Saturday, December 29, 2012

Can mouth cancer be prevented or found early?

Our bodies are made up of many small units called cells. These cells have a limited lifespan. The process of forming new cells and dying of older or injured cells is a continuous one. For some reason, this process may get disturbed and cells can start to grow out of control. When this happens, it is called cancer. These cells either invade the surrounding areas or spread to distant parts of the body through the blood or lymph circulation (metastasis).
Mouth cancer, also called oral cancer, is a major health concern in India. It is the most common cancer among men and the 3rd most common cancer among women. Chewing tobacco in its many forms causes nearly 90% of the cases. Some oral cancers begin as leukoplakia a white patch, red patches, or non-healing sores that have existed for more than 14 days. In Indian subcontinent Oral submucous fibrosis is very common. This condition is characterized by limited opening of mouth and burning sensation on eating of spicy food. This is a progressive lesion in which the opening of the mouth becomes progressively limited, and later on even normal eating becomes difficult. It occurs almost exclusively in India and Indian communities living abroad.

Causes of Mouth Cancer
1. Tobacco
Smoking and other tobacco use are associated with about 75 percent of oral cancer cases, caused by irritation of the mucous membranes of the mouth from smoke and heat of cigarettes, cigars, and pipes. Tobacco contains over 60 known carcinogens, and the combustion of it, and by products from this process, is the primary mode of involvement. Use of chewing tobacco or snuff causes irritation from direct contact with the mucous membranes.

2. Alcohol
Use of alcohol and other toxic liquids is another high-risk activity associated with oral cancer. There is known to be a very strong synergistic effect on oral cancer risk when a person is both a heavy smoker and drinker. 

3. Human papillomavirus
Infection with human papillomavirus (HPV), particularly type 16, is a known risk factor and independent causative factor for oral cancer. HPV16 (along with HPV18) is the same virus responsible for the vast majority of all cervical cancers and is the most common sexually transmitted infection in the US. Oral cancer in this group tends to favor the tonsil and tonsillar pillars, base of the tongue, and the oropharynx. Recent data suggest that individuals that come to the disease from this particular etiology have a significant survival advantage, as the disease responds better to radiation treatments than tobacco etiology disease.

4. Ultraviolet light
More than 30% of patients with cancers of the lip have outdoor occupations associated with prolonged exposure to sunlight.

5. Irritation
Chronic (long-term) irritation to the lining of the mouth caused by poorly fitting dentures has been suggested as a risk factor for oral cancer. But multiple research studies have shown no difference between denture wearers and non-denture wearers in the occurrence of oral cancer. As poorly fitting dentures can tend to trap proven causative agents of oral cancer beneath them, such as alcohol and tobacco particulates, denture wearers should have their dentures evaluated by a dentist at least every 5 years for optimum fit. All denture wearers should remove their dentures at night and clean and rinse them thoroughly every day.

6. Vitamin deficiency
Vitamin A deficiency is associated with an increased risk of developing cancer of the oral cavity and oropharynx.

7. Hematopoietic stem cell transplantation
Patients after hematopoietic stem cell transplantation (HSCT) are at a higher risk for oral squamous cell carcinoma. Post-HSCT oral cancer may have more aggressive behavior with poorer prognosis, when compared to oral cancer in non-HSCT patients. This effect is supposed to be owing to the continuous lifelong immune suppression and chronic oral graft-versus-host disease.

How will I know if I have mouth cancer?
Mouth cancer commonly starts as one of the following:

  • An ulcer or wound in the mouth or on the tongue that does not go away
  • A swelling over the cheek and gum (which may be painful or painless)
  • Diiculty opening the mouth completely and swelling in the neck
  • Persistent sore throat
  • Difficulty in swallowing or moving the tongue
  • Slurred speech
  • Numbness of the tongue or other area of the mouth
  • A lump or mass in the neck
  • Weight loss
  • Some patients may go to the dentist with sudden loosening of teeth or pain in the jaw.

Can mouth cancer be prevented or found early?

Mouth cancer is often (but not always) preceded by some changes in the mouth. These changes serve as warning signs for cancer. Some patients may have white (leukoplakia) or red (erythroplakia) patches in the mouth. These patches bleed on removal and can be painless or painful. Stopping the use of tobacco and alcohol and eating a healthy, nutritious diet may help prevent progression of these patches to a cancer.
Quitting tobacco is an important step in the prevention of mouth cancers. Chewing betel nut and leaves (paan with supari) has also been found to increase the risk of cancer and should be stopped. Looking at your mouth every day can also find early signs and help in diagnosing cancer at an early stage.

Regular dental checkups, that include an examination of the entire mouth, are important in the early detection of oral and oropharyngeal cancers and precancerous conditions.

Thursday, December 20, 2012

Why Do People Grind Their Teeth?

Sometimes, people grind their teeth without causing any symptoms or problems to oral health. However, regular and persistent teeth grinding can cause pain and discomfort in your jaw and it can wear down your teeth. Bruxism is the medical term for the grinding of teeth or the clenching of jaws.

What causes bruxism?
Most cases of teeth grinding occur subconsciously during sleep. It is usually associated with contributing factors, such as stress or anxiety. Grinding teeth (Bruxism) also affects people when they are awake, although this is more likely to be clenching the teeth and jaw, rather than grinding. Most people do it subconsciously while they are concentrating.

The following factors may be associated with bruxism (whether by cause or effect) :

  • Disturbed sleep patterns and other sleep disorders (obstructive sleep apnea, hypopnea, snoring, moderate daytime sleepiness
  • Malocclusion, in which the upper and lower teeth occlude in a disharmonic way, e.g., through premature contact of back teeth
  • Relatively high levels of consumption of caffeinated drinks and foods, such as coffee, colas, and chocolate
  • High levels of blood alcohol and Smoking
  • High levels of anxiety, stress, work-related stress, irregular work shifts, stressful profession and ineffective coping strategies
  • Hypersensitivity of the dopamine receptors in the brain
  • Disorders such as Huntington's and Parkinson's diseases
  • Obsessive–compulsive disorder[citation needed]
  • Eustachian tube dysfunction
  • Use of NAC (acetylcysteine) may increase glutamate and dopamine to some extent
Signs and Symptoms :
Nighttime grinding and clenching can wear down tooth enamel, chip teeth, increase temperature sensitivity, and cause severe facial pain and jaw problems, such as temporomandibular joint disease (TMJ). Most kids who grind, however, do not have TMJ problems unless their grinding and clenching is chronic. 
Patients may present with a variety of symptoms, including :
  • Anxiety, stress, and tension
  • Depression
  • Earache
  • Eating disorders
  • Headaches
  • Migraines
  • Loose teeth
  • Tinnitus
  • Gum recession
  • Neck pain
  • Insomnia
  • Sore or painful jaw
Treatment :
1. Dental guards and splints : A dental guard or splint can reduce tooth abrasion. Dental guards are typically made of plastic and fit over some or all of upper and/or lower teeth. The guard protects the teeth from abrasion and can reduce muscle strain by allowing the upper and lower jaw to move easily with respect to each other.

2. Biofeedback (Behavioural therapies) : The principle behind biofeedback in treating bruxism is to automatically detect bruxing behavior, and provide a conscious or subconscious awareness signal to the user so that the user can decrease that behavior, preferably even while asleep. 

3. Botox : Botulinum toxin (Botox) can lessen bruxism's effects. An extremely dilute form of Botox is injected to weaken (partially paralyze) muscles and has been used extensively in cosmetic procedures to 'relax' the muscles of the face.

4. Repairing damage : Damaged teeth can be repaired by replacing the worn natural crown of the tooth with prosthetic crowns and bridges. To protect the new crowns and dental implants, an occlusal guard should be fabricated to wear during sleep.

5. Other treatments, such as muscle-relaxation exercises and sleep hygiene, may also help manage your symptoms. 

6. Making some simple lifestyle changes, such as giving up smoking, reducing alcohol consumption and managing stress may also help in reducing the habit.

Wednesday, December 19, 2012

Mouth Ulcers : Causes and Treatments

What are mouth ulcers?

A mouth ulcer is a painful sore in the mouth. It appears on the tongue, the lips, and the gums or inside the cheeks. The first sign of the ulcer may be a tingling, burning sensation inside the mouth. They can occur either single or in clusters. They are usually white or yellow in color, surrounded by red halos. Usually they heal within 7 to 10 days.

Common Causes of Mouth ulcers

  • Nutritional deficiencies such as iron, vitamins, especially vitamin B12 and C
  • Poor dental hygiene
  • Food allergies
  • Stress
  • Infections particularly herpes simplex
  • Biting the cheek
  • Hormonal imbalance
  • Bowel disease
  • Skin disease
  • Coeliac disease (intolerance to a protein called gluten, found in wheat, rye and barley)
  • Crohn's disease
  • Reiter's syndrome (urethral discharge followed by conjunctivitis and arthritis)
  • HIV infection

 What are the symptoms?

  • A round sore or sores inside the mouth
  • Swollen and red skin around the sores
  • Tenderness
  • Problems with chewing or toothbrushing because of the tenderness
  • Irritation of the sores by salty, spicy or sour foods
  • Loss of appetite

How are mouth ulcers treated?
Fortunately, most mouth ulcers do not need specific treatment and heal naturally without medication they heal within 7 to 10 days. You can help a mouth ulcer to heal faster by using a soft toothbrush and avoiding hard foods. By keeping mouth clean and healthy.

Treatment includes:
 Topical antihistamines, antacids, corticosteroids, topical anaesthesia or applications meant to soothe painful ulcers may be helpful.  Oral supplements of vitamin B12 and C , iron can be taken.

Ulcers persisting longer than three weeks may require the attention of a medical practitioner.

Some Home Remedies for Mouth Ulcers

  • Extract the milk of coconut and gargle with this 3-4 times a day.
  • Keep 1 glass of chilled water and 1 glass of hot water ready at hand. Gargle alternately with hot and cold water.
  • Boil 2 cups of water. Add 1 cup fenugreek leaves and remove. Cover and keep for sometime. Strain the water and gargle 2-3 times a day.
  • Boil 1 tsp of coriander seeds in 1 cup of water. Remove when slightly warm gargle. Repeat 3-4 times a day.
  • Chew on 5-6 tulsi leaves and sip some water. Repeat 5-6 times a day.
  • Eating raw tomatoes helps rid mouth ulcers. Can also gargle with tomato juice 3-4 times a day.
  • Mix 7 parts of sugar candy (mishri) with 1 part of camphor. Apply on the blister.
  • Mix a pinch of turmeric powder to 1 tsp glycerine and apply.

Things to be remembered :

  • A mouth ulcer is the loss or erosion of the delicate epithilium lining tissue of the mouth (mucus membrane).
  • The most common cause is mechanical injury, such as accidentally biting your cheek.
  • In most cases, mouth ulcers are harmless and resolve by themselves in a few days without the need for medical treatment.
  • Aphthous ulcers are recurring ulcers with no known cause that affect around 20 per cent of the population.
  • If your mouth ulcers don’t clear up within a few days, or if you are troubled by frequent attacks, see your doctor.

Tuesday, December 18, 2012

Gingivoplasty : A Smile Makeover

Gingivoplasty is the process by which the gingiva are reshaped to correct deformities. Gingivoplasty is the shaping procedure that follows the removal of excessive gum tissue and thins the remaining gums tissue so that they fit and look natural around the tooth.A thorough dental cleaning or dental scaling and root planing, if needed, is recommended prior to the gingivectomy in order to remove tartar (calculus) from the teeth surface. Calculus free teeth help in fast recovery and healing after the surgical procedure. The gums are numbed with local anaesthesia before starting the procedure. Most of the modern dental offices use today a soft tissue laser for performing the gingivoplasty procedure. During the procedure the dentist adjusts the shape of the edge of the gums to achieve natural contours. After the procedure a periodontal dressing is placed around the tooth covering the gums to protect them until full healing.

Follow Up :

  • Normally the gums will be completely healed within one to two months after the gingivoplasty procedure, depending on the extend of the gum surgery. 
  • The dentist may prescribe pain medication and an antibacterial mouthwash (usually containing chlorhexidine) to ease any pain and prevent possible infections during the healing period. 
  • Some bleeding may occur initially but usually stops within 24 hours. The periodontal dressing is placed by the dentist over the gums to protect the soft gum tissue and make the patient feel more comfortable. 
  • Eating a soft diet is recommended to prevent gum irritation and avoid removing the periodontal dressing from the wound. 

Saturday, December 15, 2012

Invisalign ( Invisible Orthodontic Treatment)

The Invisalign system is a series of clear aligners used to straighten teeth. The Invisalign aligners are made after the orthodontist takes impressions of your teeth and sends them to a lab.  The lab makes the Invisalign aligners custom made clear aligners especially for you using computerized technology.  After a couple of weeks the clear Invisalign aligners arrive at the office of your orthodontist and the first set of Invisalign aligners are tried on your teeth.

The Invisalign aligners are clear and are barely visible to others compared to metal orthodontic Braces with brackets and wires. The number of Invisalign aligners will depend on the individual patient and the orthodontic problem. The Invisalign aligners are generally fairly comfortable.  There can be some discomfort or mild Pain when a new Invisalign aligner is placed as it exerts pressure on the teeth to move them.  Unlike traditional metal orthodontic Braces, there are no brackets to come off or wires to break and poke.  

The disadvantages of Invisalign are:
The Invisalign system is for adults not everyone is a candidate for Invisalign. Children and younger teenagers will require the more traditional orthodontic technique. Also the Invisalign system is designed for only certain tooth movements. The cost of Invisalign may be significantly more than with metal braces. The Invisalign Aligners are removable and require motivation to be worn consistently by patients.

Thursday, December 13, 2012


Loose teeth are commonly caused by periodontitis, an infection that can destroy the soft tissue and bone that support your teeth. Because poor oral hygiene is the most common cause of periodontitis, certain home remedies may help strengthen your teeth in some cases when used along with proper oral hygiene and regular visits to the dentist.

Black Pepper and Turmeric
A mixture of black pepper and turmeric can be massaged into the gums to build stronger gums. To use this treatment, combine even amounts of black pepper and turmeric root in a small bowl and crush the ingredients together. With clean fingertips, gently massage the mixture onto your gums and teeth for 1 to 2 minutes. Rinse your mouth with cool and clean water. Avoid eating or drinking anything for 30 minutes after treatment. This remedy can be used daily as long as it doesn't irritate your gums.

Table Salt and Mustard Oil
A mixture of table salt and mustard oil can help to strengthen the gums, preventing loose teeth as your age progress. Combine 1/8 tsp. table salt with 2 drops of mustard oil. Gently massage the mixture onto the gums with your fingers for 1 minute before rinsing your mouth with cool water. Use this treatment once per day as needed, as long as no irritation occurs. Avoid using this treatment if you have open cuts or sores in your mouth.

Amla Fruit
Amla fruit, commonly used in Ayurvedic medicine, can help to strengthen the gums and support connective tissue health. To use amla fruit to strengthen loose teeth and gums, combine even amounts of amla extract and clean water in a cup, and stir to combine. Rinse your mouth with this mixture once per day as needed. Avoid eating or drinking for 1 hour after rinsing your mouth with the amla mixture.

To Stop staining teeth
Use cauliflower, spinach, lettuce, and broccoli are all sources of minerals that create a protective film on teeth and help prevent red wine, cola, or coffee stains from penetrating the enamel. Strawberries have bleaching elements to brighten your smile, while hard, crunchy foods such as carrots, nuts, and seeds help slough off plaque. Chewing raw veggies also stimulates saliva, which neutralizes acids and strengthens teeth using vitamins and minerals from the foods.

Bust bacteria 
Kiwis, oranges, limes, cranberries, and strawberries are rich with vitamin C, a powerful killer of oral bacteria. Green tea contains catechins that kill bacteria in the mouth. Spicy foods such as wasabi have phytochemicals that inhibit the growth of germs.

Smell sweeter
Some herbs naturally freshen the breath you exhale. Mint and parsley kill bacteria in the mouth. Also they contain monoterpenes, substances that move rapidly through the bloodstream to your lungs to counter the odor in your mouth.

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