. The surgeon general identifies over 500 known drugs that may inhibit saliva production, including some antihistamines, diuretics and antidepressants. It’s often why older people who take more medications than younger people suffer more as a population from dry mouth.
Because of its long-term health effects, it’s important to try to boost saliva flow. If your mouth is consistently dry, try to drink more fluids during the day. If you suspect your medication, see if your physician can prescribe a different drug. It also helps to drink a little water before and after taking oral medication.
We may also recommend medication or other substances that stimulate saliva or temporarily substitute for it. Xylitol, a natural alcohol sugar that also inhibits bacterial growth, can help relieve dryness. You’ll often find it in gums or mints.
Chronic dry mouth is more than a minor irritation — it can lead to more serious conditions. In addition to these tips, be sure to also keep up your regular dental visits and maintain a daily schedule of oral hygiene to prevent dental disease.
If you would like more information on overcoming dry mouth, 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 “Dry Mouth: Learn about the Causes and Treatment of this Common Problem.”
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