A sugar that helps fight tooth decay!

  Xylitol is indeed becoming quite popular especially in dentistry and for good reason — it helps prevent cavities. It is a natural “sugar alcohol” similar to other so-called sugar alcohols such as mannitol and sorbitol used as sugarless sweeteners. Xylitol is a naturally occurring diabetic-safe, low-calorie carbohydrate that is obtained form the bark of birch trees, coconut shells and cottonseed hulls. However, it looks and tastes like sugar and is comparable in sweetness. It is also found naturally in many fruits and vegetables, including corn, raspberries, and plums.

Unlike sucrose (regular table sugar), the main culprit associated with tooth decay, xylitol is not broken down by the most prominent decay causing bacteria, Mutans Streptococci, to produce acid. In effect, xylitol starves these particular bacteria to the point where it is almost like removing sugar from the diet completely.

What you may not have known is that these bacteria are actually transmitted initially from a parent to their children through oral contact such as a simple lip-to-lip goodnight kiss. However, you can inhibit the growth and attachment of these bacteria to your teeth thereby interrupting the transmission to your children by including xylitol in your diet. Xylitol also has the added effect of stopping the saliva from becoming acidic so that decay not only doesn’t start, but rather your mouth becomes an environment that favors non-acid producing bacteria.

Researchers have found that systematic use of xylitol chewing gum significantly reduces the relative risk of caries (tooth decay) when compared to chewing gums containing sorbitol/xylitol and sucrose. Additionally, xylitol gum is more frequently associated with halting the progression of very tiny cavities versus other combinations of chewing gum. The use of other products containing xylitol such as mints, candy, and cookies has shown a decreased incidence of dental caries by arresting active decay.

Another benefit of using xylitol-containing products is that it increases salivary flow along with its acid neutralizing properties to cause a sort of natural reconditioning of teeth following an acid attack. In other words, the reaction between xylitol and your salvia’s mineral-rich calcium and fluoride content contribute to re-mineralization (hardening) of your teeth. And this benefit is not confined just to children, but rather is extended to many adults who experience dry mouth. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

The amount of xylitol needed for benefits against caries is slowly being refined. Current recommendations for moderate, high, and extreme caries-risk patients includes consuming two pieces of xylitol gum or two pieces of xylitol hard candy/mints for five minutes following meals or snacks four times daily. The target dose of xylitol is 6 to 10 grams (1-2 teaspoons) spread throughout the day. However, because excessive or prolonged gum chewing is not advised, most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. Adults who experience dry mouth or senior citizens who may not like to chew gum because of occlusion (bite) problems have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (1 teaspoon) three times per days.

So yes, xylitol really is a different kind of “sugar” that is effective at fighting tooth decay and not just for your children.

Dr. Calvo is one of only 300 members in the world to achieve AACD Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well-respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self-esteem in the patients she has helped serve through Smile Makeovers, Porcelain Veneers, Dental Implants and other artistic dental services. Click here to view her blog for more information or become a Fan of her Facebook FanPage by Clicking Here.

Source:

Dear Dr. Calvo,

I have twin daughters aged 7 and it’s a nightmare to get them to brush properly! Bad teeth already run in my family and truth be told, I had all my teeth rotten by the time I was 15 and I just don’t want my daughters to go through the same agony during puberty. Any tips you can provide to help me make them brush more? PLEASE!

Thanks,

Worried Mom

Dear Worried Mom,

It’s all about making tooth brushing FUN! Many parents make the mistake of making tooth brushing a boring routine. And no, scaring kids by telling them their teeth will all fall out does not usually work either.

Here are my tips to help make your kids brush more without appearing to be trying!

1. Go out for the sole purpose of buying new tooth brushing supplies but this time let your kids choose the toothbrush they want. The toothbrush with its own ‘timer’ or those that play music and stop to indicate it’s time to stop brushing are winners with kids!

2. Try not to make tooth-brushing look like a TASK. For instance, after a meal, ask your daughters to accompany you upstairs (or wherever your bathroom) is to get a toy or a book or something. Once in the vicinity of the bathroom, grab YOUR toothbrush and start brushing and then just hand off their toothbrushes to them too. This way, it becomes a natural thing rather than a task to dread.

3. Make things extra fun by coming up with a bathroom tooth brushing chart where you can even hand out ‘stars’ they can stick to the chart after every ‘brushing event’. Hand out certificates at the end of the month!

4. Call our office as we are very “child friendly” and have many children as patients that love coming to see us. Sometimes a simple dental visit where a professional can educate kids is enough to convince kids that brushing is a GOOD thing. This can also serve to get rid of any unfounded fears of visiting a dentist when they are older.

Good luck!

Marilyn Calvo DDS

Smile Studio LA

Accredited Member, AACD

Dr. Calvo is one of only 300 members in the world to achieve AACD Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well-respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self-esteem in the patients she has helped serve through Smile Makeovers, Porcelain Veneers, Dental Implants and other artistic dental services. Click here to view her blog for more information or become a Fan of her Facebook FanPage by Clicking Here.

photo:ralphhogaboom

If you’ve landed on this page, you may be looking for sleep apnea treatments for you or a loved one — and you should! Sleep apnea is a concern as it can cause exhaustion, memory problems, weight gain, high blood pressure and cardiovascular disease. Luckily, sleep apnea treatment is available to help you get a better night’s sleep. Treatment for sleep apnea may vary depending on whether your sleep apnea is mild or severe — but regardless, you should see a sleep professional before choosing any of the sleep apnea treatments listed below.

Treating Sleep Apnea at Home

The type of sleep apnea treatment you choose depends on the type of sleep apnea you have. As you probably know, sleep apnea is a disruption of sleep patterns caused by a pause in breathing. The most common type of sleep apnea is obstructive sleep apnea, where the muscles that support your airway become so relaxed that they collapse and block it. But you may have been diagnosed with central sleep apnea, where your brain fails to control breathing, or complex sleep apnea, which is a combination of the two.

There are home remedies for treating sleep apnea. In some cases, mild or obstructive sleep apnea treatment may just be a matter of changing your lifestyle.

Discuss the following sleep apnea treatments with your sleep professional to see what might work for you:

Lose weight. Sleep apnea is more common in overweight people because additional fat around the neck can make the airway smaller. Treating sleep apnea may be as simple as losing a little weight.

Avoid alcohol and depressants. Alcohol, sedatives, pain killers and muscle relaxants all affect the central nervous system. They not only relax the airway muscles but may reduce the ability to breathe normally.

Stop smoking. Smokers are three times more likely to have obstructive sleep apnea than non-smokers. Quitting smoking may be the perfect obstructive sleep apnea treatment.

Sleep on your side. Sleeping on your back can cause the tongue to fall back and block your airway. If you tend to sleep on your back, there are special pillows designed to position your head correctly during sleep.

Elevate your head. If you must sleep on your back, try elevating it from the torso up. Regular pillows push the chin towards the neck, which can make sleep apnea worse. Wedge-like pillows provide treatment for sleep apnea by keeping your back and head elevated during sleep.

Maintain a consistent sleep pattern. Sleep apnea can get worse if you’re tired. Going to bed and waking up at the same time every night can help you control your sleep apnea.

Open nasal passages. Breathing strips or a nasal spray may help keep your airway passages open.

Professional Sleep Apnea Treatment

Unfortunately, not all at-home sleep apnea treatments are effective. An oral appliance or sleep apnea machine may be needed if you help breathing on your own:

Oral Appliances — There are two types of oral appliances used for mild obstructive sleep apnea treatment: the mandibular advancement device (MAD), which pushes the lower jaw forward to keep the airway open, and the tongue-retaining device, which keeps the tongue from falling back over the airway. Your dentist may choose to do a combination of the two when treating sleep apnea.

Continuous Positive Airway Pressure (CPAP) — Commonly used for obstructive sleep apnea treatment, the CPAP machine consists of a mask that’s placed over your nose while you sleep. It works by pumping high-pressurized air into the mask to keep passages open.

Adjustable Airway Pressure Devices — Some sleep apnea sufferers may find wearing a CPAP mask too uncomfortable. If the CPAP doesn’t work for you, there are other sleep apnea treatments on the market. Bilevel positive airway pressure (BiPAP) exerts a higher pressure when you inhale and lower pressure when you exhale to treat central sleep apnea. Adaptive servo-ventilation (ASV) learns your breathing pattern and stores that info in a computer, then adjusts the pressure to normalize breathing patterns while you sleep.

Treating Sleep Apnea with Surgery

When home therapies and machines don’t work, surgery may be necessary. When all else fails, talk to your dentist about your surgical sleep apnea treatment options:

UPPP (Uvulopalatopharyngoplasty) — UPPP removes tissue from back of mouth or top of the throat. UPPP is more commonly used to treat snoring and may not cure sleep apnea if excess tissue is found further down the airway path. This sleep apnea treatment can now be performed with a laser.

Maxillomandibular Advancement – This dental surgery moves the jaw forward from the face bone, enlarging the space behind the tongue and soft palate to limit obstruction of the throat. Oral surgery may be combined with orthodontics to complete your treatment for sleep apnea.

Tracheostomy — A tracheostomy (sometimes referred to as a tracheotomy) is only used for severe sleep apnea. During the procedure, a metal or plastic tube is inserted in the throat through an incision in the neck. The protruding tube is covered during the day, but opened at night so you can breathe.

Other Types of Surgery — Nasal surgery removes polyps or corrects a deviated septum in the nasal cavity, helping you breathe better. Your doctor may also choose to remove your tonsils or adenoids, which can be combined with the UPPP procedure for sleep apnea treatment.

Finding a Solution

Central sleep apnea may be part of a larger problem, such as heart disease or a neuromuscular disorder. In this case, the condition that’s causing sleep apnea needs to be treated in order to solve your sleep disorder. Your sleep professional can help determine the cause of your sleep apnea and choose the right sleep apnea treatment for you.

If you need treatment for sleep apnea, we may be able to help! Many dentists are trained to diagnose sleep apnea problems and provide sleep apnea treatments so you can rest easier.

http://www.marilyncalvo.com/ Marilyn Calvo DDS - Accredited Member, AACD.  Dr. Calvo is one of only 300 members in the world to achieve Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self esteem in the patients she has helped serve through her Smile Makeovers. http://www.facebook.com/CalvoFanPage

Source: dentistry.com

A bonded dental bridge, also called a Maryland bridge, is a great way to replace amissing tooth when used in the right situation. A bonded bridge is comprised of one or two artificial teeth with "wings" connected on each side. To replace a tooth, the wings are fastened to the inside of a person’s teeth on either side of the missing one. In recent years, the bonded bridge has fallen out of favor with many dentists because the wings, previously made only out of metal, were unaesthetic and would require frequent visits to refasten it. Today, the bonded bridge wings can be made out of durable resin materials that are cosmetically pleasing and attaches firmly to the teeth.

One common way to use the bonded bridge is when someone comes to the office with a loose tooth in the front of his or her mouth. The dentist gently prepares the adjacent teeth for the bonded bridge, and then takes a mold (impression). Next, he/she sends the impression to the lab that makes the bonded bridge. He/she then brings the patient back to remove the loose tooth and put in place the bonded bridge on the same visit. This way, the patient is rid of the troublesome tooth and never has to go without a tooth in the front of his or her mouth. Another advantage of the bonded bridge is that the wings can help stabilize the teeth to which they are fastened to. This is especially important when the teeth are slightly loose due to periodontal gum disease.

The bonded bridge has several benefits over conventional fixed bridgework (a series of joined caps or dental crowns). These benefits include reduced cost, less drilling or preparation of the teeth, and less time required to complete the treatment. Despite these benefits, there are some drawbacks. The bonded bridge is not as strong as fixed bridgework and is generally only appropriate in the front of the mouth, where biting forces are typically not strong.

The decision to use a bonded bridge is at the discretion of your dentist. People with heavy jaw musculature, weak or very loose teeth, a tendency for bruxism during the day or teeth grinding at night, or too large a space where the teeth are missing may not be good candidates for the procedure. Even so, in some cases, a bonded bridge might be the best way to replace a missing tooth.

http://www.marilyncalvo.com/ Marilyn Calvo DDS - Accredited Member, AACD.  Dr. Calvo is one of only 300 members in the world to achieve Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self esteem in the patients she has helped serve through her Smile Makeovers. http://www.facebook.com/CalvoFanPage

Source: dentistry.com

Actually, sleep apnea is one of several related conditions which include snoring, obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS). These conditions have all been successfully treated with mandibular advancement procedures (either dental devices or jaw/chin advancement surgery). OSA, UARS and snoring, to a lesser degree, are essentially due to collapse of the airway (total or partial) during sleep, and each can be severe enough to induce frequent sleep state changes.

These sleep state changes can deprive the individual of adequate deep sleep and induce daytime sleepiness (hypersomnolence). Of course, the most common affliction associated with snoring is the disturbance in the bed partner’s sleep, although snorers clearly have a greater likelihood of having OSA. UARS is an intermittent partial collapse of the airway that produces labored breathing. The more serious of the three conditions is OSA since it produces an intermittent complete airway collapse during sleep.

OSA is associated with increased mortality. The research indicates the risk is for individuals with moderate to severe OSA and another pulmonary or cardiac disorder (e.g. asthma, emphysema, and angina). In a routine patient, however, the main reason treatment is sought is because OSA has a major impact on their life style due to the daytime hypersomnolence it causes.

Nasal CPAP is the principal non-dental treatment for these disorders. For the moderate to severe apnea sufferer, this treatment is very effective but often is not used by patients because it is inconvenient to attach the mask each night and sleep with it in place (Kribbs, 1993). Surgical solutions which involve the throat only have a significant failure rate (Scher 1996). In recent years, for the mild to moderate OSA patient, several good studies have shown the dental devices which advance the mandible as a very successful device to treat SDB. These devices are usually two full arch acrylic devices which cover all of the mandibular and maxillary teeth and are then attached together in such a way as to hold the jaw in a forward position. Although the degree of advancement varies between designs, it has been proposed that at least a 50% or greater movement is necessary to achieve success of the device. In 1989, Clark proposed that at least a 75% advancement is necessary. The advantage of the mandibular positioner is that it maintains a continuous, forward tongue position throughout the night and is designed so oral breathing is still possible if the nasal passage is blocked.

There are two basic theories which can be advanced to explain how a mandibular advancement works. The first and most prevalent theory is that the mandibular advancement works by increasing the airway caliber, thus making the airway’s resistance to collapse with negative pressure produced by inspiration. The second theory is that there is a stretch-induced activation of the pharyngeal motor system where the device and this motor activation provides enough stiffness to the system to prevent collapse of the airway. At this time it is impossible to know which theory is more correct. An issue which researchers must consider is that the passive shape of the airway may not be the critical factor in prediction of OSA development at all. Instead the issue may be how collapsible the airway is when placed under negative pressure (inspiration). Assessing the later will require a completely different methodology than radiographic or MRI based images.

http://www.marilyncalvo.com/ Marilyn Calvo DDS - Accredited Member, AACD.  Dr. Calvo is one of only 300 members in the world to achieve Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self esteem in the patients she has helped serve through her Smile Makeovers. http://www.facebook.com/CalvoFanPage

Source: dentistry.com

A consultation with Dr. Michael Simmons

Dear Sandra,
Your question is timely as more research and knowledge is accumulating in the area of sleep and sleep disorders. In the near future, Dear Doctor will be publishing a feature article on this topic, but here is a brief introduction in response to your question.

Snoring occurs when the soft tissue structures of the upper airway (back of the throat) collapse onto themselves, the tongue drops back, and air is obstructed in its movement through the mouth and nose into the lungs. As a results, these obstacles create the vibration that produces snoring. Large tonsils, a long soft palate, a large tongue, the uvula (the tissue that looks like a mini punch-bag dangling at the back of the mouth), and even fat deposits can also contribute to blockage and hence snoring.

Your husband may have a condition called Obstructive Sleep Apnea (OSA; “A” - without; “Pnea” - breath) , which occurs  when the upper airway disruption, or even no airflow whatsoever for 10 or more seconds. This is often associated with many “micro-arousals,” one to three second waking episodes throughout the sleep cycle. this can be quite dangerous to health as blockage of the upper airway causes reduced airflow into the lungs and therefore low blood oxygen levels. And when oxygen levels drop low enough, the brain moves out of deep sleep and the individual partially awakens followed by a loud gasp as the flow of air starts again. This can happen many times during the night, sometimes more than 50 times an hour. the combination of low oxygen levels and fragmented sleep are the major contributors to most of the ill effects associated with sleep apnea. In addition to excessive daytime sleepiness, studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes, as well as a higher incidence of work and driving-related accidents.

“Oral appliances are worn in the mouth to treat snoring and Obstructive Sleep Apnea (OSA). These devices may look like orthodontic retainers or sports mouth guards but are designed to maintain an opened, unobstructed, upper airway during sleep.”

Some helpful things you can do for yourself if you have sleep apnea include losing weight and exercising. medical and dental treatments include:

Continuous Positive Airway Pressure(CPAP): CPAP bedside machines generate pressurized air delivered through a tube connected to a mask covering the nose and sometimes mouth. The force of the pressurized air opens the airway (windpipe) in the same manner as blowing into a balloon; when air is blown in, the balloon opens and gets wider.

Oral Appliance Therapy: Here’s the dental connection. Oral appliances are worn in the mouth to treat snoring and OSA. These devices may look like orthodontic retainers or sports mouth guards but are designed to maintain an opened, unobstructed, upper airway during sleep. There are many different oral appliances available but less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. They may be used alone or in combination with other means to treat OSA. And they work in several ways: repositioning the lower jaw, tongue, soft palace and uvula; stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.

Other Dental Approaches: Specially trained oral and maxillofacial surgeons may include more complex jaw advancement surgeries. Additionally, an Ear, Nose & Throat (ENT) specialist may consider surgery to remove excess tissues in the throat. it also may be necessary to remove the tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate.

Since OSA is a serious medical condition, a physician specially trained in this area of medicine must diagnose it. Diagnosis is based on the results of an overnight laboratory sleep study called a polysomnogram ( PSG; “Poly”-many; “Somno” - sleep; “Gram” - record) . However, determining the best treatment is enhanced by joint consultation with your physician and dentist. It is also important to note that only dentists trained in sleep disorders and related oral appliance therapy are familiar with the various designs of appliances. These experts can best determine what is suited for an individuals specific needs as well as manage any unruly tooth, bite, gum, or jaw joint effects.

If your husband needs an oral appliance, it may take several weeks to months to complete. Afterwards, your husband’s dentist will continue to monitor his treatment and evaluate the response of his teeth and jaws. His dentist needs to work with a physician as part of the medical team in diagnosis, treatment, and on-going care of your husband’s sleep disorder.

In conclusion, chronic loud snoring, pauses in breathing during sleep, and daytime sleepiness are neither benign nor inconsequential and should be addressed early to avoid serious health problem. These can include heart problems, blood pressure issues, and brain and general health effects on the body - all of which can affect long-term health and well-being

http://www.marilyncalvo.com/ Marilyn Calvo DDS - Accredited Member, AACD.  Dr. Calvo is one of only 300 members in the world to achieve Accreditation status.  Recently, she was honored by being selected as the featured dentist in an ad for Accreditation published in several dental journals.  Dr. Calvo is a well respected Cosmetic Dentist in the Los Angeles and Beverly Hills areas.  Dr. Calvo is passionate about changing lives and increasing self esteem in the patients she has helped serve through her Smile Makeovers. http://www.facebook.com/CalvoFanPage

Source: DearDoctor.com

For more information, visit the American Academy of Dental Sleep Medicine at www.AADSM.org

This newsletter from Smile Studio LA  contains articles such as: What’s that about implants, Oral Cancer, The Heart and Dental Health, How to stay happy, healthy and smiling and How to say goodbye to a bad breath. This information is provided by Dr. Calvo (Accredited Member: AACD) of Smile Studio LA. Marilyn Calvo and her team provide both cosmetic and restorative dentistry services in the Beverly Hills and Los Angeles areas.

Smile Studio LA Newsletter Download Here.

I’ve found the real tooth fairy. I won’t give you my long unhappy dental backstory. Suffice it to say that I was unhappy with my teeth and in need of a solution. After 6 decades of use, I was grateful they lasted that long. Anyway, after two other dentists said I was not a candidate for veneers, I went to Calvo and she found a way. I’d be leaving out half of the picture if I didn’t mention that Calvo’s wonderful staff has great smiles and greater personalities. You won’t believe it, but even though it’s a dentist’s office, you can almost feel comfortable sitting in that chair with your mouth open, trying to grin at the pretty assistants who are there to assist Dr. Calvo.

Dr. Calvo went beyond the call of duty; nowadays, how often does a dentist give you her cell number and home phone and assure you to call her if you are in pain or have problems? But she was quick, and there was no pain, and no problem. One sitting she ground my teeth and gave me temporaries, and on the next, I came out of there with a mouthful of veneers. When my night guard was ready, she personally delivered it to my residence, I couldn’t believe it: A house call at night-a reminder I need to wear that guard, every night.

In the eighteen months since I had this done, my old dread of dentists has evaporated. I still don’t like to smile, but when I do smile, I’m not as self conscious as I used to be. While I wouldn’t say my shiny new teeth gave me a shiny new life (my life was already pretty good), my self confidence has been boosted. My teeth look better than ever. For the price, they are better than ever. You know the legend of that fairy who comes while you’re asleep and exchanges the baby teeth under your pillow for money? Calvo does one better by making used up adult teeth better than new. All I can say is Dr. Calvo, thank you.

George Hatcher

Doctors are focusing increasingly on the role that human papilloma virus plays in oral cancer, and new research is prompting hope that treatments can be better tailored to patients.
People with oral cancer have a better chance of surviving if the cancer is linked to HPV, according to a new study led by an Ohio State University researcher.

Dr. Maura Gillison and her colleagues found that 82 percent of those with HPV-positive tumors in the back of their mouths survived at least three years, compared with 57percent of those with mouth tumors not tied to HPV. Their study included 323 oropharyngeal cancer patients.

HPV, which is spread by sexual contact, is the virus that also causes cervical cancer. It can cause cancer of the mouth through oral sex. The research took into account other risk factors such as tobacco use. It was published online yesterday in the New England Journal of Medicine.

This study should prompt more studies and advances in treatment, Gillison said. For example, it could be that patients with a better prognosis could have less radiation and suffer fewer side effects, she said.

Side effects of treatment include trouble swallowing, dental problems, difficulty speaking and inflexibility in the neck.

Gillison also presented new data yesterday at the American Society of Clinical Oncology meeting in Chicago. The data showed a worse outcome for smokers who have HPV-positive cancers than for patients with the same type of cancer who don’t smoke. The risk of death increased about 2.4 percent per year of smoking.

“Everything we’d been thinking for 50 years has been completely turned upside down in the last 10,” said Brian Hill, executive director of the California-based Oral Cancer Foundation, referring to the link between HPV and oral cancer, which once was chiefly associated with tobacco use.

He said individualized treatment based on HPV status is probably a ways off, but it could make a big difference.

“About 45 percent of people will die from it (any oral cancer). If you’re part of the lucky 50-some percent who make it, you don’t make it unscathed,” said Hill, who was treated for the disease 12 years ago.

Though no research has proved that vaccination against HPV lowers the incidence of oral cancer, there is hope that robust vaccination efforts in young people could slash the number of cases that are diagnosed each year, he said.

In an editorial that accompanied the research in the journal, Dr. Douglas Lowy of the National Institutes of Health and Karl Munger of Harvard Medical School agreed that the findings might lead to more individualized treatments and said that vaccination against HPV might lower the incidence of oral cancers.

Most HPV-linked oral cancers are caused by types 16 and 18, both of which are targeted by the two vaccines approved for use in the United States.

So far, vaccination efforts have been focused mostly on girls and young women because the virus causes cervical cancer, but boys also can be vaccinated.

HPV is common and is passed from one partner to another during sexual contact. Most people infected with HPV never have any problems because their immune systems adequately fight it off.

As of 2003, about 5,800 of 12,000 cases of oropharyngeal cancer in the United States were linked to HPV, said Gillison, an oncologist and head-and-neck cancer specialist at Ohio State’s Comprehensive Cancer Center.

That number has undoubtedly increased as oral-cancer diagnoses have gone up in the past seven years, she said.

In all, there are about 36,000 oral-cancer cases diagnosed in the United States each year, according to the American Cancer Society.
Source-http://www.dispatch.com/live/content/local_news/stories/2010/06/08/oral-cancer-data-could-prompt-new-treatments.html?sid=101

Chances are that you’re not thinking about oral cancer when you go for a dental exam, but your dentist is probably checking you for it.

Many dentists do a visual examination for signs of oral cancer, but some dentists are also offering a ViziLite exam for early detection. The exam costs between $45 and $70 and typically isn’t covered by insurance.

Is it worth it?

“To me, the biggest benefit is that it enables us to identify people who have cancerous lesions when they’re still in Stage I or II,” said Dr. Steven Kreiner, a Mechanicsburg dentist who began offering ViziLite in December. “In my 33 years of practice, I’ve found 10 cases of oral cancer, and they’ve all been beyond salvation. The people all ended up dying. I never want to have that happen again.”

Dr. Stephen Verber, a Camp Hill dentist, began offering ViziLite in 2008 to high-risk patients — people who indicated on their patient health forms that they regularly smoke and drank alcohol — and he was surprised at how many opted for the exam. Now, however, he has some reservations.

“Initially, the research on this was very favorable, but guess who was doing it? The manufacturer,” Verber said. “Subsequent research by non-biased entities has shown it is of questionable value.”

The Journal of the American Dental Association, for example, has reported there is insufficient evidence that devices based on tissue reflectance such as ViziLite improve detection of potentially malignant lesions beyond that of a conventional visual and tactile examination.

During a ViziLite exam, patients rinse with acetic acid before a luminescent light is shone inside their mouths to look for signs of oral cancer, typically found on the tongue, lips, tonsils, salivary glands and gums. Abnormal tissue shows up as a whiter area, which can be confirmed with a dye that stains the area. Dentists can then refer the patient for a biopsy.

Dr. Becky Fox, a dentist in Lemoyne who began offering ViziLite four years ago, has referred one suspicious case out for biopsy and it returned normal, she said. However, she said she would have referred the patient anyway, based on the visual exam.

“I use it more as a confirmation tool of what I think I’m seeing,” said Fox, who recommends ViziLite to high-risk patients. “It’s an added expense that most insurances don’t cover, and so I don’t recommend it to everyone. I think you can get to the same end result by doing a thorough, visual exam.”

Verber said it seems to be most useful for finding a spot that the dentist wouldn’t be able to see with the naked eye. “In an ideal world, that means everyone should have it done every time they go to the dentist. I would have to see more value proven by research before I would recommend that.”

Dr. Thomas Filip, a dentist in Carlisle, said he has found pre-cancerous lesions with ViziLite that he would not have seen with just a visual exam, and therefore, he thinks it’s a great product.

“I’ve had patients convinced to stop smoking or chewing [tobacco] because of the results from it,” he said. “And I have some patients who ask for the ViziLite exam every six months to a year because they have not stopped the activity that is high risk for oral cancer.”

If caught early, 90 percent of oral cancers are treatable, however more than half the cases are caught in later stages, according to the American Cancer Society. About 30,000 Americans will receive an oral cancer diagnosis each year, and about 6,100 will die, the ACS reports.

“More people develop oral cancer than cervical cancer, yet women go religiously for pap smears,” Kreiner said. “One quarter of people who develop oral cancer don’t have any risk factors for it. And most times with oral cancer, there are no happy stories.”

Only about 10 percent of his patients have opted for the ViziLite exam, many citing cost as the reason. “But for something that could save your life, $45 is not that much,” said Kreiner, who hasn’t found any suspicious lesions in the ViziLite exams he has done.

Verber said one reason that oral cancer is detected in later stages is that people aren’t going to the dentist for regular checkups.

“I also think that dentists, as a group, have not placed enough emphasis on detection because we’ve been so focused on teeth, teeth, teeth, rather than health, health, health. I think that’s changing, though,” he said, noting he offers free counseling on how to give up tobacco.

“People aren’t generally thinking of oral cancer, but they need to be more aware of things they can do to prevent it. Giving up tobacco is a big one,” he said.

Signs and symptoms of oral cancer include:
• A sore in the mouth that does not heal (most common symptom).
• Pain in the mouth that doesn’t go away (also very common).
• A persistent lump or thickening in the cheek.
• A persistent white or red patch on the gums, tongue, tonsil or lining of the mouth.
• Trouble chewing or swallowing.
• Persistent bad breath.

Source- http://www.pennlive.com