Periodontal Disease Could Raise Pancreatic Cancer Risk

About 1.5 percent of American men and women develop pancreatic cancer, and only about 5 percent survive five years after being diagnosed. Research has suggested that periodontal disease may increase people’s risk of developing pancreatic cancer.

Researchers at New York University’s Langone Medical Center collected data from 361 patients with incident pancreatic cancer and 371 matched controls. The subjects were enrolled in the Cancer Prevention II Study and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The researchers controlled for other factors, such as age, race, gender, tobacco and alcohol use, body mass index, and history of diabetes, that could have increased the risk of developing pancreatic cancer.

The researchers found a significant correlation between pancreatic cancer risk and the presence of the bacteria Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. They also found that the presence of Fusobacteria lowered participants’ risk of developing pancreatic cancer.

The participants were mostly white and non-Hispanic, so the researchers are not sure if their findings are applicable to other racial groups. The findings did not demonstrate a causal link between oral bacteria and pancreatic cancer, but they have helped scientists identify a new potential risk factor. They believe this information could be helpful in developing new approaches to prevent and detect pancreatic cancer.

Another study conducted by researchers at the Harvard School of Public Health, the University of San Juan, and the Dana-Farber Cancer Institute involved 51,000 men between the ages of 40 and 75. Researchers adjusted for age, smoking, obesity, diabetes, diet, and other factors and found that men with periodontal disease had a 63 percent higher risk of developing pancreatic cancer than men with healthy gums. The study did not establish a causal link.

Periodontal disease is an infection that affects the area just below the gums. It causes the tissues supporting teeth to break down. People who smoke or chew tobacco, have diabetes, take certain medications, have bridges that do not fit correctly, have defective fillings, are pregnant, or use oral contraceptives have an increased risk of developing periodontal disease. People can reduce their risk of developing gum disease by brushing twice a day and flossing once a day.

Dental Care for Patients with Heart Disease

dental care heart diseasePatients with heart disease have special dental needs. Heart problems and the medications used to treat them can increase the risk of developing dental problems and can contribute to complications during procedures.

Give your dentist a list of all prescription and over-the-counter medications you take so that he or she can decide on the best course of treatment for you. Provide your dentist with your cardiologist’s name and phone number so they can discuss your care. Discuss any concerns you have about your dental care with your dentist and cardiologist.

If you have had a heart attack and need to undergo a dental procedure, discuss it with your cardiologist first to find out if he or she recommends waiting. Tell your dentist if you are taking anticoagulant medication (blood thinners) because they can cause excessive bleeding during some dental procedures. Ask your dentist if the office has oxygen and nitroglycerine available in case there is a medical emergency during your procedure.

If you have had a stroke, tell your dentist if you take anticoagulants. If you cannot produce enough saliva because of your stroke, your dentist may recommend that you use artificial saliva. If the stroke affected your face, tongue, or dominant hand, your dentist may recommend using fluoride gel or strategies to make it easier to take care of your oral hygiene.

Some medications used to treat hypertension (high blood pressure) or heart failure can cause dry mouth or affect the sense of taste. Your dentist may recommend using artificial saliva.

If you have angina (chest pain) treated with calcium channel blockers, they can make your gum tissue swell and grow over teeth, which can make it difficult to chew. You may need to get more frequent cleanings or have a procedure called a gingivectomy to remove excess gum tissue.

If you are going to have a dental procedure done and you have angina, ask if oxygen and nitroglycerine are available. If you have stable angina (chest pain that follows a predictable pattern), you can undergo any dental procedure. If you have new or unpredictable chest pain (unstable angina), you should not undergo any elective dental procedures and should receive emergency dental care in a hospital or an office that can monitor your heart.

If your dentist plans to use anesthesia during your procedure, ask if it contains epinephrine. If you have high blood pressure, epinephrine can cause dangerously high blood pressure, angina, heart attack, or arrhythmia.

What Are Your Options after a Tooth Is Extracted?

extraction dental implantWhen a tooth has been damaged by disease, action needs to be taken in an attempt to save it. In some cases, a root canal or other endodontic treatment can save a diseased tooth. In other cases, those treatments will not work and the tooth must be extracted. A missing tooth can make it difficult to bite, chew, and speak clearly and can also make you feel self-conscious.

If a root canal is not appropriate for the situation and the tooth needs to be extracted, you can have it replaced it with a dental implant. An implant is an artificial tooth that is placed in the jaw to hold a crown that resembles your natural tooth. The implant is designed to resemble the shape of your natural tooth’s root. It is usually made of titanium and other materials.

An implant is put in the jaw during surgery. Over time, it fuses with the bone so that a crown can be attached later. Dental implants have been used for many years in thousands of patients. Implants can replace one or multiple teeth and can also support partial or full dentures.

In some cases, an implant can be placed in one visit. Most implants require two or three visits. The first step is to place the implant in the gums and then secure the gums over it. The implant will fuse with the jaw over the next three to six months.

After the implant has fused with the jaw bone, the dentist may attach an abutment. In most instances, the implant and abutment are one unit. A second surgery may be needed in some cases to attach the abutment to the artificial tooth. After your jaw has healed, the dentist will make a crown in the same size, shape, and color as your natural tooth and attach it to the abutment.

Other options if a tooth needs to be extracted are a bridge or a removable partial denture. In order to perform these treatments, the adjacent teeth will also need to undergo treatment.

When Should You Brush Your Teeth?

best times to brush teethDentists recommend that people brush their teeth twice a day for two minutes to prevent cavities. However, many people are unsure when are the best times to brush. In some cases, brushing right after a meal can actually do more harm than good.

Foods that contain sugar, especially ones that are sticky or liquid, react with bacteria in the mouth to produce acid that wears away tooth enamel and leads to decay. Some people think that the best way to prevent cavities is to brush right after eating a sugary meal or snack. The problem with that approach is that many sugary foods are also highly acidic.

Eating acidic foods or drinking acidic beverages causes the pH in the mouth to fall. A neutral pH is 7, but soda can have a pH as low as 2.5, which is about the same as vinegar. Acid causes demineralization and weakens teeth, which can lead to cavities.

Brushing right after consuming acidic foods or beverages can speed up the process of tooth decay. Brushing can scratch acid into the surfaces of teeth and cause cavities. If you wait 30 minutes before brushing your teeth, your saliva will naturally neutralize the pH of the acid, so you will not damage your teeth when you brush. After you eat or drink something acidic, rinse your mouth with water instead of brushing right away. You can use an antibacterial mouthwash to stop plaque from producing more acid.

You can also fight cavities by eating string cheese. This can make you salivate, which reduces the acidity of bacterial plaque. Chemicals in cheese can also cause teeth to remineralize.

Another helpful option is to chew sugarless gum. Xylitol in gum has been shown to help prevent cavities.

It is important to brush your teeth before you go to bed. Your mouth produces less saliva at night, which makes cavities more likely to form.

BIOLASE WaterLase Laser Can Eliminate Pain

BIOLASE WaterLase laserMany people avoid going to the dentist because they are concerned about the potential for pain. The BIOLASE WaterLase iPlus 2.0 system can allow dentists to perform many procedures with little or no pain, alleviating anxiety for patients who fear going to the dentist. Light energy removes bacteria without harming healthy tissues. The treatment is so gentle that many patients do not require anesthetic.

Plaque, a substance that consists of bacteria and acid from food, collects on teeth and hardens around the base of teeth and below the gum line. If it is not removed by good oral hygiene or by a professional cleaning, plaque can lead to cavities and gum disease.

A drill that is typically used to treat a cavity uses friction, which causes heat and pain. This requires the dentist to inject the patient with anesthetic and also creates the possibility of damage to surrounding tissue. A drill can also cause vibration and macrofractures. This can allow bacteria to penetrate the tooth and lead to further decay. The WaterLase laser cuts and shapes tissue without contact, heat, pressure, or vibration. It can be used on teeth, skin, gums, and bone.

The laser vaporizes harmful tissue and can be used to remove lesions. It causes little or no bleeding, and cuts and stitches are not necessary. When the BIOLASE WaterLase laser is used for soft tissue procedures, it minimizes bleeding, swelling, and pain. After periodontal treatment, the gums are more likely to fully reattach to the roots of teeth because the laser causes healthy tissue to regenerate. This reduces the risk of gum recession.

The BIOLASE laser delivers precise amounts of air and water that excite water molecules from the hand piece spray and inside the tissue. This creates an effective biological micro-ablation of the tooth and rehydrates it to prevent heat and pain. This can make common dental procedures painless and comfortable for the patient and alleviate stress and anxiety.

Prosthodontists Offer Tips on Caring for Restorations

dental restoration tipsMarch 20 has been designated as World Oral Health Day. According to the National Institutes of Health, an estimated 158 million people around the world have no teeth. The Centers for Disease Control and Prevention reports that 120 million people living in the United States are missing at least one tooth.

Many people who lose teeth or need to have them extracted receive dental restorations, such as crowns, bridges, and veneers, from prosthodontists. These restorations can be supported by natural tooth structure or by implants. However, many people do not know the best way to care for their restorations.

Taking care of restored teeth can keep them healthy and functional and can also protect an expensive investment. A 17-year retrospective study found that patients who participate in a maintenance program are 90 percent less likely to have their restorations fail than patients who do not. Following proper maintenance procedures can keep restorations, as well as the surrounding gums and bone, healthy and keep bridges, veneers, and crowns looking natural and white for many years.

The American College of Prosthodontists recently presented new recommendations from prosthodontists, general dentists, and hygienists. A panel of experts appointed by the American College of Prosthodontists, American Dental Association, Academy of General Dentistry, and American Dental Hygienists Association developed the guidelines. The goal of the first Clinical Practice Guidelines for Patients with Dental Restorations is to keep restored teeth healthy throughout a patient’s lifetime.

The guidelines recommend that patients with dental restorations receive an exam and cleaning every six months and follow individual at-home maintenance tips given by their dentist. Patients should brush with fluoride toothpaste twice a day, floss once a day, use mouthwash, and wear a night guard if their dentist recommends it to protect their restorations. Patients should also not smoke or use chewing tobacco and should try to eat a low-sugar diet to avoid cavities.

Scientists Discover Bacteria That Can Prevent Cavities

bacteria prevent cavitiesTooth decay is a common problem that affects millions of adults and children every year. Many common foods cause acid that wears away at tooth enamel and causes cavities. While good oral hygiene can help, some people who brush and floss every day still get cavities.

Scientists may be able to develop a pill in the future that can prevent cavities. Researchers have discovered a strain of bacteria that might be able to be used in supplements to prevent tooth decay.

The previously unidentified strain of bacteria is called Streptococcus A12. The study found that the bacteria reduce the amount of other bacteria that can lead to cavities by neutralizing acid found in the mouth.

Cavities occur when the pH in the mouth becomes too acidic and causes decay. Streptococcus A12 kills an especially harmful type of bacteria called Streptococcus mutans, which turns sugar in the mouth into lactic acid that then contributes to cavities.

The researchers discovered that Streptococcus A12 can kill Streptococcus mutans bacteria and can also metabolize arginine in the mouth, which contributes to a more neutral pH. Arginine is one of two compounds that are broken down in the mouth to help neutralize acid. This reduces the amount of acid in the mouth that could contribute to tooth decay. Past research found that people who have little or no dental decay are better at breaking down arginine than people who have more cavities.

Even if Streptococcus A12 does not kill the Streptococcus mutans bacteria, it can interfere with its normal processes that could lead to cavities. If the two bacteria are grown together, Streptococcus mutans cannot grow well and produce biofilms, or dental plaque.

The researchers theorize that a pill could be developed using bacteria from the mouths of people who are better at breaking down arginine. It could be given to people as a supplement to increase the amount of beneficial bacteria in their mouths and help prevent tooth decay.

Silver Diamine Fluoride Can Treat Cavities without Drilling

silver diamine fluoride cavitiesDentists have traditionally treated cavities by drilling, removing decay, and filling teeth, but that does not treat the underlying problem. A relatively new treatment that has been used successfully for decades in Japan can stop tooth decay in its tracks.

Silver diamine fluoride uses two elements that have been important in dentistry for decades. Silver has long been used in fillings because of its antimicrobial properties. Silver kills bacteria and prevents the formation of new biofilm on teeth. Fluoride prevents further demineralization of the tooth enamel and hardens enamel to prevent cavities.

Silver diamine fluoride is applied without any need for drilling or surgery. It is applied to teeth like an ointment to seal cavities and prevent further decay. It is used along with ammonia, a stabilizing agent.

The teeth are brushed without toothpaste and rinsed. Teeth with cavities are isolated and kept dry, and excess debris is removed. A microbrush is dipped in a drop of silver diamine fluoride and placed on the cavity for two minutes, and then the excess is removed. The patient should not eat or drink for an hour after treatment.

Silver diamine fluoride and silver nitrate have been available for the treatment of cavities since the late 1800s, but they were used less after local anesthesia was developed and dentists were able to drill cavities. Silver diamine fluoride was approved by the Food and Drug Administration in 2014 after a decade of clinical studies and a public health campaign. It is usually imported from Japan.

One problem with silver diamine fluoride is that the oxidation of the silver can stain teeth black. Potassium iodide can be used to keep teeth white. The upsides are that there is no drilling or local anesthesia required and that silver diamine fluoride costs a fraction of the amount it costs to drill and fill a cavity in a tooth.

KoR Whitening System Can Treat Serious Teeth Discoloration

KoR teeth whiteningThe KoR whitening system is a technique that can lighten teeth by several shades. It is designed to help patients with serious staining and discoloration that is not lightened by other teeth whitening methods. It can also reduce sensitivity after treatment.

The process uses KoR-Seal Trays and specially formulated KoR whitening gels that condition the patient’s teeth and make them permeable to bleaching factors so they whiten better. This allows the KoR system to produce consistent whitening results every time.

Bleaching gels that are commonly used to whiten teeth begin to break down at room temperature or above after they are produced. The KoR whitening gel is refrigerated immediately after it is manufactured. Refrigeration stops KoR gel from breaking down, so it is just as effective at the time it is used as it was when it was refrigerated.

KoR desensitizers can prevent sensitivity problems. The product includes desensitizers that plug dentinal tubules to prevent sensitivity, rather than treating the symptoms.

Unlike other teeth whitening products, the KoR system can produce permanent results. It fully restores teeth to their previous ability to absorb bleaching factors by flooding pigments and stain molecules with bleaching factors and breaking down large stain molecules to colorless and white particles. This makes periodic at-home maintenance easy and allows patients to maintain a white smile even if they consume coffee, tea, red wine, and other staining foods and beverages.

After undergoing in-office KoR whitening treatment, patients should use the at-home whitening gel and wear KoR-Seal Trays with whitening gel at least one night per month indefinitely. If patients have persistent stains, they can continue with an Accelerated Maintenance program.

Gum Disease Can Lead to Bone Loss

periodontal disease bone lossGum disease can start out as mild gum inflammation and progress over time into a severe case of periodontitis. The inflammation can spread to surrounding tissues and can eventually affect the bone in the gums. If the disease progresses, treatment and even surgery may be necessary to save the jaw bone and teeth.

Untreated periodontal disease can lead to bone loss. Bacteria can spread beyond the gums and cause inflammation called gingivitis that infects tissue beneath teeth.

In a healthy mouth, the bones and teeth are surrounded by connective tissue and gum tissue without any wiggle room. The place where the teeth and bone meet creates a tiny dip called a gingival sulcus. As gum disease progresses, the gums can pull away from the teeth and plaque can fill the gingival sulcus. The space can grow into a periodontal pocket. Bacteria can reach the tooth roots and jaw bone, and bacterial toxins can wear away at the bone. If the bone is no longer protected by healthy gums, it can lead to tooth loss, bone craters, or severe deterioration of bone.

The first step in treating bone loss is to address periodontal disease. Your dentist or periodontist will examine your mouth visually and may also use digital imagery. He or she will clean out the infection in the periodontal pocket manually using a process called root planing and scaling.

This may be followed by other treatments. A pocket reduction is a surgical procedure that resets the gums against the teeth. Loose teeth may be removed and replaced with implants. A bone with dips may be reshaped to remove places where bacteria can accumulate. Bone may be regenerated using a surgical procedure involving bone grafting with either natural or synthetic bone. Bone regeneration may be followed by dentures or dental implants.