Dental Calamities

Dental Calamities That Can Truly Hurt

• DENTAL cavities are not good news, but when it comes to preventive oral health, they may be among the smaller problems.
• The advice is familiar: brush and floss regularly, use fluoride mouthwash, limit snacks and sweet drinks, visit the dentist twice a year. Good suggestions, even if not everyone follows them: by age 12, 50 percent of children have cavities. But there are two much more serious problems, common dental diseases that can lead not only to loss of teeth but also to loss of life: periodontal disease and oral cancer.
• Periodontal disease — a chronic bacterial infection of the gums that destroys the bone and tissues that hold the teeth — is the leading cause of tooth loss in adults. Some people are genetically susceptible, and the problem can be aggravated by smoking, taking certain medications, stress and other factors.
• Several studies have found that gum disease is associated with an increased risk for heart attack. “It isn’t nailed down yet,” said Dr. Martin J. Davis, professor of clinical dentistry at the College of Dental Medicine at Columbia, “but there seems to be a link between the inflammation of gums and the inflammatory markers of heart disease.”
• It may be that oral bacteria enter the bloodstream, attach to fatty plaques in the coronary arteries and cause clots to form. Or maybe inflammation itself increases plaque buildup. A 2007 study showed that periodontal disease increased the risk of heart disease in men by one third and doubled it in women, even after controlling for smoking.
• Studies also suggest that gum disease is associated with the risk for stroke, altered glycemic control in people with diabetes and adverse pregnancy conditions like pre-eclampsia (pregnancy-induced high blood pressure), low birth weight and preterm birth. When periodontal disease is treated by reducing inflammation and lowering the quantities of harmful bacteria in the mouth, it can have a major impact on inflammation in the rest of the body.
• Smoking and alcohol abuse are the major causes, but 25 percent of oral cancers appear in people who have never smoked or drunk to excess. The suspected cause of at least some of these cancers is human papillomavirus, or H.P.V., the same sexually transmitted virus that causes most cervical cancers, which can invade the mouth during oral sex. For now, prevention, screening and early treatment are crucial to lowering the death rate.
• The first sign of oral cancer is often a tiny white or red spot in the mouth, but the disease can be detected before a sore appears. In the last two or three years, manufacturers have produced noninvasive devices for detecting abnormal tissue that may be invisible to the naked eye, and some dentists are beginning to use them, even though their effectiveness remains controversial.

Health Sense : Teeth and oral cancer: How to detect and treat it?

 

While most people are familiar with high blood pressure and diabetes, not many have heard about oral cancer and its devastating effects. 

About 640,000 cases are diagnosed every year worldwide and only about 50 percent of these patients will still be alive five years’ later. These grim statistics are testament to the fact that the disease is often discovered too late. 

The five-year survival rate for early-stage oral cancer is more promising, however, at 80 to 90 percent. But, in the case of late-stage cancer, these rates go down to 20 to 30 percent. Unfortunately, most cases of oral cancer may start as a small red or white patch in the mouth, which patients do not notice. It can take only two or three months for early-stage oral cancer to progress to a late stage, when it invades the tissues and becomes an ulcer or swelling, sometimes spreading to the neck. 

Heavy smoking and alcohol consumption are the main risk factors in the West, though in this part of the world, habits such as chewing betel nut, which contains nicotine, are also a major cause of the 
disease. 

There are many oral screening methods, one of which is the Velscope, which was used for a mouth-cancer awareness campaign in Singapore. Velscope uses a special filter to detect alterations in the fluorescence of oral mucosal tissues and has been reported to be a useful way to detect early carcinogenic changes. 

This is principally due to ignorance, and a study in India has validated that early detection could reduce late-stage oral cancer and directly improve survival rates. With some modifications to the study, we devised a system of oral self-examination so that patients could examine their own mouths more adequately and on a regular basis, and then report to a doctor or dentist if there was a suspicion of something wrong. This method consists of ten quick steps that a patient can easily use on a daily basis to look carefully into the mouth to detect early oral cancer; it functions in the same way as women conducting self-examination of their breasts for the early detection of breast cancer. 

Another condition, though not deadly, and one that is common among young people is the problem of wisdom teeth. These teeth typically appear in people aged between 18 to 21 years old and being the last to erupt, there is often a lack of space, which results in them growing abnormally. 

The gums overlying these partially buried teeth can become infected, and cause a painful condition called pericoronitis. This is when most patients will present themselves to the clinic. 

Most impacted wisdom teeth can be removed surgically in ten minutes by an experienced oral and maxillofacial surgeon. 
More serious complications, such as numbness of the lips and tongue, can occur if the surgeon is inexperienced and damages these nerves. Cone-beam CT scans constitute the latest technology, and are very useful for planning implant surgery as well as other surgical procedures, as it allows the surgeon to visualize the precise anatomy of the problem.