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SteelyDanFoundersDeathHighlightsImportanceofEarlyCancerDetection

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.”

AdvancingGumDiseaseRequiresThoroughTreatmenttoControlit

If you ever get out of the habit of daily brushing and flossing, you’re setting yourself up for dental disease. Neglecting oral hygiene allows bacterial plaque to build up on tooth surfaces, which can give rise to aggressive gum infections known collectively as periodontal (gum) disease.

Gum disease may first manifest itself as gingivitis, an inflammation of the outer gum tissues around teeth. Resuming hygiene habits could help reduce the infection if it’s detected early enough. If the infection has spread deeper below the gum line, though, brushing and flossing won’t be able to reach and remove the offending plaque — you’ll need our help with that.

The objective of any such treatment is the same as your daily brushing and flossing — remove plaque as well as hardened deposits (calculus) that cause disease. The most basic technique is called scaling in which we use specialized hand instruments (scalers) or ultrasonic equipment to loosen and remove the plaque and calculus from all tooth and gum surfaces.

For deeper plaque, we may need to use a technique called root planing. As its name implies, we use equipment similar to scalers to shave or “plane” plaque, calculus, bacteria or other toxins from the roots that have become ingrained in their surfaces.

These procedures are often carried out with local anesthesia to ensure patient comfort and allow us to be as meticulous as possible with plaque and calculus removal. It’s imperative that we remove as much plaque and calculus as possible, and which often involves more than one session. This is because as the gum tissues become less inflamed it allows us to access more plaque-infested areas during subsequent sessions.

Hopefully, these techniques will arrest the infection and restore good health to gum tissues. It’s then important for you to recommit and follow through on a renewed daily hygiene regimen to reduce the chances of re-infection that could lead to more serious problems and potential tooth loss.

If you would like more information on treating periodontal (gum) disease, 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 Planing.”

KeepAlertforthisExtremeFormofGingivitis

It takes only a few days of inadequate oral hygiene for bacterial plaque to trigger the periodontal (gum) disease gingivitis. Though sometimes subtle, there are signs to watch for like inflamed, reddened or bleeding gums.

Untreated gingivitis can develop into more advanced forms of gum disease that infect deeper levels of the gums and supporting bone and ultimately cause bone and tooth loss. Fortunately, though, prompt treatment by a dentist removing plaque from teeth and gums, along with you reinstituting daily brushing and flossing, can stop gingivitis and help restore health to your gums.

If you’re under acute stress or anxiety, however, basic gingivitis can develop into something much more serious and painful, a condition called Acute Necrotizing Ulcerative Gingivitis (ANUG). It’s also known as “trench mouth” from its common occurrence among World War I soldiers experiencing stressful periods in front line trenches without the means for proper oral hygiene.

ANUG develops from a “perfect storm” of conditions: besides anxiety and deficient hygiene practices, ANUG has a high occurrence risk in people who smoke (which dries the mouth and changes the normal populations of oral bacteria) or have issues with general health or nutrition.

In contrast to many cases of basic gingivitis, ANUG can produce highly noticeable symptoms. The gum tissues begin to die and become ulcerative and yellowish in appearance. This can create very bad breath and taste along with extreme gum pain.

The good news is ANUG can be treated and completely reversed if caught early. In addition to plaque removal, the dentist or periodontist (a specialist in the treatment of gum disease) may prescribe antibiotics along with an antibacterial mouthrinse to reduce bacteria levels in the mouth. A person with ANUG may also need pain relief, usually with over-the-counter drugs like aspirin or ibuprofen.

It’s important that you seek treatment as soon as possible if you suspect you have ANUG or any gum disease. It’s possible to lose tissue, particularly the papillae (the small triangle of tissue between teeth), which can have an adverse effect on your appearance. You can also reduce your risk by quitting smoking, addressing any stress issues, and practicing diligent, daily oral hygiene and visiting your dentist for cleanings and checkups twice a year or more if needed.

If you would like more information on the signs and treatments for gum disease, 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 “Painful Gums in Teens & Adults.”

GumDiseaseisStillaThreattoYourDentalImplants

You’ve invested quite a bit in your new dental implants. And it truly is an investment: because of implants’ potential longevity, their long-term costs could actually be lower than other restorations whose upfront costs might be less.

But to better ensure their longevity, you’ll need to keep your implants and the natural tissues supporting them clean of bacterial plaque, a sticky biofilm that can cause periodontal (gum) disease. Although the implant itself is unaffected by disease, the natural tissues around it can be.  An infection could ultimately weaken the bone supporting the implant and lead to its failure.

Such an infection involving implants could advance rapidly because they don’t have the natural defenses of the original teeth. Our natural teeth are connected to the jaw through the periodontal ligament, a collagen network that attaches to both the teeth and the bone through tiny tissue fibers. This connection also provides access to antibodies produced by the body to fight infection.

By contrast, we place implants directly into the jawbone. While this creates a very secure attachment, the implant won’t have the same connection as teeth with the body’s immune system. That means any infection that develops in surrounding tissues can spread much more rapidly—and so must be dealt with promptly.

Treating this particular form of gum disease (known as peri-implantitis) is similar to infections with natural teeth and gums, with one important difference involving the tools we use to remove plaque from them. While natural teeth can handle metal scalers and curettes, these can create microscopic scratches in the porcelain and metal surfaces of an implant and create havens for further bacterial growth. Instead, we use instruments made of plastic or resin that won’t scratch, as well as ultrasonic equipment to vibrate plaque loose.

To avoid an infection, it’s important that you brush your implants and surrounding tissues just like you would your natural teeth (be sure you use a soft-bristled brush). And keep up regular dental visits for thorough cleanings and checkups to stay ahead of any developing gum infection. Maintaining your dentures will help ensure they continue to brighten your smile for a long time.

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 “Dental Implant Maintenance: Implant Teeth Must be Cleaned Differently.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”





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