Weapons of Mouth Destruction, Part 2
These WMDs are unquestionably real. In this post, I will continue discussing the various threats to your oral health so that you can be on guard against them. Please see part 1 for weapons 1-3.
#4 Tobacco This one is a no-brainer when it comes to your overall health, but many people don’t recognize the damaging effects of tobacco on the oral cavity. The most significant risk of tobacco is oral cancer. Squamous cell carcinoma is the most dangerous form, accounting for the vast majority of oral-cancer related deaths. It is rare for an individual who has no history of tobacco use to get this type of cancer. Since it is mostly preventable, dental professionals such as myself owe it to their patients to discuss the risk of using tobacco and encourage quitting. It is also critical to perform an oral cancer screening, where all the soft tissues in the mouth are closely examined for lumps, patches, ulcers or other irregularities as part of routine check-ups. Smoking tobacco is the worst offender, but chewing tobacco carries risks as well. It is easy to recognize when a person regularly uses chewing tobacco due to the obvious changes in the tissue where the tobacco routinely sits. There is no safe form of tobacco. Period. The other major threat of tobacco is gum disease, or what dentists call periodontal disease. When a person uses tobacco regularly (especially smoking), the immune system is compromised and cannot respond adequately to bacterial infection. Since periodontal disease is caused by bacteria, it progresses more rapidly in smokers. It starts with the breakdown of the gum attachment around the tooth, and if not treated, advances to bone loss. Eventually this can cause loosening of the teeth, and ultimately their loss. The effects of tobacco are dose-dependent, so the more you use, the higher your risk of losing your teeth. The solution is simple, but not easy – quit using tobacco! Fortunately, there are many options for patients today who desire help with quitting. Ask us at Inspire Dental for help if you are ready to quit.
#5 Acid In WMDs part 1, I discussed the mechanism by which sugar causes tooth decay and the role of acid in this process. Strong acids have the ability to literally dissolve, or ‘erode’ the teeth. The enamel will start to be negatively affected at a pH of 5.5 or less. Acids from dietary sources can be damaging on their own if they are present in the mouth frequently. People who suck on lemons or other acidic foods will have a characteristic pattern of enamel erosion in the area where the acid contacts the teeth. Stomach acid is extremely strong with a pH as low as 1.5, and if an individual suffers from acid reflux (heartburn or GERD) or vomits very frequently, the surface of the teeth will have a characteristic eroded appearance. Sodas and sports drinks are bigtime offenders as well, with pH levels ranging from 2.5 to 4. Seriously!?!? The amount of contact time is critical, so sipping on an acidic beverage vs. chugging it is much more dangerous over the long-term. I can’t help but cringe when I see young people drinking these energy drinks that are loaded with sugar, caffeine and acid. Erosion is irreversible – once enamel is gone, it is GONE! Without enamel the teeth are at much higher risk of decay or further erosion or abrasion, as the dentin (the next layer inward) is softer and much less resistant to damage. The solution? Avoidance is the best defense. These super-acidic-sugar-loaded drinks are always a losing proposition. If you insist, have the drink with a meal instead of sipping throughout the day. The same goes for fruit juice. Keep contact time to a minimum and don’t brush your teeth immediately after an acid challenge since you can more easily wear away the enamel. If you have acid reflux or vomit frequently, seek treatment from your primary care doctor.
#6 Dry mouth Saliva is a beautiful, wonderful thing. It helps us swallow food and keeps of our soft tissues from sticking to each other. It contains enzymes that start the digestive process, ions to buffer the pH, hormones and antibacterial agents. This SPIT is amazing! Many of us don’t realize just how great it is until we suddenly have less of it. Many medications cause saliva output to decrease, leaving the mouth feeling dry. Medical treatments such as chemotherapy and radiation can make the production come to a screeching halt. Without all the protective and comforting effects of saliva, people experience pain and burning in their mouths, have much higher risk of tooth decay, even bad breath – all negative for oral health and quality of life in general. The treatment of dry mouth is tricky and complex because often the medication or procedure causing the problem cannot be avoided. This typically means that we must do our best to counteract the negative effects. There are several products marketed to people with dry mouth. These include specialized mouthwash products, toothpastes, and saliva substitutes which can be quite helpful. For very extreme cases, medications can be prescribed to increase saliva production. This doesn’t come without a few side effects of its own, however, which must be weighed against the benefits to the individual. Sometimes higher concentrations of fluoride are used in toothpaste or gel form to aid in preventing tooth decay. While the benefit to the teeth is obvious, it presents concerns to overall health since it’s not a good idea to ingest much fluoride. Ask me for more information about this if you are interested… I hope this information has made you more aware of the various threats to your oral health. I firmly believe that knowledge is the first step to prevention and informed patients are empowered to take charge of their health and well-being. Along with the amazing team at Inspire Dental, I am here to educate you and support you in achieving the best health possible!