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For many of us, our ethnicity is not easily seen from outward appearances. As generations go by, the different ethnic backgrounds have been mixed to produce a large variety of people in the world. Recent research has shown that the diverse oral bacteria in our mouths is actually as powerful as a fingerprint. It turns out the bacteria deep within our gums can give clues to our unique ethnic origins.

Ethnicity Study And Oral Bacteria

Research completed at the Ohio State University periodontology department studied the oral bacteria found in different ethnic groups . The researchers identified about 400 species of oral bacteria in the mouths of 100 subjects. The study consisted of 4 ethnic groups: white, non-Hispanic blacks, Chinese, and Latinos.

More than 60 percent of oral bacteria in the human mouth have never been classified, named or studied. The reason being, that  many oral bacteria will not grow in a laboratory culture dish. To get around this problem, the researchers found a different way to identify the different oral bacteria. The solution was to identify different species by utilizing DNA sequencing.

The study found that only a small percentage ( 2%) of the oral bacteria were found in every one of the research subjects. Bacteria were found in different concentrations based upon the subjects ethnicity. The researchers found that each ethnic group was represented by their own unique signature of oral bacteria.

Another research of ethnicity and oral bacteria found that African Americans and Latinos are more susceptible to periodontal disease.

What Does This Mean?

-Some oral bacteria leave us highly susceptible to tooth decay, some to periodontal disease. Knowing who is more prone to which specific oral diseases can make it easier to monitor and prevent.

-Knowing which bacteria you have allows for specific antibiotic regimens to be customized to target your particular bad oral bacteria, and allows you to decrease your odds of succumbing to oral disease.

-Understanding the genetic basis of bacteria allows researchers to study particularly harmful bacteria, and find new ways to battle it.

-Knowledge of your ethnic background may help you understand why you are genetically prone to certain bacteria related diseases and what you can do to improve your overall oral health.

What Your Dentist Can Do For You

-Test your particular oral bacteria via saliva samples sent to MyPerioPath.

-Help you understand your risk factors.

-Custom design an antibiotic regimen to substantially reduce the dangerous oral bacteria present in your mouth.

-Oral hygiene regimen and instruction.

-Monitoring the mouth for disease progression.

 Effects Of Oral Bacteria On Dental Health

Bacteria are present throughout our body. Some bacteria are sticky and form biofilm. A thin grouping of oral bacteria, plaque biofilm, lives on gum tissue and teeth. Plaque is constantly forming on your teeth. The oral bacteria in the biofilm release acids that attack the enamel of our teeth, and break down tissue attachments in the gums. The plaque bacteria can cause tooth decay and periodontal disease. Knowing which bacteria you have present in your oral environment allows you to know what you are up against.

Conclusions From Research Study

Understanding the genetic basis to bacteria not only helps scientists study them and find cures, but can help you fight oral disease.  Being aware of your particular harmful bacteria and potential issues they may cause, could and should lead to a more personalized approach to dental and medical care.

Dental Hygiene - The practice of keeping the mouth, teeth, and gums clean and healthy to prevent oral disease, by regular brushing and flossing and visits to a dentist.

Halloween time is a fun time for the whole family…the weather begins to turn, leaving cooler weather for lots of quality family time. It also means its time to pick out Halloween costumes for the kids and family as well as looking forward to collecting bags full of candy from the neighbors and at school. In those bags of candy lies an unsuspecting hazard…Sugar! Sugar consumption without proper dental hygiene leads to tooth decay.

But this time does not have to be a time being scared of possible dental issues following Halloween. It can give parents and children alike a chance to learn new dental hygiene tricks to maintain their dental health throughout the year.

Dental Hygiene Tips

By following the dental hygiene tips below, parents can help prevent tooth decay for their trick or treaters while teaching them good dental hygiene habits:

1. Be Selective. Not all of the Halloween treats are scary. A good dental hygiene tip is to encourage kids to eat candy that melts fast and can be eaten quickly. Try to avoid gooey, sticky sweets (like caramels) that can linger on in the mouth and on the teeth. This will allow the bacteria in the mouth to produce more acid which will cause tooth decay. Remind kids after eating any sugary candy to brush their teeth or at the very least rinse their mouths out with water. This will lessen the amount of time the sugar stays in contact with the teeth. A really good idea might be to buy a new toothbrush that is Halloween related as a final “treat”.

2. Hide the excess candy. Do not just leave the Halloween candy around the house after the Halloween trick or treating is over. Store it in a secret place out of reach from kids and adults.

3. Avoid grazing. If you maintain dental hygiene tip #2 this should not be an issue. The idea is not to just keep picking at the candy throughout the day. This reduces the time the sugars are in the mouth decreasing chance of tooth decay. A better idea is to hold back candy and use it as an after meal treat. Then have your child immediately brush and rinse to neutralize the sugar and acid production. Another option, if you cannot brush or rinse is to give them a sugar free xylitol gum. The gum will help increase salivary flow which will also help to neutralize the acids in the mouth.

4. Eat a Healthy Meal first. Have children not fill up on snacks and Halloween candy but fill up on a healthy nutritious meal first. This will give them less temptation to overdo their candy consumption. This is a good dental hygiene tip for all year and not just Halloween time.

So there you have it, a few easy dental hygiene tricks to allow you and your family to fully enjoy the Halloween time. Candy is not necessarily the enemy, the enemy is not maintaining a diligent dental hygiene regimen. As always visit your dentist regularly for dental examinations and professional cleanings.

 

Almost one third of all Americans diagnosed with cancer each year will develop oral health issues. Patients who undergo life saving treatments for various cancers are usually unaware they may develop painful and debilitating conditions following their cancer treatment. A thorough dental examination is a critical step in maintaining their overall health throughout cancer treatment. This includes examination prior to, during, and after cancer treatments. Untreated oral disease can also complicate cancer treatment. The dentists role in patient management can be beneficial to the patient beyond their oral cavity.

Cancer can be treated or slowed down with proper treatments like, chemotherapy and radiation therapy. The type of treatment can be very effective but also can have very debilitating or even painful side effects that can can affect other parts of your body. These can include your mouth, teeth, gums, oral tissues and salivary glands. Being aware of these possible cancer treatment side effects can help patients reduce and manage them with help from physicians and dentists alike.

How can your oral health be affected by cancer?

Chemotherapy and radiation therapy treatment for cancer can have oral side effects. This varies depending on the type of cancer and the aggressiveness of the treatment. Those side effects can display

American Cancer Society

American Cancer Society

themselves in different ways:

-Dry Mouth (Xerostomia). Salivary production and flow are affected because the salivary glands can be affected during treatments for cancer.

-Tooth Decay. This can happen very rapidly due to the dry mouth condition.

-Burning Mouth Syndrome. There might be a painful or burning feeling in the mouth, tongue and gums. This also occurs from the reduction in salivary flow.

-Erosion of teeth due to high acid in the mouth following reflux and vomiting

-Stiffness in jaws..

-Problems with eating, speaking, and swallowing.

-Alteration of taste sensation. Your ability to taste properly will decrease..

-Gum inflammation and swelling, Periodontal disease can develop.

-The immune system is weakened.

In order to manage all the side effects from cancer, your dentist can make you recommendations to keep your mouth comfortable and healthy.

Dental Examination Before Treatment of Cancer

A pretreatment dental examination can identify potential issues and help educate the patient about the importance of maintaining good oral care. This examination can be completed by a your local or by a hospital based dentist. The evaluation includes a thorough examination of hard and soft tissues It will also include x-rays to detect trauma and possible sources of infection. Before cancer treatment begins, the dentist can also do the following:

-Removal of orthodontic bands if highly stomatotoxic chemotherapy is planned or if the bands will be in the field of radiation.

-Evaluate comfort and fit of dentures and oral appliances.

-Any teeth that need to be removed or have large fillings, crowns, should be performed at least two weeks prior to the beginning of radiation therapy to allow for proper healing, and at least 7-10 days before myelosuppressive cancer chemotherapy starts.

-For adults receiving head/neck radiation, removing teeth that may pose a problem in the future. The jaw bone , after being exposed to radiation does not heal properly following trauma, a simple removal of a tooth can result in bone death (osteonecrosis) which can destroy large areas of jaw bone. If you receive head and neck radiation you will need to take extreme precaution to avoid needing extractions for the rest of your lifetime.

-For children, consider extracting highly mobile primary teeth and teeth that are expected to fall out during the cancer treatment window.

-Instruct patients on the maintenance of proper oral hygiene, nutrition, the use of fluoride gel, rinses, dry mouth products, and the need to avoid tobacco and alcohol use.

During the examination, the patient will also learn about home care to protect oral tissues and minimize oral complications. The dentist or hygienist will instruct the patient on special brushing and flossing techniques, mouth rinses, and other approaches to keep the mouth as moist and clean as possible to reduce the risk of infection and pain.

Oral Care during Treatment

Even with examinations before cancer treatment, regular oral exams and care are necessary during cancer treatment. Good communication and planning between physician and dentist can reduce the Dental Carerisks of oral complications and maximize the efficacy of dental and supportive care. Specific oral health symptoms to remember when treating patients undergoing chemotherapy or radiation include the following:

Symptoms can include:

-A sticky, dry feeling in the mouth.

-Trouble chewing, swallowing, tasting or speaking due to dryness in oral cavity.

-A burning feeling in the mouth.

-A dry feeling in the throat and tongue.

-Dry,Cracked lips.

-Mouth sores.

-A fungal infection in the mouth or at the corners of the lips, like oral candidiasis.

Chemotherapy Issues

-Fever of unknown origin may be linked to an oral infection.

-Have the patient schedule appointments carefully. Patients should be seen when blood counts will be at safe levels.

-Conduct blood work 24 hours before dental treatment to determine whether the patient’s platelet count, clotting factors, and absolute neutrophil count are at adequate levels to prevent hemorrhage and infection.

-If the patient has a central venous catheter, careful consideration should be given to implementing the American Heart Association (AHA) prophylactic antibiotic regimen before any dental work.

Radiation Therapy Issues

-Treat infections. Ulcerations and dry, friable tissues are easily infected.

-Nutrition.Instruct the patient on the importance of healthy eating to maintain nutritional status, emphasizing the need to avoid foods that irritate sore tissues or cause dental decay.

-Show patients exercises to reduce tightening of mouth muscles,( trismus). Fibrosis of the tissue may occur if the chewing muscles are in the direct field of radiation. Ask your dentist to teach you how to exercise and stretch these muscles properly to avoid or alleviate the symptoms.

Follow up Dental care

Patients may continue their regular dental care schedule once all complications from chemotherapy have subsided and blood counts have recovered.

Once radiation therapy has been completed and acute oral complications have subsided, the patient should be evaluated by a dentist every four to eight weeks for the first six months. After that the dentist can decide the schedule the patient needs based on findings.

Post Cancer Treatment

Head and neck radiation therapy can cause oral complications that continue or emerge long after treatment has been completed. Although cancer patients may no longer be under an oncologist’s care at that time, what they learn about oral health during their treatment will affect how they deal with subsequent complications. Patients receiving radiation therapy need to know about its risks:

-High dose radiation treatment carries a lifelong risk of osteonecrosis, xerostomia and dental cavities

-Because of the risk of osteonecrosis, people who have received radiation should avoid invasive surgical procedures (including extractions) that involve irradiated bone

-Radiation to the head and neck may permanently reduce the quantity and quality of normal saliva. Daily fluoride application, good nutrition and maintaining proper oral hygiene are very important.

-Radiation can change oral tissues. Dentures may need to be remade or relined after treatment is completed and the tissues have become stable. Some patients are never able to wear dentures following cancer treatment again because of friable tissues and xerostomia

-A dentist should closely observe children who have received radiation to craniofacial and dental structures. They want to ensure that abnormal craniofacial growth and skeletal development does not occur.

Cancer can be a very debilitating disease in many areas. But if planned accordingly before cancer treatment, we can limit those issues together and face them head on to create the scenario for the best possible outcome from cancer.

Diabetes affects almost 26 million people in the United States and is a growing problem due to the obesity epidemic.  The relationship between a person’s oral health and his/her diabetes is of utmost concern to health care professionals but especially dentists.

Patients with Diabetes have an increased risk of oral health issues due to poorly controlled blood sugars. Diabetes impairs white blood cells, which are the body’s main defense against bacterial infections.  These bacterial infections can affect everything in the mouth as well as the rest of the body.

A number of oral disorders are associated with Diabetes. The association between periodontal disease and diabetes has been studied at length with a definite correlation between the two.

The common oral health issues facing Diabetic patients include:

*Increased Dental Caries. There has been no study to effectively correlate this relationship. But anecdotal evidence leads me to believe this is a real problem for Diabetic patients withBioteneout good control over their blood glucose levels. Patients who are type 2 diabetics(meaning that it is not genetically caused but caused by diet) tend to eat more carbohydrates and sugary foods enhancing the possibility of increased caries rate. Also some patients experience xerostomia, which is more commonly referred to as “dry” mouth. I usually recommend Biotene for patients.Biotene  has the added benefit of containing a bio-active salivary enzyme protein system that actively combats bacteria, reducing bad breath, improving oral hygiene and relieving oral dryness.Some of the salivary dysfunction is caused by medications and age as well.

*Oral Mucosal Disease and other infections. Different types of oral disease are found, including lichen planus and recurrent aphthous stomatitis. People with diabetes that are often taking antibiotics to fight off infections are prone to developing Oral candidiasis(a fungal infection of the mouth and tongue). Oral candidiasis is found more frequently in patients with diabetes. Candidiasis occurs due to a patient being in a weakened immune state as well as a secondary response to the “dry” mouth mentioned above. This particular fungus thrives on the high levels of sugar in the saliva of people with uncontrolled diabetes.  This fungus results in a burning sensation in areas of the mouth and sometimes a loss or change in taste.

*Periodontal Disease (gingivitis and periodontitis) have been shown to have a direct link to Diabetes. It has been noted that elevated levels of Periodontal disease also lead to complications in management of blood glucose levels. This disease tends to be more prevalent and more severe in diabetic patients than in the general population. This is mainly due to the fact that diabetics have decreased wound healing and infection fighting ability.

Diabetics who smoke are at a much higher risk of disease.  Their risk factor can be as much as 20x more likely than non-smokers to develop thrush and periodontal disease. Smoking does seem to reduce blood flow to the gums and this can also affect healing in the tissue area.

Because people who suffer from diabetes can be more prone to symptoms that may harm their oral health, it’s very important to follow dental home care instructions and to note any changes in your oral health. Promptly schedule a dental consultation if you notice any changes.

Dental Hygiene for Diabetics

We always recommend visiting the dentist and hygienist at least twice a year but it is doubly important in patients with diabetes. They need to strive to keep their mouths as bacteria free as they can. In conjunction with proper brushing we also recommend that patients floss after every meal if possible. A daily mouthwash can be beneficial as well.