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Dentists Journal

HIV/AIDS and Dental Health

If you, or someone you know, is living with HIV/AIDS, the American Dental Association recommends that dental health care be part of all HIV/AIDS treatment plans. That’s because people living with HIV/AIDS are more susceptible to infections including dental infections, which can affect their overall health.

What Is HIV/AIDS?

HIV (human immunodeficiency virus) is a virus that attacks a specific type of T cell known as CD4 cells. T cells are an important part of the body’s immune system which is needed to fight infection. If left untreated, HIV can destroy so many CD4 cells that a person can no longer fight off infections and disease. AIDS (acquired immunodeficiency syndrome) is the last state of HIV infection where the immune system is so very weak that infection and cancer can take over.

How Does HIV/AIDS Affect the Mouth?

Your mouth may be the first part of your body to be affected when infected with HIV. Because infection with HIV will weakened your immune system, this means you will be susceptible to infections and other problems. In your mouth, this can cause pain and tooth loss. People with HIV may experience the following mouth issues:

Dry mouth

Thrush

White lesions on the sides of the tongue (oral hairy leukoplakia)

Red band gingivitis

Ulcerative periodontitis

Karposi’s Sarcoma

Outbreaks of herpes simplex virus

Canker sores

Mouth ulcers

Dental and mouth problems related to HIV can be painful, which can cause trouble chewing or swallowing. This may prevent you from taking your HIV medication. It can also result in malnutrition, as you may have trouble eating and absorbing enough essential nutrients. A compromised digestive system may affect the absorption of your HIV drug treatment.

How Can I Cope with Dental and Mouth Issues Related To HIV?

Most mouth health problems related to HIV are treatable. Talk to your dentist about what treatment is best for you. The best ways to prevent these issues are to do the following:

Visit your dentist for regularly scheduled appointments.

Brush and floss your teeth twice daily for two minutes.

Take your HIV medicine on schedule.

Tell your doctor if your HIV medicine is causing dry mouth. Ask what treatment is best for you.

If you do not have a regular dentist, ask your primary care provider or clinic for a referral.

(11/14/2020)
by ADA

More Information: https://www.mybestdentists.com/resources/AmericanDentalAssociation

Signs of acid reflux and its effects on the body you might be ignoring

Acid reflux can masquerade as everything from a cold to poor dental hygiene. If you notice any of the following GERD signs, especially if you also get typical heartburn symptoms, talk to your doctor.

A sore throat that doesn’t go away and isn’t accompanied by typical cold symptoms (like a runny nose) may in fact be a symptom of acid reflux. “Your throat feels sore because a little bit of acid is coming up from the esophagus and irritating the throat,” says Gina Sam, MD, MPH, a gastroenterologist and the director of the Mount Sinai Gastrointestinal Motility Center in New York, NY. Unexplained hoarseness may be caused by stomach acid moving up to your larynx, or voice box, and tends to be more noticeable in the mornings when it’s had all night to travel while you were lying down. These natural remedies for heartburn relief may help silent acid reflux too.

Persistent cough or wheezing

“Wheezing or a cough that mimics asthma or bronchitis can be caused by acid reflux moving from the stomach to the lungs,” says Evan Dellon, MD, the director of the Center for Esophageal Diseases and Swallowing at the University of North Carolina School of Medicine in Chapel Hill, NC. On the other hand, wheezers and coughers can sometimes make themselves more prone to reflux, says Dr. Dellon, because the actions put pressure on the belly and push stomach acid upward.

You’re having dental problems

If you’re a dedicated brusher and flosser but your dentist is still filling cavities, tells you your tooth enamel is eroding, or notices discoloration, acid reflux may be to blame. “Even a small amount of acid reflux making its way up from the esophagus to your throat or mouth while lying down can impact tooth enamel,” says Dr. Dellon. It’s a good idea to avoid eating these foods if you have acid reflux.

You have trouble swallowing

Food getting stuck when you swallow, liquid that just won’t go down, or the sensation that something is stuck in your throat could all be acid reflux symptoms, says Dr. Sam. Chronic reflux can irritate the throat, and scar tissue can develop in the esophagus and narrow it. See your doctor if you have difficulty swallowing, as this can also be a symptom of other more serious conditions. Don’t miss these foods that can make your heartburn and reflux worse.

(11/14/2020)
by The Healthy

More Information: https://www.thehealthy.com/digestive-health/acid-reflux-symptoms/

What is a periodontist?

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.

Periodontists often treat more problematic periodontal cases, such as those with severe gum disease or a complex medical history. Periodontists offer a wide range of treatments, such as scaling and root planing (in which the infected surface of the root is cleaned) or root surface debridement (in which damaged tissue is removed). They can also treat patients with severe gum problems using a range of surgical procedures. In addition, periodontists are specially trained in the placement, maintenance, and repair of dental implants.

During the first visit, the periodontist usually reviews the patient’s complete medical and dental histories. It is extremely important for the periodontist to know if any medications are being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.

The periodontist examines the gums, checks to see if there is any gum line recession, assesses how the teeth fit together when biting, and checks the teeth to see if any are loose. The periodontist will also take a small measuring instrument called a probe and place it between the teeth and gums to determine the depth of those spaces, known as periodontal pockets; this helps the periodontist assess the health of the gums. X-rays may also be taken to observe the health of the bone below the gum line.

WHO SHOULD SEE A PERIODONTIST?

Some patients’ periodontal needs can be managed by the general dentist. However, as more and more patients are exhibiting signs of periodontal disease, coupled with research that suggests a relationship between periodontal disease and other chronic diseases of aging, periodontal treatment may necessitate a greater understanding and increased level of expertise by a trained specialist. Patients who present with moderate or severe levels of periodontal disease, or patients with more complex cases, will be best managed by a partnership between the dentist and periodontist.

(11/15/2020)
by AAP

More Information: https://www.mybestdentists.com/resources/AmericanAcademyofPeriodontology

The most common dental implant problems

Dental implant procedures are incredibly common and very safe, but that doesn’t mean they never run into problems. Dental implant problems can often be combated, however, and this gives patients a much better shot at having a successful dental implant experience. When a dental implant procedure is all finished, the implant will then need to have some time to fuse to the jawbone in order to anchor the new tooth. In some cases, the implant doesn’t properly fuse, and this is considered a dental implant failure. A few leading causes of dental implant problems and failures are:

• Infection – In some cases, an infection may develop at the site of the dental implant procedure. If this infection cannot be controlled, it will cause the need for your dental implant to be completely removed in order to treat the infected area. The most common cause for infection after a dental implant procedure is poor or sub-par oral hygiene allowing bacteria to grow in the implant site.

• Smoking – Smoking is a huge factor in dental implant failure or success. In many cases, smokers can have a successful dental implant procedure, but their failure rates are also significantly higher than those who do not smoke. Smoking may lead to infections in and around the dental implant site, poor bonding, and peri-implantitis, which is a disease causing inflammation in and around the implant site. The best way to keep your implant procedure successful is to pursue smoking cessation before dental implant surgery if you are a smoker.

• Bone density problems – A sinus lift or bone graft may be necessary before a dental implant procedure if the bone density isn’t high enough to support the implant structure. Without this graft or lift, the jawbone may not have the density necessary to allow the anchor implant to successfully fuse to the bone itself. Your dentist should be able to let you know if you require any prep procedures before a dental implant is placed.

• Tissue damage – With the way dental implant procedures are performed, one can expect some tissue damage and inflammation in the following days after the procedure. If this damage persists, however, big problems can arise leading to dental implant failure. If you experience discomfort or inflammation that you don’t believe is normal, it’s important to call the dentist straight away.

• Cracks or breaks – In some cases, a dental implant can crack or break while in the mouth, and this could lead to dental implant failure. These breaks are most often caused by injury, tooth grinding, or an uneven bite. It’s important to be careful with the new implanted tooth area as often as possible, although accidents do happen.

The appropriate treatment depends on the severity of the infection and how long you waited to report your dental implant problems. Dental surgery is sometimes an option to replace the implants, but that can be another months-long procedure while you heal. If you’re opposed to surgery, you have non-surgical treatment options as well.

(11/13/2020)
by Eden Rise Dental

More Information: https://www.dentalimplantsofli.com/how-to-combat-the-most-common-dental-implant-problems/

NYU study shows oral cancer pain may predict likelihood of cancer spreading

An oral cancer patient's pain intensity score could predict cancer metastasis, helping with future testing options and surgical decision-making, according to a study from the New York University College of Dentistry.

The authors of "Oncogenes Overexpressed in Metastatic Oral Cancers from Patients with Pain: Potential Pain Mediators Released in Exosomes," published in September by Scientific Reports, an open-access journal from Nature Research, used a questionnaire to document the pain experienced by 72 oral cancer patients before oral cancer surgery.

While most patients reported some pain, those with the most pain were more likely to have cancer that had spread to lymph nodes in the neck, suggesting patients with less pain were at lower risk of metastasis, according to the study. "While we need to undertake a follow-up study, our current data reveal that a patient's pain intensity score works as well as the current method — depth of invasion, or how deeply a tumor has invaded nearby tissue — as an index to predict metastasis," lead author Aditi Bhattacharya, Ph.D., said in an NYU news release about the study.

To help understand why metastatic cancers are more painful, the researchers looked for differences in gene expression in metastatic cancers from patients with high levels of pain and nonmetastatic cancers from patients not experiencing pain and identified 40 genes that were more highly expressed in painful metastatic cancers, suggesting those genes are associated with oral cancer metastasis and mediate cancer pain, according to the study.

One cause of cancer pain is attributable to the release of mediators from cancers that sensitize nerves near the tumor. Many of the 40 genes identified in this study code for proteins found in exosomes, small vesicles that break away from a cell and can be taken up by other cells. This is a potential mechanism for how oral cancer cells affect nerves, according to the study.

When the researchers injected the paws of mice with the extracellular fluid of oral cancer cells grown in culture, only those animals injected with the fluid containing exosomes experienced pain. This suggests exosomes from cancer may be responsible for oral cancer pain, according to the study."The identified genes are targets for therapy aimed at stopping pain and cancer. In addition, exosomes shed from cancers can be detected in saliva, blood and urine, offering the potential for an objective molecular test to diagnose risk of metastasis," said Donna Albertson, Ph.D., professor in the department of oral and maxillofacial surgery at the NYU College of Dentistry, an investigator at the NYU Bluestone Center for Clinical Research and the study's corresponding author.

When oral cancer spreads to lymph nodes in the neck, a patient's chance of survival is cut by half, according to the release. Because it's often unclear through imaging and physical assessment if oral cancer has spread, most oral cancer surgeries include preemptively removing lymph nodes, even though research shows as many as 70% of these prophylactic neck dissections are unnecessary, the release stated.

"Clinicians and researchers are keen to define a biomarker that accurately predicts metastasis," said Dr. Bhattacharya, who is also an assistant professor in the department of oral and maxillofacial surgery at the NYU College of Dentistry and an investigator at the NYU Bluestone Center for Clinical Research.

"Given that patients with metastatic oral cancer experience more pain, we thought that a patient’s level of pain might help predict metastasis. A surgeon could then use this knowledge to only remove lymph nodes in patients with cancers that are most likely to metastasize."

The study was supported by grants from the National Institutes of Health.

(11/17/2020)
by NYU

More Information: https://www.mybestdentists.com/dental-schools/NewYorkUniversity

Excellence in dentistry begins with a careful co-diagnosis and treatment plan to establish the goals we will achieve together says Dr Stratford-Jones

Dr. Stratford-Jones was educated at the University of California, Davis and was accepted to the University of California, Los Angeles School of Dentistry in 1987. Graduated in June1991 and began practice dentistry after passing the board exam in August of 1991. After spending some time practicing in Orange County he maintained a very successful practice from 1993-2006 in Ventura, CA. In early 2006, concurrent with the sale of the Ventura practice, he purchased this practice from a Dr. John Burk who was retiring after 20+ years successfully building the practice. Dr. Stratford-Jones has and is carrying on the skills and devotion that Dr. Burk had in treating his patients.

In his spare time Dr. Stratford-Jones enjoys fly-fishing and snow skiing. He also is an avid racing fan and car fanatic as well as enjoying time kayaking in the local waters. He has a wife, Kathy, and two children, Sean and Jake that he spends much of his time enjoying his passions with.

Communication and long-term relationships are important to us. Let us know what is on your mind and ask questions. We will help you realize an investment in yourself pays dividends for a lifetime. We are caring, skilled professionals, dedicated to simplifying what is often a very complicated and confusing area of health care.

(11/16/2020)

More Information: https://mybestdentists.com/JeffreyAlanStratfordJones

We want to make your visits as comfortable and stress-free as possible says Dr. Alin N. Chera

We love to welcome our patients at Sonoma County Smiles in a comfortable environment that is also state of the art. One of the things that we feel is lost in today’s high-tech world is personal touch. We strive to bring our patients a balanced mix of the latest technology and personal attention.

As such, we started with an 1875 farm house with a lot of character. We kept the envelope of the building, but the guts of the building were replaced to house an entire array of the latest medical technology including digital records, x-rays, sedation, and digital displays that help us deliver the best care in a comfortable environment.

We also know that many people feel anxious about visiting the dentist. For some, it's mild. For others, certain aspects of dentistry give them the heebie-jeebies like nothing else.

We want to make your visits as comfortable and stress-free as possible says Dr Chera. Would it help you to listen to music or watch a DVD during your treatment? No problem. Need a little nitrous oxide to get you through a procedure? Just tell us, and our staff will work with you to help you through it. Need your special blanket but forgot to bring it? We've got blankets you can borrow.

For those who want a deeper sedation level, we offer a well controlled and closely monitored Deep Sedation, also known as Sleep Dentistry.

As much as we enjoy educating our patients about the latest in dentistry, we believe that our greatest asset is the gift of listening.

Our patients have the opportunity to share with us their previous health, dental and other health related history. We encourage our patients to share with us what they expect from us, why they seek our services, and the level at which they would like to be involved. We then customize our treatment plan to meet each patients needs and wants.

(11/18/2020)

More Information: https://mybestdentists.com/AlinNicolaeChera

First aid and treatment for a tongue laceration

A tongue laceration refers to a deep cut or tear in the surface of the tongue. This type of injury can cause significant pain and bleeding.

Tongue lacerations occur when a person accidentally bites their tongue. This may occur: while eating, while playing sports, during sleep, during a seizure, while under dental anesthesia or as a result of an injury, such as a fall or vehicle collision, as a result of self-harm.

In this article, we discuss the symptoms and treatment of tongue lacerations. We also cover first aid and aftercare tips, potential complications, and ways of preventing mouth injuries.

Symptoms:

Tongue lacerations can cause significant pain, bleeding, and swelling. They usually occur on the tip or middle section of the tongue. As a person uses their tongue to talk, drink, and swallow food, these symptoms can be very disruptive.

Lacerations at the back of the tongue are less common, as this area is more difficult to reach. However, injuries to this area of the tongue can be more serious due to the presence of a major nerve.

Without treatment, a tongue laceration may become infected. The signs of an infection include: fever, swelling or throbbing, clear or white discharge.

First aid:

If a person cuts their tongue, they should administer first aid treatment as soon as possible. They can do so by following these steps:

washing the hands thoroughly with warm water and soap

rinsing the mouth with clean water to get rid of any debris

applying a gauze pad or clean cloth to the laceration

applying firm, consistent pressure to stop the bleeding while tipping the head forward to avoid swallowing blood

Once the bleeding has stopped, people can try to reduce swelling and pain by either sucking on an ice cube or wrapping it in a clean cloth and applying it to the cut.

Over the next few days, it is important to monitor the laceration for signs of infection, such as pus, fever, or swelling.

The time it takes a tongue laceration to heal varies depending on the severity of the injury. Minor lacerations can heal quickly, whereas severe injuries may take several weeks to heal.

If a doctor closes a laceration with absorbable stitches, these may take 4–8 weeks for the body to absorb. A healthcare professional will need to remove nylon and other nonabsorbable stitches after the wound has closed.

A person can aid the healing process by following their doctor’s aftercare advice. The doctor may recommend:

1. keeping the tongue still as often as possible

2. rinsing the mouth with a saltwater solution after every meal

3. applying a cold compress to the injury site a few times a day

4. taking OTC pain relievers, such as ibuprofen or acetaminophen

5. eating foods that are soft and easy to swallow, such as yogurt, eggs, and cooked vegetables

6. avoiding acidic, spicy, and salty foods

7. avoiding tobacco products and alcohol

(11/17/2020)
by Jamie Eske

More Information: https://www.medicalnewstoday.com/articles/tongue-laceration

Teeth grinding and facial pain increase due to coronavirus anxiety

The stress and anxiety experienced by the general population during Israel's first lockdown brought about a significant rise in orofacial and jaw pain, as well as jaw-clenching in the daytime and teeth-grinding at night, according to a new study from Tel Aviv University (TAU).

The research also found that women suffered more from these symptoms more than men, and that 35- to 55-year-olds suffered most.

"We believe that our findings reflect the distress felt by the middle generation, who were cooped up at home with young children, without the usual help from grandparents, while also worrying about their elderly parents, facing financial problems and often required to work from home under trying conditions," the researchers say.

The study was led by Dr. Alona Emodi-Perlman and Prof. Ilana Eli of TAU's Goldschleger School of Dental Medicine at TAU's Sackler Faculty of Medicine. The paper was published in the Journal of Clinical Medicine on October 12, 2020.

The study examined questionnaires that assessed the presence and possible worsening of these symptoms in the general population during the first COVID-19 lockdown, due to the national emergency and rise in anxiety levels. The questionnaire was answered by a total of 1,800 respondents in Israel and Poland.

During Israel's first lockdown, the general population exhibited a considerable rise in orofacial pain, as well as jaw-clenching in the daytime and teeth-grinding at night -- physical symptoms often caused by stress and anxiety. The prevalence of symptoms rose from about 35% pre-pandemic to 47%; the prevalence of jaw-clenching in the daytime rose from about 17% to 32%; and teeth-grinding at night rose from about 10% to 36%. People who had suffered from these symptoms before the pandemic exhibited a rise of about 15% in their severity.

Altogether a rise of 10%-25% was recorded in these symptoms, which often reflect emotional stress.

In addition, comparing findings in Israel to results in Poland, the researchers found that probability of TMD and Bruxism was much higher among respondents in Poland.

The study was conducted in collaboration with Dr. Nir Uziel and Dr. Efrat Gilon of TAU, and researchers from the University of Wroclaw in Poland, who examined the Polish population's reaction to the pandemic.

(11/18/2020)
by Tel Aviv University

More Information: https://www.sciencedaily.com/releases/2020/11/201116184431.htm

The Connection Between Oral Health and Systemic Diseases

It’s not news that there is a significant link between one’s oral health and overall health. Though studies are ongoing, researchers have known for quite some time that the mouth is connected to the rest of the body. “Your mouth is the entry point of many bacteria,” said Dr. Steven Grater, Pennsylvania Dental Association (PDA) member and general dentist from Harrisburg. “To keep this bacteria from going into your body, cleaning your mouth (brushing, flossing and rinsing) is necessary.”

PDA strives to educate the public about the role oral health plays in some systemic diseases, such as diabetes and heart disease, and oral health complications during pregnancy. PDA wants you to know what you can do to keep your teeth, gums and body healthy.

Diabetics are more prone to several oral health conditions, including tooth decay, periodontal (gum) disease, dry mouth and infection. According to “Oral Health in America: A Report of the Surgeon General,” the relationship between type I and type II diabetes and periodontal disease has often been referred to as the “sixth complication” of the disease.

Periodontal disease is an infection of the tissues that support your teeth, and is caused by plaque-forming bacteria in your mouth. In diabetics, it is often linked to how well a person’s diabetes is under control. Diabetic patients should contact their dentist immediately if they observe any of the symptoms of periodontal disease, including red, swollen or sore gums or gums that bleed easily or are pulling away from the teeth; chronic bad breath; teeth that are loose or separating; pus appearing between the teeth and gums; or changes in the alignment of the teeth.

Diabetic patients often suffer from dry mouth, which greatly increases their risk of developing periodontal disease. If you suffer from dry mouth, talk to your dentist. He or she may recommend chewing sugarless gum or mints, drinking water, sucking on ice chips or the use of an artificial saliva or oral rinse. Studies also have shown that periodontal disease may be linked to cardiovascular disease, stroke, bacterial pneumonia, preterm births and low-birth weight babies. Research suggests that people with periodontal disease are nearly three times as likely to suffer from heart disease.

Oral bacteria can affect the heart when it enters the blood stream, attaching to fatty plaques in the heart’s blood vessels and contributing to the formation of clots.

Due to the increase in hormone levels, particularly estrogen and progesterone, pregnant women are at greater risk to develop inflamed gums, which if left untreated can lead to periodontal disease. A five-year study conducted at the University of North Carolina found that pregnant women with periodontal disease are seven times more likely to deliver a premature, low-birth-weight baby.

Oral health problems can cause more than just pain and suffering. They can lead to difficulty speaking, chewing and swallowing, affecting your ability to consume the nutrition your body needs to stay healthy, participate in daily activities and interact with others. Poor nutrition also can lead to tooth decay and obesity. In a recent study, researchers at the University of Buffalo examined 65 children, ages two through five, who were treated for cavities in their baby teeth. Nearly 28 percent of them had a body-mass index indicating they were either overweight or obese.

To keep your teeth, gums and body healthy, PDA recommends the following:

Provide your dentist with a complete health history, including any illnesses and medication use.

Brush your teeth twice a day with fluoride toothpaste.

Floss daily to help remove plaque, the sticky film of bacteria that gets stuck between your teeth and under your gums.

Visit your dentist regularly for a checkup and professional cleaning to help prevent any problems and detect possible problems in their early stages. The mouth is often the location used to diagnose a variety of diseases.

Eat a well balanced diet, which will help you maintain a healthier immune system, help prevent heart disease and slow diabetes disease progression.

If you smoke, talk to your dentist about options for quitting.

“A clean mouth will lead to a clean body,” Dr. Grater said. “Although you clean your mouth every day at home, regular checkups to the dentist will prevent additional disease that can likely cause you to be sick.”

(11/18/2020)
by PDA

More Information: https://www.padental.org/Online/Resources___Programs/News_Releases/Past_News_Releases/Connection_Between_Oral_Health_and_Systemic_Diseases.aspx