Posts for: September, 2013

By Arnold Cutler, D.D.S.
September 25, 2013
Category: Oral Health
Tags: toothache  
IdentifyingtheSourceofMouthPainLeadstoMoreEfficientTreatment

You have a toothache… or do you? That's not a facetious question — sometimes it's difficult to determine if it's your tooth that hurts, your gums or both. It's even difficult at times to pinpoint which tooth may be hurting.

This is because the pain can originate from a variety of causes. Determining the cause is the first step to not only alleviating the pain, but also treating the underlying condition. Those causes generally follow one of two paths: either the problem originates within a tooth and spreads to the gums and other tissue, or it begins with infected gum tissues and can spread to the teeth.

We refer to the first path as endodontic, meaning it originates from within a tooth. Most likely the tooth has decayed (also referred to as a cavity), which if untreated can progress, allowing bacteria to infect the tooth pulp (living tissue inside the tooth that contains nerve fibers). Pain results as the nerves become inflamed and sensitive, though often varying in quality (sharp or dull) or frequency (constant or intermittent); outside stimuli, like temperature or pressure, may also trigger pain.

Although likely originating with one tooth, it may be difficult to pinpoint which one is actually causing it; you might even feel pain in your sinus cavity radiating upward from the tooth. An untreated infection will continue to spread to surrounding soft tissue, or result in a painful abscess, an infected pocket of bacteria between the tooth and gums.

The other path is periodontal, meaning the infection originates in the gum tissues. A thin layer of dental plaque known as biofilm develops and sticks to teeth at the gum line, which can lead to infection of the gum tissue, which then becomes inflamed and painfully sensitive. The untreated infection can then progress along the tooth and invade the pulp through the accessory root canals.

Knowing the source of an ache will determine the best course of treatment, whether a root canal, root planing, or a combination of these or other procedures. It's also the best, most efficient way to relieve you of that unpleasant mouth pain.

If you would like more information on the various causes of tooth pain, 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 “Confusing Tooth Pain.”


By Arnold Cutler, D.D.S.
September 17, 2013
Category: Dental Procedures
FiveFactsAboutTooth-ColoredFillings

For decades, dental amalgam — the common “silver” fillings found in the mouths of millions — was the best option for restoring teeth after the removal of decay. This time-tested material is still going strong, but in recent years it's had serious competition from newer restoration techniques that use tooth-colored substances to make fillings. If you've heard of these new materials and want to know more, you can start with the following five facts.

1) Filling materials must match the properties of natural teeth.

When properly cared for, teeth are strong, resilient, and superbly functional. A good filling material should mimic the strength and durability of natural teeth under biting forces. It should also last a long time in the mouth, be relatively easy to place, and be economical in cost. In the past, amalgam fillings were the best choice to do the job. But that was then.

2) Tooth-colored filling materials offer similar benefits, plus aesthetic appeal.

Composite resins and dental porcelains are tough, durable materials that have been found to hold up well under years of use. Unlike traditional silver fillings, however, they match the appearance of natural teeth quite closely. This means that even a restoration in the front of the mouth may be virtually undetectable. And who wouldn't like that?

3) Tooth-colored resins may allow more conservative treatment in decay removal.

In order to keep them securely in place, amalgam (silver) fillings may require “undercutting,” which removes more of the tooth structure. The process involved in bonding tooth-colored restorations, however, generally requires removal of less tooth material. This means a stronger base for rebuilding the tooth's structure.

4) Different treatment methods are used for different degrees of tooth restoration.

Small cavities can be treated by direct “chairside” techniques, which are very similar to the methods used for traditional amalgam (silver) fillings: in one brief visit, it's all done. When a greater volume of tooth structure must be replaced, we may be able to create a larger tooth-colored filling in a longer visit. Or, we might need to have a special restoration made to match your teeth; then, you can come back to have it securely bonded for a natural and long-lasting result.

5) Both amalgam and tooth-colored fillings are safe and effective.

Each has advantages and disadvantages in particular cases. But as the technology of tooth-colored filling systems evolves, some dental researchers have heralded the beginning of the “post-amalgam era.” Are tooth-colored fillings right for your individual situation? We're the ones to ask.

If you would like more information about tooth-colored fillings, 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 “The Natural Beauty of Tooth-Colored Fillings.”


By Arnold Cutler, D.D.S.
September 09, 2013
Category: Oral Health
Tags: oral health   oral cancer  
ReducingYourRiskofOralCancer

Oral cancer is not as uncommon as people think. In 2008 an estimated 34,000 cancers of the mouth and throat were diagnosed. In order to minimize your risk of developing oral cancer, be aware of habits that increase your risk.

Risk Factors for Oral Cancer include:

  • Use of smoking or chewing tobacco: Tobacco smokers have 5-9 times greater risk of developing this cancer than non-users; snuff and chewing tobacco users have a four times greater risk than non-users.
  • Excessive use of alcohol: Moderate to heavy drinkers at are 3-9 times greater risk than non-drinkers.
  • Exposure to sun: Chronic sun exposure is associated with development of lip cancers.
  • Certain viral infections such as the human papilloma virus that can cause cervical cancer in women can also cause oral cancer.
  • Compromised immune (resistance) systems that are not functioning properly can be associated with cancers.
  • Poor nutrition including diets low in fruits and vegetables can increase risk for all cancers including oral cancer.
  • Family history: People carry a predisposition in their DNA (the genetic material they inherited from their parents) for developing cancer.

Oral Cancers Can Mimic Harmless Sores

Early signs of oral cancer can mimic harmless sores that occur in the mouth such as canker sores, minor infections, or irritations that occur from biting or eating certain foods. Cancers in the lip area can easily be mistaken for harmless sores.

Early Detection is Key

It is important to have regular oral examinations to detect signs of oral cancer. Although 90 percent of oral cancers occur in people who are over 40, it is becoming more prevalent in younger people, particularly those who adopt risky behaviors: smoking, drinking and oral sex.

  • If you notice any unusual lesions (sores or ulcers), or color changes (white or red patches), anywhere in your mouth that do not heal within two to three weeks, come and see us and have it examined immediately.
  • Definitive diagnosis may require a small biopsy, the microscopic examination of a piece of tissue from the affected area.

It is important not to let a suspicious sore go unchecked. If detected and treated early, while a lesion or growth is small, survival rates can exceed 80 percent. Contact us today to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”


By Arnold Cutler, D.D.S.
September 06, 2013
Category: Oral Health
Tags: oral health   oral cancer  
FiveFactsAboutOralHealthDuringCancerTreatment

According to a recent study from the National Cancer Institute, a branch of the National Institutes of Health, the incidence of cancer is dropping and the survival rate is increasing. In general, the outlook for patients undergoing treatment for the disease is getting better and better. Unfortunately, it's possible that some essential lifesaving treatments, like chemotherapy and radiation, can adversely affect your oral health. If you (or a loved one) need cancer treatment, however, there are some things you should know that can help minimize the possible complications and side effects.

  1. Chemotherapy and radiation are effective cancer treatments, but they may cause oral health problems. These therapies work by attacking cancer cells, but they can also damage healthy cells, including those in the salivary glands and the lining of the mouth. Common symptoms may include a dry mouth or uncomfortable mouth sores. Cancer patients may also be at higher risk for dental disease, especially tooth decay.
  2. Prevention is the best way to minimize these problems. It's important to have a complete dental evaluation before cancer treatment begins. Side effects often result when the mouth isn't healthy prior to the start of therapy — so if there's time for necessary dental treatment beforehand, it can be beneficial in the long run.
  3. Taking good care of the mouth is crucial at this time. During cancer treatment, proper brushing is more important than ever. A fluoride gel or antibacterial rinse may be prescribed to help prevent tooth decay. Prescription medications are sometimes recommended to alleviate dry mouth, but drinking plenty of water, chewing xylitol-containing gum, or using a soothing rinse of salt, water and baking soda can help too.
  4. A team approach is essential for the best care. This includes coordination between dentists and oncologists (cancer specialists), and sharing information about prescription and non-prescription drugs, medical histories and treatment plans.
  5. It's vital to understand and follow medical recommendations. This means not only getting the necessary treatments and taking prescribed medications, but also learning to recognize the warning signs of potential problems. With the support of our office, your oncologist, and caring family and friends, we can make cancer treatment as comfortable as possible and help obtain the best outcome.

If you would like more information about cancer treatment and oral health, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Oral Health During Cancer Treatment.”




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