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A Healthy Smile, A Healthy You

The Changing Face of Oral Cancer

by Dr. Scot Ioset, DDS on 07/12/11

     When I graduated from the University of Michigan School of Dentistry in 1984, we had been taught that the vast majority of oral cancers occurred in older men who where tobacco users and heavy drinkers.  A quick review of several "health" internet sites shows that they repeat the old mantra for oral cancer causation. Well that was true right up to Y2K, but since then an alarming increase of squamous cell carcinoma of the mouth and throat has been noted in young people, some as early as their mid-teens and with a 2 to 1 prevalence in women over men. What is going on?!?
     This pandemic has been attributed to the rising rates of infection of the human papilloma virus  (HPV), transmitted primarily via sexual contact.  When this contact occurs orally, the mouth becomes susceptible to HPV infection and HPV- induced cancers. More cancers are now seen on the soft palate, whereas before the floor of the mouth and the lateral borders of the tongue were more common sites.
     The numbers on the morbidity of oral cancer is not good.  1 in 4 people with oral cancers die from it.  If it is detected late in advanced stages, the 5 year survival rate is a dismal 25 to 30%.  However, early detection of oral cancer leads to 5 year survival rate approaching 90% or better.
     If you are my patient, you have always been given an oral cancer screening every 6 months. As of July 1, 2011,  I have added a new technology to our screening procedure--the Velscope.  Its blue light causes healthy tissue to fluoresce green when viewed through the green filter of the device. Unhealthy, precancerous and cancerous tissue appears dark to black.
     One great success in medicine has been the reduction of deaths in women from cervical cancer. The primary cause of cervical cancer? HPV. Pap smears have become routine in screening cervical tissues to identify early cellular changes in the cervical mucosa. As a result, cervical cancer has fallen from #2 to #14 as causes of cancer deaths in women.
     Our office has a similar device for screening questionable lesions in the mouth--the Oral CDX.  It utilizes a brush to scrub cells off of the lesion, which are then placed on a microscope slide, fixed with alcohol, then sent to the CDX laboratory for a very careful evaluation of the cells. Based on the findings, we can refer for care to a specialist for treatment if required.
     The Velscope, coupled with the Oral CDX provides state of the art care to our patients. The cost of a Velscope screening may be covered by your insurance, and our fee is $10.  We want it available to all of our patients and do not want cost to be an issue.
     What are the signs of oral and pharyngeal cancer?
1.White or red sores or ulcers that fail to heal after ten days. These can occur anywhere in the mouth, lips and pharynx.
2. Persistent throat and/or unilateral ear pain lasting more than two weeks.
3. Hoarseness lasting more than a few days and does not get better.
4.Lump in the neck. If you experience any of these symptoms, contact our office or your physician to have them evaluated.
     Finally, prevention is the best medicine. Avoid all tobacco, limit alcohol consumption, avoid chronic use of alcohol-containing mouthwash, use 50 SPF sunscreen on lips and face, and practice safe sex at all times. Dr. Oz has done an excellent 5 part series that can be viewed on YouTube




Periodontal Health Is Key to Your Overall Health

by Dr. Scot Ioset, DDS on 06/15/11

Did you know that the health of your teeth and gum tissue is closely related to the overall health of your body? Did you know that poor care of your mouth has been correlated to conditions such as heart disease, stroke, diabetes and even some cancers? Many people don't realize the connection between good oral hygiene and their health.

Periodontal disease can be defined as an infection of the tissues that support your teeth (ADA). It is the major cause of tooth loss in adults. Signs and symptoms of possible periodontal disease include: gums that bleed easily; red, swollen, tender gums; gums that have pulled away from the teeth; persistent bad breath or bad taste; permanent teeth that are loose or separating; puss or sores in gums; any change in the way that your teeth come together when you bite; and any change in the fit of partial dentures (ADA).

A Look at Periodontal Disease

Periodontal disease is caused by plaque, a sticky film of bacteria that constantly forms on teeth. Plaque, and therefore bacteria, along the gum line can cause irritation and infection. This may be mild at first, but as the condition progresses the infection can undermine the integrity of the teeth as the infected gums pull away from the teeth, exposing and compromising the bone.

So how is periodontal disease connected to other serious conditions within the body?  The body recognizes the infection within the gums and responds to it. Periodontal disease is a chronic disease causing inflammation, and therefore the response of the body is constant, with no time for recuperation. The continuous presence of bacteria, immune cells and inflammatory markers, such as C-reactive protein and other cytokines, may directly or indirectly influence or injure tissue to cause or worsen some common chronic diseases. Researchers are finding that increased levels of inflammatory proteins may facilitate the build-up of plaque within blood vessels more favorable for the build-up of fatty deposits. Insulin resistance, blood clot formation and brain cell activity may also be impacted by the presence of the previously mentioned cells and markers. Bacteria from the mouth also can travel to other places in the body, colonize and cause infection there.

The following diseases have been correlated or linked to periodontal disease:

  • Heart disease and heart attack
  • Stroke
  • Diabetes
  • Memory loss, dementia and Alzheimer's disease
  • Miscarriage, preeclampsia and preterm birth
  • Pneumonia and other lung diseases
  • Cancer of the blood, pancreas, tongue, lung and kidney
  • Osteoporosis
It is not known whether periodontal disease causes or exacerbates these conditions, but since a correlation has been found to such serious conditions, good reason dictates that good oral care is a good, simple step toward your best health possible.

Care of your mouth is fairly simple; you already know the steps to prevent and treat mild forms of periodontal disease. Brush twice a day to remove the plaque from your teeth. Your tooth brush can't reach everywhere, cleaning between your teeth using floss or interdental cleaners ensures the plaque has been removed from those spaces. Lastly, visit your dentist's office at least once every 6 months for regular cleanings and periodontal exams. Very often you don't notice the development of periodontal disease within your mouth; this can be easily diagnosed by your hygienist and dentist. By regularly visiting your dentist, you can detect and treat periodontal disease in its early stages and prevent the damage caused by later, more advanced stages of the disease.

Dr. Oz, a physician that hosts a popular daytime television show on health topics, has covered periodontal disease and its impact on overall health. Visit his website to read an excellent article that reviews the information we discussed today: http://www.doctoroz.com/videos/can-good-oral-hygiene-save-your-life

From the Desk of the Dentist

by Dr. Scot Ioset, DDS on 05/24/11

Welcome to Hamilton Dental's first blog! The purpose of this blog is to give you, the patient, useful information for your dental health as well as updates on what's new in our office and the field of dentistry. We want this blog to be relevant to your interests and to answer your questions; please comment on this blog with any questions and/or topics that you would like to see discussed. Remember a healthy smile is an important part of a healthy you!