Dentist.Net - Online Dental Health Care

Oral Cancer to Increase 11 Percent This Year

2007-03-01T11:19:00.000-08:00

Zila, Inc. noted with dismay that while the American Cancer Society (ACS) celebrated new data with a headline "Cancer Deaths Down for Second Year", the same data showed a marked increase in the number of expected new cases and deaths due to oral cancer.

"The ACS data, published in 'Cancer Facts & Figures 2007', projects 34,360 new cases of Oral Cavity & Pharynx Cancer - a remarkable 11 percent increase over the 30,990 cases that ACS projected for 2006, and a 20 percent increase among males," notes Frank Bellizzi, president of Zila Pharmaceuticals, Inc., marketer of the ViziLite® Plus with TBlue630 system for the early detection of oral abnormalities that could lead to cancer. Nearly as many women will be diagnosed with oral cancer as with cervical cancer this year. ACS projects that total deaths due to oral cancer will rise nearly two percent to 7,550 in 2007, from 7,430 in 2006.

"As the ACS celebrates a decline in many cancers," Dr. Bellizzi added, "it is critical to note that oral cancer remains a common cancer type in men, and a critical threat to women. Early detection is the key to reducing death and minimizing the quality-of-life impact of this insidious disease. As the ACS reports, the 5-year survival rate when oral cancer is detected early is 81.3 percent, but late detection results in a survival rate of only 26 percent.

"Dentists across America are moving rapidly to adopt the three-minute, non-invasive, absolutely painless ViziLite Plus technology to improve their chances of detecting potentially deadly abnormal tissue at a very early, highly treatable stage. Respected dental groups, like Heartland Dental Care, Coast Dental, Aspen Dental, Midwest Dental and SmileCare, as well as thousands of independent dental offices, are now routinely providing ViziLite Plus exams as part of their annual patient wellness evaluations. Major insurers are moving quickly to extend coverage to this important technology."

One American dies every hour of oral cancer, and while tobacco and alcohol use contribute to incidence, one quarter of all oral cancer cases occur in people with no risk behaviors. "Take the ACS data to heart," Dr. Bellizzi said. "Ask your dentist for an oral cancer exam at your earliest opportunity."

Think the way your teeth look doesn’t really matter? Survey says: think again.

2007-01-31T17:25:00.000-08:00

Without saying a word, your mouth is sending messages to everyone you meet. According to the American Association of Orthodontists (AAO), people often make snap judgments about individuals based solely on the condition of their teeth.

“This phenomenon was documented more than 25 years ago,” says Dr. Don Joondeph, president of the American Association of Orthodontists, referring to an eye-opening study in which photos of young smiling individuals were altered to show varying orthodontic problems and then reviewed by focus groups.

“When the focus groups looked at the altered photos they used unflattering terms such as ‘unattractive’ and ‘aggressive’ to describe the individuals,” says Dr. Joondeph. “However, when groups saw photos of the same individuals with a healthy, beautiful smile, they were more likely to view the individuals as ‘intelligent,’ ‘attractive’ and ‘a friend I’d like to have.’”

Dr. Joondeph believes that the original study, which was published in 1981, is even more applicable in today’s image-obsessed world. “More than ever, young people and adults want to be perceived as healthy, attractive and appealing to their peers and others.”

To obtain optimal oral health and achieve a healthy, beautiful smile, the AAO recommends a team approach. “In addition to seeing a dentist for regular check-ups and cleaning, patients also should see an orthodontist to ensure that any underlying orthodontic problem is not overlooked,” says Dr. Joondeph. “An orthodontic consultation is especially important for children or for anyone who is considering a cosmetic dental procedure.”

For children, an orthodontic check-up no later than age seven can identify potential problems and ensure that any future treatment is timed appropriately. For adults, an orthodontic consult may reveal that cosmetic dentistry is unnecessary. “Patients may be pleasantly surprised to learn that their unattractive teeth are generally healthy, just misaligned,” says Dr. Joondeph.

In regards to the study, Dr. Joondeph believes that the first thing that people notice about his young and adult patients is obvious: “The confidence and sense of self-esteem that comes with their healthy, beautiful smiles is unmistakable to anyone they meet.”

Who is an orthodontist? An orthodontist specializes in the diagnosis, prevention and treatment of dental and facial irregularities. Orthodontists receive an additional two-to-three years of specialized education beyond dental school to learn the proper way to align and straighten teeth. Only orthodontists are eligible for membership in the AAO.

Are cosmetic procedures ever appropriate? Certainly there is a place for cosmetic enhancements. After the orthodontist has moved teeth into their ideal positions, the patient’s dentist can improve the appearance of teeth that are worn down, badly formed, cracked, chipped or discolored. When teeth are properly positioned through orthodontic treatment, veneers or bonding can be easier to place, look better and may be easier to maintain.

About the American Association of Orthodontists: The AAO comprises 15,000 members in the United States, Canada and abroad. Founded in 1900, the AAO supports research and education leading to quality patient care and promotes increased public awareness of the need for and benefits of orthodontic treatment. Orthodontists are uniquely qualified to correct improperly aligned teeth and jaws. They are specialists in the diagnosis, prevention and treatment of dental and facial irregularities. The American Dental Association requires orthodontists to have at least two academic years of advanced specialty training in orthodontics in an accredited program, after graduation from dental school.

Tooth Whiteners Do Not Cause Cancer - Hydrogen Peroxide Found to Have No Negative Health Effects

2007-01-03T04:01:00.000-08:00

Common tooth whitening products, which have been used by millions of people, are found to be safe and do not increase the risk of oral cancer when used as directed. This exhaustive review of the literature, including numerous unpublished clinical studies involving over 4,000 human subjects, appeared in an article by Dr. Ian Monroe entitled, " Use of Hydrogen Peroxide-Based Tooth Whitening Products and it Relationship to Oral Cancer," published in Journal of Esthetic and Restorative Dentistry.

Clinical and laboratory data on tooth whitening products show no evidence for the development of oral cancer or of other effects that could be associated with increased oral cancer risk. Exposures to hydrogen peroxide, generally the effective ingredient in tooth whiteners, are too low and of too short of a duration (30–60 minutes) to cause any oral tissue changes that could enhance risks for oral cancer development. Concentrations of hydrogen peroxide rapidly decline to near undetectable levels usually within 15 to 60 minutes.

Given the likely use of tooth whitening products by smokers, the review also sought to examine any possibility of increased oral cancer development due to combined exposure (i.e., hydrogen peroxide and carcinogenic agents that are present in cigarette smoke). A possible combined-effect, as seen in the increased likelihood of lung cancer development in smokers also exposed to asbestos, was found to be groundless with regards to bleaching and smoking and further illustrates the relative safety of tooth whitening products.

New Study Strengthens Use of Saliva to Diagnose Diseases

2006-12-17T15:12:00.000-08:00

ALEXANDRIA, Va., Nov. 22 U.S. Newswire - A new study published in the December issue of the Journal of Dental Research reveals a new breakthrough in salivary diagnostics, the non- invasive method of using saliva to diagnose oral and systemic conditions, including some cancers. The study shows a co- existence between the human saliva proteome (all the proteins found in an individual's saliva) and the saliva transcriptome (all of the mRNAs - transcribed genes - found in an individual's saliva). Transcriptome analysis involves the measurement of messenger RNA (mRNA) content, which is quicker and easier than measuring all of the protein in saliva, and may provide a more easily attainable platform for salivary diagnostics.

By analyzing the vast salivary proteomes and transcriptomes from three healthy subjects, the study found that over 90 percent of the salivary proteins had a corresponding mRNA in saliva. The high co-existence rate for saliva proteins and their counterpart mRNAs means that the salivary transcriptome can serve as a good indicator of the diversity and range of the salivary proteome and can be used as a guideline for human saliva proteome analysis.

"The technological process of finding all the proteins in one person's saliva could take up to four months," said David Wong, DMD, DMSc, associate dean of research at the UCLA School of Dentistry. "Genomics, on the other hand, is much faster. The platforms for identifying all the bits and pieces of genomic information, such as mRNA, in one person's saliva take about 24 hours. Therefore, when you compare the difference in throughput of the two technologies, it will take much less time to use a genomic approach for salivary diagnostics."

Coming clean about toothpaste

2006-11-28T12:09:00.000-08:00

Whitening claims contain little bite

Drugstore aisles teem with toothpastes claiming to do everything from fighting plaque or curbing tartar to freshening breath or shielding sensitive teeth. But the most prominent claim — whitening teeth — presents something of a gray area. Read the fine print on these products and you’ll discover that most promise to whiten by removing stains, not by lightening the base color of the teeth.

Our tests of 41 toothpastes found no correlation between whitening claims and stain-removing ability. Even the seven toothpastes we tested that contain peroxide — the main bleaching ingredient in whitening strips and professional treatments — lightened or bleached out stains no better, overall, than other toothpastes.

In addition to tests measuring stain removal, we rated our toothpastes on their abrasiveness — the extent to which they scraped away the dentin layer under the enamel and gumline — and their fluoride content. We also checked them for unusual tastes and noted their claims to control plaque or tartar. Only those products bearing the American Dental Assn.’s seal of acceptance have clinical evidence backing such claims. Claims without the seal may or may not be valid. One toothpaste shone above the rest.

Ultrabrite All in One Advanced Whitening doesn’t contain peroxide, but it proved excellent at stain removal — and with only average abrasiveness. Its two closest competitors in stain removal — Colgate Max Fresh and Colgate Luminous, both very good overall — were on the high side of what testers labeled “medium” abrasiveness. Ultrabrite also stood out for its price: At just 28 cents per ounce, it qualifies as a Consumer Reports Best Buy.

If you have special brushing needs beyond cleaning, other products might be beneficial:

* Plaque control. Plaque is a soft, sticky, readily removable substance composed of bacteria and their byproducts that accumulates on teeth. Its removal is determined more by flossing and how you brush than by what toothpaste you use. But if you have excessive plaque, consider Colgate Total Whitening Gel (60 cents per ounce). It was the only toothpaste we tested that’s ADA-accepted for plaque and gingivitis prevention.
* Tartar control. Plaque that hardens over time becomes tartar — what the dentist scrapes off during cleaning. Colgate Tartar Control Whitening Gel (33 cents per ounce) is the highest-rated product we tested that bears the ADA seal for this problem. It’s also very good for stain removal.
* Low abrasion. None of the products we rated lowest for abrasiveness cleaned well. Of those with fairly low abrasiveness that also do a good job of removing stains, Aim Whitening with Baking Soda was the least costly (23 cents per ounce).
* Sensitivity. The toothpastes we tested that were specially formulated for sensitive teeth all contain potassium nitrate, an effective ingredient for reducing tooth discomfort. We recommend Crest Sensitivity Original Formula Maximum Strength (91 cents per ounce) because the ADA seal backs its claims.

Claims by 40 of the 41 toothpastes we rated to contain cavity-fighting fluoride within ADA’s acceptable range were confirmed by our tests. The ADA advises everyone to use a fluoride toothpaste. Some evidence suggests that even adults with healthy teeth can benefit from it.

AGD Launches Dry Mouth Awareness Effort; Some Medication Warning Labels Are Tough To Swallow

2006-11-09T09:27:00.000-08:00

More than 32 million adults are at risk of dry mouth, or xerostomia, caused mainly by prescription and over-the-counter drug products. Dry mouth can lead to extensive decay, serious oral infections and make it difficult to swallow and speak. More than 80 percent of patients complain about dry mouth and dry mouth symptoms per week, according to a recent online member poll conducted by the Academy of General Dentistry (AGD).

To help the public better understand dry mouth as well as find the most effective treatment, the AGD developed a new print public service announcement (PSA) intended to raise awareness about the causes and consequences of dry mouth. The AGD also developed a special section on its Web site -- http://www.agd.org -- which provides free tools the public can use to learn more about this very serious issue.

"Our profession and our members continue to see an increase of cases of this condition due to a rise in medication consumption by the public," says AGD President Bruce DeGinder, DS, MAGD. "We want to educate the public that more than 400 prescriptions and over-the-counter drugs are known to cause dry mouth and that their general dentist can help provide solutions to this problem."

Dry mouth (www.dentist.net) is caused by a decrease in the amount of saliva in the mouth when the salivary glands do not work properly. The salivary glands help keep the mouth moist, which helps prevent decay and other oral health problems.

Many medications, prescription and over-the-counter, may decrease saliva flow and they can contribute to symptoms associated with dry mouth. The most common troublemakers are anti-hypertensives, anti-depressants, painkillers, tranquilizers, diuretics and antihistamines. Dry mouth can cause extensive tooth decay, even in people who have had a healthy mouth for years, and it contributes to many other oral health problems. Dry mouth (www.dentist.net) may be a sign of a serious health condition or may occur when a person is upset or experiences stress.

"The PSA educates the public that their general dentist can help identify medications that may be responsible for causing dry mouth," says Cindy G. Bauer, DDS, MAGD, chair of the AGD's Council on Public Information. "They may recommend home remedies such as sucking on ice chips, sucking on sugar-free hard candy or chewing gum and rinsing with a mixture of baking soda and water.

Dental Floss - by Dr. David Leader

2006-11-02T21:09:00.000-08:00

Imagine a black and white checkerboard kitchen floor. Down on your knees, you carefully clean all of the white tiles. Standing back, the floor shines, the sun glinting off the pearly white tiles. Yet, you know the floor is not clean. When you brush carefully and do not floss, you know that the same is true of your teeth.

Flossing is the standard of care for cleaning between teeth. Manufacturers offer many devices and medicaments that clean between teeth. For example, some companies advertise toothbrushes with special bristles to clean better between teeth. Recently, Listerine produced a short-lived advertising campaign quoting in-house research that demonstrates that rinsing is as effective as flossing. While many products compare to the action and effect of flossing, not one matches the effect of floss.

The correct flossing technique involves wrapping a long piece of floss around the middle finger of each hand. Index fingers and thumbs guide the floss between the teeth and even behind the very last teeth. Scrape the floss up and down against the sides of the teeth and gently under the gum. That way, floss will remove plaque, the coating of bacteria that forms on the teeth and causes cavities and gum disease.

If flossing is not a habit, the gums will usually bleed the first several times. That is because plaque forms sores inside the gum pockets around the teeth. After a week or two, the bleeding will cease. If bleeding continues, speak with your dentist.

For the many kinds of people and teeth, there are many kinds of floss. Some people have trouble getting floss to slide easily between their teeth. This is a good thing. Tight contacts between teeth prevent food from becoming stuck. Dentists often recommend waxed dental floss; wax lubricates the floss to allow it to slide more easily between the teeth.

Another strategy is to make floss that is thinner and stronger. Proctor & Gamble manufactures Glide floss from Gore Tex fibers. (www.dentist.net) Glide is very thin and slippery. Glide slides between teeth more easily than most other brands of floss. However, some find it to be uncomfortable to hold as it cuts tightly into the skin.

Some companies manufacture wider floss for use between teeth with wider spaces. The larger dental floss or dental tape cleans teeth more efficiently than regular or thin floss. For teeth even more widely spaced, dentists recommend using thin, acrylic yarn.

A new trend is to add abrasives or medicaments to floss such as tea tree oil to help treat gingivitis or silica to help whiten teeth. While this trend does not translate into more recommendations from the dental community, it does afford the floss manufacturers more shelf space in the dental aisle at the market.

Some patients are not able to hold floss due to arthritis, muscle, or skin ailments. Dental professionals introduce those patients to floss holders. A floss holder is a fork made of the same material as a toothbrush handle. The user wraps the floss around the fork and can clean between their teeth using this device. The J. Butler Company makes the Flosbrush that includes a supply of floss within its handle (www.dentist.net). Oral B makes a powered device that they call the Hummingbird that works the same way using preloaded, disposable floss holders in a vibrating handle (www.dentist.net). Both of these devices are easy to use and work well.

Bridgework and braces makes flossing between teeth more difficult. Dentists and dental hygienists recommend the use of floss threaders, plastic needle like devices, to pass floss between teeth that are connected together. Floss threaders are easy to find near the toothbrushes in pharmacies and grocery stores or online.

The proper use of floss threaders demands excellent fine muscle control. For that reason, some patients find flossing joined teeth to be difficult or impossible. There are devices that make this task easier. Small brushes clean between teeth very effectively. Proxabrush, by Butler, is the brand that most dentists think of; OralB makes a similar product that they call the Interdental Brush System.

Another kind of interdental cleaner for bridgework and braces is a mechanical pick that rotates or vibrates a brush or pick between the teeth. The OralB Hummingbird has optional picks. Water Pik makes the Power Flosser (www.dentist.net). These devices are not a replacement for floss, but are useful for people who cannot handle floss or take the time every day to floss around dental devices.

Toothpicks have been used to clean between teeth since prehistoric times. Some people are able to clean with toothpicks as well as others use floss. This is not easy to do. There is a particular way to clean bacterial plaque from teeth with a toothpick. Hold the toothpick perpendicular to the tooth and gently scrape the pocket in the gum around the tooth. Be very gentle.

The most important dental care your teeth get is the care you give them. Do not leave your teeth half clean. Speak with your dental team about the best way for you to clean between your teeth. Ask them to show you how. It will make their day.

ADA Applauds Health Claim for Fluoridated Bottled Water

2006-10-26T21:50:00.000-07:00

The American Dental Association (ADA) supports the Food and Drug Administration’s (FDA) decision to allow bottlers to claim that fluoridated water may reduce the risk of dental cavities or tooth decay.

“Whether you drink fluoridated water from the tap or buy it in a bottle, you’re doing the right thing for your oral health,” says ADA executive director James B. Bramson, D.D.S. “Thanks to the FDA’s decision, bottlers can now claim what dentists have long known—that optimally fluoridated water helps prevent tooth decay.”

The ADA also agrees with the FDA that this health claim is not intended for use on bottled water marketed to infants for whom lesser amounts of fluoride are appropriate.

According to the FDA’s Center for Food Safety and Applied Nutrition, “the food eligible to bear the claim is bottled water...containing greater than 0.6 and up to 1.0 mg/L total fluoride, and meeting all general requirements for health claims....”

The American Dental Association (ADA) continues to endorse fluoridation of community water supplies as safe and effective for preventing tooth decay. This support has been the Association’s position since policy was first adopted in 1950. Approximately 170 million people in the United States are served by public water systems that are fluoridated. The ADA, along with state and local dental societies, continues to work with federal, state, and local agencies to increase the number of communities benefiting from water fluoridation.

Oral Hygiene - Cleaning Your Teeth and Gums

2006-10-13T12:16:00.000-07:00

The ADA recommends the following for good oral hygiene:

Brush your teeth twice a day with an ADA-accepted fluoride toothpaste.
Clean between teeth daily with floss or an interdental cleaner. Decay–causing bacteria still linger between teeth where toothbrush bristles can’t reach. Flossing removes plaque and food particles from between the teeth and under the gum line.
Eat a balanced diet and limit between-meal snacks.
Visit your dentist regularly for professional cleanings and oral exams.

Talk to your dentist about what types of oral care products will be most effective for you. The ADA Seal on a product is your assurance that it has met ADA criteria for safety and effectiveness. Look for the ADA Seal on fluoride toothpaste, toothbrushes, floss, interdental cleaners, oral irrigators, mouth rinses and other oral hygiene products.

Replace your toothbrush every three or four months , or sooner if the bristles become frayed. A worn toothbrush will not do a good job of cleaning your teeth. Children’s toothbrushes often need replacing more frequently than adults because they can wear out sooner.

The Importance Of Tooth Brushing And Flossing - A new study

2006-10-04T21:26:00.000-07:00

Researchers found that gingival bleeding and halitosis were greatly reduced after a two-week oral hygiene program of dental flossing and tooth brushing

The list of excuses for not brushing or flossing is endless, but according to a new study published in the Journal of Periodontology, these are two tasks that should not be omitted from the daily hygiene routine.

Researchers found that tongue and tooth brushing in combination with dental flossing significantly decreased gingival bleeding by 38 percent after a two-week oral hygiene program. Halitosis, or Bad Breath, was also reduced. In the group that did not floss as part of their daily routine, gingival bleeding sites increased by almost four percent.

"Gingival bleeding and halitosis is often the first sign of poor oral hygiene that may eventually lead to further periodontal problems," said Walter A. Bretz, DDS, PhD, Department of Cariology & Comprehensive Care, New York University College of Dentistry and the mentor of the study. "A good way to prevent periodontal disease and tooth decay is through at-home oral hygiene care and routine dental visits."

"Bad Breath and bleeding gums can also occur in people who routinely brush their teeth and gums," said Kenneth A. Krebs, DMD and AAP president. "Bleeding gums can be a sign of periodontal disease, and bad breath may be from certain bacteria that have built up in the mouth. People with bleeding gums or Bad Breathshould ask their dentist or periodontist about their periodontal health."

So Many Ways to Brighten Your Teeth, So Few That Are Worth the Money

2006-09-30T18:21:00.000-07:00

Most cosmetic procedures have both critics and disciples. For every face-lift, nose job, baldness fix or hair removal scheme, there's one camp that finds the whole thing ridiculous and another that can't face the future without it.

But tooth whitening has few public foes: Who stands in favor of yellow teeth? So the question for those with teeth the shade of a manila folder isn't whether to whiten but how. Here we present a guide to the bewildering array of rinses, pastes, trays and treatments only your dentist can do.

It's hard to find a tooth-whitening expert who isn't somehow affiliated with a maker of tooth-whitening products. For this story, we checked with two widely published researchers whose work consistently appears in peer-reviewed journals: Gerard Kugel, associate dean for research at Tufts University School of Dental Medicine (who has been paid for research by Ultradent Corp., Discus Dental and Procter & Gamble), and Robert Gerlach, principal scientist for Procter & Gamble (maker of Crest products). We also spoke with representatives of companies that make other whitening products and read published research.

A few overarching points:

Conventional wisdom -- touted mostly by dentists themselves -- holds that you should have a dentist check your mouth for decay or disease before embarking on your tooth-whitening journey.
Whitening products take two basic approaches. Some contain bleach that permeates the teeth to remove both internal, or "intrinsic," stains and those on the outside of the teeth. Others use mechanical or chemical means to loosen or buff away the junk that stains the outside.
Most experts agree that the effectiveness of any tooth-bleaching method comes down to two factors: the concentration of bleaching agent (usually hydrogen peroxide or carbamide peroxide) and the length of time that agent is in direct contact with the teeth.

Matt Messina, a Cleveland dentist and the American Dental Association's go-to guy on whitening, says, "Whitening is basically a continuum. The less expensive, less involved procedure produces lower results, while the most expensive, more complicated procedures can produce dramatic changes in color. There is no one right answer."

Connecticut dentist Marty Zase, president of the American Academy of Cosmetic Dentistry, notes that, for treatments done by a professional, the cost of whitening is determined by the dentist's location, experience and skill. Any dentist can call himself a cosmetic dentist; to find one with extra training, go to http://www.aacd.com/ Ask to see photos of a whitening the dentist has actually performed, Zase suggests, and don't be shy about asking for references.

The American Dental Association says whitening is a pretty safe procedure. But bleaching agents can cause short-term tooth sensitivity and, if poorly applied, temporarily make your gums and other parts of your mouth hurt. Both problems should go away if you lay off the bleach for a day or so.

The Food and Drug Administration regards tooth-whitening products as cosmetics, not drugs. So as long as manufacturers don't say their products cure or prevent disease or make other health claims, they're free to say just about anything they like without substantiating those claims with research. So it's up to you, oh dingy-toothed one, to choose carefully.