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Dental health has been shown to be directly related to a person’s general overall health.  Your mouth is connected to the rest of your body so it makes sense that what happens in the mouth (teeth and gums) can have a profound impact on the rest of your body.  Scientific research also shows the reverse, the breakdown and disease processes of the body can directly affect your dental health.

1.  Stress

Oral Symptoms: Headaches with flat, worn down teeth.

Stress is one those things that people underestimate. It takes a tremendous toll on the body and mind. Teeth grinding and clenching during sleep is a classic sign of emotional or psychological stress factors. People who grind or clench their teeth tend to be quite surprised to find out they are doing it. After all, this activity generally occurs in their sleep, when they’re not aware of it, unless a partner hears the noise and tells them.

Patients can sometimes see the flatness of their own teeth, or even feel it with their tongue. They may notice their jaw feeling sore and achy upon waking. Headaches, which are caused by spasms in the muscles during and after clenching or grinding. Often the pain can radiate from the the teeth and TMJ and head down to the neck and upper back. Night guards can relieve the symptoms and protect the teeth from the harmful effects of grinding and clenching.

2. Diabetes or Sjogren’s Syndrome

Oral Symptoms: Dry Mouth or Xerostomia

Dry mouth can be casued by a variety of things. These can include dehydration and taking a new medication.Hundreds of drugs list dry mouth as a side effect. These include medications commonly prescribed such as muscle relaxants, antianxiety medications, and antihistamines. A lack of saliva in the mouth can also be an early warning sign of two different autoimmune diseases. These diseases are Diabetes and Sjogren’s sundrome.

Sjogrens syndrome is largely unknown. It is when the white blood cells of the body attack the salivary glands. This affects many, approximately 4 million Americans suffer with Sjogrens. It is much more prevalent in women, 90% of those diagnosed are female. In Sjogren’s, the eyes are dry as well as the mouth, but the entire body is affected by the disorder. Sjogren’s symptoms often appear like other diseases and often goes misdiagnosed or undiagnosed.

Diabetes affects about 24 million people in the United States alone. It affects both men and women. It is a metabolic disorder caused by the bodies inability to process blood sugars properly. Other symptoms of diabetes include excessive thirst, dry mouth, tingling in the hands and feet, frequent need to urinate, blurry vision, and loss of weight.

3. Lichen planus

Oral Symptoms: White webbing inside cheeks.

Many people would never imagine they can discover a skin disease through an oral examination but you can. Lichen planus is a mild disorder that affects both men and women in the age range of 30-70. The cause is unknown. It affects the mucus membranes in the mouth.

Oral lichen planus  appears as a whitish, lacy pattern on the insides of the cheeks. About 70% appear in the oral cavity before they show up in other parts of the body.

The vagina is another common area where lichen planus can also appear. Lichen planus often goes away on its own, but sometimes further treatment is needed.

4. Oral Cancer

Oral Symptoms: Sores that just will not go away in mouth.

Marielaina Perrone DDS VelscopeMany people bite the insides of their mouth as a nervous habit. Sometimes people bite their cheek accidentally, creating a wound or sore. But when an open sore in the mouth does not go away on its own within a week or two, it needs to be shown to a dentist or doctor.

More than 20,000 men and 10,000 women a year are diagnosed with oral cancer, according to the National Cancer Institute. Most are over the age of 60. Oral cancer has a survival rate of only about 35 percent. This is mainly due to late detection. Smokers are six times more likely to develop oral cancer, but one in four oral cancers develop in non-smokers.

Suspicious oral sores or ulcers tend to be raised sores and often have red or white borders. They may hide under the tongue, where they’re hard to see. Bleeding and numbness are other signs, but sometimes the only sign is a sore that doesn’t seem to go away. A biopsy usually follows a visual check. At each dental visit you can increase your chances for early detection by seeing a dentist that uses a Velscope oral cancer screening system. This tool is effective in detecting precancerous changes in the mouth. Earlier detection means better chance for survival and cure.

5.  Aspiration pneumonia

Oral Symptoms: Crusting Dentures

Connecting pneumonia and dentures may seem like a real stretch but they have a deadly connection. A leading cause of senior deaths is from aspiration pneumonia. This is caused by inhaling debris from around teeth and dentures.

In aspiration pneumonia, foreign material is breathed into the lungs and airway, causing dangerous inflammation. This often occurs in those who fail to clean their dentures properly. Dentures need to be removed every day from the mouth. They should be properly cleaned daily with a brush and stored in a cleansing solution.

6. Angular chelitis and Candidiasis

Oral Symptoms: Mouth Irritation

Itching, burning, chronic irritation found at the corners of the mouth and inside the mouth and throat. The irritation in the mouth tends to be bright red with or without a white, creamy, layer. The corners of the mouth tend to crack and bleed easily. Both of these are caused by the same culprit, yeast. Chronic yeast infections tend to be a sign of immune system issues, extremely dry mouth, and/or  a collapsed bite.

Conclusion

The above six issues are just a sampling of the many symptoms that can be seen in the mouth. While you care for your dental health, you should be doing a routine thorough self examination for changes. You should know what the normal appearance of your mouth is, so that when something changes, you can have it checked early. Know your body, and find an experienced dentist who you feel comfortable with, so that all of your questions can be answered satisfactorily. Regular dental visits are usually key to early diagnosis for any of the diseases listed in this article..

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.

Oral Cancer Awareness Month

April, 2013

 

Oral Cancer Facts

-Expected to have approximately 42,000 new cases of oral cancer diagnosed in 2013 alone.

Oral Cancer Marielaina Perrone DDS

VELscope Saves Lives From Oral Cancer

-Males account for almost 70% of all new cases.

Survival Rates of Oral Cancer

1 year – 89% survival

5 year – 56% survival

10 year – 41% survival

-Approximtely 8,000 deaths per year from oral cancer.

Age 0-44 – 9%

Age 45-54 – 20%

Age 55-64 – 29%

Age 65-74 – 21%

Over Age 75 – 21%

Oral Cancer Marielaina Perrone DDS

Keep The Whole Family Healthy With Regular Oral Cancer Screenings

Risk Factors of Oral Cancer

-Family History of Cancer

-Presence of HPV-16 Virus

-Smoking Tobacco – Increases risk by a factor of 6.

-Alcohol Consumption – Increases risk by a factor of 6.

-Chewing Tobacco – Increases risk by a factor of 50!

-25% of all new oral cancer cases are patients who never smoke and only drink on occasion (or never). This is where the biggest growth of new oral cancer cases is occurring.

Signs and Symptoms of Oral Cancer

-White or red patches.

-Long term earache that never seems to go away.

-Bleeding.

-Tooth Loss

-Sores in mouth that never heal.

-Lumps in head and neck area.

-Numbness of jaw or surrounding tissues.

-Pain upon swallowing.

Early Diagnosis Is The Key To Beating Oral Cancer

The earlier the cancer diagnosis is made and the quicker treatment is begun, the better chance for a successful long term prognosis from oral cancer. Oral cancer will spread very quickly and needs to be found early in its localized state before it progresses to other parts of the head and neck as well as the rest of the body.

The tool of choice in early diagnosis of oral cancer by many dentists is the VELscope. The Velscope uses a special light that can distinguish normal healthy tissue from precancerous and cancerous tissues. The VELscope examination takes about 1-2 minutes (and is non invasive!) and has literally saved thousands of lives. There are currently about 10,000-12,000 VELscopes in the United States alone. Make sure your dentist has a VELscope to ensure you are getting proper dental care for the possibility of oral cancer development.

Oral Cancer Marielaina Perrone DDS

Oral cancer affects approximately 40,000 people in the United States each year. Oral Cancer kills one person every hour, every day totaling about 8,000 deaths per year. Only a little more than half of those 40,000 diagnosed, will be alive in 5 years. This is a number that has stayed steady for quite a number of years. Around the world, the problem is even greater with about 640,000 new cases of oral cancer each year. Historically, the death rate for oral cancer is higher than in cancers such as cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, testicular cancer, and endocrine system cancers (thyroid).

While not all oral lesions become malignant, the majority are removed surgically. The key is to find lesions as early as possible. One of the more effective ways for early detection is screening with a velscope. The velscope is a quick painless way to find tumors in the mouth that are not yet visible to the eye.  As many as 1/3rd of patients with cancerous oral lesions experience a recurrence of their oral cancer. Researchers have been studying this issue for years in attempts to figure out why the oral cancer returns and how to either stop it or slow it down or to avoid surgery altogether.

Oral Cancer Study

After more than 30 years of research, scientists at Ohio State University College of Dentistry, might have found a key to give oral cancer survivors hope for the future. That hope lies in a combination of black raspberries and

Velscope oral cancer screening Marielaina Perrone DDS

Velscope oral cancer screening system for early detection

fenretinide (a drug that has been used to treat certain cancers, rheumatoid arthritis, acne, and psoriasis, has been found to also slow the production and accumulation of a toxin that leads to vision loss in Stargardt’s patients).

The study conducted consisted of using a topical gel application containing freeze dried black raspberries directly on precancerous lesions in the mouth. This gel application reduced clinical and microscopic premalignant features (Pharmaceutical Research, April 2010, Vol. 27:4, pp. 628-643). Early results have shown definite efficacy of the freeze dried black raspberry gel while the placebo showed no effect.

How Does It Work to Stop Oral Cancer?

The study believes that the berry compounds work at the cellular level by activating two related pathways in the premalignant cells. These pathways are:

-Apoptosis. A genetically determined process of cell self-destruction that  is a normal physiological process. Cells only live and reproduce new cells for a set amount of times until they die. Tumor cells, on the other hand continue to divide and produce without dying off. Normal cells have this ” programmed cell death”, to eliminate  DNA-damaged cells, uncontrolled cell growth, and tumor formation.

-Terminal Differentiation. Final stage of cell division, where the cell may stay in this phase and no longer proliferate (grow more cells).

The benefit of all this, is that damaged cells do not continue to divide and multiply and are therefore sloughed away by the body.

The goal of the research is for the raspberry compound (in a gel or mouthwash), to encourage the epithelium to differentiate, creating a barrier to ward off development of oral cancer. The data initially supports that the black raspberry gel is doing just that. It is thought to be re-educating the cells to differentiate away from the cancerous state.

While the black raspberry gel was quite effective in many of the patients involved in the study, not all of them responded equally well to the black raspberry gel treatment. The theory is that is a direct reflection of individual patient differences in metabolism. So, the researchers added the chemotherapy agent  fenretinide.  The black raspberry gel in combination with fenretinide was more effective, acting as a one-two punch in fighting the oral cancer lesions.

The fenretinide will be delivered as a patch whereas the black raspberry gel can be placed directly on the lesions in the mouth. The theory by the research team is that this will treat both visible lesions and lesions that are yet to develop.

Oral Cancer Conclusion

This could be potentially game changing oral cancer research if the results continue to stay strong throughout the research study. Until the study progresses further, our only hope is to diagnose oral cancer as early as possible. This can be achieved via the use of the Velscope Oral Cancer Screening System. This is a tool that gives the dentist the best chance of diagnosing oral cancer and precancerous tissue as early as possible. Very important to see a dentist using this system and to go for regular dental examinations.