Oral cancer is not as uncommon as people think. In 2008 an estimated 34,000 cancers of the mouth and throat were diagnosed. In order to minimize your risk of developing oral cancer, be aware of habits that increase your risk.

Risk Factors for Oral Cancer include:

• Use of smoking or chewing tobacco: Tobacco smokers have 5-9 times greater risk of developing this cancer than non-users; snuff and chewing tobacco users have a four times greater risk than non-users.
• Excessive use of alcohol: Moderate to heavy drinkers at are 3-9 times greater risk than non-drinkers.
• Exposure to sun: Chronic sun exposure is associated with development of lip cancers.
• Certain viral infections such as the human papilloma virus that can cause cervical cancer in women can also cause oral cancer.
• Compromised immune (resistance) systems that are not functioning properly can be associated with cancers.
• Poor nutrition including diets low in fruits and vegetables can increase risk for all cancers including oral cancer.
• Family history: People carry a predisposition in their DNA (the genetic material they inherited from their parents) for developing cancer.

Oral Cancers Can Mimic Harmless Sores

Early signs of oral cancer can mimic harmless sores that occur in the mouth such as canker sores, minor infections, or irritations that occur from biting or eating certain foods. Cancers in the lip area can easily be mistaken for harmless sores.

Early Detection is Key

It is important to have regular oral examinations to detect signs of oral cancer. Although 90 percent of oral cancers occur in people who are over 40, it is becoming more prevalent in younger people, particularly those who adopt risky behaviors: smoking, drinking and oral sex.

• If you notice any unusual lesions (sores or ulcers), or color changes (white or red patches), anywhere in your mouth that do not heal within two to three weeks, come and see us and have it examined immediately.
• Definitive diagnosis may require a small biopsy, the microscopic examination of a piece of tissue from the affected area.

It is important not to let a suspicious sore go unchecked. If detected and treated early, while a lesion or growth is small, survival rates can exceed 80 percent. Contact us today to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”

No one wants to hear the word “cancer.” But thanks to advances in detection and treatment, the disease increasingly can be stopped in its earliest stages when it's most treatable and outcomes are most favorable. Oral cancer accounts for a relatively small 3% of cancers in men and 2% in women, but early detection rates are lagging. Our office screens for oral cancer as part of your regular checkups. Knowing some of the signs and symptoms can help you monitor as well.

The main areas where oral carcinomas (cancers) occur are:

• the tongue (most common location, particularly the sides and on the floor of the mouth),
• the lip (especially the lower one),
• the oral cavity (the mouth), and
• the pharynx (back of mouth and throat).

Early Signs

Most oral cancers are preceded by surface changes (lesions) of the oral membranes. In the “precancerous” stage, white or red patches start forming and a non-healing ulcer may appear. The most common locations on the tongue for this to occur are on the sides and underneath on the floor of the mouth. Lip cancers typically develop on the lower lip, usually in people with a history of sun exposure. There has often been prior damage at the site such as scaling and crusting.

Be aware that oral cancers can be mistaken for cold and canker sores, ulcers, minor infections, and even irritations caused by biting or certain types of food. If lesions don't heal within two or three weeks, there's a higher likelihood that they are cancerous.

An in-office examination includes the following:

• visual inspection of face, lips, neck and mouth;
• inspection of sides and underneath of tongue and floor of mouth using gauze to gently manipulate the tongue;
• palpation of the floor of the mouth, sides of neck and glands to detect unusual lumps; and
• an “open wide and say ‘Aah’” examination of the back of your throat.

There are some risk factors for oral cancer that can't be controlled, such as a family history, age and race. But awareness, monitoring for potential signs and seeking prompt attention are always key ingredients in protecting your oral health!

If you would like more information about oral cancer detection, 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 Cancer.”

Congratulations! In a few months, you're expecting a new baby... but, in the mean time, your body is adjusting to nausea, weight gain, food cravings, and a hundred other changes. Is this really the time to worry about your teeth and gums?

Yes and no — don't worry, but do be aware of a few basic facts about your oral health and your pregnancy, and how they affect each other.

Being pregnant may make your teeth and gums more sensitive. It also puts you at greater risk for some periodontal diseases, like pregnancy gingivitis (“gingival” – gum tissue; “itis” – inflammation of) and benign growths on the gum called “pregnancy tumors.” You may think these problems are just uncomfortable, but you should really have them evaluated as soon as they develop. Why?

Once upon a time, it was believed that periodontal (gum) diseases just affected the mouth. Today, we think these diseases and their associated bacteria may be involved with the whole body, playing a role in cardiovascular ailments, heart attacks, strokes, diabetes, and other illnesses.

What's more, recent studies suggest that these oral bacteria may be able to cross the placenta, stimulating an inflammatory response that may lead to preterm delivery. Babies who are born pre-term often have low birth weight, and are at greater risk for a number of health complications. That's one reason why maintaining good oral health is so important to expectant moms.

So, what should you do? First of all, keep in mind that maintaining your own general and dental health is the best thing you can do for your developing baby. Eat a balanced diet, keep up healthy habits — like limiting sugary between-meal snacks and brushing regularly — and don't put off visiting your dentist to get your dental cleanings. Those cleanings and a thorough evaluation can set your mind at ease and give your baby the best chance at a healthy start.

If you would like more information about pregnancy and oral 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 articles “Pregnancy and Oral Health,” and “Expectant Mothers.”

If you see blood when you brush or floss your teeth, it generally indicates a problem with your oral health. You may think you are brushing too hard, but this is not usually why gums bleed. The usual culprit is dental plaque.

Plaque is the sticky, whitish film of bacteria that forms on your teeth every day. If you brush regularly, you probably remove most of it — but some may remain behind and accumulate where your teeth meet your gums, particularly between your teeth. As the bacteria build up, along with by-products of their metabolism (the chemical reactions that maintain their lives), they cause inflammation, called gingivitis, in the adjacent gums.

Bleeding gums are an early symptom of gingivitis. Continuing contact with plaque at the gum line can cause your gum tissue to separate from nearby teeth, creating pockets in which the inflammation becomes even worse. The process leads to periodontal disease (“peri” – meaning around, “odont” – tooth). The increasing infection can eat away the bone that anchors the teeth, leading to possible tooth loss. Periodontal disease is not an uncommon problem. About 90% of the population has bleeding gums at some time or another, and approximately 10% go on to develop periodontal disease.

When you lose bone around your teeth, the gums separate from the tooth and “pockets” form between your teeth and gums. The inflammation and infection may continue within the pockets even if your gums have stopped bleeding when you brush. That's why it is important to have regular dental exams — to check up on and stop periodontal disease before it has a chance to cause serious damage.

There may also be other reasons for bleeding gums that have to do with your general state of health. Women who have elevated levels of hormones caused by birth control pills or pregnancy may experience an increased response to plaque that makes their gums bleed more easily. Increased bleeding in your gums can also be caused by some diseases or as a side effect of some medications.

The most important way to prevent bleeding gums is to learn proper brushing and flossing techniques so that you effectively remove plaque from your teeth on a daily basis. If you are not sure you are using the right techniques, make an appointment and have us demonstrate at your next dental visit.

With all the best intentions, some plaque may remain. Plaque that is allowed to stay on your teeth hardens into a substance called tartar or calculus. This must be removed periodically with a professional cleaning by me or by our hygienist.

With not too much effort, you can ensure that your teeth are clean and plaque free, and your healthy gums no longer bleed.

Contact us today to schedule an appointment to discuss your questions about bleeding gums. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums.”

The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.

A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.

Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.

The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.

Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.

Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”