Charles McGee DDS

More than 1 million Americans are diagnosed with cancer each year and many of them will develop problems with their oral health as a result of their cancer treatment.

While it’s natural that they’ll be focused on their cancer treatment, it’s important not to overlook the importance of a dental examination as part of the process of maintaining overall health.

For example, radiation therapy of the head and neck area may lead to certain complications such as dry mouth, sensitive lesions in the oral cavity, hypersensitive teeth, rapid tooth decay and difficulty swallowing.

Chemotherapy and other medication can also have significant effects in the mouth.

To help prevent, minimize and manage such problems, the dentist and oncologist can work together – before and during cancer treatment.

Many medications lead to dry mouth, which can lead to a higher risk of gum disease and other problems. The dentist may therefore recommend a saliva replacement, an artificial saliva that is available over-the-counter at pharmacies.

Frequent fluoride applications may also be recommended.

If you are receiving treatment, schedule regular screenings with your dentist and contact your dentist or physician immediately on any sign of mouth infection. This may have serious implications for your overall health.

Your dentist and physician both want your treatment to be as safe and effective as possible.

With many people concerned about the taste and purity of tap water, the sales of bottled water have increased significantly in recent years.

Tap water goes through a process of purification designed to eliminate suspended materials, remove tastes and odors and kill microorganisms.

Fluoride is added to most tap water supplies with the aim of reducing cavities.

Fluoride becomes incorporated into our teeth as they develop and makes them more resistant to decay. It can reverse the progress of early cavities and reduce the need for dental treatment.

Mass water fluoridation has played an important role in reducing tooth decay.

The problem with bottled waters is that they usually don’t contain fluoride.

So there is a risk that drinking bottled water can increase the risk of cavities for some people.

If you drink a lot of bottled water, you can make up for this by using fluoride toothpaste and mouth rinse.

Your dentist may even suggest a fluoride supplement if they notice an increase in cavities.

For many patients, the dental cleaning appointment may seem little more than a more complicated version of brushing your teeth.

However, this appoinment plays a crucial role in patient education and prevention of dental disease.

The appointment is called a “dental prophylaxis,” or “prophy” and it’s one of the most important steps in your dental care program.

Here are some of the elements that it may include, depending on your needs:

– Oral hygiene evaluation

– Tooth brushing and flossing instructions

– Scaling above the gum to remove plaque and tartar

– Debridement of tartar beneath the gum

– Polishing the teeth

– Periodontal charting

It’s important to remove plaque from the teeth as it ultimately forms a hard, rough sediment known as tartar or calculus, which must be removed by a dental professional to help prevent periodontal disease.

Polishing the teeth removes stains and creates a feeling of fresh breath and a clean mouth.

The hygienist or dentist may recommend a prophylaxis visit every two to six months.

Although insurance may only cover two prophies a year, recall frequency depends on many factors and should be based on individual needs.

These appointments can help you have much better dental health and could save you a great deal of time and money in the long run.

Gum disease � also known as periodontal disease � often progresses slowly, without pain, over a long period of time and that’s one reason it is common among older adults.

The longer the disease goes undetected and uncontrolled, the more damage it causes to gums and other supporting tissues.

Although periodontal disease is caused by plaque, other factors can increase the risk or severity of the condition, including:
– Food left between the teeth
– Tobacco use � smoking and smokeless tobacco
– Badly aligned teeth
– Ill-fitting bridges or partial dentures
– Poor diet
– Systemic diseases such as anemia

Although periodontal disease is common, it can be controlled and, if caught in its early stages, it can be reversed. However, in advanced stages, it may require surgery.

Look out for the following warning signs and see your dentist if you notice any of them:
– Bleeding gums when you brush
– Red, tender or swollen gums
– Gums that have pulled away from the teeth
– Pus between your teeth and gums when the gums are pressed
– Loose teeth or teeth moving apart
– Any change in your bite
– Any change in the fit of your partial dentures
– Constant bad breath or bad taste

Keeping an eye out for these problems and having regular dental checkups can help you stop gum disease becoming a major and expensive problem.

When diabetes is not controlled properly, high glucose levels in saliva may create problems that lead to an increased risk of tooth decay.

Your teeth are covered with plaque, a sticky film of bacteria. After you eat food that contains sugars or starches, the bacteria react with these sugars to release acids that attack tooth enamel. This can cause the enamel to break down and may eventually result in cavities.

Brushing twice a day with fluoride toothpaste and cleaning between your teeth with floss or an interdental cleaner helps remove decay-causing plaque.

Plaque that is not removed can eventually harden into calculus, or tartar. When tartar collects above the gumline, it becomes more difficult to clean thoroughly between teeth. This can lead to chronic inflammation and infection in the mouth.

Because diabetes reduces the body’s resistance to infection, the gums are among the tissues likely to be affected.
Periodontal diseases are infections of the gum and bone that hold your teeth in place. Patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than those who have good control of their diabetes.

Because of the lower resistance and longer healing process, periodontal diseases often appear to be more frequent and more severe among persons with diabetes.

You can help reduce these risks through good maintenance of blood sugar levels, a well-balanced diet, good oral care at home and regular dental checkups.

Plaque is a sticky film of bacteria that covers our teeth and, when we eat something, these bacteria release acids that attack the tooth enamel.

When these attacks are repeated over time, the enamel will break down and this will eventually lead to cavities.

When plaque is not removed through daily brushing and cleaning it hardens into calculus or tartar. When tartar collects above the gum line, brushing and cleaning between the teeth becomes more difficult.

The gum tissue can become swollen or may bleed. This is called gingivitis and it is the early stage of periodontal (gum) disease.

There are several steps you can take to protect yourself against this happening:

– Brush your teeth twice a day with fluoride toothpaste
– Clean between teeth daily with floss or an interdental cleaner
– Eat a balanced diet and limit the number of snacks between meals
– Visit your dentist regularly for professional cleanings and oral exams
– Ask your dentist about sealants – these are protective coatings that can be applied to the back teeth where decay often starts.

If you take steps to remove the plaque each day, you have a greater chance of avoiding tooth and gum problems.

Having a good relationship with your dentist means they should be able to explain things clearly to you and talk to you in language you understand.

The challenge for the dentist is that, as with any type of medical and professional training, they have to learn many unusual and technical terms.

This jargon has a purpsoe as it allows professionals to communicate clearly with each other on the same basis.

But often there is no need to use this terminology with the patient. Using these terms becomes a habit and they forgat to translate for the patient.

Soemtimes. it’s easier to say what you are thinking to a patient rather than have to translate it into something he or she will understand. And the dentist is usually thinking using the jargon.

Many common dental words such as restoration (filling), dentition (set of teeth) and occlusion (how the teeth come together) can easily be translated into terms patients understand.

Your dentist wants to help you understand as much about your dental health as possible so they would prefer that you stop them and ask what terms mean or simply ask them to speak in plain English.

They often slip into jargon out of habit or because it allows them to communicate more easily with others on the team.

They want you to get the treatment you need and be satisfied. So they won’t mind if you stop and remind them to communicate more effectively.

The process of having a tooth extracted may seem worrying but you’ll find it much easier if you know what to expect on the day and afterwards.

Your dentist will make the process as comfortable as possible for you by numbing the area around the tooth to be extracted.

In most cases, a small amount of bleeding is quite normal and your dentist will advise you what process to follow to allow healing as quickly as possible.

Generally, you should avoid anything that might prevent normal healing.

For example, it’s best not to smoke, rinse your mouth vigorously or drink through a straw for 24 hours afterwards as these could delay healing.

For the first few days, if you need to rinse your mouth, do it gently. If you are suffering pain or swelling, apply a cold cloth or an ice bag.

If necessary, your dentist will recommend something for any pain.

At the beginning, don’t clean around the socket where the tooth has been removed but you should brush and floss the other teeth as usual.

Modern procedures make having an extraction and the follow-up more comfortable than ever before.

Although there have been huge advances in dental care in recent years, there are records of people dealing with teeth going back over thousands of years.

Here are some of the key dates from the early years in the development of dentistry.

5000 BC: A Sumerian text describes “tooth worms” as the cause of dental decay.

2600 BC: Hesy-Re, an Egyptian scribe, often called the first “dentist”, dies. An inscription on his tomb includes the title “the greatest of those who deal with teeth, and of physicians.”

500-300 BC: Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

166-201 AD: The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

500-1000: During the Early Middle Ages in Europe, medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700: A medical text in China mentions the use of “silver paste,” a type of amalgam.

1130-1163: A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade � sharp knives and razors � were useful for surgery. Following the edicts, barbers assume the monks’ surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210: A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s: A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

It would be easy to get overwhelmed by the huge range of dental care products now available.

Even looking just at toothbrushes present a wide range of choices.

There are hundreds of manual and powered toothbrushes to choose from.

Start by looking for products that carry the American Dental Association Seal of Acceptance – this is an important symbol of a the product’s safety and effectiveness.

When you buy a toothbrush, replace it every three to four months. Replace it sooner if the bristles become frayed as a worn toothbrush will not clean your teeth properly.

Make it easy for your children to brush their teeth by choosing a child-sized toothbrush and make it more interesting for them by selecting fun colors and designs.

Often people who have difficulties with hand, arm or shoulder movements find that powered toothbrushes are the best choice. However, it’s also possible to make a few small changes to modify a manual toothbrush and make it easier to use.

For example, you can:

– Enlarge the handle with a sponge, rubber ball, or bicycle handle grip
– Lengthen the handle with a piece of wood or plastic
– Bend the handle slightly while running it under hot water

Your dentist will give you tips on what toothbrushes would be right for your needs.