If you’re facing cancer treatment, we wish you the best outcome possible. Treating this disease has advanced tremendously in recent decades, but the available options are still often challenging to endure. It will be your primary focus for the foreseeable future.
As a dental provider we also want you to be aware how the two main treatments, chemotherapy and radiation, could adversely affect your teeth and gums, especially if you’re receiving radiation therapy near the head and neck. The aim of cancer treatment is to attack and destroy cancer cells to prevent their growth. Unfortunately, it can also destroy neighboring healthy cells and lead to harmful consequences in different parts of the body, including the mouth.
Salivary glands, for example, are especially vulnerable to damage during cancer treatment. This could create a situation where the mouth no longer produces adequate saliva flow, leading to a condition called xerostomia or dry mouth. Besides a lot of discomfort, restricted saliva flow can also increase your risk of tooth decay and other dental diseases. This is because saliva is the body’s acid neutralizer (acid can erode tooth enamel) and its first line of defense against microbial infection.
To guard against this, it’s important to support salivary flow as much as possible if you experience dry mouth symptoms during treatment (as well as beyond—it’s possible the damage to these glands could be permanent). Since some medications also contribute to dry mouth, you should speak with your physician about the prescriptions you’re taking: if any have dry mouth side effects ask if there’s an alternative drug without these side effects. You should also drink more water during the day and especially when taking medications. And consider substances like xylitol gum that can help boost saliva flow.
Unfortunately, it may not be possible to fully avoid the effects of these treatments on your teeth and gums. So, be sure you keep up daily brushing and flossing and see your dentist regularly for cleanings and checkups. If necessary, there are a number of restoration options to restore your smile after you’ve completed your treatment.
Good nutrition is vital for maintaining health and preventing disease, especially for your mouth. A diet rich in whole foods — fresh fruits and vegetables, protein and dairy products — and low in sugar will not only promote strong teeth and gums, but lessen your chances of developing tooth decay or periodontal (gum) disease.
Diet is also a prominent factor in reducing the risk for another serious mouth disease — oral cancer. While oral cancer makes up only 3% of total cancer cases reported annually, the five-year survival rate is a sobering 50%, much lower than for other types of common cancers. While genetics plays a role in your susceptibility to oral cancer, lifestyle choices and practices present the greater risk factors for the disease.
Of these lifestyle factors, refraining from tobacco products, moderating your alcohol consumption and avoiding risky sexual behavior are of primary importance in reducing your cancer risk. With that said, you should also take into account the foods that are part of your daily diet — both what you should and shouldn’t eat. As an example of the latter, some foods contain a class of chemicals known as nitrosamines that are carcinogenic (cancer-causing). One such chemical, nitrite, is used as a preservative in meats like bacon or ham, and may also be found in beer, and seafood products.
On the positive side, your diet should be rich in foods that supply antioxidants, substances that protect the body’s cells from damaging, unstable molecules known as free radicals. The best sources for antioxidants (more so than dietary supplements) are plant foods rich in fiber and vitamins C and E. Eating more of these may also reduce your intake of nitrates, animal fat and saturated fat.
Adopting a moderate, nutritious diet, along with exercise, can have a huge positive impact on your general health and quality of life. Along with other lifestyle changes, better dietary choices can also help ensure a healthy mouth and reduce your risk of oral cancer.
If you would like more information on the role of nutrition in reducing your risk 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 “Diet and Prevention of Oral Cancer.”
You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.
The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.
But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.
Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.
His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.
One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.
In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.
Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.
If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”
When you hear the word “surgery,” your first thought might be of a high-charged operating room with a surgeon operating intently as a nurse mops sweat from their brow. While there are high-stakes surgeries, most aren’t quite that dramatic.
Dental implant surgery falls into the latter category. It does qualify as a surgical procedure because we make incisions and tissue alterations for the implant. But it’s no more rigorous than a surgical tooth extraction.
Still, if you’re new to implant surgery, it’s natural to feel some apprehension about it. To calm any nervousness, here’s a rundown of what to expect before, during and after the procedure.
Pre-Planning. Implant surgery is usually a routine affair because of meticulous planning beforehand. Often, we map out the implant site using CT scanners or other high-level imaging, identifying obstacles like nerves, blood vessels and sinus cavities, verifying there’s enough bone present to support an implant. With this information we can create a surgical plan or guide for placement in the mouth to accurately situate the implant.
Site Prep. On the day of the surgery we’ll first administer local anesthesia to numb the entire work area to pain. We’ll start with a few small gum incisions to expose the bone. Then using the surgical plan or guide, we’ll create a small channel for the implant with a drilling sequence that successively enlarges it until we achieve the best fit for the implant.
Implant Placement. Once we’ve completed drilling the channel, we’ll remove the implant from its sterile packaging and install it in the channel. After we’ve made any necessary adjustments and verified proper placement with x-rays, we’ll suture the gum tissue back into place.
After the Surgery. You might experience mild to moderate discomfort afterward that’s usually manageable with over-the-counter pain relievers like ibuprofen or acetaminophen. We can, if necessary, prescribe medication if you require something stronger. We may also prescribe an anti-bacterial mouth rinse for a short time to reduce the risk of infection.
After the implant has integrated with the bone which usually takes about 8-12 weeks, we’ll install your life-like crown or restoration. Your new smile and improved dental function will be well worth the process.
If you would like more information on the process for obtaining dental implants, 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 “Dental Implant Surgery.”
Tooth enamel erosion is a serious issue for many children that can result in permanent impairment of oral health. The problem isn’t just bacterial acid that causes tooth decay — it’s also the high acid content of sodas, energy and sports drinks widely popular among children and teenagers today.
Enamel is made of the strongest substance in the human body, which enables it to shield the inner layers of the teeth from disease and other environmental factors. Its chief nemesis, though, is acid: when enamel interacts with high concentrations of acid for a prolonged time, its mineral content will begin to soften and dissolve, a process known as de-mineralization. Saliva is the enamel’s main protection against acid with the ability to neutralize (or buffer) acid and restore some of the enamel’s mineral content, usually within thirty minutes to an hour after we eat.
The high acid content of many popular beverages, however, can overwhelm saliva’s buffering ability, especially if a person is sipping for an extended time on an acidic drink. This kind of exposure is different from acid produced by bacteria that causes tooth decay: bacterial acid tends to concentrate in specific areas of the teeth, while the constant wash from acidic beverages will have a more generalized eroding effect on teeth.
This level of enamel loss is irreversible, which can leave a tooth in peril of decay and ultimate loss — and increase long-term dental care and costs. The best strategy is to have your child stop or significantly curtail drinking highly acidic beverages. Rather than drink sports beverages for hydration, substitute water, nature’s hydrator. Milk can also be a viable beverage substitute.
If you do allow some acidic beverages, try to limit them to mealtimes and discourage extended sipping. Look for drinks with added calcium as this can reduce the beverage’s erosive potential. The goal is to reduce the amount and duration beverage acid is in contact with tooth enamel.
Making these changes will help greatly to protect your child’s tooth enamel, and give saliva a chance to do its job protecting it. Your efforts will also increase your child’s chances of better dental health in the future.
If you would like more information on dental erosion, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Erosion.”
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