Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
Although costly in the beginning, dental implants often turn out to be the least expensive tooth replacement option. That's because their enviable record for longevity often outpaces dentures or bridges. Over the long-term you might spend less for implants than these other restorations.
But even with the high success rate of dental implants (greater than 95% survive the ten-year mark), we can't guarantee they won't fail. And if you're a tobacco smoker, the risk of failure might be even higher. One study, for example, found early implant failures were twice the rate for smokers over non-smokers. Although implant failures overall are low, smoking seems to be a factor in those that do.
There are a number of reasons to account for this. For one thing, inhaled smoke can damage salivary glands, reducing the flow of this important fluid. Saliva helps control bacterial growth and neutralize mouth acid, so without it you're more susceptible to tooth decay or periodontal (gum) disease. Either infection could ultimately weaken implant-supporting bone.
The nicotine in tobacco can also restrict oral blood vessels and lower their ability to supply antibodies and nutrients to the teeth and gums. This slows healing, which could have one particular effect on implant durability.
During the intervening weeks between implant placement and crown attachment, the implant's titanium post attracts bone cells that grow and adhere to its surface. The effects of nicotine on healing, especially right after implant surgery, can interfere with this integration process so that the implant doesn't anchor in the bone as well as it should.
If you're a smoker, you can increase your chances of implant success—and have a healthier mouth overall—by quitting smoking beforehand with the help of a cessation program. Or at the least, consider stopping smoking for one week before implant surgery and for two weeks afterward.
And be sure to brush and floss your teeth daily and visit your dentist regularly to keep your teeth and gums as healthy as possible. Stopping smoking and practicing effective oral hygiene could make a big difference in the success or failure of your implant.
If you would like more information on smoking and your dental health, 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 Implants & Smoking.”
People improve their smiles for a lot of reasons: to better their career prospects, to put some juice in their social lives or just to do something special for themselves. But you may have an even stronger reason: a once-in-a-lifetime event—maybe your wedding day—is coming up soon.
You have several options for transforming your smile for the big day—and some are even quite economical. Here are 4 affordable ways to make your smile beautiful for that forever moment.
Cleanings. While dental cleanings should already be part of your regular dental care, scheduling one right before a big event can do wonders for your smile. Not only can your hygienist remove any lingering dull and dingy plaque and tartar, but they can polish your teeth for a brighter shine. Remember, though: dental cleanings support your own hygiene efforts, they don't replace them. Your own daily practice of brushing and flossing will also help you maintain a beautiful smile.
Teeth Whitening. You can also get an extra boost of brightness with a tooth whitening procedure. Using a professional bleaching solution and other techniques, your dentist can lighten your smile to your tastes, from a more natural hue to dazzling white. The whitening effect, though, is temporary, so plan to see your dentist no more than a few weeks before your big day.
Bonding. Perhaps a tiny chip is all that stands between you and a knockout smile. Your dentist may be able to repair that and other minor defects by bonding tooth-colored materials to the chip site. These composite resin materials have the shine of enamel and can be color-blended to match your tooth's natural shade. Composite resins are also fairly rugged, although you should avoid biting down on hard foods or objects.
Veneers. Although more expensive than the previous options mentioned, veneers are still affordable compared to crowns or bridgework. Usually made of thin layers of dental porcelain, dentists bond veneers to the front of teeth to mask mild to moderate problems like heavy staining, disfiguration and minor gaps. But because veneers are custom-fabricated by a dental lab, you'll need to plan them with your dentist at least six months before your event. The resulting change to your smile, though, may well be worth the wait.
If you would like more information on transforming your smile for a special event, 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 “Planning Your Wedding Day Smile.”
Dairy foods have played a role in human diets for thousands of years. More than one kid—whether millennia ago on the Mesopotamian plains or today in an American suburb—has been told to drink their milk to grow strong. This is because milk and other dairy products contain vitamins and minerals that are essential for a healthy body, including healthy teeth and gums. In honor of National Dairy Month in June, here are four ways dairy boosts your oral health:
Dental-friendly vitamins, minerals and proteins. Dairy products are an excellent source of many vitamins and minerals that are important for good dental health. They are packed with calcium and phosphorus, two minerals that work together to strengthen tooth enamel. In addition to the vitamins they contain naturally, milk and yogurt are fortified with vitamin D, which aids in calcium and phosphorus absorption; cheese contains a small amount of vitamin D naturally. What's more, dairy proteins have been shown to prevent or reduce the erosion of tooth enamel and strengthen the connective tissues that hold teeth in place.
Lactose: a more tooth-friendly sugar. Sugars like sucrose or high fructose corn syrup, which are routinely added to processed foods, are a primary trigger for tooth decay. This is because certain oral bacteria consume sugar, producing acid as a by-product. The acid weakens tooth enamel, eventually resulting in cavities. Dairy products—at least those without added sugar—are naturally low in sugar, and the sugar they contain, lactose, results in less acid production than other common sugars.
The decay-busting power of cheese. We know that high acidity in the mouth is a major factor in decay development. But cheese is low in acidity, and a quick bite of it right after eating a sugary snack could help raise the mouth's pH out of the danger zone. Cheeses are also rich in calcium, which could help preserve that important mineral's balance in tooth enamel.
Dairy for gum health. A study published in the Journal of Periodontology found that people who regularly consumed dairy products had a lower incidence of gum disease than those who did not. And since gum health is related to the overall health, it's important to do all we can to prevent and manage gum disease.
For those who cannot or choose not to consume dairy products, there are other foods that supply calcium naturally, such as beans, nuts and leafy greens—and many other foods are fortified with calcium, vitamin D and other nutrients. It may be wise to take a multivitamin or calcium with vitamin D as a supplement as well.
If you would like more information about nutrition and oral health, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “How to Help Your Child Develop the Best Habits for Oral Health.”
Wearing braces isn't just for teenagers — straightening teeth can be just as viable a need when you're an adult. For example, it may be necessary to first move teeth away from an empty tooth socket before you obtain a dental implant or other restoration.
But braces could have complications, especially if you have periodontal (gum) disease. These infections caused by plaque, a thin film of bacteria and food particles, inflame and weaken gum tissues and erode supporting bone. It can be treated and brought under control — but keeping it under control requires daily brushing and flossing, along with frequent office cleanings and checkups.
Braces can make this more difficult: it's harder to brush and floss effectively through the hardware of brackets and wires, which can give plaque a chance to build up. Patients susceptible to gum disease are more likely to have re-infections while wearing braces. The hardware can also cause enamel to come in prolonged contact with acid, which can dissolve its mineral content and open the door to tooth decay.
Clear aligners are an alternative to braces that can accomplish tooth movement while minimizing infection flare-ups for people with gum disease. Aligners are a series of customized clear plastic trays worn over the teeth, with each succeeding tray incrementally moving the teeth further than the preceding one. After wearing one tray for a specified time period, you then switch to the next tray. The teeth gradually move to the desired new position over the course of the aligner series.
This option is especially advantageous for gum disease patients because the trays can be removed temporarily for brushing and flossing. There are also other benefits: we can hide a missing tooth space with a temporary false tooth attached to the aligner; and, they're nearly invisible so it won't be obvious to others you're undergoing orthodontic treatment.
Not all orthodontic situations benefit from this alternative, while some cases may call for a combination approach between aligners and braces. But in the right setting, clear aligners are a good choice for not only obtaining better teeth position, but also helping you avoid a new encounter with dental disease.
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