Update on Gum Disease, Prevention and Oral Cancer

Our staff recently attended a continuing education program updating us on the most recent scientific evidence concerning Gum disease, prevention and oral cancer. For sometime I have been talking about the oral-systemic connection. If you think about it, it just makes sense but the reason it such a big deal is the way the professions had divided it into the dental and medical worlds. The two have been treated as separate for sometime. The medical profession is not trained on anything inside the month and thus has never considered it a source of infection. Unfortunately, this is a man-made error which has hurt scientific research. Today we know that dental infections cause an inflammatory state in the bloodstream resulting an immune response that makes us more susceptible to respiratory and heart disease as well as Alzheimer, diabetes and low birth weight babies in pregnant females. The primary cause of the dental infection today is gum disease. Infected teeth and failing root canals can also cause the bacteria in the blood stream.

Another susceptible area as we get older is root decay. Since roots are 7 times softer or less dense than enamel, bacteria have little trouble penetrating the surface. Thus as we get older and our gums recede, the roots are exposed and we are prone to root cavities. We now have a product called MI paste which makes the roots more resistant to bacteria attacks and re-mineralizes the roots to decrease cavities. It contains a mixture of calcium and phosphate for re-mineralization and fluoride for bacteria. The third area of concern is oral cancer.

While oral cancer is not a popular, highly published topic, it is serious enough that our office has been screening all our patients for it annually for the last 25 years. We do this by a visual examination of all the intra-oral tissues and palpation of the head and neck lymphatic system. Both myself and my hygienist, Kim, do this every year for all our patients. We do this because the medical profession does not look or examine inside the mouth. The reason is based on history and politics, not logic. Thus, it is left to the dentist to detect oral cancer.

Approximately 36,000-50,0000 people in the U.S ,depending on the report you read, will be newly diagnosed with oral cancer in 2010. This is the fourth year in a row in which there has been an increase in the rate of occurrence of oral cancers. In 2007 there was a major jump of over 11% in that single year. There are two distinct pathways by which most people receive oral cancer. One is through the use of tobacco and alcohol, a long term historic problem and cause, and the other is through exposure to the HPV-16 virus (human papillomavirus version 16), a newly identified etiology, and the same one which is responsible for the vast majority of cervical cancers in women.

While some think this is a rare cancer, mouth cancer will be newly diagnosed in about 100 new individuals each day in the US alone, and a person dies from oral cancer every hour of every day. If you add the sub category of laryngeal cancers, the rates of occurrence (about 10,000 additional new cases per year) and death are significantly higher. When found early, oral cancers have an 80 to 90 % survival rate. Unfortunately at this time, the majority are found as late stage cancers, and this accounts for the very high death rate of about 45% at five years from diagnosis, and high treatment related morbidity in survivors

The increase in oral cancer is related to the increase in Human Papillomavirus (HPV). This is a common viral 75-80 % of us get in our life time but our immune system defeats it. There are 120 known strains, but only 9 cause cancer. The increase is believed to be from an increase in sexual and saliva transmission. Thus, people with new or multiple partners are a higher risk. This virus usually causes warts in the mouth and most are benign, but the name of the game with oral cancer is early detection and by the time they are visible to the naked eye or lymph nodes become swollen, it may be too late.

This new scientific and medical information has lead me to investigate methods of better early detection. In the near future, we will be offering a new early detection devise called “Trimira” that detects evidence of oral cancer before they erupt through the skin through the use of specific wave length. It has three different light transmission levels that offer information to help differentiate cancerous lesions from benign lesions without having to biopsy them so frequently. This device allows us to detect the cancer before it erupts through the skin. The key is early detection and removal. It is suggested to have this done yearly and will be offered for $40.00 per screening. I will keep you posted on the implementation. Our Dallas dentistry office will still offer the visual and palpitation exam at no charge.