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More than 34,000 Americans will be diagnosed with oral or pharyngeal cancer this year. It will cause over 8,000 deaths, killing roughly one person every hour, every day. Of those 34,000 newly diagnosed individuals, only half will be alive in 5 years.

The two most common pathways by which most people develop oral cancer is through tobacco and alcohol use and through exposure to the human papilloma virus (HPV) - the same virus responsible for the majority of cervical cancers in women.

Oral cancer often starts as a tiny, unnoticed white or red spot or sore somewhere in the mouth and often goes unnoticed until it has metastasized (spread) into another part of the body. It can affect any area of the mouth including the lips, gums, cheek lining, tongue, and the hard or soft palate. When found early, oral cancers have an 80 to 90 % survival rate. Dental professionals can act as a first line of defense in the early detection of oral cancer. Dr. Collins includes oral cancer screening as part of a routine oral exam.

Knowing the early signs can increase survival. Early signs include:

		A sore that bleeds easily or does not heal.
		A color change of the oral tissues.
		A lump, thickening, rough spot, crust or small eroded area.
		Pain, tenderness, or numbness anywhere in the mouth or on the lips
		Difficulty chewing, swallowing, speaking or moving the jaw or tongue.
		A change in the way the teeth fit together.

While oral cancer has been found in individuals with no risk factors, the disease most often occurs in individuals that use tobacco in any form. Alcohol in addition to tobacco increases the risk even more. Oral cancer is more likely to occur in individuals over 40 years old and in those with prolonged sun exposure. Eating a diet high in fruits and vegetables may help prevent cancer.

If you notice any unusual spots anywhere in your mouth, contact Dr. Collins immediately for an exam. Be sure to note how long the spot has been there and if it has grown or changed in color or consistency. Remember, early detection is the best strategy for survival.

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Teeth Straightening with Invisalign

One of the more recent technologies, Invisalign uses very thin clear trays is sequential order to correct issues with crownding and spacing in smiles. They are so thin, people don't know you're wearing them! Ask Dr. Collins or Sylvia for more information, or check out Invisalign will it work for me.

Curious how it works? here's a YouTube video that shows how it works.

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Dentistry has come a long way since wooden dentures were used to replace George Washington's teeth! Nowadays, when you are missing one or more teeth, there are a variety of methods to replace them, including removable appliances, fixed bridges and implants. Dr. Collins will discuss your options with you and help you decide the method that is best for you.

What are implants? Implants have been around for many years and have gained wider and wider acceptance over time as they have proved a successful method for replacing missing teeth. They offer a way to have artificial teeth that look natural and feel secure.

The implant itself, often made of titanium, is used like an artificial root to support the false tooth or teeth. The dental surgeon, usually a periodontist (gum specialist) or an oral surgeon, places the implant into a hole made in the jawbone. A post can then be secured to this “artificial root” and can be used to secure a prosthetic device, such as a crown or bridge, above the gum. Implants can also be used in conjunction with a removable denture to create a more secure and stable base for the denture.

Why implants? Implants have some advantages over removable dentures. Because removable dentures are not permanently fixed in place, they can move around when you eat and speak. Additionally, over time the bone that supports the denture changes and shrinks, making it increasingly difficult to support a denture comfortably.

Implants also have some advantages over fixed bridges, especially when the teeth adjacent to the missing tooth or teeth are healthy. In order to create a fixed bridge, your CDA member dentist must usually place crowns on these adjacent teeth – as they are the support for the replacement tooth or teeth. If these teeth are free from decay and existing restorations, you may prefer to leave them in their natural state, rather than alter them to hold the necessary supporting restorations. Implants replace the missing tooth or teeth while leaving all adjacent teeth unaltered.

How successful are implants? While implants are highly successful, the likelihood of success depends on several factors. The amount of bone available to support the implant, the patient’s health, whether or not the patient smokes and the quality of ongoing home care all effect long-term success.

Remember, replacing missing teeth is important to maintaining good dental health. Dr. Collins will evaluate the conditions in your mouth and help you decide if you are a good candidate for implants.

Courtesy of California Dental Association Website

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Bad breath, also called halitosis, is a common condition and sometimes a distressing source of embarrassment. Frequently, people aren't even aware there is a problem. While there are many causes for bad breath, it most commonly results from a lack of good oral hygiene. Daily brushing and flossing and regular dental checkups and cleanings are the best prevention for bad breath.

However, when bad breath persists, despite good oral health, there may be other reasons for mouth odor and a consultation with Dr. Collins or physician is in order.

The odor may result from the air you exhale.
Aromatic foods, especially garlic and onions, are often the source of breath odor. Food that is absorbed into the bloodstream is transferred to the lungs, where it is expelled, often with the odor still recognizable. Brushing, flossing and mouthwash will only mask the odor temporarily. Odors continue until the body eliminates the food. Additionally, during the digestion process, the odor may make its way back up the esophagus and is expelled during talking and breathing.

Sometimes odors emanating from the lungs or sinuses will contribute to bad breath. A sinus infection, bronchitis, or other respiratory tract infection can sometimes be detected through breath odor. Furthermore, post-nasal drip that collects at the back of the throat can be a source of mouth odor. Gargling mouthwash can help wash away fluids that coat the throat, reducing this effect.

Tobacco use is another common source of mouth odor, as the tobacco smoke is inhaled, so it is exhaled. If you use tobacco products, consult with your dentist for advice and support on how to quit.

A dry mouth may be the culprit.
Good saliva flow cleanses the teeth and tissues, and is essential to keeping the mouth healthy and in balance. A common side effect of many medications is reduced saliva flow, which results in a dry mouth (also called xerostomia) and increased mouth odor. Dry mouth may also be caused by other problems involving the salivary glands or from continuously breathing through the mouth. Several over-the-counter products are available for xerostomia and Dr. Collins or one of our hygienists can advise you on the best way to manage this condition.

There are other medical conditions that contribute to mouth odor.
Beyond infections of the sinuses and lungs, there are other medical conditions that can sometimes be detected through mouth odor. These include diabetes, gastrointestinal disturbances and liver or kidney ailments. If Dr. Collins determines that your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of bad breath.

What else can you do?
The best control for mouth odor is good oral hygiene. Mouthwashes and breath sprays are mostly cosmetic and do not have a long-lasting effect. Additionally, breath mints generally contain sugar or citric acid and, when allowed to dissolve slowly in the mouth are decay producing. These products should be used sparingly. If you constantly use one of these products to mask mouth odor, talk to Dr. Collins or one of our hygienists.

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Xerostomia is the medical term for a dry mouth due to lack of saliva. Dry mouth can cause difficulty eating and talking and can also lead to halitosis (bad breath). Without saliva to lubricate the mouth, wash away food particles, balance the acidity of the mouth, and remineralize the teeth, cavities and other infections can easily form.

Seniors are particularly susceptible to dry mouth because they often take multiple medications to control diseases they have developed throughout their lifetime. Seniors are also more likely to have teeth with exposed roots due to a number of factors including, but not limited to their age, tobacco use, and oral hygiene habits. Root surfaces become exposed when the bone around the teeth is lost, usually caused by gum disease. Root surfaces are more prone to cavities because they do not have enamel to protect them. The combination of exposed root surfaces and dry mouth increases the likelihood of cavities forming.

Causes of Dry Mouth

Medication: Medication is the most common cause of dry mouth; over 400 common prescriptions and over-the-counter drugs are known to cause dry mouth.

Radiation and Chemotherapy: Individuals who undergo radiation or chemo-therapy for head and neck cancers experience xerostomia. The salivary glands can be permanently damaged and saliva can be reduced and/or its consistency changed.

Disease: Dry mouth may be a sign of an underlying disease such as diabetes or Sjögren's syndrome, a disorder in which immune cells attack and destroy the tear and saliva glands.

Substance Abuse: Dry mouth is a common symptom of substance abuse as many drugs reduce saliva production. Abusers tend to have a higher incidence of cavities and gum disease and often develop meth mouth.

What dry mouth looks like on the tongue

Solutions

Although there is no cure for xerostomia, there are steps you can take to help manage this condition. Drink plenty of water and/or sugar free beverages. Chew sugar free gum containing xylitol; gum stimulates saliva production and xylitol helps protect teeth against cavities. Avoid tobacco, caffeine, and alcohol. If you use mouthwash, be sure it is alcohol free. Use a saliva replacement gel to help lubricate your mouth; they are available at drug stores. Talk to your dentist and physician about changing your medications to ones that do not cause dry mouth.

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One word: bruxism. Also known as teeth grinding. Many people suffer from this disorder unknowingly, as it usually occurs during sleep. And, unless the constant racket of your grinding is keeping someone else awake, you may not think your sore jaw, restless sleep and general fatigue are symptoms of bruxism. Left untreated, it could lead to painful or loose teeth, or teeth that are literally ground down, leaving worn surfaces or fractured enamel. While your dentist can usually detect the telltale signs of wear on your teeth, if you suspect you might have a grinding problem, be sure to mention it at your next visit. Your dentist can then determine the cause and appropriate treatment of your problem.

A major cause of bruxism is stress. Dr. Collins dentist may recommend that you wear a plastic mouth guard at night to prevent grinding. The custom-made guard keeps the upper and lower teeth from coming together, helping to relax your jaw muscles, and making it impossible for you to grind your teeth against one another. He may also prescribe muscle relaxants or anti-inflammatory medications.

If an abnormal bite, or crooked or missing teeth are causing you to grind, Dr. Collins may treat your bruxism by removing the high spots on the problem teeth. In more serious cases, he or she will reshape or reconstruct the biting surfaces of the problem teeth with crowns or inlays or may even suggest orthodontic treatment to establish a more functional bite.

If you want to get your grinding under control, talk to Dr. Collins. With the proper treatment, he can help alleviate the pain in your jaw, improve your sleep, and protect your teeth from abnormal wear.

Courtesy of California Dental Association Website

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Preventing tooth decay can become even easier. You may already be aware that daily brushing and flossing are the most important weapons against the formation of plaque, the primary cause of cavities. In addition to your regular routine of brushing and flossing, your dentist can apply a coat of plastic material - called a sealant - on the top or biting surfaces of your back teeth. This plastic coating creates a barrier on your teeth and seals out the decay-causing bacteria that live in plaque.

What is plaque and why does it cause cavities?

The food and liquids you eat and drink combine with bacteria to produce a sticky film called plaque. Plaque attaches on and in between teeth, where it starts to eat away at the tooth enamel. If plaque is not removed regularly by brushing and flossing your teeth, it can produce acids that will create pits or holes (cavities) in the tooth. This is tooth decay.

How can sealants help prevent cavities?

Applying a thin plastic coating to your teeth makes it harder for the plaque to stick to the tiny groves on the biting surfaces of the back teeth - protecting the tooth surface and reducing the risk of forming cavities.

Is it difficult to apply sealants?

No. Sealant placement is quick, simple and painless. Most often, sealants will last for several years. At regular check-up visits, Dr. Collins or the dental hygienist will check to see that sealants are still in place.

Who should get sealants?

Sealants are most effective in reducing cavities in children with newly formed permanent teeth. In fact, all children should have their molars (back teeth) evaluated for sealants soon after they erupt. For most children, this occurs approximately at ages 6 and 12.

Sealants can also be useful in cutting down formation of decay in adult teeth, as well. An application of sealants is a preventative measure to keep teeth healthy. It is an effective way to reduce the need for fillings and more expensive treatments that may be required to repair the damage from cavities, so sealants can save you money.

Ask Dr. Collins whether sealants would be an appropriate treatment for you and your children to help prevent tooth decay.

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Meth-amphetamine is a chemical with stimulant properties similar to adrenaline. It may be snorted, smoked or injected. Meth, like adrenaline, increases heart rate, blood pressure, breathing rate, constricts blood vessels, dilates pupils, releases sugar and fat into the blood stream and energizes the brain. Amphetamines act as an appetite suppressant while producing feelings of well being, exhilaration or euphoria. Meth can also invoke feelings of increased alertness, anger, fear, or agitation. Crystal meth is known by several different names -- crank, crystal, speed, chalk and produces a “high” that lasts much longer than a crack cocaine high; 12 hours versus one hour. Like all addictive drugs, meth produces an initial pleasurable effect followed by a rebound unpleasant effect.

Various reports link the tooth decay associated with meth to the acidic and corrosive effects of the chemicals found in the drug, such as anhydrous ammonia (found in fertilizers), red phosphorus (found on matchboxes) and lithium (found in batteries), which when smoked or snorted might erode the tooth's protective enamel coating; however, it's more likely that this degree of tooth decay is brought on by a combination of drug-induced mental and physical changes resulting in xerostomia (dry mouth), extended periods of poor oral hygiene, frequent consumption of high calorie, carbonated beverages and tooth grinding and clenching.

Some users describe their teeth as “blackened, stained, rotting, crumbling or falling apart.” The extent of tooth decay varies widely among meth users. A 2000 report in theJournal of Periodontology found that users who snorted the drug had significantly worse tooth decay than users who smoked or injected it, although all types of users suffered from dental problems. Often, the teeth cannot be salvaged and must be extracted. Visit a your dentist for a complete exam and to discuss treatment options.

If you use methamphetamine or know someone who does, a visit to a primary care physician is recommended as soon as possible.

Courtesy of California Dental Association Website

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