Posts for: February, 2015
No one wants to hear the word “cancer.” But thanks to advances in detection and treatment, the disease increasingly can be stopped in its earliest stages when it's most treatable and outcomes are most favorable. Oral cancer accounts for a relatively small 3% of cancers in men and 2% in women, but early detection rates are lagging. Our office screens for oral cancer as part of your regular checkups. Knowing some of the signs and symptoms can help you monitor as well.
The main areas where oral carcinomas (cancers) occur are:
- the tongue (most common location, particularly the sides and on the floor of the mouth),
- the lip (especially the lower one),
- the oral cavity (the mouth), and
- the pharynx (back of mouth and throat).
Most oral cancers are preceded by surface changes (lesions) of the oral membranes. In the “precancerous” stage, white or red patches start forming and a non-healing ulcer may appear. The most common locations on the tongue for this to occur are on the sides and underneath on the floor of the mouth. Lip cancers typically develop on the lower lip, usually in people with a history of sun exposure. There has often been prior damage at the site such as scaling and crusting.
Be aware that oral cancers can be mistaken for cold and canker sores, ulcers, minor infections, and even irritations caused by biting or certain types of food. If lesions don't heal within two or three weeks, there's a higher likelihood that they are cancerous.
An in-office examination includes the following:
- visual inspection of face, lips, neck and mouth;
- inspection of sides and underneath of tongue and floor of mouth using gauze to gently manipulate the tongue;
- palpation of the floor of the mouth, sides of neck and glands to detect unusual lumps; and
- an “open wide and say ‘Aah’” examination of the back of your throat.
There are some risk factors for oral cancer that can't be controlled, such as a family history, age and race. But awareness, monitoring for potential signs and seeking prompt attention are always key ingredients in protecting your oral health!
If you would like more information about oral cancer detection, 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.”
A dental implant can permanently restore the form and function of a missing natural tooth. But there’s an important prerequisite for this smile-transforming therapy — you must have enough bone remaining at the implant site to securely anchor the implant and ensure proper crown placement for the most natural looking result.
Patients who don’t meet this prerequisite may need to consider other restorative options. In some cases, however, we may be able to encourage sufficient bone growth to support an implantation through a technique called bone grafting.
Bone grafting involves opening the gum tissues at the intended implant site to expose the underlying bone. We then place the grafting material (usually a processed material) around the bone, sometimes with collagen membranes that serve as subterranean band-aids to guide bone growth. In most cases, the graft is actually a scaffold for the natural bone to grow upon; the natural bone will eventually replace the graft material. The procedure is normally performed with local anesthesia to minimize discomfort.
While bone grafting is a fairly routine procedure, it shouldn’t be undertaken unless there’s a firm prognosis it can successfully support a future implant. We must therefore determine if anything else in your oral health would disqualify you as an implant candidate, even if sufficient bone existed or not. We must also determine if there’s enough remaining bone currently at the site to even attach a bone graft.
Once we’re satisfied that bone grafting would be both possible and helpful, we must then consider what type of grafting material to use. If we’re only replacing one tooth we may choose to use an autograft, bone material taken from another area of your own body. Although autografts have advantages because of their regeneration ability, it does involve creating another surgical site within the body. In most cases we may use processed materials, for example allografts, material that originates from another human being; xenografts, taken from another species of animal; or synthetic (man-made) materials. Regardless of the source, these materials are first processed to be safe for human use.
If successful, the regeneration process will result in enough new bone structure to make dental implants a reality. Your mouth will be healthier — and your resulting smile will be more beautiful than ever.
If you would like more information on bone grafting, 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 “Can Dentists Rebuild Bone?”
We most often associate plastic surgery with cosmetic enhancements to our outer appearance. While this is their primary purpose, some forms of reconstructive surgery restore lost function and health as well as improve appearance. A classic example is cosmetic periodontal (gum) surgery that restores receded gum tissues that have exposed more of the tooth than is visually appealing.
Gum recession occurs primarily because of excessive brushing (too hard or for too long) or because of periodontal (gum) disease, a bacterial infection that ultimately causes gum tissue to detach and pull away from the teeth. Gum recession not only affects the appearance of the teeth, it can expose the tooth’s root surface to further infection and decay. Without treatment, the disease could progress causing further damage with the potential for the tooth to be eventually lost.
In conjunction with plaque removal to stop gum disease and possibly other treatments like orthodontics to correct misaligned teeth, cosmetic gum surgery is used to rejuvenate lost gum tissues around teeth through tissue grafting. In these procedures, a combination of surgical approaches and/or grafting materials are attached to the area of recession to stimulate the remaining tissue to grow upon the graft and eventually replace it.
Donor grafts can originate from three sources: from the patient (an autograft); another person (an allograft); or another animal species, usually a cow (a xenograft). Tissues from outside the patient are thoroughly treated to remove all cellular material and bacteria to eliminate any possibility of host rejection or disease transmission.
Depending on the nature of the gum recession and tooth condition, the procedure can take different forms. It could involve completely detaching the graft tissue from the host site and re-attaching it to the recipient site. But if more of the tooth root is exposed, the surgeon may cover the graft with tissue adjacent to the host site to supply blood to the graft, and affix the loosened pedicle to the graft site. While any technique requires advanced training and experience, the latter procedure involves microsurgical techniques that require the highest levels of technical skill and art.
Cosmetic gum surgery can result in healthier gum tissues and teeth that are less susceptible to infection and loss. No less important, though, these procedures can return a more natural look to your teeth and gums — and a more pleasing smile.
If you would like more information on gum tissue reconstruction, 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 “Periodontal Plastic Surgery.”
Many people use a mouthrinse as part of their daily oral hygiene. If you’d also like to include a mouthrinse in your regimen, the kind you choose will depend on what you want it to do for you.
If your main desire is fresh breath, then a cosmetic rinse that imparts a minty smell to the mouth should fit the bill. That, however, is all they do — cosmetic mouthrinses don’t contribute to oral health beyond your personal satisfaction that your breath is free of bad odors. But, if you want more — added protection against dental disease, for example — then you’ll need to consider a therapeutic mouthrinse.
Therapeutic mouthrinses are usually described as anti-cariogenic (prevents decay) or anti-bacterial, and include both over-the-counter (OTC) and prescription rinses. Their purpose is to either strengthen teeth or reduce the mouth’s bacterial levels. Of the OTC variety, most contain a small amount of sodium fluoride, which can strengthen tooth enamel. They’ve proven highly effective: a number of studies show using a sodium fluoride mouthrinse in conjunction with brushing and flossing reduces the chances of new cavities forming.
A number of OTC rinses also have an anti-bacterial effect, usually provided by active ingredients such as triclosan, zinc or essential oils like menthol. Even a slight reduction in bacteria can help lessen the chances of gingivitis (gum inflammation), an early form of periodontal (gum) disease. Reducing bacteria levels may also help alleviate bad breath.
Some individuals, though, have higher than normal levels of bacteria, or a systemic weakness in fighting certain bacterial strains. If this is your case, you might benefit from a prescribed mouthrinse intended to lower bacterial levels. Most prescription mouthrinses contain chlorhexidine, which has been amply demonstrated as an effective anti-bacterial control of tooth decay and gum disease. Chlorhexidine prevents bacteria from adhering to the teeth and so disrupts plaque buildup, the main cause of dental disease. Its prolonged use will result in the dark staining of teeth in some people, but this can be removed during dental cleanings and teeth polishing. Long-term use is generally not preferred compared to getting the proper attention from regular cleanings and examinations.
If you would like more advice on adding a mouthrinse to your daily hygiene regimen, especially to help reduce your risk of dental disease, please feel free to discuss this with us at your next checkup. Regardless of which type of mouthrinse you choose, they should always be used as a complement to daily brushing and flossing, along with regular dental cleanings and checkups.
For more information on mouthrinses, 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 “Mouthrinses.”