Posts for tag: oral health
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
Cancer treatment can consume all of your focus to the exclusion of other health issues. But these other issues still need attention, especially how treating cancer could affect other parts of your body. That definitely includes your teeth and gums.
Treatments like radiation or chemotherapy eradicate cancer cells disrupting their growth. Unfortunately, they may do the same to benign cells — “collateral damage,” so to speak. This could cause a ripple effect throughout the body, including in the mouth. Radiation, for example, could damage the salivary glands and result in reduced salivary flow. Because saliva neutralizes acid and diminishes bacterial growth, your risk for tooth decay as well as periodontal (gum) disease could increase.
While you may be able to recover from reduced salivary flow after treatment, your health could suffer in the meantime, even to the point of tooth and bone loss. Fortunately, there are some things we can do before and during your treatment.
If you can, have any necessary dental work performed well before you begin cancer treatment. You’ll be more resistant to side effects if you can start treatment with as healthy a mouth as possible.
Keep up your regular dental visits if at all possible, or see us if you begin seeing signs of dental disease. By staying on schedule, we’ll have a better chance of detecting and treating problems before they advance too far; we may also be able to provide preventive measures like topical fluoride applications to help keep your teeth resistant to disease. If you need more extensive treatment like tooth extraction or surgery we may need to coordinate with your cancer treatment provider.
Above all, continue to practice daily brushing and flossing to remove plaque, the main cause of dental disease. Drink plenty of water or take substances that boost salivation. And be sure to eat a nutritious diet while also reducing or eliminating tobacco or alcohol from your lifestyle.
Taking these steps will help protect your teeth and gums during cancer treatment. As a result, you have a better chance for maintaining your dental health during this critical time in your life.
If you would like more information on dental care during cancer treatment, 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 Health During Cancer Treatment.”
Eating is one of the pleasures — and necessities — of life, but people who suffer from temporomandibular joint disorders (TMD) may find eating no pleasure at all — and they may not be eating the right nutritional balance of foods.
TMD is a collection of conditions that affect the jaw joints, connecting muscles and other related facial structures. If you've been diagnosed with TMD, you're probably not only acquainted with severe pain, but also difficulty opening your jaw as widely as normal. This can make it difficult to chew certain foods.
There are a number of effective treatments for TMD, including thermal therapy (hot or cold packs), joint exercise, medication or surgery (as a last resort). But these treatments often take time to make a noticeable difference. In the meantime, you may still need to change what and how you eat to ensure you're getting the nutrients your body needs.
The overall strategy should be to soften and reduce the chewing size of your food. With fruits and vegetables, you'll want to peel and discard any hard or chewy skins, and then chop the fruit flesh into smaller pieces. Steam or cook vegetables like greens, broccoli or cauliflower until they're soft and then chop them into smaller portions. You might also consider pureeing your fruit (and some vegetables) to make smoothies with ice, milk or yogurt, or vegetable-based soups.
Treat meat, poultry or seafood in much the same way, especially biting sizes. Besides cooking meats to tenderness, include moisteners like broths, gravies or brazing liquids to further make them easier to chew.
Dairy foods are an important source of nutrition: eat milk-based products like yogurt or cheese as much as you can handle. If you have problems with these or also nut butters, then consider meal replacement beverages like instant breakfast or whey protein beverages.
And don't forget whole grains. Although some can be hard to chew, you can prepare them in hot cereal form (like oatmeal) to tenderize them. You can also prepare thin bread toast and cut into smaller pieces.
Hopefully, your treatment will bring your TMD symptoms under manageable control. Until then (and after, if need be) adjust your diet to eat the foods that keep you healthy.
Although normally benign, a cold sore outbreak can be irritating and embarrassing. Understanding why they occur is the first step to minimizing outbreaks.
The typical cold sore (also known as a fever blister) is caused by the Herpes Simplex Virus (HSV) Type I, medically known as “Herpes Labialis” because it occurs on or around the lips. This virus is not to be confused with HSV Type II, which causes a genital infection. Unlike most viruses, HSV Type I can cause a recurring sore outbreak in certain people. Most viruses tend to occur only once because the body produces anti-bodies to prevent further attack; it’s believed HSV Type I, however, can shield itself from these defenses by hiding in the body’s nerve roots.
These cold sore outbreaks often occur during periods of high stress, overexposure to sunlight or injuries to the lip. Initially you may have an itch or slight burning around the mouth that escalates into more severe itching, redness, swelling and blistering. The sores will break out for about a week to ten days and then scab over and eventually heal (unless they become infected, in which case the healing process may go longer). You’re contagious between the first symptoms and healing, and so can spread the virus to other people.
In recent years, anti-viral prescription medications have been developed that can effectively prevent HSV outbreaks, or at least reduce the healing time after an occurrence. The most common of these are acyclovir and valcyclovir, proven effective with only a few possible mild side effects. They can be taken routinely by people with recurring cold sores to suppress regular outbreaks.
While HSV Type I cold sores are more an aggravation than a health danger, it’s still important for you to see us initially for an examination if you encounter an outbreak. It’s possible for a more serious condition to masquerade as a cold sore or blister. A visit to us may also get you on the right track to reducing the frequency of outbreaks, as well as minimizing discomfort when they do occur.
If you would like more information on the treatment of cold sores, 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 “Cold Sores.”
Periodontal (gum) disease is the most likely cause of a loose, permanent tooth. This progressive infection causes damage to the gums and bone tissues that hold teeth in place, leading to looseness and ultimately tooth loss.
Gum disease, however, isn’t the only cause: although not as common, excessive biting forces over time may also lead to loose teeth. The excessive force stretches the periodontal ligaments that hold teeth in place, causing the teeth to become loose.
This condition is called occlusal trauma. In its primary form, the patient habitually grinds or clenches their teeth, or bites or chews on hard objects like pencils or nails. Generating 20-30 times the normal biting force, these habits can cause considerable damage. It can also be a factor when gum disease is present — supporting bone becomes so weakened by the disease, even normal biting forces can cause mobility.
If you recognize the early signs of grinding or clenching, particularly jaw soreness in the morning (since many instances of teeth grinding occur while we sleep), it’s important to seek treatment before teeth become loose. The symptoms are usually treated directly with muscle relaxants, an occlusal guard worn to soften the force when teeth bite down, or stress management, a major trigger for teeth grinding. The sooner you address the habit, the more likely you’ll avoid its consequences.
If, however, you’re already noticing a loose tooth, treatment must then focus on preserving the tooth. Initially, the tooth may need to be splinted, physically joined to adjacent teeth to hold it in place while damaged tissues heal. In some cases, minute amounts of enamel may need to be removed from the tooth’s biting surfaces to help the tooth better absorb biting forces. Other treatments, including orthodontics and gum disease treatment, may also be included in your treatment plan.
If you notice a loose tooth, it’s critical you contact us as soon as possible for an evaluation — if you delay you increase the chances of eventually losing it. The earlier you address it, the better your chances of preserving your tooth.
If you would like more information on loose teeth, 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 “Loose Teeth.”