Posts for tag: oral health
We’ve come a long way since the early 1980s when we first identified the HIV virus. Although approximately 35 million people worldwide (including a million Americans) now have the virus, many are living relatively long and normal lives thanks to advanced antiretroviral drugs.
Still, HIV patients must remain vigilant about their health, especially their oral health. In fact, problems with the teeth, gums and other oral structures could be a sign the virus has or is moving into the full disease stage, acquired immunodeficiency syndrome (AIDS). That’s why you or a loved one with the virus should maintain regular dental checkups or see your dentist when you notice any oral abnormalities.
One of the most common conditions among HIV-positive patients is a fungal infection called candidiasis (or “thrush”). It may appear first as deep cracks at the corners of the mouth and then appear on the tongue and roof of the mouth as red lesions. The infection may also cause creamy, white patches that leave a reddened or bleeding surface when wiped.
HIV-positive patients may also suffer from reduced salivary flow. Because saliva helps neutralize excess mouth acid after we eat as well as limit bacterial growth, its absence significantly increases the risk of dental disease. One of the most prominent for HIV-positive patients is periodontal (gum) disease, a bacterial infection normally caused by dental plaque.
While gum disease is prevalent among people in general, one particular form is of grave concern to HIV-positive patients. Necrotizing ulcerative periodontitis (NUP) is characterized by spontaneous gum bleeding, ulcerations and a foul odor. The disease itself can cause loosening and eventually loss of teeth, but it’s also notable as a sign of a patient’s deteriorating immune system. The patient should not only undergo dental treatment (including antibiotics), but also see their primary care physician for updates in treating and managing their overall symptoms.
Above all, HIV-positive patients must be extra diligent about oral hygiene, including daily brushing and flossing. Your dentist may also recommend other measures like saliva stimulators or chlorhexidine mouthrinses to reduce the growth of disease-causing bacteria. Together, you should be able to reduce the effects of HIV-induced teeth and gum problems for a healthier mouth and better quality of life.
If you would like more information on oral care for HIV-AIDS patients, 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 “HIV-AIDS & Oral Health.”
There’s been a growing awareness about the effects of gluten, a protein found in grains like wheat, rye and sometimes oats, on certain people. An estimated 1 in 133 Americans have Celiac Disease (CD), a gluten-related disorder that causes the body’s immune system to work against itself. And if you have CD, you could eventually face dental problems like enamel pitting and erosion.
When a person with CD consumes gluten, their immune system mistakenly identifies the protein as malicious and attacks it. The attack occurs in the membranes that line the digestive system, which in the process destroys cilia, tiny hair-like structures that aid in food absorption. This disrupts the body’s normal absorption of nutrients, which can lead to a number of systemic conditions including intestinal cancer.
Because of the lack of nutrients, your teeth’s enamel may develop defects. You may begin to see dull spots or pitting, or chalky grooves in its normally shiny surface: this is a sign you’ve lost surface enamel crystals (decalcification). You may also be more susceptible to outbreaks of aphthous ulcers (canker sores).
Because symptoms can be misdiagnosed or go unnoticed, it may be years before you know you have CD. You can, however, get a definitive diagnosis through a blood test for gluten antibodies, which is then confirmed with a biopsy of a tissue specimen from the intestine.
While there’s ongoing research for CD-related medication, there’s currently only one recognized treatment for it — remove gluten from your diet. This is much harder than it sounds, and requires knowing what you can and can’t eat, along with strict monitoring of food package labeling. Thankfully, the world is becoming better educated in this respect as more food manufacturers are clearly labeling products containing gluten and restaurants are providing gluten-free menu options.
Once you have dietary controls in place, your dental issues can be treated as any other person, with one exception: none of the products used in treatment like polishing paste or fluoride gels should contain gluten, and must be verified before using.
CD is a serious condition that could even become life-threatening. Knowing you or someone in your family has it will help you protect both your overall health and your teeth.
If you would like more information on the gluten’s effect on dental 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 “Gluten & Dental Problems.”
What does November make you think of? Pumpkins? Turkeys? Dry leaves and frosty mornings? How about cigarette butts?
If you’re wondering about the last item, remember that November 15 is the date of the Great American Smokeout—a day set aside for those who want to take the first steps toward quitting the tobacco habit. While the percentage of smokers in the U.S. has dropped to less than 16% in recent years, according to the American Cancer Society there are still some 38 million Americans who smoke cigarettes. Smoking causes over 480,000 deaths every year, and is the leading preventable cause of death in the U.S.
Even if it doesn’t kill you, the effects of tobacco use can be devastating to your entire body—including your mouth. Whether you smoke cigarettes or use chewing tobacco, your risk of oral cancer is greatly increased, as is your chance of developing periodontal (gum) disease. What’s more, smoking can mask the symptoms of gum disease, so your condition is actually worse than it appears. Severe gum disease is one reason why smokers tend to lose more teeth than non-smokers.
In addition, because smoking interferes with the natural healing process, smokers have a much greater chance of dental implant failure. Tobacco use also can lead to increased amounts of plaque, which results in tooth decay and other oral health problems. It also stains your teeth, reduces your senses of smell and taste, and gives you bad breath.
Ready to quit yet? If so, there are lots of resources to help you on the road to a healthier life. The American Cancer Society, sponsor of the Smokeout, can help you make a plan to quit tobacco—and stay off it. It’s not easy, but over a million Americans do it every year. See their website for more information, plans and tips on quitting. Your health care professionals are also a great source of information and help when it’s time to get off the tobacco habit. Feel free to ask us any questions you may have.
And here’s the good news: The moment you quit, your body begins to recover from the effects of tobacco use. In just one year, you’ll have cut your risk of heart attack and stroke in half. After 5 to 15 years, your risk of stroke, coronary heart disease, and several other conditions is the same as someone who has never smoked.
If you have questions about smoking and oral health, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Dental Implants and Smoking.”
Cancer treatment can be an all-out battle with intense side effects for your entire body. One particular area that can suffer is your mouth.
Chemotherapy and radiation target and destroy cancer cells, which can lead to non-cancerous cells caught in the crossfire and also destroyed. The salivary glands in the mouth are prone to such damage, which could greatly impact your ability to ward off dental disease.
Saliva, what salivary glands produce, plays a major role in oral health. The bodily fluid disseminates antibodies throughout the mouth that fight disease-causing bacteria. It also neutralizes acid, which can erode tooth enamel, and helps restore lost minerals to the enamel.
If the salivary glands become damaged, however, they may produce less saliva and create a condition called xerostomia or “dry mouth.” This is a common occurrence for cancer patients, which can rob them of saliva’s benefits and make them more susceptible to tooth decay or periodontal (gum) disease. The end result could be tooth loss.
There are things you and your dentist can do to prevent this. First, have a complete dental checkup before undergoing cancer treatment. If at all possible have any necessary dental work undertaken (with adequate recovery time afterward) before beginning chemo or radiation. Your dentist and oncologist (cancer specialist) may need to coordinate any planned dental work.
You should also practice daily oral hygiene with brushing and flossing, along with keeping up your regular dental cleanings. This will prevent the buildup on teeth of bacterial plaque, which in turn will reduce your chances for dental disease. Your dentist may also prescribe antibacterial as well as fluoride mouth rinses to help limit the growth of oral bacteria.
To minimize dry mouth, increase your water consumption as much as possible. You may also use saliva boosters like xylitol, an alcohol-based sweetener found in many gums or mints that promotes salivation (it also deters oral bacterial growth).
And don’t forget to maintain a healthy diet, which will not only benefit your stamina during cancer treatment but can also help you maintain better dental health. Providing good care for your mouth during this trying time will help ensure your teeth and gums stay as healthy as possible.
If you would like more information on oral care, 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.”
As dentists, we often see other mouth problems besides those with teeth and gums. One of the most common is cracking around the corners of the mouth. Although usually not serious, it can be irritating and uncomfortable.
Medically known as angular cheilitis (literally “an inflammation of the angles of the lip”), it’s also called perleche, derived from the French lecher, “to lick.” The latter moniker aptly describes the tendency of sufferers to compulsively lick the sores to relieve irritation, which actually can make things worse.
Perleche has a number of possible causes, mostly from in or around the mouth (although systemic diseases or medications can cause it on rare occasions). It’s often found among younger people who drool during sleep or older people with deep wrinkles along the sides of the mouth that increase the chances of dryness and cracking. Long-term wind or cold exposure, ill-fitting dentures or a lack of back teeth (which help support facial structure) may also contribute to the condition.
Patients with perleche can also develop yeast infections from a strain called candida albicans. The infection can spread through the whole mouth, significantly increasing the chances of physical discomfort.
Treating perleche often involves topical ointments with inflammation-reducing steroids and zinc oxide, which has antifungal properties, to provide an environmental barrier during the healing process. If a yeast infection occurs, we may treat it with oral or topical antifungal medication like Nystatin for the whole mouth and chlorhexidine rinses, which has antibacterial properties.
It also helps to adopt a few preventive measures that can minimize the occurrence of perleche. If you wear dentures, for example, cleaning them often (including, if necessary, with chlorhexidine) and leaving them out at night reduces bacterial and fungal growth. We can also see if your dentures are fitting properly. Replacing missing teeth provides better facial support and could minimize wrinkling around the mouth. And, of course, keeping up daily brushing and flossing helps ensure a healthy and disease-free mouth.
If you’re experiencing cracked mouth corners, let us know at your next appointment. With our help and of other medical professionals we may be able to give you relief from this irritating condition.
If you would like more information on gaining relief from angular cheilitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Cracked Corners of the Mouth.”