In a study, Identification of Unrecognized Diabetes and Pre-diabetes in a Dental Setting, published in the July 2011 issue of the Journal of Dental Research, researchers at Columbia University College of Dental Medicine found that dental visits represented a chance to intervene in the diabetes epidemic by identifying individuals with diabetes or pre-diabetes who are unaware of their condition. The study sought to develop and evaluate an identification protocol for high blood sugar levels in dental patients and was supported by a research grant from Colgate-Palmolive. The authors report no potential financial or other conflicts.
“Periodontal disease is an early complication of diabetes, and about 70 percent of U.S. adults see a dentist at least once a year,” says Dr. Ira Lamster, dean of the College of Dental Medicine, and senior author on the paper. “Prior research focused on identification strategies relevant to medical settings. Oral healthcare settings have not been evaluated before, nor have the contributions of oral findings ever been tested prospectively.”
For this study, researchers recruited approximately 600 individuals visiting a dental clinic in Northern Manhattan who were 40-years-old or older (if non-Hispanic white) and 30-years-old or older (if Hispanic or non-white), and had never been told they have diabetes or pre-diabetes.
Approximately 530 patients with at least one additional self-reported diabetes risk factor (family history of diabetes, high cholesterol, hypertension, or overweight/obesity) received a periodontal examination and a fingerstick, point-of-care hemoglobin A1c test. In order for the investigators to assess and compare the performance of several potential identification protocols, patients returned for a fasting plasma glucose test, which indicates whether an individual has diabetes or pre-diabetes.
Researchers found that, in this at-risk dental population, a simple algorithm composed of only two dental parameters (number of missing teeth and percentage of deep periodontal pockets) was effective in identifying patients with unrecognized pre-diabetes or diabetes. The addition of the point-of-care A1c test was of significant value, further improving the performance of this algorithm.
“Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications,” says Dr. Evanthia Lalla, an associate professor at the College of Dental Medicine, and the lead author on the paper. “Relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important,” she adds. “Our findings provide a simple approach that can be easily used in all dental-care settings.”
Other authors who contributed are: Dr. Carol Kunzel, associate clinical professor at the College of Dental Medicine and at Columbia’s Mailman School of Public Health; Dr. Sandra Burkett, at the College of Dental Medicine; and Dr. Bin Cheng, an assistant professor in the Department of Biostatistics at the Mailman School of Public Health.
According to the Centers for Disease Control and Prevention, one in four people affected with type 2 diabetes in the United States remains undiagnosed. And those with pre-diabetes are at an increased risk for type 2 diabetes and also for heart disease, stroke and other vascular conditions typical of individuals with diabetes.
Your comments are appreciated.
Source: Science Daily
Photo: DearDoctor.com
I have listed a few simple steps to help prevent gingivitis and periodontal disease as a reminder to all of our patients.
STEP 1. When normally healthy, pink, and firm gums become red, swollen, and spongy, you have a problem — a problem called gingivitis. If the condition becomes severe enough, it can lead to periodontal disease — a deterioration of the teeth and bone that anchor the teeth. So the first step in combating gingivitis is to make sure you’re brushing twice a day, flossing once a day, and visiting a dentist at least twice a year for a checkup and cleaning.
STEP 2. When you brush your teeth, make sure you’re working it for at least two minutes. Most dentists suggest spending 30 seconds on each quadrant of your mouth.
STEP 3. When it comes to germs, your tongue can be like Velcro, so brushing it along with your gums and teeth will not only help keep your breath fresher, but will reduce the chance that bacteria, viruses, or fungi find harbor in your mouth.
STEP 4. Next, make the most out of your flossing time. Floss between every tooth, all the way down to the edge of the gum line at least once a day.
STEP 5. Finally, use an ADA-approved antimicrobial mouth rinse to finish off your routine. If these steps don’t keep gingivitis away, you’ll need to see a dentist right away. He or she may need to perform a more extensive cleaning or provide you with a prescription dental rinse, or both.
Source: American Dental Association
Rotting teeth. Diseased lungs. A corpse of a smoker.
Nine new warning labels featuring graphic images that convey the dangers of smoking will be required by the Food and Drug Administration to be on U.S. cigarette packs by 2012. Other images include a man with a tracheotomy smoking and a mother holding a baby with smoke swirling around them. The labels will include phrases like “Smoking can kill you” and “Cigarettes cause cancer.”
The labels, which the FDA released in late June, 2011, are a part of the most significant change to U.S. cigarette packs in 25 years. They’re aimed at curbing tobacco use, which is responsible for about 443,000 deaths in the U.S. a year.
The labels will take up the top half — both front and back — of a pack of cigarettes and each will include a national quit smoking hotline number. Warning labels also must appear in advertisements and constitute 20 percent of an ad. Cigarette makers have until the fall of 2012 to comply.
“These kind of graphic warning labels strengthen the understanding of people about the health risks of smoking,” FDA Commissioner Margaret Hamburg said in an interview with The Associated Press. “We clearly have to renew a national conversation around these issues and enhance awareness.”
Mandates to introduce new graphic warning labels were part of a law passed in 2009 that, for the first time, gave the federal government authority to regulate tobacco, including setting guidelines for marketing and labeling, banning certain products and limiting nicotine. The announcement follows reviews of scientific literature, public comments and results from an FDA-contracted study of 36 labels proposed last November.
The legality of the new labels is part of a pending federal lawsuit filed by Winston-Salem, N.C.-based Reynolds American Inc., parent company of America’s second-largest cigarette maker, R.J. Reynolds; No. 3 cigarette maker, Greensboro, N.C.-based Lorillard Inc.; and others.
Tobacco makers in the lawsuit have argued the warnings would relegate the companies’ brands to the bottom half of the cigarette packaging, making them “difficult, if not impossible, to see.”
A spokesman for Richmond, Va.-based Altria Group Inc., parent company of the nation’s largest cigarette maker, Philip Morris USA, said the company was looking at the final labels but would not comment further.
In recent years, more than 30 countries or jurisdictions have introduced labels similar to those being introduced by the FDA. The U.S. first mandated the use of warning labels stating “Cigarettes may be hazardous to your health” in 1965. Current warning labels — a small box with black and white text — were put on cigarette packs in the mid-1980s.
The FDA says the new labels will “clearly and effectively convey the health risks of smoking” aimed at encouraging current smokers to quit and discouraging nonsmokers and youth from starting to use cigarettes.
“These labels are frank, honest and powerful depictions of the health risks of smoking,” Health and Human Services Secretary Kathleen Sebelius said in a statement.
American Cancer Society CEO John R. Seffrin applauded the new labels in a statement, saying they have the potential to “encourage adults to give up their deadly addiction to cigarettes and deter children from starting in the first place.”
The new labels come as the share of Americans who smoke has fallen dramatically since 1970, from nearly 40 percent to about 20 percent. The rate has stalled since about 2004. About 46 million adults in the U.S. smoke cigarettes.
It’s unclear why declines in smoking have stalled. Some experts have cited tobacco company discount coupons on cigarettes or lack of funding for programs to discourage smoking or to help smokers quit.
While it is impossible to say how many people quit because of the labels, various studies suggest the labels do spur people to quit. The new labels offer the opportunity for a pack-a-day smoker to see graphic warnings on the dangers of cigarettes more than 7,000 times per year.
The FDA estimates the new labels will reduce the number of smokers by 213,000 in 2013, with smaller additional reductions through 2031.
Tobacco use costs the U.S. economy nearly $200 billion annually in medical costs and lost productivity, the FDA said. Tobacco companies spend about $12.5 billion annually on cigarette advertising and promotion, according to the latest data from the Federal Trade Commission.
The World Health Organization said in a survey done in countries with graphic warning labels that a majority of smokers noticed the warnings and more than 25 percent said the warnings led them to consider quitting.
While some have voiced concerns over the hard-hitting nature of some of the labels, those concerns should be trumped by the government’s responsibility to warn people about the dangers of smoking, said David Hammond, a health behavior researcher at the University of Waterloo in Canada, who worked with the firm designing the labels for the FDA.
“This isn’t about doing what’s pleasant for people. It’s about fulfilling the government’s mandate if they’re going to allow these things to be sold,” Hammond said. “What’s bothering people is the risk associated with their behavior, not the warnings themselves.”
In places like Canada, Hammond said smokers offended by some of the images on cigarettes packs there started asking for different packs when they received ones with certain gory images, or used a case to cover them up. But smokers said those warnings still had an effect on them.
Canada introduced similar warning labels in 2000. Since then, its smoking rates have declined from about 26 percent to about 20 percent. How much the warnings contributed to the decline is unclear because the country also implemented other tobacco control efforts.
Your comments are appreciated.
Cary Feuerman, DMD
Periodontal Associates
Source: New Haven Register
Photo: U.S. Food and Drug Administration
Do you know what’s lurking on your toothbrush?
Your toothbrush is loaded with germs, say researchers at England’s University of Manchester. They’ve found that one uncovered toothbrush can harbor more than 100 million bacteria, including E. coli bacteria, which can cause diarrhea, and staphylococci (“Staph”) bacteria that cause skin infections.
But don’t panic. Your mouth wasn’t exactly sterile to begin with.
Mouthful of Bacteria
“The bottom line is, there [are] hundreds of microorganisms in our mouths every day,” says Gayle McCombs, RDH, MS, associate professor and director of the Dental Hygiene Research Center at Old Dominion University.
That’s no big deal. Problems only start when there is an unhealthy balance of bacteria in the mouth. McCombs says.
“It’s important to remember that plaque — the stuff you’re removing from your teeth — is bacteria,” says dentist Kimberly Harms, DDS, consumer advisor for the American Dental Association. “So you’re putting bacteria on your toothbrush every time you brush your teeth.”
Could Your Toothbrush Be Making You Sick?
Probably not. Regardless of how many bacteria live in your mouth, or have gotten in there via your toothbrush, your body’s natural defenses make it highly unlikely that you’re going to catch an infection simply from brushing your teeth.
“Fortunately, the human body is usually able to defend itself from bacteria,” Harms says. “So we aren’t aware of any real evidence that sitting the toothbrush in your bathroom in the toothbrush holder is causing any real damage or harm. We don’t know that the bacteria on there are translating into infections.”
Still, you should exercise some common sense about storing your toothbrush, including how close it is to the toilet.
Don’t Brush Where You Flush
Most bathrooms are small. And in many homes, the toilet is pretty close to the bathroom sink where you keep your toothbrush.
Every toilet flush sends a spray of bacteria into the air. And you don’t want the toilet spray anywhere near your open toothbrush.
“You don’t store your plates and glasses by the toilet, so why would you want to place your toothbrush there?” McCombs says. “It’s just common sense to store your toothbrush as far away from the toilet as possible.”
You also wouldn’t eat after going to the bathroom without first washing your hands. The same advice applies before brushing your teeth, McCombs says.
Toothbrush Storage Tips
Once you’ve moved your toothbrush away from the toilet, here are a few other storage tips to keep your brush as germ-free as possible:
- Keep it rinsed. Wash off your toothbrush thoroughly with tap water every time you use it.
- Keep it dry. “Bacteria love a moist environment,” Harms says. Make sure your brush has a chance to dry thoroughly between brushings. Avoid using toothbrush covers, which can create a moist enclosed breeding ground for bacteria.
- Keep it upright. Store your toothbrush upright in a holder, rather than lying it down.
- Keep it to yourself. No matter how close you are to your sister, brother, spouse, or roommate, don’t ever use their toothbrush. Don’t even store your toothbrush side-by-side in the same cup with other people’s brushes. Whenever toothbrushes touch, they can swap germs.
Do Toothbrush Sanitizers Really Work?
Various products pledge to sanitize your toothbrush. Some say they kill bacteria with heat or ultraviolet light, germ-killing sprays, or rinses. Others have built-in antibacterial bristles.
There’s evidence that at least some of these products do effectively kill germs. But there’s no real proof that using any toothbrush sanitizer will reduce your risk of getting sick.
If you choose to use one of these products, make sure that it has been reviewed by the FDA, which checks the validity of consumer health product marketing claims.
Remember that even the best products won’t kill all the germs on your toothbrush. At best, they’ll kill 99.9% of the germs.
That means if you have one million bacteria on your toothbrush to start, you’ll still have about 1,000 remaining when you’re finished sanitizing, Harms says.
Some websites recommend putting your toothbrush into the microwave oven or dishwasher to sanitize it. Although these methods will kill some of the bacteria, they will probably damage your toothbrush in the process. It’s better to just buy disposable brushes and throw them out.
When to Toss Your Toothbrush
The best way to limit the bacteria on your toothbrush is to replace it on a regular basis.
The American Dental Association recommends throwing out your toothbrush every three to four months. If the bristles become frayed, you’re sick, or you have a weak immune system, throw it out even more often. If you use an electric toothbrush, throw out the head as often as you’d discard a disposable toothbrush.
Every time you’re tempted to skip brushing and flossing your teeth, remember how many bacteria lurk in your mouth – and what they can do.
“It’s bacteria that cause gum disease, and decay, and bad breath,” Harms says. “Make sure you’re brushing and flossing as often as possible to eliminate some of those bacteria.” Rinsing your mouth with an antibacterial mouthwash before you brush can also help eliminate bacteria before they can get onto your brush.
Article by Stephanie Watson
Source: KTVQ.com
To make your teeth last a lifetime, don’t do these things.
Teeth are tough — their enamel is the hardest part of the body — but they’re no match for neglect, misuse, or abuse. Here are some surefire ways to find out how vulnerable your teeth are — trust us, you don’t want to do this:
1. Don’t Brush After Every Meal.
The ideal is to brush your teeth three times a day: after breakfast, lunch, and dinner. But if you do it too soon, you can scrub away tooth enamel that becomes softer in the acidic environment created in your mouth when you eat.
“Make sure you wait 30 to 60 minutes after each meal, which gives the acidity time to neutralize and the teeth time to remineralize,” says Debra Gray King, DDS, FAACD, of the Atlanta Center for Cosmetic Dentistry.
Brushing too much, too hard, or with a hard-bristle brush can also erode your enamel. Brush gently, using circular strokes and a soft brush.
2. Forget About Flossing.
Flossing stimulates gum health by cleaning between the teeth and under the gum line. Gums bleed when you brush vigorously? That’s a sign of mild gingivitis, or inflammation of the gums, which can lead to tooth loss.
“You need to brush and floss your teeth every time you eat,” says Jeffrey Gross DDS, FAGD, a Cleveland dentist. “The longer food stays in contact with the teeth and the gums, the easier it is to create problems.”
3. Skip checkups.
Dentists recommend every six months, but most patients fail to comply. This allows plaque to form tatar, which attracts more plaque on its surface, carrying the plaque deeper within the gums. This can weaken supporting structures, such as bone.
“The sooner you find issues, the easier and a lot less expensive they will be to address,” King says.
4. Use Your Teeth as Tools.
Chomping ice and hard candy, not to mention popping off bottle caps and ripping open potato chip bags, can crack or break your teeth.
“People tend to do some wild things with their teeth,” King says. She recalls a patient in her 50s who habitually gripped the ropes of her sailboat’s mast between her teeth.
Over time, the woman’s natural teeth had worn to the point she needed porcelain veneers. Find a bottle opener or pair of scissors. And if you’re sailing, use your hands.
5. Ditch the Mouthguard.
The Academy of General Dentistry (AGD) recommends mouthguards for many athletes.
“Anytime there is a strong chance for contact with other participants or hard surfaces, it is advisable to wear a mouthguard. Players who participate in basketball, softball, football, wrestling, soccer, lacrosse, rugby, in-line skating, and martial arts, as well as recreational sports such as skateboarding and bicycling, should wear mouthguards while competing,” the AGD’s web site states.
6. Grind Away.
Some people clench or grind their teeth when bored, lifting something heavy or stressed; others do it while they sleep. Tooth-to-tooth clenching can wear down teeth and “make you look 10 to 20 years older,” King says.
Grinding also paves the way for cavities. “Aside from causing pressure and fractures, grinding wears away the top layer of enamel and the lower levels of enamel beyond the dentin, which can lead to decay,” Gross says. Can’t stop? Get fitted for a mouthguard.
7. Guzzle Soda, Sports Drinks, and Fruit Juices.
Soda and sports drinks often have either too much sugar or, in the case of diet soda, too much acid. Fruit juices often contain sugar but compared to soda and sports drinks, are “a healthier choice” and water is even better yet, Gross says.
8. Drink Lots of Red Wine, Coffee, or Tea.
The surface of stained teeth is like sandpaper and attracts more bacteria, which can indirectly lead to tooth decay.
As wine editor for Dish magazine, Yvonne Lorkin of Christchurch, New Zealand, tastes thousands of wines each year. At 37, she spends more on dental upkeep than people twice her age.
“The constant onslaught of acid on my enamel is an occupational hazard, I guess, as we’re swilling the wines around in our mouths rather than just swallowing,” Lorkin tells WebMD in an email interview.
Aside from cutting back, Gross recommends using a straw, when possible, so staining liquids bypass your teeth.
9. Whiten Too Often.
Chronic whitening or failing to follow instructions can lead to gum irritation and increased tooth sensitivity. Desensitizing toothpaste can help.
If you have very sensitive teeth, gum disease, or worn enamel, “your dentist may discourage whitening,” says Charles H. Perle, DMD, FAGD, a dentist in Jersey City, N.J. and a spokesman for the AGD. Check before starting any whitening treatment.
10. Drink Bottled Water.
Most bottled water has little or no fluoride and most home filtration systems filter much of it out. Stick with fluoridated tap water since it’s “the most cost-effective way to prevent cavities and fight tooth decay,” Perle says. If your water isn’t fluoridated, your dentist may prescribe fluoride supplements.
11. Get Your Tongue Pierced.
When you speak, your tongue moves to make certain sounds and consequently “you’re jamming the metal piercing into your teeth,” Gross says. Fractured teeth may require veneers or crowns in a patient who otherwise doesn’t have other issues.
Jason Lazarus, CEO of Gadgets and Gear in Hauppauge, N.Y., got his tongue pierced and admits he played with it “all the time.” Lazarus says he was shocked when X-rays showed his front teeth “dramatically shaved and chipped” and immediately took his tongue ring out.
“I didn’t want my teeth to get worse,” Lazarus says. He has since spent $2,000 on laminates for his two front upper teeth.
12. Be Bulimic.
Bulimia, which is characterized by bingeing and vomiting, can cause significant dental problems because of the stomach acids.
“The enamel is usually just kind of worn off, mostly on the front teeth, but even going to the back teeth,” King says. If the damage is done, you may need restorations.
13. Abuse Drugs Such as “Meth.”
Crystal methamphetamine, an illegal and highly addictive stimulant, can wreak havoc on your mouth. Users often crave sugary foods and drinks, clench their teeth, and have dry mouth. Telltale signs of “meth mouth” are rampant decay with blackened teeth on the verge of falling out.
“People on methamphetamines are notorious for not taking care of themselves,” Gross says. “By the time the patient is 25 or 30, they are looking at a full set of dentures.”
14. Chronically Use Some Legal Medications.
Oral contraceptives change a woman’s hormonal balance and can lead to chronic gum disease.
“Once they get off the medication, the damage is often done,” Gross says. Some over-the-counter cough medications have lots of sugar, and antihistamines can cause dry mouth, which can lead to decay since saliva protects the teeth.
15. Continue Lighting Up.
Smoking is bad for teeth and gums. Stains make teeth more susceptible to bacteria. It’s also a factor in the development of periodontal or gum and bone disease.
“The smoke impedes the ability of the gum tissue to maintain a healthy state and fight off disease-creating bacteria,” Gross says. “Almost half of the people who are over 60 who wear dentures are smokers.”
Comments are appreciated!
Source: WebMD
Photo: Flickr
HUMAN PAPILLOMA VIRUS CELL
I came across an interesting article by Laura Landro in the Wall Street Journal.
A sharp rise in a type of throat cancer among men is increasingly being linked to HPV, the sexually transmitted human papillomavirus that can cause cervical cancer in women. A new study from the National Cancer Institute warns that if recent trends continue, the number of HPV-positive oral cancers among men could rise by nearly 30% by 2020. At that rate, it could surpass that of cervical cancers among women, which are expected to decline as a result of better screening. The study was recently presented at the annual American Society of Clinical Oncology meeting.
Between 1988 and 2004, the researchers found, the incidence of HPV-positive oropharynx cancers—those that affect the back of the tongue and tonsil area—increased by 225%. Anil Chaturvedi, a National Cancer Institute investigator who led the research, estimates there were approximately 6,700 cases of HPV-positive oropharynx cancers in 2010, up from 4,000 to 4,500 in 2004, and cases are projected to increase 27% to 8,500 in 2020.
Recent studies show about 25% of mouth and 35% of throat cancers are caused by HPV, according to the Centers for Disease Control and Prevention.
Men account for the majority of cases, and currently the highest prevalence is in men 40 to 55, says Eric Genden, chief of head and neck oncology at Mount Sinai Medical Center in New York. Studies have shown that the cancer can show up 10 years after exposure to HPV, which has become the most common sexually transmitted virus in the U.S.
“We are sitting at the cusp of a pandemic,” says Dr. Genden.
Dr. Chaturvedi says more studies are needed to evaluate whether a vaccine now used to prevent HPV for genital warts and genital and anal cancers can prevent oral HPV infections.
The HPV vaccine, Gardasil, made by Merck & Co., was approved in 2006 for girls and young women up to age 26, but while it is routinely recommended, only about 27% of girls have received all three doses needed to confer protection.
The FDA in 2009 approved the vaccine for males ages 9 through 26 to reduce the risk of genital warts, and in 2010 approved it for both sexes for the prevention of anal cancers. However, the CDC has only a “permissive” recommendation for boys, rather than a routine recommendation, meaning doctors generally will only administer it if parents or patients ask for it, says Michael Brady, chairman of the American Academy of Pediatrics infectious disease committee.
Lauri Markowitz, a CDC medical epidemiologist, says the CDC advisory committee that sets vaccine recommendations will review new data related to the issue at a meeting next month. However, at present there aren’t any clinical-trial data showing the effectiveness of the vaccine against oral infections, she says.
A Merck spokeswoman says the company has no plans to study the potential of Gardasil to prevent these cancers.
Researchers say it isn’t clear why men are at higher risk for HPV-positive oral cancers. But for both men and women a high lifetime number of sex partners is associated with the cancer.
Changes in sexual behaviors that include increased practice of oral sex are associated with the increase, but a 2007 New England Journal of Medicine article also said engagement in casual sex, early age at first intercourse, and infrequent use of condoms each were associated with HPV-positive oropharyngeal cancer. Mouth-to-mouth contact through kissing can’t be ruled out as a transmission route.
Most infections don’t cause symptoms and go away on their own. But HPV can cause genital warts and warts in the throat, and has been associated with vaginal, vulvar and anal cancers.
Anna Giuliano, chairwoman of the department of cancer epidemiology at the Moffitt Cancer Center in Tampa, Fla., who studies oral HPV infections of men in several countries, says the rise in cancers among men shows it is important for males, as well as girls, to be vaccinated.
Doctors typically don’t test for HPV-positive oral cancers. But Jonathan Aviv, director of the voice and swallowing center at New York’s ENT and Allergy Associates, says his group looks through a miniature camera inserted through the nose at the back of the throat and tongue, and can biopsy suspicious warts or tumors.
In addition to being asked about symptoms such as hoarseness, difficulty swallowing, a neck mass or mouth sore that won’t heal, patients are asked to fill out a risk-assessment sheet that includes the number of lifetime oral-sex partners. “People do get upset sometimes, but if your sexual history puts you at an increased risk for HPV, you should go and see an ear, nose and throat doctor,” says Dr. Aviv.
Fortunately, says Mount Sinai’s Dr. Genden, those with HPV-positive oral cancers have a disease survival rate of 85% to 90% over five years, higher than those with oral cancers that aren’t linked to HPV, but are more commonly linked to alcohol use, tobacco, and radiation exposure.
Source: WSJ Online
Photo Credit: hpvvirusinwomen.com
The American obsession with dental hygiene has taken an ironic turn over the past decade. In an attempt to have the bright, white, healthy-looking smile of the stars, many consumers are bleaching their teeth into oblivion. Dentists call this addiction to whitening “bleachorexia,” calling the overbleachers “bleach junkies.” Such patients abuse in-office and at home bleaching agents, leaving teeth eroded, prone to sensitivity and extremely unhealthy, despite their pearly white exteriors.
“The media has done a good job of making whitening sound innocuous, but it’s not,” says Dr. Ira Handschuh, a White Plains, N.Y., dentist. Carbamide peroxide, the whitening agent in most bleaches, can irritate the gums, causing them to recede, making the teeth brittle, chalky and so thin as to be translucent at the edges when the product is overused.
Lyndsey Gurowitz, 28, has been bleaching her teeth for the past decade with a combination of professional bleaching trays tailor made for her teeth, at-home whitening kits and a few sessions at a “bleaching spa.”
“Whenever I thought my teeth weren’t up to par, I’d do another bleaching. I would use the product for the prescribed amount of time, but then they say to do it only once a month and I would just kind of do it whenever I was unhappy with the color,” says Gurowitz, who lives in New York. “I think it’s a level of hygiene. I don’t want my teeth to look dirty, or like I don’t take care of them. I think I’m being realistic — I don’t want them to look like Chiclets,” she says.
After her dentist told her she was losing the enamel on her teeth, she was given a special, more gentle toothbrush and she started using special toothpaste for sensitive teeth, but she continues to bleach regularly. The bleaching trays, designed to fit snugly on her teeth, are now too large, possibly due to the wearing down of her teeth by the bleach, says Dr. Jennifer Jablow, Gurowitz’s dentist. “For some people, their teeth are never white enough, so they’ll do anything to brighten,” says Jablow, who coined the term “bleachorexic” back in 2005. Ironically, beyond making teeth weak and prone to decay, overbleaching can actually strip away the protective enamel allowing the underbody of the teeth, which is naturally more yellow in color, to show through.
When someone is a bleaching junkie, you can spot it right away, says Dr. Irwin Smigel, founder and current president of the American Society for Dental Aesthetics. “It’s not everybody, but we see it often enough that it bothers me. Enamel doesn’t grow back. Sometimes we have to put crowns or veneers on when the teeth have become too damaged,” he says.
Bleaching in the Time of the Bard
Whitening strips and bleach trays may be an invention of the past 30 years, but techniques for teeth whitening go back centuries. In the 1100s, physicians would recommend scrubbing teeth with elecampane (a yellow flower) or a sage and salt mixture to make “them firm, white and healthy” or “clean, white, and sweet,” Trevor Anderson, an osteoarchaeologist, notes in a 2004 paper on medieval dentistry. Later on, some would use acid washes in an attempt to strip away stains, but unfortunately, these rinses mostly stripped away all the enamel on the teeth, leaving them crumbling, says Dr. Scott Swank, curator of the National Museum of Dentistry in Baltimore. It wasn’t until the advent of Hollywood and Technicolor movies that there was widespread interest in whitening teeth, usually through whitening toothpastes, he says. Enter the 1980s and in-office bleaching treatments, and it only took off from there, Swank says. “I think it’s followed the rise in plastic surgery and other elective cosmetic procedures throughout the 1990s. It’s a matter of what people are willing to put their income into.”
Bright White or Bust
Today, Americans spend more than a billion dollars a year just on over-the-counter teeth-whitening products, according to the American Academy of Cosmetic Dentistry. While bleaching can be done safely, especially under the guidance of a dentist, the advent of at-home bleaching kits and spa bleaching treatments have made it all too easy for bleaching junkies to double up or triple up on treatments at the expense of their dental health.
“Bleaching is very effective in moderation, and it’s safe in moderation,” says Dr. Jablow. “It’s when you’re bleaching all the time, beyond what is recommended — that’s when you run into problems.”
Source and Photo Credit: ABC News/Health
It is known that women are more susceptible to gum disease and associated periodontal problems. The primary reason for this finding is related to both normal and abnormal hormonal changes that women experience throughout their life. A few are listed below.
Puberty
During puberty, an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum’s sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red and feel tender.
As a young woman progresses through puberty, the tendency for her gums to swell in response to irritants will lessen. However, during puberty, it is important to follow a good at-home oral hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.
Menstruation
Occasionally, some women experience menstruation gingivitis. Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman’s period and clears up once her period has started.
Pregnancy
Women may experience increased gingivitis or pregnancy gingivitis beginning in the second or third month of pregnancy that increases in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue.
In some cases, gums swollen by pregnancy gingivitis can react strongly to irritants and form large lumps. These growths, called pregnancy tumors, are not cancerous and are generally painless. If the tumor persists, it may require removal by a periodontist.
Studies have shown a relationship between periodontal disease and pre-term, low-birth-weight babies. Any infection, including periodontal infection, is cause for concern during pregnancy. In fact, pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small! If you are planning to become pregnant, be sure to include a periodontal evaluation as part of your prenatal care.
Women who use oral contraceptives may be susceptible to the same oral health conditions that affect pregnant women. They may experience red, bleeding and swollen gums. Women who use oral contraceptives should know that taking drugs sometimes used to help treat periodontal disease, such as antibiotics, may lessen the effect of an oral contraceptive.
Menopause and Post-Menopause
Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.
In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition. Most women find that estrogen supplements help to relieve these symptoms.
Bone loss is associated with both periodontal disease and osteoporosis. Research is being done to determine whether the two are related. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth as well as other parts of the body.
So, what can women do to help prevent or minimize gum problems?
Steps to Protect Oral Health:
Careful periodontal monitoring and excellent oral hygiene is especially important for women who may be noticing changes in their mouths during times of hormonal fluctuation. To help ensure good oral (and overall) health, be sure to:
- See a dental professional for cleaning at least twice a year.
- if you or your dentist notice problems with your gum tissue. Problems may include:
- Bleeding gums during brushing
- Red, swollen or tender gums
- Gums that have pulled away from the teeth
- Persistent bad breath
- Pus between the teeth and gums
- Loose or separating teeth
- A change in the way your teeth fit together when you bite
- A change in the fit of your dentures
- Keep your dental professionals informed about any medications you are taking and any changes in your health history.
- Brush and floss properly every day. Review your techniques with a dental professional.
For more information, check out the American Academy of Periodontology. Happy and Healthy Mother’s Day!
Source: AAP
Photo: publicdomainpictures.net
Cary Feuerman, DMD
Periodontal Associates
Nurses who care for elderly patients with dementia now have a tailored approach to dental hygiene for these special patients, thanks to a pilot study by a team of nurses. “Poor oral health can lead to pneumonia and cardiovascular disease as well as periodontal disease,” said Rita A. Jablonski. According to Jablonski, assistant professor of nursing, Penn State, persons with dementia resist care when they feel threatened. In general, these patients cannot care for themselves and need help.
Jablonski and her team introduced an oral hygiene approach called Managing Oral Hygiene Using Threat Reduction (MOUTh) specifically for dementia patients. Many of their strategies focus on making the patient feel more comfortable before and while care is provided, the researchers report in the current issue of Special Care in Dentistry. “We have come up with 15 strategies — techniques to help reduce threat perception,” said Jablonski. These strategies include approaching patients at eye level if they are seated, smiling while interacting, pantomiming, and guiding patients to perform their own care by placing a hand over the patient’s hand and leading. People with dementia are often no longer able to distinguish low or non-threatening situations from highly threatening situations. This happens when the parts of the brain that control threat perception — particularly the fight, flight or freeze responses — begin to deteriorate. As a result, patients with dementia often react to something as intimate as a nurse brushing their teeth as a perceived threat.
In the past 30 years the number of nursing-home residents who still have their own teeth has risen significantly. Many of these people need assistance with their dental hygiene, as well as with other hygiene.
Jablonski and her team conducted a pilot study with seven people who had either moderate or severe cases of dementia. The researchers used the MOUTh technique on the subjects for two weeks, recording the state of the patients’ mouths and how the patients reacted throughout the study. At the beginning of the study all seven subjects had poor oral health, as determined by the Oral Health Assessment Tool. Eight categories concerning oral health are scored between zero and two. The lower the score the healthier the mouth. The average score for the subjects at the start of the study was 7.29. By the end of the study the average score was 1.00.
“To my knowledge, we are the only nurses in the country who are looking at ways to improve the mouth care of persons with dementia, especially those who fight and bite during mouth care,” said Jablonski. “Our approach is unique because we frame resistive behavior as a reaction to a perceived threat.”
Source: Science Daily
Reports Suggest Overuse of Fixodent and Older Version of Poligrip May Cause Nerve Damage:
Feb. 15, 2011 — Many cases of mysterious nerve damage turn out to be caused by overuse of popular denture products, an increasing number of reports suggests.
The culprit: zinc in Fixodent, from Procter & Gamble, and — until it became zinc-free last May — Poligrip from GlaxoSmithKline.
The body needs zinc. But because the body balances zinc and copper, people who get way too much zinc have dangerously low levels of copper. Moreover, zinc overdose itself may be toxic.
The result is bone marrow suppression and degeneration of the spinal cord, usually resulting in crippling nerve damage. It’s been called “human swayback disease.”
This may be a good reason for edentulous patients to explore implant therapy to retain dentures more securely or for implant supported restorations.
Read full article: http://webmd.com/oral-health/news/20110215/zinc-poisoning-linked-to-popular-denture-creams