My Tooth Talk

Below are some of the tooth talk topics that Dr. Boitet has covered recently:

4/27/09-5/1/09 ORAL CANCER SCREENING

How common is oral cancer?
Each year in the U.S. approximately 34,000 individuals are diagnosed with oral cancer and if you combine throat cancers it increases to 46,000. Oral cancer kills one person every hour in the United States. It is the 6th most commonly diagnosed cancer in the United States. Sadly the mortality rate of oral cancer hasn’t changed in over 30 years. The 5 year survival rate for oral cancer is 52% but when discovered early it can increase to 80-90%. Many women routinely get checked for cervical cancer but not as often for oral cancer and oral cancer is more common. The main risk factors for oral cancer are tobacco and alcohol use although it can occur in any patient. Tobacco use in all forms is the biggest risk factor as about 75% of oral cancer patients use tobacco. Early screening, diagnosis, and treatment planning saves lives. Unprotected exposure to the sun will increase the likelihood of lip cancer. Use at least SPF 30 sun block on your lips. Many chap stick type products come with these sun blocks. High gloss lipstick can actually magnify the sun and increase its damaging affects.

Besides just looking, are there other ways to help detect oral cancer?
One new technology, called the VELSCOPE helps us to see tissue changes that are occurring below the tissue surface that may be difficult to see with the regular overhead light. It is a very simple and painless examination which uses a high energy special blue light that we shine on our patients’ oral tissues. This light reflects off of healthy tissue but if abnormal tissue changes have occurred at or below the surface the light doesn’t reflect back-this makes detection much easier and effective. It will not detect every type of oral cancer but it is a wonderful additional tool in cancer detection. The light does not have any harmful effects to your tissue. X-rays can help detect cancers in the jaw bone. Many cancers such as breast cancer and prostate cancer can spread to bones including the jaws such as breast cancer and prostrate cancer. We routinely do head and neck examinations on our patients. This has allowed us to detect a number of cancers outside of the mouth. It is important for dentists to do thorough exams on their patients as the dentist plays an important role in detecting oral cancer.

What are some of the signs and symptoms of oral cancer?
In the early stages it is often painless and not obvious. Early type indicators are red and/or white discolorations in your mouth, sores that do not heal within 14 days or hoarseness which lasts for a prolonged period. Obviously other things can cause similar appearances so it is important to have a thorough examination. More advanced indications are the feeling that something is stuck in your throat, numbness in the mouth area, difficulty in moving the jaw or tongue, difficulty in swallowing, ear pain on one side only, a sore under a denture or partial which even after adjustment still doesn’t heal, or finally a lump or thickening which develops in the mouth or on the neck.

4/13/09-4/24/09 CROWN V.S. VENEER

What is a crown and what is the purpose of a crown?
A crown, also referred to as a “cap”, is typically a full covering over a tooth. This can be done to protect a broken tooth or one that is cracked or has a very large filling. Crowns can also be done to protect a root canal treated tooth. A crown may also be done to correct bite problems or simply to improve the appearance or position of a tooth. The crown preparation involves some reduction or reshaping of the existing tooth. This allows for the crown to slide over the remaining tooth to protect it yet not make the tooth bigger. In other words the reduction makes up for the thickness of the crown.

What are the different types of crowns?
Crowns can be made of all porcelain, porcelain on the outside with a metal substructure, or all metal such as a gold crown. Temporary crowns are usually made out of acrylic or resin type materials. Sometimes it is necessary to rebuild part of the core of the tooth to have adequate support for a crown. The crown is cemented on to your remaining tooth structure so it stays fixed in place.

What is the difference between a crown and a veneer?
A veneer is a resin or porcelain facing on a tooth that typically does not cover the back side of a tooth. Porcelain veneers tend to be stronger and more stain resistant than resin veneers but usually they are associated with a higher fee due to the increased laboratory cost involved because of materials and labor costs. Veneers can be used to improve the appearance of severely stained, misshapen or misaligned teeth. There is usually less tooth structure removed preparing a tooth for a veneer than for a crown. Porcelain will typically outlast resin due to its increased strength and resistance to staining and so tend to stay looking nice much longer. There are indications for both types of restorations and your dentist can discuss with you which is best for your given situation. Typically veneers are done more on front teeth and not nearly as often on your back chewing teeth.