Friday, August 22, 2014

Oral Cancer - Part 1

Sigmund Freud, Babe Ruth, Roger Ebert, Sammy Davis Jr. all impacted the world with their career defining legacies and will always be remembered for their contributions in their respective fields but they all share one common trait: they were all victims of oral cancer.

Within the US and Canada 1 person dies from oral cancer every hour of every day. Incidence rates are almost twice as high for men vs woman. According to the American Cancer Society incidence rates showed that death rates have been slightly decreasing over the past 3 decades but the number of HPV related oropharynx cancers is on the rise. Currently the WHO estimates that over 450,000 new cases of oral cancer are diagnosed every year. While historically the majority of people are over the age of 40 when diagnosed the number of young people diagnosed with oral cancer is on the rise.

Signs and Symptoms:
  • A sore in the throat or mouth area that does not heal and bleeds easily
  • A persistent red or white patch or a lump or thickening in the mouth, throat, ear, neck or coughing up blood
  • Difficulty chewing, swallowing, or moving the tongue or jaw often indicates a more advanced state

Risk Factors:
  • All forms of smoked or smokeless tobacco products
  • Alcohol
  • A strong correlation exists between the combined use of alcohol and tobacco and a higher susceptibility to oral cancer.  For individuals who smoke and drink heavily studies have shown more than a 30-fold increase in risk 
  • HPV infections are commonly associated with the tonsils or base of the tongue and are believed to be transmitted through sexual contact

Early Detection:
  • Cancer can affect any part of the oral cavity and dentists are often the first line of defense in detecting premalignant abnormalities 
  • Treatment will be less invasive if a cancer can be found in stages 1 or 2 of development
  • A yearly visual cancer screening is essential to catching this disease early
  • A biopsy is the gold standard for confirming a cancer diagnosis

  • This may involve surgery, chemotherapy or radiation individually or as a combined therapy
  • Cetuximab (Erbitux) is a epidermal growth factor receptor (EGFR) drug that has been used successfully in the treatment of head and neck squamous cell carcinomas
  • A multidisciplinary approach involving the efforts of surgeons, radiation oncologists, chemotherapy oncologists, dental practitioners, nutritionists, and rehabilitation and restorative speech specialists will have the highest success rate for therapy

Survival Rates:
  • For combined stages 1-4 approximately 84% of people diagnosed survive 1 year after diagnosis
  • The 5 year survival is 62%
  • The 10 year survival is 52%

In our next BLOG I’ll go over the dental professionals role in cancer treatment

Thursday, August 7, 2014

How to Utilize the Healing Properties of Tea Following a Tooth Extraction

Everyone has had a tooth taken out at one point or another.  Remember when your were a child and you kept wiggling that tooth like their was no tomorrow!  As you grow older it’s possible to lose a tooth for a variety of reasons:

Tooth Decay – Bacteria can metabolize sugar and cause cavities that become so large that a tooth can become sensitive.  If these cavities get into what’s called the nerve pulp tissue of the tooth this can result in a root canal.  If a tooth still cannot be saved following a root canal then the only option would be a tooth extraction.

Gum Disease – A tooth is surrounded by an imperceptibly thin ligament.  In turn this ligament has small projections that are uniquely called Sharpey fibres; these fibres are a connective tissue matrix that secures the tooth to the bone surrounding it.  Over time if the balance between these three structures is thrown into flux a tooth can suffer from recession.  If this recession becomes severe enough a tooth may need to be removed.

Wisdom teeth – The not so smart tooth, evolutionary theory suggests that these extra teeth are present because prehistoric humans needed to have more teeth for chewing all the raw uncooked foods they consumed. In modern times these “extra teeth” have become more of a nuisance than an essential component of the chewing system. Infections have the potential to cause serious problems as wisdom teeth develop. Shown here is a wisdom tooth that is actually resorbing the patients 2nd molar because of an impaction. If a pocket develops around the tooth a painful infection can result and there is a real danger of the infection spreading to other parts of the body.

Orthodontia - Space issues for orthodontic treatment may necessitate removal in order to create space to move teeth around or to sometimes expose an impacted tooth. This exposed tooth can then be gripped with a bracket to facilitate its movement back into a normal position.

Root fractures – While vertical fractures can be associated with tooth decay they are more commonly associated with root canaled teeth that have become weak.  They also can be the result of a bruxer who puts so much force on a tooth that a small crack propagates all the way through the tooth.  These situations can make a tooth quite sore and sensitive to eating and pressure.

One of the complications that can result from having a tooth pulled out is excessive bleeding from the extraction site.  This is quite normal for some due to their body’s inability to form a blood clot quickly enough to stop the bleeding.  While this is not a life threatening condition it certainly can lead to increased post-operative pain.

One easy at home remedy available to control bleeding is to use teabags.  If after using moistened guaze pads for an hour, for 20 minute intervals, the bleeding doesn't stop then use this technique.  Place the moistened tea bag directly on the site for 20 minute intervals for up to an hour using slight pressure until the bleeding stops. 

So what is it about tea bags that allow it have this highly beneficial side effect? Tea contains an herbal ingredient known as tannins that are a bitter astringent plant phenol that can either shrink or bind to proteins. 

Have you ever had that dry feeling on your lips after drinking wine, a strong tea or eating an un-ripened fruit? That's actually caused by the astringency of tannins.

Tannins have also been linked to helping stop the spread of infections while providing a protective sheath for internal healing.  It is possible to use teabags for really any type of bleeding and/or infection.  Just make sure to moisten the tea bag before placing it on the wound to prevent it from inadvertently removing any portion of the healing tissue on the top of a wound.

So there you go, tea isn’t just a drink that you enjoy to bring some relaxation into your day, it’s also a great healing tool. So the next time you have an injury or a tooth taken out don’t forget to keep some teabags handy just in case!