Posts for tag: oral health
It’s rare now to encounter a news story about an infection spreading among a group of dental patients — a rarity thanks to the development of standards and procedures for infection control. As these standards have improved over the last few decades, the prevention of infection stemming from dental treatment has become more effective and easier to perform.
Like other healthcare providers, dentists are held (and hold themselves) to a high legal, moral and ethical standard to stop the spread of infection among their patients, and both governmental authorities and professional organizations mandate safety procedures. The United States Center for Disease Control regularly publishes recommendations for disinfection and sterilization procedures for all healthcare providers and facilities, including dental clinics. Dental and medical licensing bodies in each U.S. state also mandate control procedures and have made continuing education on infection control a condition of re-licensure.
For both medical and dental facilities, blood-borne pathogens represent the greatest risk of infection. These viral infections spread through an infected person’s blood coming in contact with the blood of an uninfected person, via a cut or a needle injection site. One of the most prevalent of these blood-borne diseases is hepatitis. This disease, which can severely impair the function of the liver and could be fatal, is caused by either of two viruses known as HBV and HCV. Any medical facility that encounters blood through needle injection or surgical procedures (including blood transfusion and surgical centers, and dental offices) must have a high degree of concern for controlling the spread of hepatitis and similar viral diseases.
Infection control protocols cover all aspects of potential exposure, including protective wear for workers and patients, proper disposal of contaminated refuse and disinfection of instruments and facilities. These comprehensive procedures not only keep patients safe from viral exposure, they also protect healthcare providers who experience greater exposure and risk for infection than the patients they serve.
Thanks to this strong emphasis on infection control, your dental visits are reliably safe. If you do have concerns, though, about the risk of infection during a dental visit, please let us know — we’ll be happy to discuss all we do to protect you and your family from infection.
If you would like more information on infection control, 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 “Infection Control in the Dental Office.”
While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.
Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.
It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.
Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.
Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.
The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.
If you would like more information on the effect of eating disorders on 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 article “Bulimia, Anorexia & Oral Health.”
Fluoride has been proven to strengthen tooth enamel against decay. That’s why it’s not only added to toothpaste and other dental products, but also to drinking water — in nearly three-quarters of U.S. water systems.
While research has eased most serious health questions about fluoride, there remains one moderate concern. Too much fluoride over time, especially in infants and young children, could lead to “enamel fluorosis,” an excess of fluoride in the tooth structure that can cause spotting or streaking in the enamel. While often barely noticeable, some cases of fluorosis can produce dark staining and a pitted appearance. Although not a symptom of disease, fluorosis can create a long-term cosmetic concern for the person.
To minimize its occurrence, children under the age of 9 shouldn’t regularly ingest fluoride above of the recommended level of 0.70 ppm (parts per million). In practical terms, you as a parent should monitor two primary sources of fluoride intake: toothpaste and drinking water.
Young children tend to swallow toothpaste rather than spit it out after brushing, which could result in too much fluoride ingestion if the amount is too great. The American Academy of Pediatric Dentistry therefore recommends a small “smear” of toothpaste for children under two, and a pea-sized amount for children up to age six. Brushing should also be limited to no more than two times a day.
Your child or infant could also take in too much fluoride through fluoridated drinking water, especially if you’re using it to mix infant formula. You should first find out the fluoride levels in your local water system by contacting the utility or the health department. If your system is part of the U.S. Centers for Disease Control and Prevention’s (CDC) “My Water’s Fluoride” program, you may be able to access that information on line at http://apps.nccd.cdc.gov/MWF/Index.asp.
If the risk for developing fluorosis in your area is high, you can minimize your infant’s intake with a few recommendations: breastfeed rather than use formula; use “ready-to-feed” formula that doesn’t need mixing and contains lower fluoride levels; and use bottled water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”
Fluoride can be a wonderful adjunct to dental care in reducing risk for tooth decay. Keeping an eye on how much fluoride your child takes in can also minimize the chance of future appearance problems.
If you would like more information on the possible effects of fluoride on young children, 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 “Tooth Development and Infant Formula.”
Baseball legend Babe Ruth, President Ulysses S. Grant and George Harrison of the Beatles — these three notable people from different backgrounds and historical eras have a sad commonality — they all died from oral cancer. They are a reminder that regardless of one’s wealth or fame, no one is immune from oral cancer and its deadly effects.
Like other cancers, oral cancer is characterized by abnormal cell growth capable of spreading into nearby tissue or other parts of the body. Although oral cancer accounts for less than 3% of all occurring cancers, it’s among the most deadly: only 58% of oral cancer patients survive five years after treatment. This is mostly due to the difficulty of detecting oral cancer in its early stages; in fact, 30% of oral cancers have already spread (metastasized) when they’re finally diagnosed.
Early detection through careful monitoring is the best strategy for defeating oral cancer. If you have a predisposing factor like a family history of oral cancer, then regular screenings during dental checkups are a must. During an exam we may be able to detect abnormalities (like unusual white spots on the gums or jaws) that may signal a cancer in a pre-cancerous or early stage. You also should be on the lookout for a persistent sore throat or hoarseness, lingering mouth pain, a painless lump in the mouth or on the neck, or ear pain on only one side.
There are also conditions or behaviors that may increase your risk for oral cancer, like using tobacco (both smoke and smokeless) or consuming alcohol. If you use tobacco you should consider quitting it altogether; you should consider cutting back on alcohol consumption if you’re a moderate to heavy drinker. You should also avoid sexual behaviors that increase your chances of viral infection — research has found a link between oral cancer and the viral infection caused by the sexually-transmitted human papilloma virus (HPV 16).
Improving your nutrition can also reduce your cancer risk. A diet rich in fresh fruits and vegetables supplies the body with cancer-fighting nutrients, including antioxidants that protect cells from damage caused by carcinogens. Studies have shown this kind of diet consistently lowers the risk of oral and throat cancer, as well as cancers of the esophagus, breast, prostate, lung and colon.
If you would like more information on oral cancer, 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.”
The main strategy in fighting dental disease is to try to prevent it in the first place. The success of this strategy depends largely on effective oral hygiene with three essential elements: daily brushing, daily flossing, and semi-annual checkups with professional cleaning.
Many people have little trouble incorporating brushing into their daily routine; flossing, though, is a different matter for some. They may feel it’s too time-consuming or too hard to perform. Patients with orthodontic appliances especially may encounter difficulty navigating the floss around the appliance hardware.
Flossing, though, is extremely important for removing bacterial plaque, the primary aim of oral hygiene. This thin film of food remnant that builds up and sticks to the teeth is the breeding ground for bacteria that cause both tooth decay and periodontal (gum) disease. It’s important that as much plaque as possible is removed from the teeth and gum surfaces every day. While brushing removes plaque from the open surfaces of the teeth, flossing removes plaque clinging between teeth and around the gums that can’t be accessed with a toothbrush.
If traditional flossing is too difficult, there’s a viable alternative using an oral irrigator. Also known as a water flosser, an oral irrigator directs a stream of pressurized, pulsating water inside the mouth to blast away plaque in these hard to reach places. The hand applicator comes with a variety of tips that can be used for a number of dental situations, such as cleaning around braces or implants. In home use since the early 1960s, the latest versions of oral irrigators have proven to be very effective, especially for orthodontic patients — research shows an oral irrigator used in conjunction with brushing can remove up to five times more plaque than just brushing alone.
That being said, traditional flossing is also effective at plaque removal when performed properly. Sometimes, resistance to flossing can be remedied with a little training during dental checkups. We can work with you on techniques to improve your flossing activity, as well as train you to use an oral irrigator.
Whichever method you choose, it’s important for you to incorporate flossing (or irrigation) into your daily routine. Removing plaque, especially in those hard to reach places, is essential for reducing your risk of developing destructive dental disease.
If you would like more information on flossing or oral irrigation, 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 “Cleaning Between Your Teeth.”