A half million people are diagnosed every year with oral cancer. While other cancers are more prevalent, oral cancer is among the most dangerous with only a fifty percent five-year survival rate.
A major reason for this low rate is because this fast growing cancer is difficult to detect early — diagnosis comes far too often after the disease has already well advanced. In an effort to detect cancer earlier many dentists visually screen for oral abnormalities during checkups, especially patients over fifty, tobacco or heavy alcohol users, patients with a family history of cancer or a medical history of exposure to the sexually transmitted human papilloma virus, HPV-16.
If they detect an abnormality, the dentist often refers the patient to an oral surgeon or other specialist for a possible biopsy. In this procedure the surgeon removes a sample of the abnormal tissue, which is then examined microscopically for cancer cells. A biopsy remains the most effective way to diagnose oral cancer.
Because of the disease's aggressive nature, many dentists lean to the side of caution when referring patients for biopsy. As a result 90% of oral biopsies reveal no cancer. Reducing the number of biopsy referrals is highly desirable, especially for the patient undergoing the procedure. Tissue samples tend to be large to ensure complete detection of any cancer cells. Depending on the size and location of the sample, there may be a risk for loss of function or disfigurement.
A new screening tool using a sample of a patient's saliva could help reduce the number of biopsy referrals. Besides DNA, saliva also contains dormant genes called biomarkers that activate in response to the presence of a specific disease. This particular saliva test identifies those biomarkers for oral cancer if they're present.
A sample with a low score of biomarkers indicates no cancer present (with a statistical confidence of 99%). A medium or high score indicates cancer may be present, but only a biopsy can determine for sure. Using this test, dentists might be able to reduce the number of biopsy referrals and instead be able to employ watchful waiting in certain cases. Because of its simplicity and non-invasiveness, saliva screening could help identify oral cancer earlier.
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
For over three decades, veneers have helped mask dental imperfections like chipping, staining or gaps and improve the appearance of millions of teeth. As the name implies, this thin layer of porcelain covers a tooth's visible surface and accurately mimics the texture, color and translucence of natural teeth.
Veneers could be just the solution you need for a more attractive smile. But before you begin treatment, be sure you have these 3 essentials in place to ensure a successful outcome.
True expectations. While the transformation of a tooth's appearance with a veneer can be astounding, veneers in general do have their limitations. You need an adequate amount of the tooth's structure present for a veneer to properly adhere — if not, you may need to consider a porcelain crown instead. Likewise, gaps and other misalignments may be too great for a veneer to cover: in that case, you should consider orthodontics. A thorough examination beforehand will determine if veneers are the best option for you.
An artisan team. Every veneer is custom made to match an individual patient's tooth shape and color, handcrafted by a skilled dental technician. There's also an art to the dentist preparing the tooth beforehand and then properly positioning the veneer for bonding to achieve the most attractive result. Be sure, then, that your veneer "team" comes highly recommended by others.
The best materials. The first porcelains were powdered glass ceramics mixed with water to form a paste. Technicians shaped the paste in successive layers and as it oven-cured it took on the beautiful translucence of natural teeth. Unfortunately, this type of porcelain could be brittle and prone to shattering when subjected to heavy biting forces. In recent years, though, we've begun to use ceramics reinforced with other materials like Leucite for added strength. Today, the materials dentists use have much better durability.
If you would like more information on porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers.”
If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”
What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury — and one that could have been avoided.
You might not realize it, but when it comes to dental injuries, basketball ranks among the riskier sports. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. Whenever you’re playing those sports, the ADA recommends you wear a high-quality mouth guard.
Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.
Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, and the ones that offer your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.
“I would have saved myself a lot of dental heartache if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…
Whatever problems you may have with your teeth and gums, there are effective solutions in modern dentistry. But like other aspects of healthcare, dental treatment can be quite costly. For many it isn't what can be done but what they can afford to have done.
If you too have limited financial means, don't lose hope — there are effective ways to manage your dental care, especially with a little planning ahead.
The most important thing you can do to manage dental costs is to prevent disease through consistent oral hygiene — brushing and flossing — at least once a day. Removing bacterial plaque, a film of leftover food particles that can trigger infection, from your teeth will significantly lower your risk of tooth decay and periodontal (gum) disease, two very common sources of dental care costs.
It's also important that you visit the dentist at least twice a year. Although it's an expense, it's worth budgeting because it could, along with daily hygiene, save you money in the future. During these visits we'll remove plaque and calculus (hardened plaque deposits) from hard to reach places you might have missed. We'll also check for developing problems: the earlier they're detected the less the long-term impact on your finances.
We'll also evaluate your individual risk factors for dental disease. Some, like hereditary factors, we can't control. But others, like diet and lifestyle choices, we can alter to significantly lower your chance of disease.
With this risk factor profile, we can then put together an ongoing treatment strategy. Not only will this help prevent or at least reduce problems with your teeth and gums, it will help reduce costs in the long run.
Unfortunately, even with the best efforts we can't altogether rule out problems. We'll need to treat those that arise, and usually the sooner the better. Even so, we can usually take your financial situation into account, such as a less expensive temporary measure until you can afford a more permanent solution. We also have payment programs that can help you manage costs as well.
The important thing is not to delay regular dental checkups. The sooner you begin quality dental care the less of an impact any problems we find will pose to your dental health and your wallet.
If you would like more information on financial management for your dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cost-Saving Treatment Alternatives.”
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