Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”
It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.
Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.
Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.
Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.
For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.
If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.
As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.
If you would like more information on caring for primary teeth, 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 “Root Canal Treatment for Children’s Teeth.”
We’re all familiar with “naughty” and “nice” lists for food: “nice” items are beneficial or at least harmless; on the other hand, those on the “naughty” list are not and should be avoided. And processed sugar has had top billing on many people’s “naughty” list for some time now.
And for good reason: it’s linked to many physical ills including obesity, diabetes and heart disease. As a favorite food for oral bacteria that cause dental disease, sugar can also increase your risk for tooth decay or periodontal (gum) disease.
Most people agree that reducing sugar in their diet is a great idea health-wise. But there’s one small problem: a great many of us like sugar—a lot. No matter how hard we try, it’s just plain difficult to avoid. Thanks perhaps to our ancient ancestors, we’re hard-wired to crave it.
But necessity is the mother of invention, which is why we’ve seen the development over the past half century of artificial sweeteners, alternatives to sugar that promise to satisfy people’s “sweet tooth” without the harmful health effects. When it comes to dental health, these substitute sweeteners won’t contribute to bacterial growth and thus can lower disease risk.
But are they safe? Yes, according to the U.S. Food and Drug Administration (FDA). The agency has approved six types of artificial sweeteners for human consumption: acesulfame K, saccharin, aspartame, neotame, sucralose and rebaudioside A. According to the FDA any adverse effects caused by artificial sweeteners are limited to rare conditions like phenylketonuria, which prevents those with the disease from safely digesting aspartame.
So, unless you have such a condition, you can safely substitute whatever artificial sweetener you prefer for sugar. And if dental health is a particular concern, you might consider including xylitol. This alcohol-based sweetener may further deter tooth decay—bacteria can’t digest it, so their population numbers in the mouth may actually decrease. You’ll find xylitol used as a sweetener primarily in gums, candies and mints.
Reducing sugar consumption, couple with daily oral hygiene and regular dental visits, will certainly lower your risk of costly dental problems. Using a substitute sweetener might just help you do that.
If you would like more information on sweetener alternatives, 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 “Artificial Sweeteners.”
Like most people, you’ve no doubt experienced occasional dry mouth as when you’re thirsty or just waking from sleep. These are normal occurrences that usually don’t last long.
But xerostomia or chronic dry mouth is another matter. Not only is this continual lack of adequate saliva uncomfortable, it could increase your risk for tooth decay or periodontal (gum) disease.
What’s more, chronic dry mouth can have a number of causes. Here are 3 common causes and what you can do about them.
Inadequate fluid intake. While this may seem obvious, it’s still common—you’re simply not consuming enough water. This deprives the salivary glands of adequate fluid to produce the necessary amount of saliva. If you’re regularly thirsty, you’ll need to increase the amount of water you drink during the day.
Medications. More than 500 drugs, both over-the-counter and prescription, can cause dry mouth as a side effect. This is one reason why older adults, who on average take more medications, have increased problems with dry mouth. There are some things you can do: first, talk with your healthcare provider about alternative drugs for your condition that are less likely to cause dry mouth; drink more water right before taking your medication and right afterward; and increase your daily intake of water.
Diseases and treatments. Some systemic diseases like diabetes or Parkinson’s disease can lead to xerostomia. Autoimmune conditions are especially problematic because the body may turn on its own tissues, the salivary glands being a common target. Radiation or chemotherapy treatments can also damage the glands and lead to decreased saliva production. If you have such a condition, talk with your healthcare provider about ways to protect your salivary glands.
You can also ease dry mouth symptoms with saliva boosters like xylitol gum or medications that stimulate saliva production. Limit your intake of caffeinated drinks and sugary or acidic foods. And be sure you stay diligent with your oral hygiene habits and regular dental visits to further reduce your risks of dental disease.
If you would like more information on the causes and treatments of dry mouth, 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 “Dry Mouth: Learn about the Causes and Treatment of this Common Problem.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
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