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There are many dental myths floating around the internet that have little to no basis in truth.

MYTH: I should not brush my teeth when my gums bleed.

TRUTH: Normally, when the body has a wound we need to give it time to heal. Usually that means placing a band aid over it so we do not disturb the healing process. The opposite is true of bleeding gums.  Bleeding gums could be a sign of more than just periodontal disease and should be examined by a dentist. Gingival tissue bleeds because of a buildup of plaque and bacteria. The plaque, food particles and bacteria are producing toxins that will eventually destroy the supporting tissues surrounding your teeth. The earliest form of this is called gingivitis and it is reversible. But periodontal disease is a progressive one and it will get worse without proper care. Seeing your dentist regularly will allow you to manage and stop this disease before it can progress further.

MYTH: Placing an aspirin in my mouth next to a toothache can relieve pain.

TRUTH: This is an old at home remedy that has somehow continued to linger. Even ingested orally aspirin will do little for a toothache. It is not powerful enough of an analgesic. But placing it in the mouth against the oral tissues is a recipe for disaster.

The only safe and effective way to take an aspirin tabs to swallow it. The aspirin then gets absorbed into your body through your digestion. It then enters your bloodstream and travels throughout your body. Aspirin works by stopping the production of prostaglandins.Prostaglandins transmit pain messages from the injured part of your body to your brain. This reduces pain felt in the body. Also placing the aspirin directly on the gums or lips can cause an acidic burn to the oral tissues.

MYTH: By eating more sugar, you will get more cavities.

TRUTH: Many of us can remember our parents or grandparents telling us not to eat too much sugar or our teeth will fall out. But truth be told, the amount of sugar is not the deciding factor whether or not you end up with tooth decay. How tooth decay process works is the bacteria that are naturally in your mouth are able to feed on sugars (and carbohydrates in general). In turn these bacteria produce acids that erode our teeth. The longer the sugar is able to stay in your mouth, the longer these bacteria are producing acid which will eventually erode the tooth and cause a cavity.

So, this means eating two candy bars, then immediately brushing and rinsing your teeth is less harmful than eating one candy bar and not brushing afterwards. This is why sugary soft drinks are bad for our teeth. Every sip we are reintroducing sugar into the mouth for the bacteria to feed on.

MYTH: Using tooth picks will widen the gaps between your teeth.

TRUTH: Most commercially available tooth picks are quite harmless and when used properly are a good cleansing tool for the plaque and food build up between teeth. However, it should not replace flossing and brushing as the staple to your oral hygiene program. One word of warning regarding tooth picks…..be careful not to injure your gums.

MYTH: Osteoporosis does not affect teeth and only affects major bones like the spine and hips.

TRUTH: Osteoporosis is a disease that affects the bones. It is the thinning of bone tissue and loss of bone density over time. Osteoporosis can also affect the bones of the jaws so tooth loss is possible. Diet become doubly important in osteoporosis patients to maintain the nutrients needed for proper bone support.

MYTH: Bad Breath means you are not brushing properly.

TRUTH: A person’s bad breath can be caused by poor oral hygiene but it can also be a sign of a systemic disease. The foods we eat like garlic or onions will also change our breath smell but only for a short time. A well known systemic disease that gives a tell tale bad breath sign is diabetes. In diabetics this is called diabetic ketoacidosis. Ketoacidosis is usually seen in type 1 diabetics. This complication occurs when the body is unable to use sugar (glucose) as a fuel source because the patients do not produce enough insulin, and because of that the fat is used instead. Ketones build up in the body and this is the byproducts of fat breakdown. The bad breath smell is from the ketones. The body has only two ways of removing these ketones, thru our urine and thru our breath.

MYTH: Losing baby teeth from tooth decay is not a big deal.

TRUTH: This is a very common myth. Most people believe well the primary teeth are going to fall out anyway so no big deal. The tooth decay in the primary teeth can affect the erupting teeth. If the primary teeth are lost prematurely the permanent teeth may erupt misaligned. The other purpose of primary teeth is to hold “space” for the permanent teeth. if those space holders are gone prematurely then there will be less room for the adult teeth to erupt. This will cause overcrowding. and require orthodontics later on.

MYTH: Poor oral health only affects the teeth and gums.

TRUTH: This has been a big misconception for years but the media has done a good job of late bringing this to the general public’s attention. Periodontal disease has shown stperfect smilerong links to diabetes and heart disease. Untreated periodontal disease will affect your body as a whole. Research has proven this.

MYTH: Teeth whitening is bad for your teeth.

Teeth whitening when done properly is completely safe and harmless to the teeth and gums. Teeth whitening products only affect color of teeth not their strength or health. There are some possible side effects to teeth whitening that are generally very temporary. These include teeth sensitivity or possibly gum irritation if not applied properly.

MYTH: Avoid the dentist when pregnant.

When a woman is even thinking about becoming pregnant she should schedule a dentist appointment to ensure her teeth and gums are healthy for the possible baby on the way. Necessary dental treatment is safe and effective for most pregnant women throughout their pregnancy. Obviously you prefer to not have treatment in the third trimester when sitting in a dental chair may be uncomfortable for the mother.

 

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.