How Does Oral Cancer Happen?

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Andra Mahoney BS RDH

Two weeks ago, Becky gave us some great info raising our Awareness to Oral Cancer.  She touched on the importance of screenings and mentioned the risk factors.

But How Does Oral Cancer Happen?

According to the Oral Cancer Foundation, about 48,000 people are diagnosed each year.  Of those, about 9,500 people will loose their battle with oral cancer.  Of the 48,000 people diagnosed, only 57% of them will be alive 5 years after diagnosis.  Sadly, the number of diagnosis and deaths have not decreased over the last decade.

Let’s review the risk factors in detail…

Age

Probability dictates that the older you get, the more likely you have a chance of getting cancer.  Therefore, age will be a risk factor.  Oral Cancer is more often detected in those over the age of 40.  However, this statistic is changing with the prevalence of HPV.  We will talk more about this in a following section.

Although age does play a part, around 91% of all diagnoses of Oral Cancer are linked to “lifestyle” choices.
These following risk factors will show us why.

Sun Exposure

Excessive and unprotected exposure to the sun is linked with cancer in the lip area. To reduce your risk of lip cancer, decrease your unprotected exposure to sunlight and other sources of ultraviolent (UV) radiation.  (1)

Sun exposure and other sources of UV radiation can damage lip cells.  This damage can cause them to multiple when naturally they should die.  Fast reproduction of abnormal cells is how we classify cancer.

Tobacco Use (use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others)

The report from the Institute of Medicine (2007) says that tobacco kills more Americans annually than AIDS, alcohol, cocaine, heroin, homicides, suicides, car accidents, and fires combined.

Nationally, tobacco contributes to about one-third of U.S. cancer, one-quarter of heart disease and about 490,000 premature deaths each year. Tobacco is a known cause of lung, bladder, mouth, pharyngeal, pancreatic, kidney, stomach, laryngeal, and esophageal cancer. About ten million people in the U.S. have died from causes attributed to smoking and tobacco use (including heart disease, emphysema, and other respiratory diseases) since 1964. Tobacco is the most global cause of cancer, and it is preventable. (2)

There are thousands of chemicals contained in a single cigarette, and their point of entry is the mouth.  Smoking helps to transforms saliva into a deadly cocktail that damages cells in the mouth and can turn them cancerous. (3)

If you would like help on quitting, please check out the resources on this page: http://smokefree.gov

Alcohol Use

People who consume approximately 3.5 or more alcoholic drinks per day, or 21 drinks in a week, have at least a two to three times greater risk of developing cancer than nondrinkers. (4)

Those who both smoke and drink, have a 15 times greater risk of developing oral cancer than others.

Alcohol’s effect on the mouth may be the key to understanding how it works with tobacco to increase the risk of developing cancer. The dehydrating effect of alcohol on cell walls enhances the ability of tobacco carcinogens to permeate mouth tissues; additionally, nutritional deficiencies associated with heavy drinking can lower the body’s natural ability to use antioxidants to prevent the formation of cancers. (5)

HPV Infection

The human papilloma virus (HPV) is a common, sexually transmitted virus, which infects about 40 million Americans today. There are about 200 strains of HPV, the majority of which are thought to be harmless. Most Americans will have some version of HPV in their lifetimes, and most immune systems will be able to fight off the virus.  Those who get specific strains, and lack the ability to fight those strains off, are the ones who develop cancer.

The two strains that are mainly associated with oral cancer are HPV16 and HPV18.  HPV is a double-stranded DNA virus that infects the epithelial cells of skin and mucosa.

It is likely that the changes in sexual behaviors of young adults over the last few decades, and which are continuing today, are increasing the spread of HPV, and the oncogenic versions of it.  You can get HPV by vaginal, anal, or oral sex.  Condoms can limit, but do not prevent HPV.  HPV significantly increases with multiple (especially more than four) sexual partners. (6)

How to Spot it

One of the real dangers of this cancer, is that in its early stages, it can go unnoticed. It can be painless, and little in the way of physical changes may be obvious. The good news is however, that your Physician or Dentist can, in many cases, see or feel the precursor tissue changes, or the actual cancer while it is still very small, or in its earliest stages.

It may appear as a white or red patch of tissue in the mouth, or a small ulcer which looks like a common canker sore. Because there are so many normal tissue changes that happen normally in your mouth, and some things as simple as a bite on the inside of your cheek may mimic the look of a dangerous tissue change. It is important to have any sore or discolored area of your mouth, which does not heal within 14 days, looked at by a professional. Other symptoms include; a lump or mass which can be felt inside the mouth or neck, pain or difficulty in swallowing, speaking, or chewing, any wart like masses, hoarseness which lasts for a long time, or any numbness in the oral/facial region. (7)

But like any cancer, even if you do not do these risk factors, there is still a possibility of getting it. 

The best way to detect oral cancer is to do self exams and to see your Dentist regularly.  The Dental Team is the forefront in prevention and detection as their main focus is your mouth!  Your Dentist and/or Hygienist will perform a visual and tactile screening at each appointment.  If they do not, please ask for one.  There are also additional screenings available, and they can tell you more about them during your appointment.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

(1) http://www.cancer.net/cancer-types/oral-and-oropharyngeal-cancer/risk-factors-and-prevention

(2) http://www.oralcancerfoundation.org/tobacco/

(3) http://www.mouthcancer.org/risk-factors/

(4) http://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

(5) http://www.oralcancerfoundation.org/understanding/alcohol-connection.php

(6) http://www.pureeducation.org/index.asp?N=Pure-Education-Lake-Stevens-WA-HPV-Coaching&C=577&P=7764

(7) http://oralcancerfoundation.org/facts/

http://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/dxc-20157232

http://www.oralcancerfoundation.org/hpv/

Oral Cancer Awareness

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Becky Larson, RDH

Oral Cancer Awareness

It’s April again!  Which means Oral Cancer Awareness month.  I can’t even begin to tell you how critical it is to receive regular oral cancer screenings.  Your dentist and/or dental hygienist should perform a basic screening at your six month check-ups.  We also recommend having a more in depth oral cancer screening (such as the Velscope, Oral ID, or Identafi) annually.  These more in depth screenings use florescent or ultra violet lights that can detect signs of oral cancer much earlier.  The earlier cancer is caught, the sooner treatment can begin and the better the prognosis.

Oral cancer is any abnormal growth of cells in the oral cavity (mouth).  Abnormal cell growth can be benign (no cause for concern) or malignant (can be life-threatening).  The oral cavity consists of the lips, cheek lining, salivary glands, hard and soft palates, uvula, tongue, floor of the mouth (underneath the tongue), gums, and tonsils.  The tongue and the floor of the mouth are the most common areas for oral cancer to occur.  However, the cancer can spread to other areas of the oral cavity and/or other areas of the body.

Oral cancer can manifest itself in many ways including swellings, lumps or bumps, numbness, abnormal bleeding, white patches, red patches, speckled patch, sores that do not heal, sore throat, pain when chewing/speaking/etc., changes in voice, ear pain, and dramatic weight loss.  If you are experiencing any of these symptoms please visit your dentist or primary care physician.

Risk factors for oral cancer include tobacco use, alcohol use, sun exposure, having HPV (Human papillomavirus), and a history of having oral cancer previously.  Tobacco use is the reason for most oral cancers, especially in those individuals who have used tobacco for lengthy amounts of time.  The risk increases when tobacco users become heavy alcohol drinkers.  Three out of every four oral cancers occur in people who use alcohol, tobacco, or both.  The Human papillomavirus is mainly linked to oropharyngeal cancers.  Limiting sun exposure and the use of sun screen and lip balm can help reduce the risk.  Men are twice as likely to develop oral cancer than women.  It is also important to note that more than 25% of oral cancers are found in individuals with no risk factors.

Everyone is at risk!  Make sure to visit your dentist and dental hygienist for regular oral cancer screenings.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.medicinenet.com/oral_cancer/article.htm

http://www.webmd.com/oral-health/guide/oral-cancer

http://www.cdc.gov/std/hpv/STDFact-HPVandOropharyngealCancer.htm

 

The Secrets About Halitosis

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Wendy Parker, RDH

The Secrets About Halitosis

Before we even start trading secrets, what is Halitosis?  Halitosis is the fancy word for “Bad Breath.”  We’ve all had it at one point or another.  Whether that is morning breath, when we’ve forgotten to brush, or when we’ve eaten something with a strong taste.  Whether temporary or permanent, bad breath comes to everyone.  So let’s talk about the secrets of where it comes from, why we get it, and most importantly, how to get rid of it!

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Bad breath can come from several sources.  Here’s a list of some of the most common ones:

  • Tooth decay or / and gum disease such as gingivitis
  • Dentures and bridges
  • Mouth sores
  • Dry mouth
  • Post-nasal drip and congestion of the nasal passages
  • Food stuck between the teeth
  • Coating of the tongue caused by a build up of bacteria
  • Infection of the throat and tonsils
  • Sinusitis
  • Nasal polyps
  • Bronchitis or pneumonia
  • Acid reflux and GERD
  • Chronic constipation
  • Digestive problems and stomach ulcers
  • High-protein diet that includes fish, cheeses, and meats
  • Foods that are strong smelling or spicy such as onions and garlic, exotic spices (ie. curry)
  • Supplements, such as Fish Oil Capsules
  • Low Carb Diets – causing “Ketone breath” as a result of the low carb consumption causing the body to burn fat as it’s energy source which then causes an end product of the body making ketones, which causes a fruity acetone-like odor when exhaled
  • Certain medications
  • Smoking
One of the most common reasons people have halitosis is due to a condition called “Black Hairy Tongue” or a coated tongue.  It sounds scary and unusual, but it’s something that can be cured quickly.
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The bacteria build up on tiny rounded projections called papillae which are on the surface of the tongue, also known as tastebuds. These papillae grown longer catch all the food and bacteria in the mouth.  Without brushing your tongue or removing the bacteria, it can embed in the tongue and causing a coating.  Black hairy tongue is caused by bacteria or fungi in the mouth, which make the tongue to appear black and hairy.

Certain lifestyle habits and conditions can make people more likely to develop black hairy tongue. They include:

  • poor oral hygiene
  • smoking tobacco
  • drinking a lot of coffee or tea
  • using antibiotics (which may disrupt the normal balance of bacteria in the mouth)
  • being dehydrated
  • taking medications that contain the chemical Bismuth (such as Pepto-Bismol for upset stomach)
  • not producing enough saliva
  • regularly using mouthwash that contains peroxide, witch hazel, or menthol
  • getting radiation therapy to the head and neck

Black hairy tongue is more common in men, people who use intravenous drugs, and those who are HIV-positive.

Now that we learned about Halitosis and Black Hairy Tongue, here are tips and tricks to getting rid of it:

Gently brush your teeth twice a day with a soft toothbrush, but more importantly, don’t forget your tongue!!! Start at the back of your tongue and scrape forward, being sure not to scrub the tongue and embed the bacteria even further.   You can use a tongue scraper to make sure you’re thoroughly cleaning the area. Be sure to come in for your regular check up and cleanings so that your friendly hygienist can help you too!  Soon, the coating will go away and so will the bad breath.

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If you find that you have consistent bad breath you can try our other tips:

  • If you smoke, quit.
  • Add more roughage to your diet. Soft foods won’t clean off the tongue effectively.
  • Drink plenty of water throughout the day to help keep your mouth clean.

Natural home remedies include:

  • Fenugreek should be consumed in the form of a tea made with one teaspoon of fenugreek seeds in one liter of water. Simmer till the water is infused and strain before drinking. When consumed regularly, fenugreek seeds are an excellent home remedy for halitosis.
  • Making a tea or infusion with fresh parsley or cloves is also a good way to treat bad breath. Simply boil water with freshly chopped parsley and drop in a few cloves to the mix. Cool the mixture and strain before using it as a natural mouthwash after eating. There have been numerous studies supporting claims about the efficacy of cloves and clove oil in dental care.
  • include fresh vegetables, fruits and grains into your daily diet.
  • increase your intake of Vitamin C from foods
  • include guava in your diet

An individual should consult their physician for a diagnosis if they have

  • persistent dry mouth
  • sores in the mouth
  • pain with chewing or swallowing
  • white spots on the tonsils
  • Fever
  • any other symptoms of concern

Call your doctor or dentist if the problem doesn’t get better on its own. Your doctor may prescribe antibiotics or an antifungal drug to get rid of the bacteria or yeast. Topical medications, such as tretinoin (Retin-A), are also sometimes prescribed. As a last resort, if the problem doesn’t improve, the papillae can be surgically clipped off with a laser or electrosurgery.

Hopefully this let you in on some of our secrets to a happy healthy mouth!  Happy brushing and breathing everyone!

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources: 

http://www.webmd.com/oral-health/guide/black-hairy-tongue

http://www.home-remedies-for-you.com/remedy/Halitosis.html

http://www.emedicinehealth.com/bad_breath_halitosis/page4_em.htm

What is Vaping Anyways? An Examination of Electronic Cigarettes

Kara

Kara Johansen BS RDH

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What are electronic cigarettes?

Electronic cigarettes are also known as ENDS (electronic nicotine delivery system), electronic cigarettes, or E-cigs. “Electronic cigarettes are designed to look like cigarettes, right down to the glowing tip. When the smoker puffs on it, the system delivers a mist of liquid, flavorings, and nicotine that looks something like smoke. The smoker inhales it like cigarette smoke, and the nicotine is absorbed into the lungs. The e-cigarette is usually sold as a way for a smoker to get nicotine in places where smoking is not allowed.” (www.cancer.org) When people use ENDS it is sometimes called vaping

E-cigs have a vaporization system, rechargeable batteries, controls and areas to refill the liquid for vaporization. The ENDS can contain between 6mg to over 100 mg of nicotine.  Nicotine can be lethal in large amounts, 0.5-1.0 mg per kj of weight of the person. Because the products contain nicotine they can cause dependence and addiction. The chemicals used in the liquid for vaporization is not fully known. The products are not labeled or stated on the bottles.

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ENDS are usually shaped to look like “conventional” tobacco products like cigarettes, cigars, cigarillos, pipes, hookahs or shishas. Some companies make them to look like ordinary pens, or USB memory sticks to make them more discrete. (The World Health Organization http://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/)

Why do people use electronic cigarettes?

Electronic cigarettes are on the rise throughout the world and in the United States. Here are some “commonly reported reasons for use: to quit smoking, to avoid relapse, to reduce urge to smoke, or as a perceived lower-risk alternative to smoking. Few studies, however, have explored whether electronic cigarettes (e-cigarettes) deliver measurable levels of nicotine to the blood. ” (Carcoran O., Dawkins L, 2013) This means that without measurable levels of nicotine in the blood it may not be an effective tool to quit smoking.

According to the US Centers for Disease Control and Prevention (CDC) the percentage of highschool and middle school students who have used electronic cigarettes has doubled from 2011 to 2012. Highschool increased from 4.7% in 2011 to 10% in 2012 and middle school increased from  1.4% to 2.7%. The National Youth Tobacco Study found that by 2012 more than 1.78 million middle and high school students in the US had tried e-cigarettes. (CDC, 2013)

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“ENDS use is expanding rapidly despite experts’ concerns about safety, dual use and possible ‘gateway’ effects. More research is needed on effective public health messages, perceived health risks, validity of self-reports of smoking cessation and the use of different kinds of ENDS.” (Pepper JK, Brewer NT http://www.ncbi.nlm.nih.gov/pubmed/24259045) This statement is from a study completed in 2013. It is saying that even though experts are worried that it ENDS may not be safe and can lead to drug abuse of other substances the sales of E-cigs are increasing.

“The primary concern is whether e-cigarettes have the capability of introducing nonsmoking youth to cigarette smoking,” said Thomas J. Glynn, PhD, American Cancer Society’s director of cancer science and trends and international cancer control. “Will we have new cigarette smokers out of this? A very clear message is that we are very much in need of FDA (US Food and Drug Administration) regulations that will limit access to e-cigarettes to youth.”(Simon, 2013)

Acting through the Family Prevention and Tobacco Control Act of 2009 the FDA is working on creating regulations for the ENDS products. The FDA will require that electronic cigarettes label what is in the product, and how they can market and sell the ENDS. A few states have set regulations on selling and promoting e-cigarettes to ages 18 and younger, however, it is not illegal to sell ENDS to youth in most states. (Simon 2013) The producers of e-cigs are marketing to children, creating products that are meant to taste like candy.

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Are Electronic Cigarettes Safe?

“The safety of ENDS has not been scientifically demonstrated.

The potential risks they pose for the health of users remain undetermined. Furthermore, scientific testing indicates that the products vary widely in the amount of nicotine and other chemicals they deliver and there is no way for consumers to find out what is actually delivered by the product they have purchased.

Most ENDS contain large concentrations of propylene glycol, which is a known irritant when inhaled. The testing of some of these products also suggests the presence of other toxic chemicals, aside from nicotine. In addition, use of these products -when they contain nicotine can pose a risk for nicotine poisoning (i.e. if a child of 30 Kilos of weight swallows the contents of a nicotine cartridge of 24 mg this could cause acute nicotine poisoning that most likely would cause its death) and a risk for addiction to nonsmokers of tobacco products. Nicotine, either inhaled, ingested or in direct contact with the skin, can be particularly hazardous to the health and safety of certain segments of the population, such as children, young people, pregnant women, nursing mothers, people with heart conditions and the elderly. ENDS and their nicotine cartridges and refill accessories must be kept out of the reach of young children at all times in view of the risk of choking or nicotine poisoning.

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As ENDS do not generate the smoke that is associated with the combustion of tobacco, their use is commonly believed by consumers to be safer than smoking tobacco. This illusive ‘safety’ of ENDS can be enticing to consumers; however, the chemicals used in electronic cigarettes have not been fully disclosed, and there are no adequate data on their emissions.”

http://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/

A study done by the FDA found cancer-causing substances in half the e-cigarette samples tested. Other impurities were also found, including one sample with diethylene glycol, a toxic ingredient found in antifreeze.

Studies have shown that e-cigarettes can cause short-term lung changes that are much like those caused by regular cigarettes. But long-term health effects are still unclear. This is an active area of research, and the safety of these products is currently unknown. (http://www.cancer.org/cancer/cancercauses/tobaccocancer/questionsaboutsmokingtobaccoandhealth/questions-about-smoking-tobacco-and-health-e-cigarettes)

 

Conflicting View Points

Dr. Thomas J. Glynn MA, MS, PhD, who is the director of Cancer Science and Trends and director of International Cancer Control for the American Cancer Society from the American Cancer Society created list of reasons why people favor e-cigarettes and why they oppose to their use.

Those who favor e-cigarettes list as benefits:

  • Their ability to deliver nicotine to the user without many of the other 7,000+ chemicals in a regular, burned cigarette;
  • Their absence of secondhand cigarette smoke;
  • Their resemblance to regular cigarettes, which provide the tactile and visual sensations – holding them in a certain way, a glowing tip, blowing smoke, etc. – that many cigarette smokers have become used to, or even psychologically dependent upon; and
  • Their potential for aiding cigarette smokers to who wish to quit to do so.

 Choice between cigarette and e-cigarette

Those with concerns about e-cigarettes warn of:

  • Lack of scientific data about their safety. Simply put, e-cigarette users cannot be sure of what they are inhaling, since e-cigarettes have not been subjected to thorough, independent testing and, due to their manufacture by many different companies, there are no quality assurances in their production processes;
  • Lack of scientific data about their effectiveness as quit-smoking aides;
  • Lack of scientific data regarding their ability to deliver enough nicotine to satisfy withdrawal effects;
  • Lack of scientific data about the effect of secondhand vapor from e-cigarettes;
  • Lack of scientific data about whether the use of e-cigarettes encourages smokers who might have otherwise quit to continue smoking and only use e-cigarettes when they are in no-smoking environments; and
  • Lack of scientific data about whether youth may use e-cigarettes as an introduction to smoking regular cigarettes.

In the end one can clearly see the controversy over wether or not ENDS are good or bad.

Can I use ENDS to help me quit smoking?

“The efficacy of ENDS for helping people to quit smoking has not been scientifically demonstrated.

ENDS are often touted as tobacco replacements, smoking alternatives or smoking cessation aids. But we know that for smoking cessation products to be most effectively and safely used, they need to be used according to instructions developed for each product through scientific testing. There are no scientifically proven instructions for using ENDS as replacements or to quit smoking. The implied health benefits associated with these claims are unsubstantiated or may be based on inaccurate or misleading information. When ENDS are used as cessation aids, they are intended to deliver nicotine directly to the lungs. None of the approved, regulated cessation aids, such as nicotine patches and chewing-gum, delivers nicotine to the lungs. Therefore, the biological mechanism by which smoking cessation might be achieved by delivery of nicotine to the lungs and its effects are unknown. Delivery to the lung might be dangerous. Therefore, independently of the effects of nicotine, it is of global importance to study lung delivery scientifically.

The dose of delivered nicotine is also unknown. It is suspected that the delivered dose varies notably by product, which contain nicotine in various quantities and concentrations.”

http://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/

 

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In Conclusion-

An article found on the US National Library of MedicineNational Institutes of Health looked at how ENDS awareness increased from 16% to 58% from 2009 to 2011, and use increased from 1% to 6%. The article included data gathered from 49 other studies. The majority of users were current or former smokers. Many users found ENDS satisfying, and some engaged in dual use of ENDS and other tobacco.

No longitudinal studies examined whether ENDS serve as ‘gateways’ to future tobacco use. Meaning no studies have been completed that extend long periods of time. Some longitudinal studies are decades of gathered data. ENDS are a new product. There is no way to tell the long term effects of electronic cigarettes on the human body until one of these studies is completed. Self-reported survey data has been completed. Meaning people using the product filled out a questionnaire which includes their feelings and beliefs. These studies have validity problems. Prospective trials  and self-reported surveys suggest that ENDS might help cigarette smokers quit, but no randomized controlled trials with probability samples compared ENDS with other cessation(quitting smoking) tools. Randomized controlled trials are the only reliable research worthy of trusting.  (Pepper JK, Brewer NT http://www.ncbi.nlm.nih.gov/pubmed/24259045)

The World Health Organization states “Until such time as a given ENDS is deemed safe and effective and of acceptable quality by a competent national regulatory body, consumers should be strongly advised not to use any of these products, including electronic cigarettes.”

In conclusion reliable, independent, randomized controlled research needs to be conducted to solidify the pros and cons of electronic cigarettes. There is simply not enough information as to whether vaping is safe to use or a good tool to decrease or end smoking. Our public health choices and policies need to be decided upon fact. As for my health and the health of our patients I will wait or advise a patient to wait to use an electronic cigarette.

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Want more info?

Want to learn more? Visit us at http://www.northstapleydentalcare.com/

Sources:

Carcoran O., Dawkins L, Acute electronic cigarette use: nicotine delivery and subjective effects in regular users. Psychopharmacology (Berl). 2014 Jan;231(2):401-7. doi: 10.1007/s00213-013-3249-8. Epub 2013 Aug 27. http://www.ncbi.nlm.nih.gov/pubmed/23978909

Centers for Disease Control and Prevention. Electronic Cigarette Use Among Middle and High School Students—United States, 2011-2012. Morbidity and Mortality Weekly Report. September 6, 2013
*(Etter, JF, Bullen, C, Flouris, AD, Laugesen, M, and Eissenberg, T “Electronic Nicotine Delivery Systems: A Research Agenda, Tobacco Control Online First, March 17, 2011 as 10/1136/tc.2010.042168).
http://www.cancer.org/cancer/news/expertvoices/post/2011/05/03/electronic-cigarettes-e28093-boon-bane-blessing-or-boondoggle.aspx

Glynn T. MA, MS, PhD, Electronic Cigarettes – Boon, Bane, Blessing, or Boondoggle?, (May 6, 2011), http://www.cancer.org/cancer/news/expertvoices/post/2011/05/03/electronic-cigarettes-e28093-boon-bane-blessing-or-boondoggle.aspx

Pepper JK, Brewer NT, Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review. (2013 Nov 20). Gillings School of Global Public Health, University of North Carolina, , Chapel Hill, , North Carolina, USA. doi: 10.1136/tobaccocontrol-2013-051122.  http://www.ncbi.nlm.nih.gov/pubmed/24259045

Questions and answers on electronic cigarettes or electronic nicotine delivery systems (ENDS) (9 July 2013) http://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/

Simon S. Electronic Cigarette Use Doubles Among Teenagers. (9-9-2013) http://www.cancer.org/cancer/news/news/electronic-cigarette-use-doubles-among-teenagers

Image Sources:
#2  https://student.societyforscience.org/article/dangerous-rise-electronic-cigarettes

#3 http://www.drugfree.org/join-together/tobacco/use-of-e-cigarettes-among-middle-and-high-school-students-doubles

#4  https://student.societyforscience.org/article/dangerous-rise-electronic-cigarettes

#5 http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm

#6 https://student.societyforscience.org/article/dangerous-rise-electronic-cigarettes

#7 http://ehealthmd.com/content/want-learn-how-quit-smoking-webquit-study-offers-free-online-smoking-cessation-help#axzz2xHfAcGUy

#8 http://www.nih.gov/health/clinicaltrials/basics.htm

 

Want to learn more? Visit us at http://www.northstapleydentalcare.com/

PLEASE, Stick Your Tongue Out at Your Dentist

Kim McCrady

Kim McCrady RDH, BA

Dedicated to Phil Swanson and his courageous family

     Come on, you know you have always wanted to stick your tongue out at your dentist and or your hygienist. Honestly, we invite you to be as impolite as possible. During the oral cancer-screening portion of your dental check up we need and want to see as much of your tongue, tissues, lips, and throat as we can.

Oral Cancer Risk Factors

     Unfortunately, according to The Oral Cancer Foundation, cancers of the tongue, lips, cheeks, throat and floor of the mouth are on the rise and have been for the last five years.   In fact, one person passes away every hour from oral cancer.  Those at the highest risk for oral cancer are people with past or current tobacco use habits.  Patients with a family history of oral cancer and men are at a greater risk for oral cancer than women.  The latest consideration as a causative factor for oral cancer is the human papilloma virus (warts) in the oral cavity.  Other listed risk factors include heavy alcohol consumption and over-exposure to the sun.  However, there are many people with oral cancer who will have none of the major known risks factors.

Signs and Symptoms

     There are some signs and symptoms of oral cancer, but most are not detectable until the later stages of development. The National Cancer Institute lists a few of the symptoms of possible oral cancer.  They are patches of tissue that become white or red or a combination of white and red.  Sores on the inside or outside of the lips, mobile teeth, difficulty or pain when swallowing.  If you wear dentures, pain while wearing your dentures can be a warning sign.  Lumps in your neck, along your jawline, behind your ears, pain in your ear that does not subside and lumps in the floor of the mouth are also possible symptoms of oral cancer. 

Oral Caner Screening

     Your dentist and hygienist will check your tissues by having you stick out your tongue.  We catch your tongue with a piece of gauze and will pull it from side to side. We will ask you if you have noticed any sores in your mouth that have been present for more than two weeks.  We will have you touch the roof of your mouth with the tip of your tongue so we can easily view the underside of your tongue.  We also evaluate the inside of your cheeks, lips, floor of the mouth and the back of your throat is also examined. Even the lymph nodes in your neck and along your jawbone need to be checked regularly for abnormalities.  We also check your face, neck and lips for abnormal changes.

     Luckily, new technology is available for oral cancer screenings.  Our office uses a piece of equipment called, the VELscope.  The VeELcope allows the doctor to see changes in the tissue using fluorescence.    This technology allows the doctor to detect changes in the tissue earlier than he can with the naked eye.   Like most technology, we are confident these tools will continue to evolve in accuracy and be used more and more in dental offices.  It is our office philosophy to stay aware of these changes in technology and make them available to you.

Diagnosis and Treatment

     If a suspicious area is detected during your oral cancer screening, your dentist will refer you to an oral surgeon, ear nose and throat specialist or a dermatologist for evaluation and probable biopsy of the area in question.  If you are diagnosed with an oral cancer, treatment will likely vary depending upon the stage of the cancer.  Surgery, radiation, targeted therapy and chemotherapy are often used in combination as treatments.  Early detection and immediate treatment is critical to survival.  Prognosis in a latter stage of development is poor because oral cancers spread (metastasize) quickly to the lymph nodes and other parts of the body as they grow. 

Prevention

     Decrease your risk of oral cancer by reducing your alcohol intake, commit to tobacco cessation.  If you need help quitting, contact your doctor or contact a support program like Ashline.  Be proactive, check your tongue and tissues at home regularly and report to your dentist immediately if you find any concerning areas in your mouth.  The ADA estimates 60% of the US population will see a dentist each year.  This means dental professionals are your partner providers in early detection.  When you see your dentist and your hygienist at your regular visit, insist on an oral cancer screening.  Our office takes oral cancer screening seriously and we invite you to, “PLEASE, stick your tongue out at your dentist!”

 

The Oral Cancer Foundation:  http://oralcancerfoundation.org

National Cancer Institute:  http://www.cancer.gov/cancertopics/wyntk/oral/page1

Ashline: http://www.ashline.org

Oral Surgeons and the VELscope system:  Partners in Early Detection and Diagnosis:  http://www.velscope.com/upload/VELscopeVX_Oral_Surgeons.pdf