Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.
The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").
Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.
The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.
Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.
Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.
It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.
Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.
If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”
We instinctively know when a smile looks normal—and when it doesn't. It could be that something simply looks out of place like crooked teeth. But we might also notice when something is missing—as with one or both of the canine teeth.
The canine teeth align just under the eyes and are recognizable by their pointed ends. When they're missing, the smile looks “incomplete.” But “missing” in this case could mean “invisible”—the teeth are there, but hidden within the gums because they failed to come in properly and became impacted. This often happens on a smaller jaw where other teeth have crowded into the space intended for them.
Fortunately, we may have a remedy, and not just for appearance's sake—any impacted tooth can cause health problems, from gum abscesses to root damage of neighboring teeth. Although this might necessitate their surgical removal, we might also be able to coax them through the gums into better position in the jaw, if they're in a reasonably good position. This could result in both a boost to a patient's oral health and a more normal looking smile.
First, though, a patient will need to undergo a thorough bite evaluation by an orthodontist. Besides pinpointing the impacted teeth's precise location with x-rays or CT technology, an orthodontist will also want to assess the positions and condition of the rest of the teeth. If the conditions are right and there's enough room in the jaw, the orthodontist may recommend drawing the impacted canines into proper alignment in the jaw.
The process starts when an oral surgeon exposes the impacted teeth by surgically cutting through the gum tissue. They then attach a small bracket to the tooth with a tiny metal chain attached, the other end of which is looped over orthodontic hardware attached to other teeth. The tension on the chain by the hardware gradually nudges the teeth downward out of the gums. This is usually done in coordination with other measures to fully correct the bite.
If the procedure is successful, bringing the canines out of impaction reduces the problems those teeth could cause the person's oral health. But just as important, it can restore normality to their smile.
If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”
Fans everywhere were recently saddened by the news of musical legend Eddie Van Halen's death. Co-founder and lead guitarist for the iconic rock group Van Halen, the 65-year-old superstar passed away from oral cancer.
Van Halen's rise to worldwide fame began in the 1970s with his unique guitar style and energetic performances, but behind the scenes, he struggled with his health. In 2000, he was successfully treated for tongue cancer. He remained cancer-free until 2018 when he was diagnosed with throat cancer to which he succumbed this past October.
Van Halen claimed the metal guitar picks he habitually held in his mouth caused his tongue cancer. It's more likely, though, that his heavy cigarette smoking and alcohol use had more to do with his cancers.
According to the American Cancer Society, most oral cancer patients are smokers and, as in Van Halen's case, are more likely to beat one form of oral cancer only to have another form arise in another part of the mouth. Add in heavy alcohol consumption, and the combined habits can increase the risk of oral cancer a hundredfold.
But there are ways to reduce that risk by making some important lifestyle changes. Here's how:
Quit tobacco. Giving up tobacco, whether smoked or smokeless, vastly lowers your oral cancer risk. It's not easy to kick the habit solo, but a medically supervised cessation program or support group can help.
Limit alcohol. If you drink heavily, consider giving up alcohol or limiting yourself to just one or two drinks a day. As with tobacco, it can be difficult doing it alone, so speak with a health professional for assistance.
Eat healthy. You can reduce your cancer risk by avoiding processed foods with nitrites or other known carcinogens. Instead, eat fresh fruits and vegetables with antioxidants that fight cancer. A healthy diet also boosts your overall dental and bodily health.
Practice hygiene. Keeping teeth and gums healthy also lowers oral cancer risk. Brush and floss daily to remove dental plaque, the bacterial film on teeth most responsible for dental disease. You should also visit us every six months for more thorough dental cleanings and checkups.
One last thing: Because oral cancer is often diagnosed in its advanced stages, be sure you see us if you notice any persistent sores or other abnormalities on your tongue or the inside of your mouth. An earlier diagnosis of oral cancer can vastly improve the long-term prognosis.
Although not as prevalent as other forms of cancer, oral cancer is among the deadliest with only a 60% five-year survival rate. Making these changes toward a healthier lifestyle can help you avoid this serious disease.
If you would like more information about preventing oral cancer, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “How a Routine Dental Visit Saved My Life” and “Strategies to Stop Smoking.”
So, when should you begin taking measures to prevent tooth decay in your child's teeth? When their teeth first begin to show? When all of their primary (baby) teeth are in? Or, wait until their permanent teeth begin erupting?
Actually, tooth decay can be a problem as early as two months of age, before a child's first tooth even comes in. In essence, then, dental disease prevention should be on your radar soon after your child is born. Here's what you can do to prevent the damage of tooth decay to their teeth now and its impact on their dental health in the future.
Start oral hygiene during nursing. Brushing and flossing are lifetime habits that reduce the risk of dental disease. When your children are young, you'll have to perform these tasks for them, ultimately training them to perform them on their own. But even earlier, before their first tooth, you'll want to clean their gums after feedings with a wet cloth to reduce disease-causing bacteria.
Initiate dental visits by age 1. It's appropriate on or before their first birthday, when most children already have a few primary teeth, to begin regular dental visits for cleanings and checkups. Seeing the dentist every six months at an early age will help your child stay well ahead of tooth decay. And starting visits early increases the likelihood it will become a regular part of their lives into adulthood.
Protect against decay. You and your dentist are partners in protecting your child from dental disease. Besides daily oral hygiene, you can also help by providing a dental-friendly diet, and especially restricting sugary snacks and avoiding sweetened liquids in bedtime bottles (including breast milk or formula). In addition to routine care, your dentist can also provide other measures to fight decay, like sealants or topical fluoride.
It's also important for you to set an example for your child to follow. Children soak up what's important to their parents—in this case, watching you take care of your teeth and seeing the dentist as a friend and ally against dental disease. That's your end goal: preventing dental disease now, and instilling the value of dental care that will last your child a lifetime.
If you would like more information on helping your child avoid tooth decay, 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 “Taking the Stress Out of Dentistry for Kids.”
May 9-15 is National Women's Health Week, which begins each year on Mother's Day. It's an important opportunity to focus on the unique health challenges women face, and ways to better meet those challenges. Among the many health aspects that deserve attention, one of the most important is the health of a woman's teeth and gums over the course of her life.
Although preventing and treating dental disease remains a primary focus throughout life, women do face a number of different situations during various life stages that often require additional attention. Here are 3 such life moments for a woman that may give rise to oral and dental problems.
Adolescence. The changes that occur in their physical bodies as girls enter puberty may make their gums more sensitive to bacterial plaque, a thin biofilm that forms on teeth. This can cause painful swelling, a condition that may become even more acute if they wear braces. To counteract this, it's important for girls in their teens to not neglect daily brushing and flossing to remove excess plaque, and to make regular dental visits at least every six months.
Pregnancy. Each of the estimated 40 million U.S. women who have given birth share a common experience—they've all undergone the hormonal changes that accompany pregnancy. Such changes can adversely affect dental health: The hormonal shifts, and the sugar cravings that often accompany them, increase the risk for dental disease, especially gum infections. As with adolescence, daily oral hygiene and regular dental visits (as well as a healthy diet) are important for staying a step ahead of possible tooth decay or gum disease.
Menopause. Women in menopause or who have passed through it can encounter new oral problems. Persistent dry mouth caused by a lack of adequate saliva flow, for example, can cause irritation and significantly increase the risk of dental disease. Osteoporosis and some medications for its treatment could also interfere with dental care. Besides daily oral hygiene, older women can ease dry mouth symptoms with saliva boosters or drinking more water. They should also work with their physicians to minimize any oral effects from their medications.
Many aspects of dental care remain constant regardless of a woman's season of life. Daily oral hygiene should be a lifetime habit, as well as seeing a dentist at least twice a year. But there are times when a unique stage of life requires something more—and it's always better to be proactive rather than reactive in meeting new challenges to oral health.
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