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Posts for: June, 2018

By James L Bialk DDS
June 24, 2018
Category: Oral Health
Tags: tooth decay  
KeepAlerttoTheseSignsofImpendingToothDecay

Although preventable, the occurrences of tooth decay are all too common. Yet decay doesn’t appear out of the blue: certain mouth conditions set the disease in motion.

Here are a few signs of such conditions to watch for — they could be telling you you’re at higher risk for tooth decay.

Visible plaque. Plaque is a thin film of bacteria and food accumulating on tooth surfaces and a prime haven for causing periodontal disease. If you actually see it — a crusty, yellowish film — that means there’s a large, unhealthy amount of it. It’s essential to remove it daily through diligent brushing and flossing and more thorough office cleanings at least twice a year.

Poor saliva flow. One of this bodily fluid’s functions is to neutralize mouth acid, usually thirty minutes to an hour after we eat. If saliva flow is inadequate, though, acid levels may remain high and endanger the enamel. “Dry mouth” can occur from a number of causes, including some medications and chemotherapy treatments. It’s important to alleviate the cause if possible by changing medications or stimulating saliva flow through other means.

Tooth shape and appliances. Largely determined by heredity, your teeth contain unique, tiny grooves known as pits and fissures that could harbor plaque. Certain appliances like retainers, braces or night guards can inhibit saliva flow and cause your teeth to retain more plaque. It’s important then to adjust your hygiene efforts to offset these anatomical or treatment factors.

Acid-producing conditions. Diseases like gastro-esophageal reflux disease (GERD) or eating disorders can introduce stomach acid into the mouth that is highly erosive to tooth enamel. It’s imperative for you or a family member to control these conditions through medication, dietary changes, or — in the case of eating disorders — behavioral therapy.

Eating habits. Sugar and other carbohydrates are a ready food source for bacteria. Likewise, acidic foods and beverages (like coffee, tea, and sports or energy drinks) can cause high acid levels for too long. Cut back on eating and drinking these foods and beverages, especially as snacks, to reduce acid levels that could lead to decay.

If you would like more information on strategies to prevent 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 “Tooth Decay: How to Assess Your Risk.”


By James L Bialk DDS
June 14, 2018
Category: Oral Health
Tags: oral cancer  
NewSalivaTestmayHelpIdentifyOralCancerEarlier

A half million people are diagnosed every year with oral cancer. While other cancers are more prevalent, oral cancer is among the most dangerous with only a fifty percent five-year survival rate.

A major reason for this low rate is because this fast growing cancer is difficult to detect early — diagnosis comes far too often after the disease has already well advanced. In an effort to detect cancer earlier many dentists visually screen for oral abnormalities during checkups, especially patients over fifty, tobacco or heavy alcohol users, patients with a family history of cancer or a medical history of exposure to the sexually transmitted human papilloma virus, HPV-16.

If they detect an abnormality, the dentist often refers the patient to an oral surgeon or other specialist for a possible biopsy. In this procedure the surgeon removes a sample of the abnormal tissue, which is then examined microscopically for cancer cells. A biopsy remains the most effective way to diagnose oral cancer.

Because of the disease's aggressive nature, many dentists lean to the side of caution when referring patients for biopsy. As a result 90% of oral biopsies reveal no cancer. Reducing the number of biopsy referrals is highly desirable, especially for the patient undergoing the procedure. Tissue samples tend to be large to ensure complete detection of any cancer cells. Depending on the size and location of the sample, there may be a risk for loss of function or disfigurement.

A new screening tool using a sample of a patient's saliva could help reduce the number of biopsy referrals. Besides DNA, saliva also contains dormant genes called biomarkers that activate in response to the presence of a specific disease. This particular saliva test identifies those biomarkers for oral cancer if they're present.

A sample with a low score of biomarkers indicates no cancer present (with a statistical confidence of 99%). A medium or high score indicates cancer may be present, but only a biopsy can determine for sure. Using this test, dentists might be able to reduce the number of biopsy referrals and instead be able to employ watchful waiting in certain cases. Because of its simplicity and non-invasiveness, saliva screening could help identify oral cancer earlier.

If you would like more information on early detection and treatment for oral cancer, please contact us or schedule an appointment for a consultation.


CharlizeTheronBackinActionAfterDentalSurgery

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”