Cavities on a Stick

I really do like Halloween, and not just because it marks the beginning of what I like to call “candy/cavity season”—the time between October 31^st and January 1^st, when almost all Americans over-consume sweet treats.  I like it because it gives me the opportunity to remind people about the right way to eat holiday goodies, and ways to limit the possible destruction of tooth enamel.

First, a little peek into the history of my obsession against certain types of candy.  Imagine being the child of a dentist around Halloween.  My kids hated it when they were school aged.  I used to insist that they deliver a toothbrush to the nice person handing out candy in the neighborhoods that we canvassed, in exchange for their treat.  They knew their collection would be inspected by me, and then sorted by "the potential for said candy to cause cavities".  I wasn’t a complete Halloween Grinch; after we returned home from trick-or-treating, I allowed each of them to chose a small handful of their favorite treats, and eat them in 20 minutes or so, then go brush and floss and off to bed.  Then I got to work.  All lollipops were the first to go.  I call them “cavities on a stick”.  Next were the hard candies like Jolly Ranchers, Sweet Tarts and Lifesavers.  Lastly, all of the sticky candies like caramels and Starbursts were removed from the bags, and kept where I could monitor their consumption—offering as special treats throughout the next several months, with the requirement of post-indulging brushing.  Don’t worry—there was still quite a bit left.  All of the chocolate bars, M&Ms and sugar-free gum passed the test, and were allowed back in the bag, becoming a prized possession of the child who collected them.

Now my children are grown, and eat what they want, when they want, and I can only hope that some of what I taught them about consuming sweet treats remains.  Here’s what I tell my patients about diet and cavities:  sugar, naturally occurring or in processed foods, feeds the bacteria that produces the acid that causes tooth decay.  Limiting the oral exposure of sugar/carbohydrates or acidic foods or beverages (acid-producing bacteria love to live in an acidic environment) will limit your risk for tooth decay.  So, eat your candy/cookies and drink your mochas/lattes relatively quickly (within 10-15 minutes), then brush or rinse with water.  Follow these simple rules, and hopefully you will sail right thru “cavity season” unscathed.  Keep smiling!

Know Your Dental Numbers

Of course you care about your health.  You see your physicians yearly for blood pressure, cholesterol ,  blood work, and, if you are a woman, pap smears, and mammograms.  Important numbers such as triglycerides, BMI, and A1C indicate your relative risk for getting a heart attack, diabetes and other diseases.  You work hard to keep your numbers in check and be healthy.  Did you know that there are important new tests to identify your risk of getting oral cancer, periodontal disease, and tooth decay?  Preventing these conditions not only improves your quality of life, but might even save your life.

Oral cancer is on the rise.  Human Papilloma Virus- HPV, is a recently discovered cause of some oral cancers.  That means many more people are potentially at risk for this disfiguring and deadly disease.  A simple test will tell us if you are at risk, by detecting the presence or absence of the HPV virus in your mouth.   HPV infection can be contracted at any time, and the virus itself can lie dormant in a person’s body, so yearly testing is advised by some health professionals.  With a positive test result, we can determine appropriate referral and monitoring options earlier, even before a pre-cancerous or cancerous lesion forms.

Eighty percent of adults have some form gum disease.  There are genetic and bacterial components to this condition.  A sample of your saliva can be sent to the lab, and analyzed for the presence of a gene associated with periodontal disease—if you have it, you’re at higher risk to develop the disease and suffer the adverse effects (gum recession, loose teeth, and possible increased risk for heart disease and other serious health conditions).  If the gene is present, your dentist can monitor you very closely to control or eliminate the possibility of problems.   The same test sample allows us to identify the types and amounts of periodontal disease-linked bacteria present, so we can prescribe appropriate antibiotics and home care to treat your disease. 

Would you like to know if you and your family are at risk for developing cavities?   A simple, inexpensive swab test, will immediately tell us your risk factor.   While you may not have tooth decay currently, your mouth may be harboring the bacteria that cause decay.  These bacteria are contagious and are transmitted to your family through saliva (sharing spoons, drinks and kissing).  We can eliminate these bacteria from your mouth and eliminate the risk.

My goal for you: early, accurate diagnosis to achieve excellent oral health.  Your dental numbers--they can be as important as your medical numbers.  Prevention is the key to a healthy smile!

Lessons from a Local Farmer

 A colleague of mine recently told me about a weatherworn old farmer who came into is office one day. “Doc,” the man said, “I got a tooth in here I need you to take out.” 

Examining him, the dentist found that the man had only one single tooth in his mouth.  It appeared, however, that several nearby teeth had been extracted recently.  “Why didn’t you just get this one taken out with the others?” my friend asked.

“’Cause I couldn’t get any leverage with the screwdriver for that last one,” the farmer answered. “There wasn’t any other teeth in there in there to pry against!”

Evidently, this self-sufficient farmer had used a household tool to remove almost every remaining tooth in his mouth.  Although he was certainly resourceful, the method he chose for tooth removal was quite unwise.  In this particular case, the patient faired OK.  He was lucky to not develop an infection from his choice of non-sterile instruments, not break off a root tip of a tooth, not impale himself with his screwdriver, nor bleed heavily.  But another patient of mine was not so lucky.

This patient came to me with the complaint of a sensitive tooth.  On examination, I noticed that he had a significant amount of gum loss between the sensitive tooth and the tooth immediately forward.  The rest of his mouth looked fine.  I asked him about this and he replied “yea, I got something stuck between my teeth, so I tooth an Exacto ™ knife and got it out.”  Well it turns out he got more than that out from between his teeth.  He succeeded in removing all of the gum there, too, and it won't all grow back.  He has exposed an area of his tooth that is supposed to be covered by gums, and now it is bare, and sensitive to cold air and drinks, and probably will be for some time to come, or at least until he gets a crown on his tooth.

The moral of the story:  Leave the dentistry to the dentist.  And for my part, I promise to leave my screwdrivers and Exacto™ knife on the workbench in my garage where they belong.

Let the dental blogging begin!

Ok--go easy on me at first--I'm a blogging neophyte...  I finally decided to take the advice of my professional advisors (isn't that what they are for?), and start my own dental blog.  I'm guessing that my blogs, like my articles in Duvall's own River Current News, will have at least some connection to the world of dentistry and health--but no promises :-)

I welcome comments, ideas, questions, etc.  It's actually one of the ways that I get my ideas--so please feel free to chime in.

A quick bit about my dental life, for those of you who do not know:  I'm a dental nerd from very early on--fourth grade to be exact.  I loved to visit my dentist (Dr. Thompson Lewis of blessed memory), and was lucky enough to have him as a professor of mine at University of Washington Dental School, class of 1988.  I was very involved in student research, won some awards, and published my first paper at 24 years of age (Journal of Dental Reasearch, The Culture and Characterization of Junctional Eptihilium).  Fast forward to today, still very interested in research, but equally interested in patient care and education.  Chose to set up in little 'ol Duvall, WA--a wonderful and beautiful community with the best patients that anyone could ask for.  Enough about me--let's talk dentistry!