Can your dentist save your life?

As a full-time dentist and a recreational blogger, I take a great deal of pride in my ability to effectively explain even the most mundane dental subjects to my patients in a way that is easy to understand.  If you have had the opportunity to read my posts on things like: bad breath, sleep apnea and periodontal disease you can see that I try very hard to provide useful information while also injecting a little humor into these subjects.  But, today, I am going to write about a subject that I take very seriously and, as you will see, very personally: Oral Cancer.

I remember it like it was yesterday.  On a Tuesday afternoon in June of 2006, a long time patient of our practice, Mr. B, came into the office with what he described as, “a sore tongue.”  To say Mr. B is a long time patient of our practice does not tell the whole story.  I have known Mr. B my entire life.  Our families lived across the street from each other in a quiet cul-de-sac in Vienna for 13 years.  The B’s were our favorite neighbors and our families have been intertwined for as long as I can remember. His wife was the neighborhood nurse and a close friend of my mother.  My oldest sister was his daughter’s matron of honor, his son took my other sister to her homecoming, and when my family drove across the country in the summer of 1980, we spent 6 weeks and 7,000 miles in a van Mr. B graciously loaned to us.  In high school, when I decided to take my father’s car out joyriding while my parents vacationed in Alaska, it was Mr. B who sat me down and “forcefully explained” the irresponsibility of my actions (and never told my parents).  Many years later, as a dental professional, we only needed one look to know, without question, what we were seeing when we examined this irritated area on the side of Mr. B’s tongue.   Mr B had cancer.

It’s hard to describe what I thought and felt when I realized that this man who I have known for my entire life had walked into our office to show us a squamous cell carcinoma on the right side of his tongue.  In all honesty, after the shock, denial and introspection had subsided, I can remember going to my computer and looking up the statistics.

According to the Oral Cancer Foundation:

• Roughly 37,000 people in North America will be diagnosed with oral or pharyngeal cancer this year.
• It will cause over 9,000 deaths, killing nearly 1 person every hour of every day.
• The death rate for oral cancer is higher than that of cancers which we hear about routinely such as: cervical cancer, Hodgkin’s lymphoma, testicular cancer, thyroid and skin cancer (malignant melanoma).
• Of those newly diagnosed individuals, only half will be alive in 5 years.
• This 5 year survival rate is a number which has not significantly improved in decades.

I can’t help feeling deep sadness when I think of any patient discovering that they have oral cancer, and certainly this sadness only intensifies when, in the case of Mr. B, the diagnosis hits so close to home.  I’m happy to report that Mr. B was in the office this week.  In 2006, his cancer was successfully removed and he recently saw his oncologist for his five year follow-up and he is cancer free!  Clearly, we are elated to know that he beat the odds.  After going thru this with Mr. B., I know that, as dental professionals, we want to do everything we can to spare our patients the experience Mr. B and his family had to endure.

So let’s start with those statistics.  Why are they so staggering?  Well the answer to this question is twofold.  Unfortunately, approximately two-thirds of the newly diagnosed cases of Oral cancer aren’t discovered until they are in the later stages.  This can be attributed to poor screening tools and the reality that oral cancers often do not produce recognizable signs and symptoms until they reach these later stages.  The other piece to this puzzle is that the face of the oral cancer patient is now changing. 

Who’s at risk?

The classic oral cancer patient exhibits the following risk factors:

• Tobacco use. It should come as no surprise that tobacco, in all its forms, is the largest contributor to the development of oral or mouth cancers.  Not using tobacco is the single most important thing you can do to avoid oral cancers.
• Excessive alcohol consumption.  More than 15 drinks per week will put a person at greater risk for oral cancer.
• The combined use of alcohol and tobacco.  This will significantly increase a person’s risk for oral cancer more than either by itself.
• Age. Older individuals (>40 years of age) tend to develop more diseases in general, including oral cancer, as their immune systems become less efficient.
• Gender. Males are statistically more likely to develop oral cancer than females.  This tends to be a direct relation to lifestyle issues and not biology.
• Diet. A low intake of fruits and vegetables will decrease the amount of protective nutrients contained in these foods.
• Excessive exposure to the sun.  Exposure to the sun will increase the likelihood of lip cancers, and it is recommended that everyone wear SPF 30 sun block on your lips.
• Use of betel nut and bedis.  This seed of the Areca palm grows in the tropical pacific, Asia and parts of east Africa.  It is chewed much like tobacco and it acts as a mild stimulant.  Excessive use has been linked to an increased likelihood of mouth cancers.
• Race, ethnicity and economics- Persons of African descent are twice as likely to develop oral cancers than other races.  Whether this is a product of biology or reflection of socioeconomic/access to care factors is still under examination.

This is the classic presentation of an oral cancer patient, and I take great pains to describe this profile to make the point that the “typical” patient is changing.  No longer are the newly diagnosed patients forty- five year old males who drink, smoke, work outside and like to occasionally chew on an east African stimulant. 

The Changing Face of Oral Cancer

Over the past decade there has been a steep increase in patients who do not fit this profile in any way.  The incidence of oral cancers diagnosed in twenty-something patients, who don’t drink, don’t smoke and lead a relatively healthy lifestyle is on the rise.  The medical and dental community has discovered that infection by The Human Papilloma Virus (HPV-16) is the most likely causative factor of this alarming trend.

The Human Papilloma Virus and Development of a Vaccine

Strangely enough, the Human Papilloma Virus is something with which I am very familiar.  As an undergraduate at Georgetown University, I had the opportunity to work for Dr Richard Schlegel, the chairman of the MD/PhD program and director of a pathology laboratory that researched HPV-16 and 18.  By mere coincidence, I spent 4 years of my life researching the papilloma virus and it was the subject of my senior thesis.  At the time, I knew it as a sexually transmitted virus that is the cause of over 95% of all cervical cancers.  And since there are no outward symptoms, individuals that carry the disease are unlikely to know that they have it.  It is now estimated that 60-80% of people will be infected by HPV in their lifetime.  I am very proud to have worked for Dr. Schlegel.  His lab contributed significantly to the new papilloma virus vaccine that is now commercially available and saving lives.  At the time that I decided to pursue a career in dentistry, I never thought that HPV-16 would reenter my life. 

Routine Screenings

So, besides the development of the HPV vaccine, is there any other good news?  Of course there is.  When we find oral cancers in their early stages, the 5 year survival rate goes from about 50% to over 80%.   All of the statistics that I have presented here have echoed one consistent reality; we are finding these patients too late in the disease progression.  Mr. B. was very lucky.  Fortunately, he came to our office when he first suspected something might be wrong with his tongue.  This allowed us to quickly get him to an oral surgeon, who immediately obtained a diagnosis and the carcinoma was removed before it traveled into his lymph nodes. 

If we can learn one thing from Mr. B’s experience, it is that early detection is the key!   This is why we and the rest of the dental community routinely screen our patients for oral cancer at every visit.  There are two ways that we now screen my patients for any tissue changes that may indicate oral cancer.  The first is a visual and tactile examination.  We have diligently performed this examination for as long as I have been in our office; it was taught to me by my father during my first week in his practice.  After asking our patients if they have noticed any lumps, bumps or swellings in or around their mouth, we carefully examine all the soft tissues of the oral cavity.  Many of you will remember the times when we ask you to stick your tongue out, then grab it with a gauze pad and inspect the sides.  This is when we are checking you for cancer.

There is now a second way that we check our patients for oral cancer using an adjunctive screening tool called the VELscope®.  We are very excited about this technology because using blue light and proprietary filters, the VELscope® allows us to use fluorescence to better visualize any changes in the tissue that are otherwise invisible to the naked eye.  Using tissue fluorescence as a screening tool is nothing new; this technology has been available for decades to examine the lungs, cervix, colon and skin, and now it has been proven to be an effective tool for examining the tissues of the oral cavity.  The test is completely safe, painless, and only takes 2-3 minutes.  This adjunctive screening tool allows us to evaluate the mouth in a way we never could before, at every hygiene visit.

Be Aware, Be Proactive!

Patients are also responsible for their own oral health.  Just as we ask you to brush and floss, we now want you to be aware of the signs and symptoms of oral cancer.  Regular screening by a qualified medical or dental professional is the single best step that you can take to ensure that any changes in your oral tissues are identified at the earliest possible stage.   It bears repeating that Mr. B’s quick action to come see us when he was first concerned about his tongue is probably the reason his treatment was so successful. 

Please give our office a call if you experience any of the following:

1. Red and/or white discolorations of the soft tissues of the mouth.
2. Any sore that does not heal in 14 days
3. Hoarseness which lasts for a prolonged period of time.

In the middle to late stages, indicators can include:

1. A sensation that something is stuck in your throat
2. Numbness in the oral region
3. Difficulty in moving the jaw or the tongue
4. Difficulty swallowing
5. Ear pain which occurs on only one side
6. A sore under a denture, which does not heal, even after an adjustment.
7. A lump or thickening which develops on the mouth or neck.

It’s important to become aware of the signs and symptoms of oral cancer, but don’t forget that the mouth is normally under constant trauma.  Anytime you eat, the tissue can be traumatized or ulcerated (remember the pizza burns on the roof of your mouth).  Keep in mind that, 99% of the time, a suspicious area in the mouth is NOTHING, but that doesn’t mean that you should take it lightly.  In our office, every suspicious area is first evaluated both visually and under the VELscope®, pictures are taken and the patient is asked to return in 14 days to allow the area to heal.  If after 14 days we remain suspicious, we can then perform an almost painless brush biopsy that removes the top layer of cells and we send those cells to a lab for evaluation.  If we are still unsure after these two steps have been completed, only then do we send the patient to an oral surgeon for further evaluation.   A referral to a surgeon should not alarm a person; we do this in an effort to conclusively determine what any abnormality may be and if early treatment should be administered.  Always remember, early detection is the key to success!

I hope you have found this blog informative, educational and reassuring.  I promise to lighten up the next post and write it in such a way as to inspire the response that I have dedicated my life to: your smile.  As always, we love answering any questions you may have.  Please feel free to write, call or drop by our office if we can be of any assistance to you or to someone you know.  Our website is loaded with useful information and we encourage you to check it out at your leisure.

Maybe the dentist isn’t the only thing that keeps you up at night.

I used to think he just wasn’t interested.  It didn’t seem to matter what we were watching: Fantasy Island, MacGyver, The Cosby Show, even the writers of Magnum PI could not craft a storyline that would keep my Dad awake after 8pm.   He would explain, “Dentistry is a physically and mentally demanding profession that requires me to focus intensely during each procedure.  It wipes me out.”  In his mind, that was the reason he would always fall asleep while reading the paper, watching the game or sometimes even in the middle of a conversation like Grandpa Simpson.  It was the family joke, “Greg, go wake up your father.  The Six O’clock news is on.”  It wasn’t until August of 2006 that we finally got our answer.  It wasn’t that he was disinterested, or that he wore himself out during the day; it was that Dad suffered from severe Obstructive Sleep Apnea (OSA).  Essentially, he hadn’t had a good night’s sleep for 30 years.

The word apnea means “without breath”.  Obstructive Sleep Apnea is a very common and very serious sleep disorder that, according to the American Academy of Dental Sleep Medicine (AADSM), affects an estimated 18 million Americans.  The AADSM defines OSA as, “a sleep-related breathing disorder that prevents airflow during sleep.  OSA occurs when the tissues in the back of the throat collapse [against the tongue] and block the airway.  This keeps air from getting into the lungs.”  When the lungs are deprived of air, the body responds by waking up.  Sometimes hundreds of times per night.  This video shows an individual with severe sleep apnea who isn’t breathing normally while he sleeps.

The signs of OSA are subtle and can be hard to recognize. This makes sense because those who suffer from it are usually asleep when they occur.   A bed partner usually helps the “apnic” in evaluating the following symptoms: 

• Loud snoring. 
• Waking with a choking or gasping sensation.   
• Long pauses in breathing during sleep
• Frequently getting up during the night due to restlessness, insomnia or night sweats
• Frequent urination
• Waking up with headaches, dry mouth and/or a sore throat.
• Bloodshot or puffy eyes

The overall health effects of OSA can be quite severe.  Because the body is not getting the oxygen it needs via the lungs, the heart has to work much harder to increase circulation.  In addition, the brain isn’t being fed all the oxygen it needs to function properly.  According to the AADSM and The American Academy of Sleep Medicine the following conditions can occur in patients with undiagnosed obstructive sleep apnea:

• Heart problems such as: heart attack, congestive heart failure and hypertension. 
• Strokes
• Diabetes
• Depression
• Excessive daytime sleepiness
• Higher incidence of driving-related accidents
• Impaired memory and concentration
• Increased sexual dysfunction
• Chronic heartburn

It was in August of 2006 that Dad was diagnosed with OSA.  It’s probably not a coincidence that 6 weeks later he was also diagnosed with three severely occluded coronary arteries that required an immediate triple bypass surgery and two months of cardiac rehabilitation.

OSA can affect more than just a person’s health and well being; unfortunately, it can also place severe stress on an individual’s family too. Loud snoring, often the tell-tale sign of OSA, is associated with greater divorce rates.   How do you know if you snore too loud?  According to this article, snoring indicative of OSA is:

• Sufficient to disturb a partner more than three nights per week
• Audible in other rooms
• Occurs despite alcohol abstinence
• Occurs in lateral sleep position
• Occurs greater than 10% of the night.

My family would describe our father’s snoring as, “the snore heard round the world.”  My mother would describe it as, “the signal to go sleep in the other room.”  As healthcare providers that now treat OSA, we take great pleasure in knowing that we’re not only providing a treatment that may save a person’s life, we may also be saving their marriage. (And don’t worry, my parents will be celebrating their 44^th wedding anniversary this July.)

So, what factors increase your risk of OSA?

• Males are twice as likely as females
• Larger neck size: 16 inches or larger for women, 17 inches or larger for men
• Snoring
• Smoking
• Weight gain (excess fat in the throat can narrow the airway)
• Alcohol consumption, (it relaxes the muscles of the throat)
• But, anyone can suffer from OSA, even athletes and children.

Are you concerned that you may have Obstructive Sleep Apnea?  Are you wondering what you can do?  Well, the first step is to answer a few questions.  If you follow this link, you will be directed to an on-line survey that you can complete in less than ten minutes.  You, or you and your partner, can sit down together and rate (on a scale of 1 to 5) where you are in these and other areas:

• Are you a loud and/or regular snorer?
• Have you been observed to gasp or stop breathing during sleep?
• Do you feel tired or worn out during the day?
• Do you fall asleep while sitting, reading, watching TV or driving?
• Do you have problems with memory or concentration?

The results of this survey will give you a score that indicates your relative risk for OSA.  From this score, you can decide if you want to take the next step.  To obtain an accurate diagnosis, we encourage any patient who may be at risk for OSA to take a sleep test. 

There are two types of sleep tests that are currently available to patients.  The first requires a patient to go to a sleep laboratory, and spend the night in a hospital or sleep center.  While sleeping, you are wired to an EKG, EEG and other monitoring devices.  In 2006, this was the only type of testing that was available to diagnose my father’s severe OSA.  His test results showed that while sleeping, he would stop breathing 70 times an hour!  In other words, he wouldn’t get a minute of sleep. 

Unfortunately, the prospect of this overnight stay- in a foreign bed, under the supervision of a sleep technician, covered in electrodes- would and probably still does discourage patients from getting the testing and subsequent treatment that they need.  That is why we are so excited to be able to offer an alternative to our patients.

The Apnea Risk Evaluation System, or the ARES device, is an FDA approved, wireless physiological recorder now available to interested patients.  This can be worn while sleeping in the comfort of your own bed.  While you sleep, this device gathers and records essential nocturnal data like body position, oxygen saturation, pulse, number of interruptions, severity of snoring and many other things.  We send this data to a certified physician of sleep medicine for analysis and interpretation.  This information gives us a very accurate snapshot of the quality of your sleep, so we can recommend a course of treatment and help you make the decision that is right for you.  In some cases, patients may find out that they do not suffer from OSA or they have a very mild form.  Other patients could find that they have a severe form of OSA, like the kind my father has, and we may choose to refer you to a sleep center for additional testing.  Spend a night or two with the ARES in your home, and then we will know if you need to spend a night or two away from home.  

As for treatment of sleep apnea, there are currently four widely accepted options:

1)      Surgery- While surgery to remove any excess tissue and create a wider airway used to be the first treatment option for OSA; the medical community seems to be moving away from this as a primary treatment option at this time.

 2)      A CPAP- the Continuous Positive Airway Pressure machine is now the preferred option for moderate to severe OSA.  This device uses a breathing mask to create a positive pressure in the airway, and by doing so, maintains an open airway through which to breathe.  And while comparisons to Darth Vader and Top Gun immediately come to mind, my father will attest to its comfort and efficacy.  He refuses to sleep without it.  My mother will attest to its relative quietness, even though she may be the wrong person to judge since she may have hearing loss from sleeping next to Chainsaw LaVecchia for 39 years.

 3)      A dental appliance- These are indicated for patients with mild to moderate apnea, for patients that are CPAP intolerant and for patients who do not want to travel with their CPAP.  There are a number of appliances currently available and they are all effective because they operate on the same basic principle.  Since the tongue is attached to the mandible, if we position the lower jaw forward, we can prevent the obstruction of the airway and make it easier for patients to breathe while sleeping.  As a regular wearer of this appliance, (I’m a chip off the old apnea block) I can tell you that it takes some getting used to.  After that initial adjustment period, it has become the security blanket of my adulthood that protects me from the Apnea monster hiding under my bed, waiting for me to fall asleep.

 4)      Lifestyle- The final treatment option for OSA involves lifestyle modification.  This is really effective for patients who are purely snorers or have a very mild form of apnea.  It involves weight loss, alcohol abstinence, smoking cessation and avoiding sleeping on your back.

Obstructive Sleep Apnea is a very serious and very intimidating condition that affects millions of people and millions of relationships.  We are now able to identify and treat these afflicted individuals, and it doesn’t have to be uncomfortable or inconvenient.  If left untreated, OSA can have devastating effects in both the short and long term.  When the signs and symptoms are read aloud, almost everyone immediately recognizes either themselves or someone they know and love.  If you do, please help yourself, your family and your friends live happier, healthier and longer lives by taking the next step.

As always, you can find more information about Obstructive sleep apnea on our website.  We are always happy to answer questions.  Feel free to call, write or email us.  Even if it isn’t with our office, we genuinely hope you get the very best dental care available.  We also hope that this doesn’t describe your nights.  Sweet dreams to you and yours.

Help me Doctor! My coworker really stinks.

If I was to compile a list of the top ten questions I get asked when people find out that I’m a dentist, “What can I do about my bad breath?” would be at the top.  There are even some wily individuals who will veil this same question behind a less self-incriminating variety, like “How can I tell my coworker that he has bad breath?”  While I would imagine Dear Abbey may be better-suited to address the question of a difficult interpersonal relationship, I do feel comfortable explaining the causes of bad breath and will even offer some tips to prevent an awkward halitosis intervention by your peers in your place of business. 

Halitosis is a Latin word that means “the condition of having bad breath.”  I mention that it is derived from Latin because it makes me sound smart, and also to illustrate that this is not a new problem to the human condition.  I realize that I am not giving anyone new information when I say that bad breath comes from the mouth, but the best way to fight bad breath is to find the source of the problem, and this can be more complicated than simply brushing and flossing.

Common causes of Bad Breath

1. Bugs: Here it is again, the same bacteria that cause periodontal disease can also emit smelly gases and toxins that will make your breath less than fresh.
2. Say Ahhh:  Take a look at your tonsils.  In some individuals, their tonsils are enlarged and pitted and this creates retentive “crypts” that will harbor food, bacteria, and a substance that almost looks like cheese.  Take my word for it, this cheese stinks!
3. Things you put into your mouth: NEWSFLASH!! Smoking, drinking coffee, chewing tobacco, eating a lot of garlic or having day old fish for lunch will make your breath smell like cigarettes, coffee, tobacco, garlic and fish, respectively.  Nuff said.
4. Things that you don’t know go into your mouth: There is more than one entrance to your mouth, and the less obvious paths are sometimes the ones that make it the hardest for you to keep your breath fresh.  Everyone knows about the door to the mouth at the lips, but what about your stomach?  Sometimes gastrointestinal problems like acid reflux, gastric ulcers and ketosis, a fat burning state that results from a low-carb diet, can all give you an exhale that will kill any canaries in the area.  And how about your sinuses?  A chronic sinusitis or underlying sinus infection can also find its way into your mouth.  As William Sears MD, an associate clinical professor at UC Irvine says, oftentimes “the purulent post-nasal drip is the culprit.”  Yummy!
5. Things we do to our mouth: A dry mouth can definitely lead to bad breath.  This is because the saliva in the mouth slows the bacterial production of odors, buffers the effects of foods and creates a slippery surface that prevents some of these causes of bad breath from adhering to the tissues of the mouth.  There are many things that we do or don’t do that will cause dry mouth and hence bad breath.  Not drinking enough water, smoking, drinking alcohol, mouth breathing and medications like antihistamines and antidepressants, can lead to Xerostomia (aka, dry mouth)  For those things that are unavoidable, consider using an over-the-counter dry mouth product like Biotene to help you replenish the natural moisture in your mouth.
6. Things we don’t do to our mouth: This is the common reason that most dentists will give for bad breath, they will say,”You are not brushing and flossing enough.”  But rarely is it that simple.  Yes, flossing is a very important step to oral hygiene and therefore fresh breath.  If you have garlic stuck between your teeth, you will have garlic breath until it dissolves or works its way out days later. (Another Yummy!)  But the culprit that we often overlook is the tongue. One study, conducted at Catholic University of Leuoven, Belgium, reported that in 43.4% of people with Halitosis a “tongue coating” was present.  Just like the tonsils, the tongue has pits and fissures that harbor food, bacteria and other things that cause bad breath.

Well if you are still reading this blog, I can assume that the causes of bad breath haven’t grossed you out to the point of immediately running from your computer and scrubbing your mouth, nose and stomach with bleach.  That’s good; because now I will give you some tips on how to improve your breath and ultimately your interpersonal relationships with your loved ones and coworkers.

1. Brush and floss…the right way.  I wouldn’t be a good dentist if I didn’t lecture anyone who will listen on the importance of proper oral hygiene.  Brush your teeth twice a day.  Don’t get too tricky, just remember the basics.  Two minutes per day, use a timer if necessary.  Brush your teeth where they meet your gums, these are the retentive areas.  Brush your tongue, especially at the base.  If you have bad breath, there is a good chance that your tongue is the cause.  Some people prefer to use a tongue scraper; they are available at most drug stores.  And for Pete’s sake, do I really have to use the f-word? If you don’t floss, you are only cleaning 60% of your teeth.
2. Use a fluoride mouthwash.  There was a reason I listed bugs as the number one reason for bad breath.  By preventing tooth decay, you are also preventing bad breath.  Most brands will work the same.  My only recommendation is to avoid repeated use of mouthwashes with alcohol/phenol in them.  They can dry the tissues of the mouth.  Some people prefer to use a peroxide rinse.  That will work well too.
3. Develop good habits.  Chewing gum with xylitol will cause you to produce more saliva.  More saliva means less dry mouth, less bacteria, better breath.  Drinking lots of water is a habit everyone knows is good for you.  And of course, I’m going to recommend that you quit smoking, drink in moderation and avoid smelly foods.  For your sake, and for those around you.
4. See your doctor.  If you think you may have any issues with your sinuses, tonsils or gastrointestinal system, there are better reasons to get those evaluated by a physician than halitosis.  But if bad breath is your reason, that’s okay too.
5. See your dentist.  You knew it was coming, and that’s why I saved it for the end.  In the words of Jerry Maguire, “Help me, to help you.”  By allowing a dental professional to clean your teeth, evaluate your gums and instruct you on the best oral hygiene, you are taking a positive step towards your overall social confidence and well being.  Together we can get the problem of bad breath under control.

I hope you have found the information provided here useful.  As always, you can look at our website for more information and contact me if you have any specific questions: www.rosslyndentist.com.  As for telling that coworker about his Halitosis, may I recommend you ask someone else?

Wait a minute. Going to the dentist can make me healthier?

I don’t know the why, but periodontal disease doesn’t get the respect it deserves.  Maybe it’s the name, Periodontal Disease.  What the heck is that?  Maybe it’s that it doesn’t hurt.  Perhaps, it’s that people don’t know that periodontal disease is an infection in your head.  I don’t know if I would believe it if I wasn’t a dentist, who is the son of a dentist, who is the son of a shoe maker, but that’s not important to this discussion. 

Let’s start with the word, Periodontal. I’ve seen too many patients’ eyes glaze over when I use this word.  So I thought I’d explain it to you here.  That’s just our fancy way of saying “everything that’s around the tooth.” It includes the gums, the bone, the ligament and the tissue that surrounds the tooth.  What causes it?  The simple answer is bugs.  Bacteria that are natural to your mouth will, over time, break down these periodontal (there’s that word again) structures and cause a chronic infection.  And the kicker is that this infection can exist in your mouth and it doesn’t even hurt.  So why fix something that doesn’t hurt?

It’s estimated that 80% of the population has periodontal disease in some form.  80%!!  That’s pretty staggering.  It probably wouldn’t be as big a deal if we hadn’t discovered that periodontal disease is related to so many other systemic diseases in the body.  As Sally Cram, DDS, a periodontist right here in Washington, D.C. and spokeswoman for the American Dental Association says, “We need to educate the public that the mouth isn’t disconnected to the rest of the body.”

So what are these systemic diseases that are affected by chronic periodontal disease?  There is a strong correlation between periodontal disease and:

• Uncontrolled Diabetes
• Increased risk for strokes
• Heart Disease
• Rheumatoid Arthritis
• Low Birth weight babies
• Alzheimer’s Disease
• Osteoporosis

All this without pain.  As Susan Karabin, DDS, a New York periodontist and president of the American Academy of Periodontology says, “Gum disease produces a bleeding, infected wound that’s the equivalent in size to the palms of both your hands.”  Pretty scary huh? 

The good news is that periodontal disease, if caught in its early stages, is very treatable.  What are the signs and symptoms of this disease?

• Gums that bleed very easily, especially when brushing and flossing, is the most common and earliest sign. 
• Gums that are red and puffy
• Bad breath, even shortly after brushing.
• Loose teeth
• Pus and/or significant tarter build up
• Oh yeah, and no pain

If you have any or all of these symptoms, I encourage you to seek a diagnosis from a dental professional.  This will usually require an examination and x-rays.  Periodontal disease comes in many types from gingivitis (swelling of just the gums) to very severe types, to everything in between.  Once a diagnosis is made, a plan can be created to start treating your particular form.  In most cases, this plan consists of a good cleaning, teaching you how to best care for your teeth and gums, and seeing you a little more frequently until we are sure that everything is healed.  But more importantly, the plan will begin the process of making you a healthier individual. 

If you have any questions or comments about the information provided here, please feel free to call me at my office or follow this link to our website: www.rosslyndentist.com.  I hope this information was useful.

Say what? A dental blog? Really?

I’d like to welcome everyone reading to my first official blog entry.  While I never thought that you would ever find me sitting in front of my computer, writing to my patients and maybe even to some people who aren’t, here I am.  Doing that very thing. 

The purpose of this blog is to provide dental information to anyone who is interested.  Often people are more comfortable finding the answers to their questions in this way.  No appointment, no lying back in the chair, no dental smells, no jaw fatigue.  So from time to time (my goal is once or twice a month) I will be writing about various topics, from the best ways to take care of your teeth, to the best time to bring a child to the dentist, to a good way to handle a dental emergency.  Who knows, I may even throw in a few blogs about what’s going on in Arlington, VA.

I hope you will find this information helpful, interesting and maybe even entertaining.  My only goal is to increase your dental IQ.  Armed with this information, you can make the best decisions about you oral health.  The best decisions for you!  Of course, I would love to be the dentist that provides you with your care, but it’s more important to me that you find the care that you need.  So sit back, enjoy, and only say “ah” if something you read strikes you.

There is tons of dental information on our website: www.rosslyndentist.com Check it out!

And we can use as many fans as we can get on our Facebook page: www.facebook.com/ArlingtonDentist

I’m An Adult, How Am I Still Getting Cavities?

 Something that most people consider to be healthy is actually causing an increase in dental cavities among children and many adults.

The culprit? Many believe it is bottled water. While most of us know the dangers of drinking sugar loaded soft drinks and their sneaky cousins, the “sports drink,” we often don’t remember that bottled water is missing the fluoride that is found in fortified tap water. The Centers for Disease Control reports that bottled water has become so prevalent in the diets of Americans that many are not getting the proper amount of fluoride they need to keep their teeth healthy.

According to the International Bottled Water Association (sounds like a wild and crazy group) – bottled water consumption has recently doubled and the average American now drinks thirty gallons per year! Believing that it is healthier, many parents are not only having their kids drink bottled water, they are preparing baby formula with it too! Even bottled water that is basically tap water in a fancy container is micro-filtered, a process that can remove fluoride.

At Greg L. LaVecchia DMD, PC our goal to keep your smile beautiful and your teeth cavity-free. Drinking tap water instead of bottled water whenever possible will not only save you money and keep millions of plastic bottles out of landfills, it can help you keep your teeth healthy!

Should you have any questions about this or any other dental related topic, including the latest ways to give you a beautiful smile, please contact us at 703-528-3336. We look forward to seeing you soon!