Posts for tag: oral health
Acquired Immune Deficiency Syndrome (AIDS) jolted our collective consciousness in the 1980s. The deadly disease caused by the human immunodeficiency virus (HIV) had no known cure and, at the time, no effective treatment.
HIV is a retrovirus, a virus with a genetic makeup and reproduction system differing from other kinds. After taking up permanent residency in the body, HIV begins “hijacking” the replication process of cells in the body's immune system and replacing it with a copy of its own. This destroys the cells' ability to protect the body from hostile organisms. As the virus affects more and more cells, the patient's condition ultimately develops into AIDS.
An estimated 35 million people worldwide (1.2 million in the U.S.) are currently infected with the virus. Thanks to new antiretroviral drugs, though, HIV can be kept from accelerating into AIDS. While their condition remains serious, many HIV positive patients can now live long and relatively normal lives. Even so, having the virus requires them to pay close attention to their health, including their mouth.
Even while stalled from becoming AIDS, HIV can still cause oral problems for 30 to 80% of patients. The fungal infection candidiasis (also known as thrush) is the most common of these problems, which appears as lesions, cracking skin or creamy white patches on the tongue or palate that easily bleed. Patients also have higher risks for dry mouth, oral cancer and periodontal (gum) disease.
HIV positive patients must practice diligent daily oral care and see their dentist for checkups regularly. Prevention, early diagnosis and treatment can keep gum disease and other damaging conditions under control. Monitoring oral health is also important because certain mouth conditions could be an early sign the infection is entering a new advanced stage in the body that requires additional attention.
Keeping vigilant in all aspects of health is a way of life for someone with HIV. Such vigilance, though, can help them maintain a healthy mouth and even prolong their life.
If you're the principal caregiver for an older person, you may have already faced age-related health challenges with them. Good preventive care, however, can ease the impact of health problems. This is especially true for their teeth and gums: with your support you're loved one can have fewer dental problems and enjoy better health overall.
Here are a number of things you should focus on to protect an older person's dental health.
Hygiene difficulties. With increased risk of arthritis and similar joint problems, older people may find brushing and flossing more difficult. You can help by modifying their toothbrush handles with a tennis ball or bicycle grip for an easier hold, or switch them to an electric toothbrush. A water flosser, a device that uses a pressurized water spray to remove plaque, may also be easier for them to use than thread flossing.
Dry mouth. Xerostomia, chronic dry mouth, is more prevalent among older populations. Dry mouth can cause more than discomfort—with less acid-neutralizing saliva available in the mouth, the risk for dental diseases like tooth decay or periodontal (gum) disease can soar. To improve their saliva flow, talk with their doctors about alternative medications that cause less dry mouth; and encourage your loved one to drink more water and use products that help boost saliva flow.
Dentures. If your older person wears dentures, be sure these appliances are being cleaned and maintained daily to maximize their function and reduce disease-causing bacteria. You should also have their dentures fit-tested regularly—chronic jawbone loss, something dentures can't prevent, can loosen denture fit over time. Their dentures may need to be relined or eventually replaced to ensure continuing proper fit and function.
Osteoporosis. This common disease in older people weakens bone structure. It's often treated with bisphosphonates, a class of drugs that while slowing the effects of osteoporosis can cause complications after certain dental procedures. It's a good idea, then, for an older person to undergo any needed dental work before they go on osteoporosis medication.
Keep alert also for any signs of dental disease like unusual spots on the teeth or swollen or bleeding gums. Visiting the dentist for these and regular dental cleanings, checkups and oral cancer screenings could prevent many teeth and gum problems.
If you would like more information on senior dental care, 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 “Aging & Dental Health.”
If you’ve noticed a small sore in your mouth, it’s possible you have a non-contagious disease known as lichen planus. Although usually benign, it’s still a good idea to have it examined and monitored.
The condition is so named because its lesions are similar in appearance to lichen, the algae and fungi organism often found on rocks and trees. It’s believed to be a type of autoimmune disease, in which the body treats some of its own cells as foreign and reacts adversely to them. Certain medications and substances may also cause a lichenoid reaction. Besides the inner cheeks, gums or tongue, lichen planus may also appear on other skin or mucous surfaces on the wrists, legs or fingernails.
When it appears inside the mouth it usually resembles a lacy pattern of white lines or ulceration. Gum tissues may become red and inflamed, with some soreness after brushing or eating. Although there’s no known cure for lichen planus, it rarely causes serious problems — in fact, you may not even be aware you have the condition unless pointed out during a dental exam. It may, in time, fade away.
If the lesions do become bothersome (painful, itchy or overly-sensitive), there are some ways to ease discomfort: brushing with a soft toothbrush (to minimize irritation), flossing, and avoiding acidic or spicy foods and beverages which have been known to cause flare-ups. Managing stress is also helpful, and a topical steroid may be prescribed for more severe outbreaks.
Perhaps the greatest concern with lichen planus, though, is it may resemble more serious conditions, particularly oral cancer. The only way to be certain that it is a benign condition is to perform a biopsy on some of the affected tissue. If you notice a problem, be sure to visit us for a complete examination. And regardless of whether you have the condition or not, regular oral cancer screenings, as well as limits on alcohol consumption and stopping use of tobacco, will also reduce your risk of oral cancer.
Odds are if you have a case of lichen planus it isn’t causing you any problems. If it does cause you discomfort, though, you can take steps to ease your symptoms.
The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues. Â The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.
Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.
The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.
Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.
Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.
Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.
In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.
As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.
If you would like more information on the effect of eating disorders on dental health, 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 “Bulimia, Anorexia & Oral Health.”
Eating disorders cause more than psychological harm. The binge-purge cycle of bulimia or the self-starvation patterns of anorexia can also injure the physical body, especially the mouth.
For example, nine in ten people with bulimia will experience tooth enamel erosion from stomach acid entering the mouth from induced vomiting. Although purging is less frequent with anorexic patients, one in five will also develop erosion.
An eating disorder isn't the only reason for enamel erosion: you can have high acid levels from over-consuming sodas, energy drinks or certain foods, or not properly brushing and flossing every day. But erosion related to an eating disorder does produce a distinct pattern in the teeth. When a person vomits, the tongue moves forward and presses against the bottom teeth, which somewhat shields them from acid contact. This can create less erosion in the lower front teeth than in others.
Eating disorders can cause other oral effects. Stomach acid contact can eventually burn and damage the mouth's soft tissues. The salivary glands may become enlarged and cause puffiness along the sides of the face. The use of fingers or other objects to induce gagging can injure and redden the back of the throat, the tongue and other soft tissues.
It's important to stop or at least slow the damage as soon as possible. To do so requires both a short– and long-term strategy. In the short-term, we want to neutralize mouth acid as soon as possible after it enters the mouth, especially after purging. Rather than brushing, it's better to rinse out the mouth with water or with a little added baking soda to neutralize the acid. This will at least help reduce the potential damage to enamel.
In the long-term, though, we need to address the disorder itself for the sake of both the person's overall well-being and their oral health. You can speak with us or your family physician about options for counseling and therapy to overcome an eating disorder. You may also find it helpful to visit the website for the National Eating Disorders Association (nationaleatingdisorders.org) for information and a referral network.
If you would like more information on how eating disorders can affect health, 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 “Bulimia, Anorexia & Oral Health.”