How cancer treatment affects oral health

When someone is undergoing cancer treatment, its important that they involve their dentist in their program of care.

They should schedule a dental exam and cleaning before the treatment actually begins and then repeat it periodically during the course of treatment.

Its important that they tell the dentist that they are being treated for cancer and that they also discuss any dental procedures, such as extractions or insertion of dental implants, with the oncologist before starting the cancer treatment.

Its therefore a good idea to ensure that the dentist and oncologist have each others details to enable them to discuss any issues to help the patient.

And the dentist and physician should be informed about any issues such as bleeding of the gums, pain, or unusual feeling in the teeth or gums, or any dental infections.

Maintaining excellent oral hygiene during cancer treatment is vital to reduce the risk of infection and to help aid the treatment process.

Caring for people who have special needs

People at any age can have a condition that makes it difficult for them to look after their own dental health.

This could affect people who suffer from a wide range of conditons such as stroke, spinal cord injury, multiple sclerosis, mental retardation, Down syndrome, genetic disorders, Alzheimers disease or arthritis.

However, people in all of these categories have the same dental needs as everyone else – they need daily brushing and flossing, regular dental visits and a balanced diet.

There are some steps caregivers can take to make it easier to look after people in those categories.

If the person is uncooperative or uncontrollable, try to explain what you are about to do and schedule the task for a time of day when they are rested.

Move in a calm, slow, reassuring manner to avoid startling them. Give praise and encourage them when they help themselves.

Support the persons head, and take special care to prevent choking or gagging when the head is tilted back.

If the person is unable or unwilling to keep their mouth open, your dentist will explain how you can make and use a mouth prop.

Ask your dentist for advice on how to care for people with special needs and check if they have facilities for caring for these needs in the dental office.

Different types of fillings and restorations

Nowadays, thanks to advances in dental techniques and materials, patients have a much wider range of choices when they have to repair missing, worn, damaged or decayed teeth.

For example, materials such as ceramics and polymer compounds that look more like natural teeth help dentists create pleasing, natural-looking smiles.

The traditional materials such as gold, base metal alloys and dental amalgam are still widely used as they have many advantages.

The strength and durability of traditional dental materials continues to make them useful in many situations. For example, they are good when fillings are required in the back teeth because the pressure of chewing is high in that area.

The choice of the best option will depend on several factors such as the patient’s oral and general health, where and how the filling is placed and the number of visits needed to prepare and adjust the restored tooth.

The choice about which option is best depends on each individuals needs so you should discuss the options with your dentist.

How sealants can give your teeth extra protection

Sealants are made from plastic material applied to the back teeth to protect the enamel from plaque and acids.

The plastic bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of the back teeth – premolars and molars.

Although thorough brushing and flossing can help remove food particles and plaque from smooth surfaces of teeth, the toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque.

The benefit of sealants is that they protect these vulnerable areas by “sealing out” plaque and food.

Your dentist can apply sealants quite easily and it takes only a few minutes to seal each tooth.

The teeth being sealed will first be cleaned. Then the chewing surfaces are roughened with an acid solution which makes it easier for the sealant to stick to the tooth.

The sealant is then ‘painted’ onto the tooth enamel, where it bonds directly to the tooth and hardens.

Sometimes a special curing light is used to help the sealant harden.

As long as the sealant remains intact, the tooth surface will be protected from decay.
They usually last several years before a reapplication is needed. Your dentist will check the condition of the sealants during your regular visits and reapply them when necessary.

Sealants are ideal for children because the risk of developing pit and fissure decay starts early in life. However, many adults can benefit from sealants as well.

Your dentist can tell you whether sealants would help your oral hygiene program.

The early years of dentistry and teeth

Although there have been huge advances in dental care in recent years, there are records of people dealing with teeth going back over thousands of years.

Here are some of the key dates from the early years in the development of dentistry.

5000 BC: A Sumerian text describes tooth worms as the cause of dental decay.

2600 BC: Hesy-Re, an Egyptian scribe, often called the first dentist, dies. An inscription on his tomb includes the title the greatest of those who deal with teeth, and of physicians.

500-300 BC: Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

166-201 AD: The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

500-1000: During the Early Middle Ages in Europe, medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700: A medical text in China mentions the use of silver paste, a type of amalgam.

1130-1163: A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade sharp knives and razors were useful for surgery. Following the edicts, barbers assume the monks surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210: A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s: A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

What to do if your tooth cracks

While our teeth are normally very strong, they can crack for a number of reasons.

Reasons could include tooth decay, trauma/injury, grinding of the teeth or a stress fracture.

Sometimes, our jaw may be stronger than our teeth and the teeth can fracture when we bite heavily on food.

We can protect our teeth in some circumstances – for example it may be advisable to wear a mouthguard during sports.

Taking proper care of the teeth and regular visits to the dentist will help keep your teeth in good shape.

If a tooth cracks, it may become painful if the nerve is exposed and the area can become tender.

If this happens, rinse your mouth with warm water to clean the area and apply a cold compress to reduce swelling. Then call your dentist immediately.

Treatment will depend on where the tooth has fractured, how close it is to the nerve and the overall condition of the tooth.

A cracked tooth may be repaired with silver alloy, gold, porcelain or plastic. Or it may require a crown or overlay or bonding, which applies porcelain or enamel to the fractured tooth.

If you contact your dentist quickly, they will be able to take the most approriate action to preserve the tooth as much as possible.

The secrets of brushing and flossing your teeth effectively

Though many of us say we brush our teeth regularly, you get the best results by making sure you brush properly.

Here are the steps you should follow:

First, place the toothbrush at a 45-degree angle to your gums.

Then, move the brush back and forth gently in short (tooth-wide) strokes.

Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.

Use the “toe” of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.

Finally, brush your tongue to remove bacteria and freshen your breath.

As well as brushing your teeth, you should floss them every day. Heres how to floss for best results.

Break off about 18 inches of floss and wind most of it around one of your middle fingers.

Then wind the remaining floss around the same finger on the opposite hand. This finger will take up the floss as it becomes dirty.

Hold the floss tightly between your thumbs and forefingers.

Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.

When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.

Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.

Repeat this method on the rest of your teeth.

Don’t forget the back side of your last tooth.

If you have difficulty handling dental floss, consider other types of interdental cleaner such as special brushes, picks or sticks.

Your dentist or hygienist will be able to give your further tips on how to brush and floss for best results.