Cancer Treatment Related Complications
In The Mouth
Each year about 400,000 people with cancer develop treatment-related
complications in the mouth ranging from lesions to chronic dry
mouth to bone disintegration. If serious, these complications
can be life threatening. While many are unavoidable, some can
be prevented or minimized.
It is recommended that whenever possible, a pre-therapy dental
evaluation with a full set of mouth x-rays be performed. Any decay,
gum disease and abscesses should be treated, if time permits,
prior to chemotherapy and/or radiation therapy.
Even patients who have no pain or dental disorders need a thorough
cleaning. The goal should be to have the patient's mouth in optimal
health prior to beginning anti-cancer therapy.
If you have questions regarding cancer treatment and your dental
health, please call our office.
Many people don't see a dentist on a regular basis. They go only
when they feel they have a problem. We call this "crisis
treatment" as opposed to "preventive treatment".
While these patients may feel they are saving money, it usually
ends up costing much more in both dollars and time. The reason
for this is that most dental problems don't have any symptoms
until they reach the advanced stages.
An example is tooth decay. We hear all the time, "Nothing
hurts...I don't have any problems". But tooth decay doesn't
hurt! Until, that is, it gets close to the nerve of the tooth.
Then a root canal and crown are usually necessary, instead of
the small filling, which could have been placed several years
ago when the cavity was small. We can usually detect a cavity
3-4 years before it may develop any symptoms. It is not uncommon
to see a patient with a tremendous cavity and they have never
felt a thing!
Decayed (Baby) Erupting Teeth
Signs and appearance of teeth displaying bottle caries:
- Brown teeth with fragmented edges
- Upper front teeth that break easily
Children who have erupted teeth or are past the age to be weaned
are highly susceptible to rotted front teeth when being put to
bed with a bottle containing milk, juice or other sugar-containing
liquids. There is decreased salivary flow during sleep and clearance
of the liquid from the teeth is slowed.
The liquid pools around the upper front teeth and creates an
excellent environment to promote the growth of decay-causing bacteria.
Removing the bottle before the first tooth appears and wiping
the child's gums and teeth with a soft cloth before being put
to bed can help prevent decay.
At 18 months of age, parents should be encouraged to ask their
dentist to examine their child and recommend home care.
Dental Decay "Cavities"
Fluoride has been a great benefit to patients of all ages in
helping prevent dental decay. Regular brushing and flossing lowers
the chance of developing "cavities." However, the most
decay-prone areas of teeth are the grooves and depressions on
the chewing surfaces of the back teeth, which require further
To prevent decay, a plastic-like coating called a sealant should
be painted on the chewing surfaces of all the back teeth. Studies
have shown that sealants can reduce tooth decay by as much as
90% to 100%.
The American Dental Association recommends sealants be placed
as soon as the first adult back teeth come in at age 6 or 7. Sealants
should continue to be used as each adult back tooth comes into
the mouth. All back teeth that need to be sealed are present by
age 13. Sealant application is simple, fast, and painless.
Please call our office with any questions you may have about
the benefits using a sealant in preventing dental decay.
Dental Disease During Pregnancy
Many mothers have experienced gum disease, dental pain and/or
tooth extraction during or shortly after their pregnancy. This
is often seen as being a "normal" side effect of being
pregnant. However, dental disease, which is an infection of the
teeth and/or gums, is not "normal" for any patient.
There are three basic events that happen during pregnancy which
make the patient more susceptible to dental disease. First, hormonal
changes may make the gums more susceptible to gum disease.
Second, pregnant women tend to eat smaller, more frequent meals,
exposing their teeth and gums to sugars and acids more often.
Third, cravings for "junk foods" and inadequate oral
hygiene pose an increased threat to the teeth and gums.
Pregnant women should be advised to schedule a dental evaluation
and receive preventive dental care. Personalized oral hygiene
instruction should also be given to fight disease and promote
overall good health for the mother and her baby.
Diet and Dental Health
Diets low in certain nutrients reduce resistance to oral and
dental infections, that is, periodontal disease (gum disease)
and decay. A healthy immune system is essential to controlling
Counseling in the Four Basic Food groups will improve dental
health and general health. The consumption of sugar, especially
in sticky forms or in a baby bottle while sleeping, contributes
to the rapid development of dental decay.
The trace nutrient fluoride, may not be adequately supplied by
bottle or municipal water supplies. Supplementation with oral
tablets and topical application will reduce the incidence of dental
decay by more than 60%.
Together, a balanced diet, daily use of fluoride, effective brushing,
and sensible eating habits can reduce the risk of, or even prevent,
infectious dental disease.
Please don't hesitate to call our office if you need more information
on diet or fluoride supplementation and its relationship to dental
More seniors today have retained their own teeth, avoiding the
trauma of removable dentures. Many are on medications creating
dryness of the mouth as a side effect. Without the natural benefit
of saliva to decrease bacterial action, we see an increase of
cavities on the root surfaces of these patients.
Anyone on a medication causing a dry mouth effect should be encouraged
to see their dentist for regular dental cleanings and topical
For more information regarding dental problems of the elderly,
please call our office.
Infections In Joint Replacements
Can Be Instigated By Severe Disease
A thorough dental examination for presence of tooth and gum infection
is recommended prior to joint replacement.
Periodontal disease is a commonly occurring oral infection of
the adult population (80% of adults are affected) destroying the
bony support of the teeth. This infection slowly progresses over
the lifetime of the patient and is often manifested in the advanced
stage in the senior population.
Because of the lack of any discomfort to the patient until total
loss of bony support to the teeth, many adults are unaware that
they have this infection. However, the bacteria from this bone
destroying disease, especially in the more advanced cases, has
been attributed to possible infection of joint replacements.
Candidates for joint replacements who have not been seen by a
dentist in over a year should be considered for a thorough dental
evaluation of their teeth and gums before surgery.
Depending on the severity of the infection, treatment of gum
infections and tooth abscesses may take from two weeks to two
months before the patient reaches adequate health before surgery.
If you have any questions about infection in joint replacements,
please call our office.
Lost Teeth Impact Total Health
In the past, the loss of teeth (edentulism) was dismissed as
a natural part of the aging process, and dentures were considered
a normal sign of old age.
While such ignorance is rapidly becoming a thing of the past,
there is still not a general awareness of the seriousness of edentulism.
Multiple tooth loss is most commonly caused by periodontal disease,
i.e. gum and bone disease. Periodontal disease has a high statistical
correlation with chronic debilitating disease, such as diabetes,
cardiovascular disease and arthritis.
So it is not very surprising that studies now show a shortened
life expectancy by as much as 10 years for persons who have lost
their natural teeth, when compared to those who have kept their
In addition to longevity, quality-of-life differences are just
as significant. The functional efficiency of dentures has been
measured to be only 20% of that of natural teeth. Can there be
any doubt that nutritional deficiencies will be much more prevalent
in those without their natural teeth?
Loss of teeth often causes a feeling of loss of wholeness and
a sense of deterioration and aging. Given these factors, preservation
of the natural teeth is integral to whole-person wellness.
Why should you wear a mouthguard? While mouthguards are not mandatory
equipment in all sports, their worth is indisputable. Mouthguards
cushion blows to the face and neck. A mouthguard should be part
of every athlete's gear, no matter the sport. Even adults or weekend
athletes need to protect their smile and preserve their health.
Do: Wear a mouthguard at all times when playing
sports. Wear a mouthguard custom-fitted by your dentist, especially
if you wear bridges or braces.
Don't: Wear removable appliances like retainers
when playing sports.
There are two types of mouthguards:
- Custom-made: Designed by a dentist and made on a cast of your
teeth. These cause very little interference with speaking or
breathing. They provide the best protection and fit over braces
and fixed bridges. They also cost more.
- Ready-made: Purchased at most sporting goods stores. They
are the least expensive, the least effective, and least comfortable.
Please call our office if you would like to "play it safe!"
and wear a comfortable mouthguard and protect your teeth.
Dental Health For Seniors
The good habits of effective daily brushing, diet, and use of
fluoride will help the aging person adapt to changing conditions.
Reduced salivary flow and addition of medications will affect
oral health dramatically.
Changes of the teeth and gums: Teeth will darken because of long-term
exposure to plaque and changes in the dentin within the tooth.
The gums may recede and uncover the roots. Exposed roots will
be darker than the enamel part of the tooth and are prone to decay.
Fillings can decay and darken, too, as they weaken over time.
"Dry Mouth" may develop: Saliva is useful to lubricate,
wash away plaque, and neutralize the acid produced by plaque.
Flow of saliva can be reduced by a medical disorder or be a side
effect of antihistamine, decongestants, pain killers or diuretics.
The build-up of plaque will accelerate tooth decay. There will
also be more gum infection which will cause a loss of bone support
for the teeth. Poorly-fitting or poorly-cleaned dentures, illness,
and some medications increase the severity of the problem.
For more information regarding dental problems of the elderly,
please call our office.
Periodontal Disease-Silent and
Periodontal disease can go on for years without pain and without
detection unless specific examination procedures are performed.
Visual oral examination by itself (even by a dentist) will not
reliably detect periodontal disease until it has reached an advanced
Early detection and adequate diagnosis require measurement of
pockets (the crevice between the tooth and gum) with a periodontal
probe. Effective prevention and treatment is available, but the
damage caused as the disease progresses is irreversible.
Early detection and treatment is critical to prevent tooth loss
and disfigurement. Although the procedure is simple, painless
and requires only a few minutes, millions of American adults have
never had it done.
Signs of periodontal disease - bleeding gums, redness of gum
tissue, swelling of gums around the teeth, breath odor, receding
gums, mobility of teeth.
Prevent Tooth Decay
Fluoride, in proper dosage, has been shown to significantly reduce
dental decay. When fluoridated water has less than the ideal amount
or is not available, fluoride supplements are recommended. (A
call to your local water district is all that is necessary to
determine whether your water has fluoride or not.)
When supplements are needed, the administration of fluoride supplements
should begin shortly after birth and continue through the time
of eruption of the second permanent molars (approx. 12 years of
Regular dental check-ups should begin no later than 18 months
If you have any questions or need more information, don't hesitate
Some Dental Problems Are Easy To
One of the easiest problems to spot is a build-up of plaque.
Plaque is the soft, sticky layer of bacteria, which is constantly
forming on the teeth. Usually it is invisible to the naked eye,
but when a person is not brushing adequately, it can build up
to where it appears to be a thick whitish coating on the teeth
at the gum line. If not removed, it can lead to gum disease.
Another potential problem, which is easy to spot, is missing
teeth. Many patients assume that if they are still able to eat,
they are O.K.
But very often, losing just one tooth can lead to the loss of
support, and teeth begin to drift into the empty space, causing
a change in the bite. It also forces the remaining teeth to carry
an additional load, sometimes past their ability to adapt. In
most cases, when even one tooth is lost, the remaining teeth suffer
and are more likely to be lost as well.
Our focus is in the treatment of problems such as these. Call
our office for the care you need.