My Blog
By Nelson Wollek, DDS
April 06, 2021
Category: Dental Procedures
Tags: oral cancer  
3ThingsYouShouldDotoOvercomeOralCancer

Rock guitarist Eddie Van Halen died last fall after a long battle with oral cancer, another in a long line of performers, athletes, politicians and other well-known personalities with this serious form of cancer. But household names like Van Halen are just the tip of the iceberg: Around 50,000 Americans are diagnosed with oral cancer each year.

Although not as common as other malignancies (around 2.5% of total cancers), oral cancer has one of the lowest five-year survival rates at a dismal 57%. Part of the reason for this has been the longstanding difficulty detecting it in its earlier stages: Early signs are easy to miss or mistake for a benign sore. As a result, it's often diagnosed after advancing significantly, complicating treatment efforts.

To improve survivability, the Oral Cancer Foundation designates each April as Oral Cancer Awareness Month to better educate people on this deadly disease. Here are 3 things you can do to prevent oral cancer or improve your survival odds if you encounter it.

Know your individual risk factors. Some risk factors for oral cancer are out of your control—for example, your risk may be higher if you're a male over 40, or if you're African-American. But there are also factors you can control like tobacco use, high alcohol consumption or a poor diet, all of which can elevate your cancer risk. You can lower that risk by making lifestyle changes for factors you can control and prioritizing cancer screening if you have factors that you can't.

Pay attention to oral “oddities.” A small mouth sore or patch of odd-looking skin may be nothing—or it may be the beginning of oral cancer. If you do notice something unusual, especially if it seems to linger beyond a couple of weeks, have us examine it as soon as possible. If it does appear suspicious, you may need to undergo a biopsy, a cancer analysis of the suspected tissue. If it is cancerous, an early diagnosis could improve your outcome.

Visit your dentist regularly. There's more to semi-annual dental visits than teeth cleaning. Regular dental visits are an important component in your “early warning system” for oral cancer—we may notice something suspicious during your regular visit, often before you do. If you're older or have other risk factors for oral cancer, we can expand your regular exam to include a comprehensive cancer screening.

Oral cancer is a serious matter. But taking steps to prevent it and staying alert to its warning signs can help you overcome it.

If you would like more information about oral cancer, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Oral Cancer.”

EatingtheRightFoodsCanBoostYourEffortstoPreventDentalDisease

You're more apt to lose teeth because of periodontal (gum) disease and tooth decay than any other cause. But neither of these bacterial diseases have to happen: You can prevent them through daily brushing and flossing and twice-a-year dental cleanings.

But that's not all: You can also boost your dental care practices by eating foods that strengthen and protect teeth. On the other hand, a poor diet could reduce the effectiveness of your oral hygiene practices in preventing tooth decay or gum disease.

A diet that might lead to the latter is often high in refined sugar (sucrose), often added to processed foods and snacks to improve taste. But sucrose is also a top food source for oral bacteria, increasing their numbers when it's readily available. A higher bacterial population greatly increases your risk for tooth decay or gum disease.

On the other hand, certain foods benefit your overall dental health. Fresh fruits and vegetables, for example, are filled with nutrients and minerals like vitamin D or calcium that strengthen teeth against disease. And although they can also contain natural sugars, these don't pose the same problems as added sucrose due to the plant fiber you consume with them.

Dairy foods can also help you maintain healthy teeth and gums. Milk and cheese contain minerals like calcium and phosphorus, and a protein called casein, all of which strengthen teeth against decay. The enzymes in cheese stimulate saliva, which in turn neutralizes mouth acid and prevent it from harming enamel.

Some foods are also natural sources of fluoride, a mineral that strengthens tooth enamel. One example is black tea, which also, along with green tea, contains antioxidants that protect against cancer.

The best strategy for “tooth-friendly” nutrition is to pursue a diet that's high in fiber-rich natural foods and low in sugar-added processed foods. In practice, you'll want most of your diet to consist of fresh fruits and vegetables and low-fat dairy food, while minimizing foods with added sugar.

Following this kind of diet will certainly benefit your overall health. But it will also make it easier for you to prevent dental disease and keep your teeth and gums healthy.

If you would like more information on how nutrition can boost your 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 “Nutrition & Oral Health.”

By Nelson Wollek, DDS
March 16, 2021
Category: Oral Health
Tags: oral health  
AcidRefluxCouldBeDamagingYourTeeth

Your tooth enamel is often under assault from oral acid produced by bacteria and certain foods. Unless neutralized, acid can erode your enamel, and lead to destructive tooth decay.

But there's another type of acid that may be even more destructive—the acid produced in your stomach. Although important for food digestion, stomach acid outside of its normal environment can be destructive. That includes your teeth, if stomach acid finds its way into your mouth. And that can happen if you have gastroesophageal reflux disease (GERD).

GERD, a chronic condition affecting 1 in 5 adults, is caused by the weakening of the lower esophageal sphincter, a ring of muscle at the intersection of the esophagus and the stomach that prevents stomach acid from traveling back into the digestive tract and damaging the esophageal liner.

It's also possible for stomach acid to travel as far up as the mouth. With a pH of 2.0 or less, stomach acid can lower the mouth's normal pH level of 7.0 well below the 5.5 pH threshold for enamel softening and erosion. This can cause your teeth, primarily the inside surfaces of the upper teeth, to become thin, pitted or yellowed. Your teeth's sensitivity may also increase.

If you have GERD, you can take precautions to avoid tooth damage and the extensive dental work that may follow.

  • Boost acid buffering by rinsing with water (or a cup of water mixed with a ½ teaspoon of baking soda) or chewing on an antacid tablet.
  • Wait about an hour to brush your teeth following a reflux episode so that your saliva has time to neutralize acid and re-mineralize enamel.
  • If you have chronic dry mouth, stimulate saliva production by drinking more water, chewing xylitol gum or using a saliva supplement.

You can also seek to minimize GERD by avoiding tobacco and limiting your consumption of alcohol, caffeine or spicy and acidic foods. Your doctor may also prescribe medication to control your GERD symptoms.

Preventing tooth decay or gum disease from the normal occurrences of oral acid is a daily hygiene battle. Don't let GERD-related acid add to the burden.

If you would like more information on protecting your teeth from acid reflux, 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 “GERD and Oral Health.”

By Nelson Wollek, DDS
March 06, 2021
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?

By Nelson Wollek, DDS
February 24, 2021
Category: Dental Procedures
Tags: dentures  
FlexibleRPDs-aSoundTemporaryWayToReplaceMissingTeeth

The timing around losing a tooth may not always sync with your financial ability. It's not unusual for people to postpone getting a dental implant—by far the best option for replacing a missing tooth—because of its expense.

So, if you have to postpone dental implants until you can afford them, what do you do in the meantime to keep your smile intact? One affordable option is a temporary restoration known as a flexible removable partial denture (RPD).

Composed of a kind of nylon developed in the 1950s, flexible RPDs are made by first heating the nylon and injecting its softened form into a custom mold. This creates a gum-colored denture base to which prosthetic (false) teeth are affixed at the exact locations for missing teeth.

Differing from a permanent RPD made with rigid acrylic plastic, a nylon-based RPD is flexible and lightweight, making them comfortable to wear. They're kept in place with small nylon extensions that fit into the natural concave spaces of teeth. And, with a bit of custom crafting, they can look quite realistic.

RPDs are helpful in another way, especially if you're waiting for an implant down the road: They help preserve the missing tooth space. Without a prosthetic tooth occupying that space, neighboring teeth can drift in. You might then need orthodontic treatment to move errant teeth to where they should be before obtaining a permanent restoration.

Flexible RPDs may not be as durable as acrylic RPDs, and can be difficult to repair or reline if needed to adjust the fit. Though they may not stain as readily as acrylic dentures, you'll still need to clean them regularly to help them keep looking their best. This also aids in protecting the rest of your mouth from dental disease by removing any buildup of harmful bacterial plaque on the RPD.

But even with these limitations, patients choose RPDs for the simple fact that they're affordable and temporary. And the latter is their greatest benefit—providing you a “bridge” between losing a tooth and replacing it with a durable dental implant.

If you would like more information on tooth replacement options, 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 “Flexible Partial Dentures.”





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