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.”
Restoring a smile with implants involves more than the surgical procedure itself. We must also take into consideration the quality of the bone they’re placed into and the gums that will surround them — the “canvas” that showcases your new beautiful smile.
Bone — not only at the missing tooth site but supporting neighboring teeth as well — is the foundation for a successful implant. Without an adequate amount of bone, we can’t place an implant to achieve a final life-like appearance. Inadequate bone can be a problem if the tooth has been missing for awhile — without the stimulation of biting forces from the tooth, the bone can shrink gradually over time. Periodontal (gum) disease and other dental conditions can also cause bone loss.
The health of your gums — as well as the tissue type you’ve inherited from your parents, thin or thick — can also determine how natural the implant crown looks as it emerges from them. If they’ve receded due to gum disease they may not regenerate sufficiently, making your teeth longer-looking or leaving the triangular bit of gum tissue between the teeth, the papillae, noticeably missing. If you’ve inherited thin tissue gums, you’re also more susceptible to gum recession and there’s less margin for error during implant surgery.
There are some things we can do to minimize these problems. Tooth removal to make room for the new implant needs to be done carefully with as little tissue trauma as possible; it’s also helpful to place grafting material in the empty socket immediately after extraction, especially if there’s going to be a time gap before implant placement. If bone loss has already occurred, we can also use similar grafting techniques to rebuild the bone.
Likewise we need to take special care during implant surgery when dealing with thin or diseased gums. With the latter, it’s usually necessary to bring the gum disease under control and allow the gums to heal first. In extreme cases, cosmetic gum surgery may also help restore lost tissues and create a more natural look between the gums and the implant crown.
Creating a natural appearance with implants is a blend of technical skill and artistic insight. Keeping the balance between all these factors will produce a smile you’ll be proud to show.
If you would like more information on 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 “Matching Teeth & Implants.”
As the host of America's Funniest Home Videos on ABC TV, Alfonso Ribeiro has witnessed plenty of unintentional physical comedy…or, as he puts it in an interview with Dear Doctor–Dentistry & Oral Health magazine, "When people do stuff and you're like, 'Dude, you just hurt yourself for no reason!'" So when he had his own dental dilemma, Alfonso was determined not to let it turn onto an "epic fail."
The television personality was in his thirties when a painful tooth infection flared up. Instead of ignoring the problem, he took care of it by visiting his dentist, who recommended a root canal procedure. "It's not like you wake up and go, 'Yay, I'm going to have my root canal today!'" he joked. "But once it's done, you couldn't be happier because the pain is gone and you're just smiling because you're no longer in pain!"
Alfonso's experience echoes that of many other people. The root canal procedure is designed to save an infected tooth that otherwise would probably be lost. The infection may start when harmful bacteria from the mouth create a small hole (called a cavity) in the tooth's surface. If left untreated, the decay bacteria continue to eat away at the tooth's structure. Eventually, they can reach the soft pulp tissue, which extends through branching spaces deep inside the tooth called root canals.
Once infection gets a foothold there, it's time for root canal treatment! In this procedure, the area is first numbed; next, a small hole is made in the tooth to give access to the pulp, which contains nerves and blood vessels. The diseased tissue is then carefully removed with tiny instruments, and the canals are disinfected to prevent bacteria from spreading. Finally, the tooth is sealed up to prevent re-infection. Following treatment, a crown (cap) is usually required to restore the tooth's full function and appearance.
Root canal treatment sometimes gets a bad rap from people who are unfamiliar with it, or have come across misinformation on the internet. The truth is, a root canal doesn't cause pain: It relieves pain! The alternatives—having the tooth pulled or leaving the infection untreated—are often much worse.
Having a tooth extracted and replaced can be costly and time consuming…yet a missing tooth that isn't replaced can cause problems for your oral health, nutrition and self-esteem. And an untreated infection doesn't just go away on its own—it continues to smolder in your body, potentially causing serious problems. So if you need a root canal, don't delay!
If you would like additional information on root canal treatment, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.
RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.
The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.
Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.
RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.
A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.
If you would like more information on teeth replacement options, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
The Millennials, those born around the turn of the Millennium in 2000, are entering adulthood. Like any generation, they have their collective promise—and problems. An example of the latter seems to involve their teeth: an estimated one in three people between the ages of 18 and 34 have some form of tooth decay.
If a recent survey is correct, that may be a result of poor oral hygiene practices. The absence of a consistent, daily habit of brushing and flossing to remove disease-causing dental plaque is the number one cause for dental disease. But a survey of 2,000 millennials found only three in ten brushed their teeth at least once a day with many often skipping brushing for two or more days a time.
Interestingly, more than half of the survey also reported an aversion to dental visits. That will likely need to change if these trends in poor hygiene continue, as aging millennials will eventually need extensive treatment for tooth decay and its close counterpart periodontal (gum) disease to save their teeth. Dental professionals recommend a different dental care track: stop dental disease before it develops. And the key to that is a simple but powerful daily brushing and flossing routine.
This routine should involve brushing teeth up to twice and flossing at least once a day. Brushing should be done with gentle strokes, but include all exposed tooth surfaces (about two minutes to perform a thorough job). Flossing is less popular than brushing, but it’s essential for removing plaque between teeth your brush can’t reach. To make it easier, you can use pre-threaded floss or a water flosser that removes plaque with a stream of water.
To round out your prevention strategy, you should see a dentist at least twice a year for professional cleanings of hardened plaque deposits (calculus), as well as overall monitoring of your dental health. And if dental visits make you anxious, your dental professional has a number of ways to help you relax.
One thing’s for sure: like any other generation, millennials prize both good health and an attractive smile. Adopting a solid oral hygiene lifestyle will do the most to achieve both.
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