Does Your Dentist Practice Oral Medicine?
Dentistry is about more than just checking your teeth. Most dentists have extensive training, education, and knowledge of systemic and oral diseases, and the symptoms to be on the lookout for. A good dentist will know how to diagnose these conditions, refer you to specialists, and sometimes prevent them from progressing. All of this adds up to comprehensive dental healthcare for you and your family.
Conditions Associated With Oral Medicine
-Oral Cancer – Can be diagnosed in early stages by your dentist. If oral cancer is not diagnosed early, it can be life threatening. About 40,000 new oral cancer cases are diagnosed each year in the United States alone. Overall survival rate at the 5 year mark is just 42%. However, if diagnosed early, the survival rate significantly improves to just over 90%.
Routine dental examinations include a full head and neck examination. This allows the dentist to monitor for any changes in the tissue. Also, many dentists use a VELscope for early oral cancer detection. The VELscope is a special light that allows the dentist to see changes in the tissue before the naked eye can see them. This improves chances of early diagnosis via biopsy and thus, higher chance of survival.
If oral cancer diagnosis is confirmed, the patient needs to be monitored during cancer treatment to ensure there is minimal detrimental effect to the teeth and oral tissues. Chemotherapy tends to create oral issues like xerostomia (increases chance of fungal infections of the mouth), mucositis (very painful mouth irritations), tooth decay(due to dry mouth), radiation necrosis (bone death), and periodontal disease. This is why it is recommended that care is coordinated between the oncologist, physician, and dentist.
Following treatment, it is imperative to get routine oral cancer screenings as the chance of oral cancer recurring is quite high.
-Temperomandibular Joint Disorder (TMD) – TMD issues can be extremely painful and uncomfortable. As TMD progresses it creates an imbalance in the facial muscles and bone structure leading to issues with simple facial movements and even chewing. Once it gets to this point, the issues get worse as the pain just increases as well as the imbalance. These patients will be at increased risk for tooth decay and periodontal disease since they will be unable to properly perform routine oral hygiene maintenance.
Treatment for TMD ranges from medications and steroids to manage the discomfort and pain to surgical options. Surgery is always the last resort as the surgery does not always pose the answer patients are looking for. Botox is a newer treatment used to freeze the muscles and attempting to restore facial muscular harmonies before the situation gets worse.
-Anemia- Patients who are anemic tend to lose papilla on the tongue, giving it a bald appearance, also, fissures of the tongue increase in depth. Anemics also tend to crave ace, and brgin to chew on ice. This is a habit that can easily cause tooth fractures.
-Herpes Simplx Viruses (HSV) - This virus is responsible for cold sores (HSV-1) and genital herpes (HSV-2). Studies have shown that almost 70% of all Americans have been exposed to the herpes simplex virus. Luckily, even if exposed they do not always show symptoms of the virus. Those that do will show the classic mouth sores around the lips. These sores or blisters can be quite uncomfortable and embarassing.
Herpes Simplex virus generally does not affect our oral health unless they are so uncomfortable that we are unable to maintain proper oral hygiene. Treatments for cold sores include changes in diet, increase intake of certain vitamins like E and Zinc, as well as pharmaceutical options. Pharmaceutical options include Xerese and Viroxyn. Both have been shown to be effective in limiting symptoms of outbreaks.
-Canker Sores (also called apthous ulcers) – Often confused with cold sores, they are very different. Most canker sores are single, isolated oral lesions usually caused by stress or trauma to oral tissues. Canker sores can occur a few times per year but are not known to be contagious. It is believed that canker sores have a genetic component to them but studies have not confirmed this to date.
It should be noted that canker sores can also be the sign of something more ominous and should be ruled out. General rule of thumb, is if they go away in under 7-10 days, only appear a few times per year, and are small there should be nothing to worry about. However, if they are large, last longer than 7-10 days and occur much more frequently, the patient should be investigated further for the presence of a systemic disorder. These disorders could include anemia, autoimmune disorders, or even inflammatory bowel disease. Sometimes the answer can be as easy as changing your toothpaste to a brand that is SLS (sodium laryl sulfate) free.
Treatment for canker sores include cauterization of sore (to facilitate faster healing), use of topical corticosteroid, or application of Debacterol. Most people will just allow the lesion to heal on its own. If the sore are SLS related, then changing toothpaste to a non-bubbling, SLS-free brand can bring instant relief.
-Autoimmune diseases- Many different autoimmune diseases cause issue in the mouth, or face, and jaw joint. Oral fungal infections, arthritic TMJ, oral tissue sloughing and blistering, facial rashes, bone growth, and other symptoms can give your dentist reason to refer you to an immunologist for a thorough workup.
Oral Medicine Conclusion
The bottom line is a well educated and trained dentist is capable of diagnosing more than just tooth decay. Your oral health is inherently linked with your general health. Understanding the importance of regular dental care for you and your family will allow you to get a jump on many diseases that might develop. Early diagnosis is the key to treating many conditions and diseases.