Dental Health March 2009 by Thornhill Smile Centre

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MARCH 2009

DENTAL HEALTH YOUR GUIDE TO ORAL HEALTH

Foreword

ral cancer has reached epidemic levels with an annual growth rate of 11 percent. As is true for most cancers, early detection improves the survival rate. But equally important for such cancer is that detecting smaller tumors early frequently results in treatment with little physical or functional impact. Unfortunately, the treatment of advanced oral cavity

cancers may require disfiguring surgery and aggressive chemotherapy combined with radiation that may impair speaking and swallowing. The most common symptoms of oral cavity cancer include a painful, non-healing ulcer, loose teeth, and a firm lump in the neck. Pre-cancerous lesions may precede the development of an ulcerated lesion all of which can easily be diagnosed by a physician or dentist carefully examining the mouth. Although early detection is possible, many patients at present have advantaged stages of the disease. They had minimal oral cavity symptoms until the tumor spread to the lymph nodes in the neck. Treatment of these cancers may involve several physician specialties including a head and neck

BY ROBERT H. MILLER, MD, MBA

surgeon, a medical oncologist, a reconstructive surgeon, and a radiation therapist. In addition, speech/language pathologists, dieticians, and other health professionals are part of the rehabilitative team. Smoking, including the use of any tobacco products in the mouth, is a well known cause of oral cavity cancer. The carcinogens in smoke affect the entire upper aerodigestive tract (mouth, throat, larynx, lungs, and esophagus) which is why patients who develop one aerodigestive cancer are at increased risk of developing a second cancer in this region. Alcohol is also associated with oral cavity cancer. In addition, excessive sun exposure increases the chance of developing cancer of the lips. Lichen planus, an unusual condition

of unknown etiology, is characterized by sometimes painful white, lacey lines in the mouth and may increase the risk of developing oral cancer. More recently, the human papilloma virus (HPV) transmitted during oral sex has been associated with oral cavity cancer. Certain HPV types are associated with cervical cancer in women, and it appears the same virus can cause oral cavity cancers in infected men. Habits in other countries have also been associated with the development of oral cancer. Maté, a South American beverage made from a type of holly tree, and betel nuts, chewed as a stimulant in areas of Asia, are known carcinogens. Elimination of known carcinogens, all involving lifestyle changes, will reduce the chance

of developing oral cavity cancer. Although some have suggested certain vitamins might be used for prevention, the results of these studies have not shown clear effectiveness. Clinical trials of other preventive measures are underway. Poor dental hygiene is associated with a higher risk of developing oral cavity cancer, so routine visits to the dentist are important not only for dental cleaning, but also for regular oral examinations during which early lesions can be detected. Recent studies have suggested an additional benefit of improved oral hygiene to reduce the risk of cardiovascular disease including stroke. Dr. Miller is the Executive Director of the American Board of Otolaryngology and Visiting Professor of Otolaryngology at Baylor College of Medicine.

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A lifetime of smiles: engaging children early in good oral hygiene E CONTENT .................................. 1 . . . . . . . . . . Foreword . . . . . . . . . . . by . . . Dr. . . . .Miller ...... oral 2 . . . . . . . . . . . . . . .Pediatric . . . . . . . . . . . . . . .care .... Oral health linked to 2 . . . . . . . . . . . . . . . . . . . overall . . . . . . . . health ....... Emerging dental 3 . . . . . . . . . . . . . . . . . . . . . .technology ............ 3 . . . . . . . . . . . . . . . .Dental . . . . . . . stem . . . . . . cells ..... Oral cancer diagnosis 3 . . . . . . . . . . . . . . . . . .and . . . . treatments ............ products 4 . . . . . .Dental . . . . . . . . . . . . . . . . . .showcase .......... 4 . . . . . . . . . . . . . . . . . .Ask . . . .the . . . .experts ........ 4 . . . . . . . . . . . . . .Cosmetic . . . . . . . . . . dentistry .......... DENTAL HEALTH A TITLE FROM MEDIAPLANET Publisher: Anthony Chiaravallo +1 646 922 1404 anthony.chiaravallo@mediaplanet.com Editor: Marlene Piturro, PhD Contributors: Kirk Van Hyning Robert Miller, MD, MBA Designer: Daniel McKernan daniel.mck@mac.com Print: Wall Street Journal Mediaplanet is the leading worldwide publisher in providing high quality and in-depth analysis on topical industry and market issues, in print, online and broadcast. For more information about supplements in the daily press, please contact Kayvan Salmanpour +1 646 922 1400 kayvan.salmanpour@mediaplanet.com www.mediaplanet.com

BY MARLENE PITURRO

espite pare n t ’ s b e s t effor ts, the i n c i den ce of too t h c av i ties is r ising. Whi l e c an d y an d soda ar e comm o n c ul pr its, per ceived he al t hy snacks such as fr u i t j u i c e an d milk can also b e t he sour ce of cavitie s . P ro tecting childr en f ro m c av ities is an import a n t g o a l for parents. Fifty p e r c e n t of children betw e e n t h e ages of five and n i n e w i l l have a cavity or f i l l i n g , accor din g to the U.S. De par tment of H eal t h an d H uman Ser vices, s o re placing bad or al hy g i e n e habits with good o n e s i s essential to rever s i n g t h e tr end. “C hildr en’ s f o rm ative year s ar e an i m p o rtant time to teach h e a l t h y habits and to s e t t h e foun dation for g o o d o ral health,” said Dr. Kan e t a Loft, a boar d cer t i f i e d p e diatr ic den tist and A m e ri can Academy of Pe d i at ri c Dentistry member. Getting kids i n v o l v e d in or al car e and ke e p i n g them engaged i s c hal lenging. A r ecent s urv e y

of parents with children, ages six to 12, conducted b y St rat e g y On e an d H arri s I n t e rac t i v e s ho w e d t hat f i f t y p e rc e n t o f p are n t s are unsatisfied with their child’s oral care habits. T he s urv e y re v e al e d ki d s u s i n g c r e a t i v e e xc u s e s to avoid proper oral care ranging from “The cat hid my toothbrush” to “My t o o t hb rus h f l e w aw ay ”. The most popular excuses were: * ‘I forgot’- 73% * ‘I’m too tired’ -46% * ‘It takes too much time’ -22% * ‘It’s boring’ -16% * ‘I lost my toothbrush’ -12% P ro p e r o ral hy g i e n e i n volves brushing, flossing a n d a d d i t i o n a l t o o l s . D r. Lo t t re c o m m e n d s i n t ro d u c i n g a f l u o r i d e r i n s e l i ke LISTERINE SMART RINSE ™ t o o f f e r e x t ra p ro t e c t i o n ag ai n c av i t i e s f o r c hi l d re n ag e s s i x an d o l d e r. Ri n s i n g al s o he l p s c hi l d re n w i t h braces to clean in places w he re b rus hi n g an d f l o s s ing don’t reach.

A special thanks to...

THE AMERICAN ACADEMY OF COSMETIC DENTISTRY (AACD) is the world’s largest non-profit membership organization dedicated to advancing excellence in cosmetic dentistry, with over 7000 members in more than 60 countries worldwide. Cosmetic dentistry is comprehensive oral healthcare that combines art and science to optimally improve dental health, esthetics, and function. To learn more about cosmetic dentistry, call 800.543.9220 or visit our website.

ZILA, INC. is a fully integrated oral diagnostic company dedicated to the prevention, detection and treatment of oral cancer and periodontal disease. Zila designs, manufactures and markets ViziLite® Plus with TBlue®, the Rotadent® Professional Rotary Toothbrush, the Pro-Select Platinum® Ultrasonic Scaler and a portfolio of oral pharmaceutical products.

THE ORAL CANCER FOUNDATION is a national public service, nonprofit entity designed to reduce suffering and save lives through prevention, education, research, advocacy, and support activities. At the forefront of our agenda is the firm establishment in the minds of the American public for the need to undergo an annual oral cancer screening, combined with an outreach to the dental and medical communities to provide this service as a matter of routine practice. 949-646-8000

JOHNSON & JOHNSON Healthcare Products Division of McNEIL-PPC, Inc. is a leader in the consumer oral health and whitening market with LISTERINE® Antiseptic Mouthwash, LISTERINE® TOTAL CARE Anticavity Mouthwash, LISTERINEÒ WHITENINGÒ VIBRANT WHITE™ Pre-Brush Rinse, LISTERINE WHITENING Pen, LISTERINE® WHITENING® Quick Dissolving Strips, LISTERINE® WHITENING® Pre-Brush Rinse, LISTERINE® SMART RINSE™, LISTERINE® AGENT COOL BLUE®, REACH® toothbrushes, REACH® floss, and REMBRANDT® tooth whitening products.

LED MEDICAL DIAGNOSTICS, INC. is a Vancouver-based company which has developed the VELscope System in partnership with the British Columbia Cancer Agency (BCCA). The technology has received over 50 million dollars in NIH and other government grants, as well as public and private equity financing to assist in its development. It is a technology platform based on the direct visualization of human tissue fluorescence and the changes in fluorescence that occur when abnormal tissue is present.

www.aacd.com

www.zila.com

oralcancerfoundation.org

www.jnj.com

www.velscope.com

Further connections found linking oral health to overall health BY MARLENE PITURRO

pening your mouth and saying “aaah” may lead to more than a dental cleaning, tooth filling or whiter smile. Alert dentists detect many links between your oral health and general health because the mouth is one of the first places disease manifests. Conversely, mouth infections such as periodontitis can cause problems throughout the body, so controlling them is critical. Scientifically establishing links between oral health and serious medical conditions is difficult but necessary. Such links would incentivize insurers to add dental benefits because proper dental care would bring cost savings for other health problems. But proving such connections involves sorting out complex issues. For example, research shows that patients with

periodontal disease are at increased risk for heart attack, stroke, diabetes, premature birth, HIV/AIDs and other conditions. However, lifestyle factors such as smoking, alcohol consumption, poor eating habits, obesity, lack of exercise and socioeconomic status are linked to both oral and systemic diseases. Research from the Mayo Clinic, World Health Organization, and the National Institute of Dental and Craniofacial Research, has documented links between oral health and the following conditions:

CARDIOVASCULAR DISEASE including arterial plaque and stroke-this top killer of both men and women globally has a complicated relationship with oral health. Some studies report a moderate link between periodontal disease while others don’t, and some researchers identify the two as having common causal factors such as smoking and obesity. Most evidence points to a 1.5-2 fold greater risk of a fatal heart attack for patients with periodontal disease

PREMATURE BIRTH AND LOW BIRTH WEIGHT are strongly linked to periodontal disease. Pregnant women with this disease are three to eight times as likely to have low birth weight babies and other perinatal complications than those with healthy mouths. Additionally, the metabolic and hormonal changes associated with pregnancy can be mitigated with proper oral hygiene.

DIABETES has a two-way relationship with oral health since it increases the risk of gum disease, cavities, tooth loss, and oral infections. Periodontal disease is often called the sixth complication of diabetes because of its high prevalence and its tendency to make glycemic control more difficult RESPIRATORY DISEASE - dental plaque acts as a reservoir of potential respiratory problems in highrisk patients such as diabetics, alcoholics and hospital patients with compromised immune systems and swallowing reflexes. Better oral hygiene has been shown to improve respiratory outcomes in these patients.

HIV/AIDS – oral problems including mouth ulcers, dry mouth, and mucosal lesions are common. Fungal, viral or bacterial infections attack the gums and are often one of the first signs of AIDS. Managing oral infections in these immuno-suppressed patients is critical.

OSTEOPOROSIS - the mouth can be the first site of systemic bone density loss because the bone supporting the jaw becomes susceptible to infectious destruction. Routine dental exams and dental x-rays help this track bone loss.

CANCER - chemotherapy and radiation often bring on oral complications such as oral Mucositis, radiation-induced dental cavities, and even jawbone necrosis, making oral hygiene critical for cancer patients because of their compromised immune systems

The links between oral disease and serious medical conditions is a strong motivation to practice good oral hygiene and have regular dental checkups to detect such problems before they become debilitating and even life threatening.

RINSE TWICE A DAY AND CALL ME IN THE MORNING.

Taking care of your mouth may be important to your overall health. Rinsing with LISTERINE® Antiseptic may help. It kills germs that cause gingivitis. If left untreated, gingivitis could progress to advanced gum disease, which emerging science suggests is associated with many other health problems.

DO IT FOR YOUR MOUTH. DO IT FOR LIFE. www.listerine.com

Use as directed to help prevent or reduce plaque and gingivitis.

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Emerging technology: new impressions Bone and organ creation from dental stem cells BY KIRK VAN HYNING

hree-D digital scanners let dental patients avoid the uncomfortable excessive salivation and gagging caused by using gooey material to make a mold of their mouths. Ziemak Aesthetic Dental Lab in Olympia, Washington uses 3-D oral scanning and found that all of the 275 crowns it has inserted have fit, a record surpassing conventional molds. Also eliminated are bacteria getting into imperfect molds; abrasions from the stone poured into a mold; and tears and holes that

typically reduce the lifespan of a crown or bridge to five years. According to Ziemek lab manager Jamie Stover, a good fit can last up to 20 years. Dentists in Ontario, Canada’s Thornhill Smile Center are getting similarly good results using the Cadent iTero ™ Digital Impression System., finding that digital scanning helps create crowns and bridges more easily and with more long lasting results than conventional molds. The system uses resin and

intraoral lasers to create a 3D image of the mouth, and is fast, comfortable and accurate.

www.thornhillsmilecentre.com www.ziemekdentallab.net

BY KIRK VAN HYNING

arvesting stem cells from teeth can unlock family dental histories and may someday be used to grow healthy bone and tissue, effectively reversing oral damage and allowing the generation of healthy organs. Dr. John Lupori of Steamboat Springs Oral has partnered with New York-based StemSave to extract and store cells found in pulp tissue at the base of teeth. Accord-

Diagnosing and treating oral cancer

n e s -

BY MARLENE PITURRO etecting stealthy oral cancers in their early stages falls to the front-line medical professionals – dentists, hygienists and physicians – in the fight against this killer that grew at an 11 percent rate in 2007. Making their jobs more difficult is contending with a new risk factor, oral/pharyngeal cancers developed through exposure to the sexually-transmitted human papilloma virus. The traditional risk factors of tobacco and alcohol use remain. Many patients don’t realize that their regular dental or physical check-up may include an oral cancer screening in which the health professional checks about 10 places inside and around the mouth, looking for lumps or irregular tissue changes. The American Cancer Society and the American Dental Association recommend such periodic visual exams. Yet visual screening alone may not reliably spot pre-malignant cells and yields only a 59 percent five-year survival rate. Early detection, in comparison, boosts the survival rate odds to 80 percent. New non-invasive screening tests and medical devices such as rinses, dyes, and hand-held optical lights are being used in conjunction with visual examination to detect abnormalities in their early stages. Most of these new tests

add $35-$65 to the patient’s annual dental check-up bill. A recent study published in the Journal of the American Dental Association (July 2008) by researchers at the University of North Carolina’s School of Dentistry shows that such adjunctive techniques may facilitate the early detection or oral premalignant and malignant lesions. The scientists evaluated the effectiveness of these new technologies: toluidine blue (TB), ViziLite Plus with TBlue (Zila Pharmaceuticals), Microlux DL (AdDent), Orascoptic DK (a Kerr Company), and VELscope (LED Dental). They concluded that there was evidence that toluidine blue is effective as a diagnostic adjunct for use with high-risk populations and suspicious mucosal lesions. They also noted that pharmaceutical grade toluidine blue is commercially available only as part of ViziLite Plus. In an online survey of 234 dentists using the VELscope system, 75% said their patients agreed to oral cancer screening, even though most insurers don’t cover such tests. Ninety-four percent of survey respondents were satisfied with VELScope’s ability to detect cancerous and precancerous tissue that would otherwise have been missed. While such research is encouraging, medical professionals need more and larger studies on these screening adjuncts.

ing to StemSave CEO Art Greco, scientists hope to one day re-create the bone using 3-D printers. The applications range from new teeth to replacement organs, made possible since stem cells are undifferentiated, meaning they are not classified as tissue or organs but can become either. Organs grown from one’s cells are not rejected and would last one’s lifetime. Dr. Bob Pensak, who elected to save his daughter’s cells when she had her wisdom teeth re-

ORAL MUCOSITIS: CANCER TREATMENT’S DEBILITATING SIDE EFFECT

TREATING CANCERS arbara Murphy, MD, a medical oncologist and Director of Head and Neck Research at VanderbiltIngram Cancer Center, sees a growing prevalence of oral cavity and oral/pharyngeal cancers, particularly in nonsmokers and non-drinkers, i.e., those infected through HPV. Unlike previous generations of oral cancer patients, diagnosed in their 60’s and 70’s, these patients are being diagnosed at a different life stage – in their 40’s and 50’s. “With these younger patients we have to strike a careful balance to optimize treatment. There’s much more expectation to return to full functionality, particularly if this is a 45-year parent of three children who is a breadwinner,” says Dr. Murphy. For example, HPV-related cancers are usually treated non-surgically with chemotherapy and radiation while anterior tongue cancers are treated surgically. “We have to be careful with the sequelae of chemotherapy and radiation such as acute mucositis leading to pain, swelling, dry mouth and difficulty swallowing. We want highly effective cancer treatment but not have patients so debilitated that they can’t return to work” she adds. Dr. Murphy is a member of the Eastern Cooperative Oncology Group/ NCI gathering data on ameliorating the pain and discomfort of mucositis using calcium/phosphorous mouth rinses. Much work remains to be done on detecting and treating oral and head and neck cancers early so that disabling and disfiguring late stage treatment can be avoided.

hemotherapy and radiation have saved millions of patients’ lives but often produce uncomfortable and even debilitating side effects. Oral mucositis, inflammation and ulceration of oral mucosa, affects over 40 percent of all patients undergoing chemotherapy and ionizing radiation, 70 percent of bone marrow transplantation patients, and nearly 100 percent of head and neck cancers. It appears seven to ten days after treatment and should be checked for at least twice daily. Oral mucositis can limit patients’ ability to eat or swallow as well as cause severe pain that can require the use of pain medication including morphine. In severe cases, oral mucositis can cause the interruption and premature termination of treatment regimens for cancer patients, according to Spencer Redding, DDS, MD. “Therefore, the oral complications of cancer therapy have the potential to adversely affect treatment outcomes, cancer prognosis and quality of life for millions of patients,” he adds. Treatment agents such as Caphosol, an advanced electrolyte solution used as a rinse by patients undergoing cancer therapy, have been shown to be effective in a UK double-blind prospective randomized clinical trial of 95 patients undergoing bone marrow transplant following radiation or chemotherapy. More than twice as many patients in the Caphosol treatment group avoided oral mucositis and the duration of symptoms was halved. These patients also used 72% less morphine for pain and nearly 75% required no morphine.

DENTAL HEALTH

moved, calls the potential “miraculous”. A crucial link between saliva and blood has aided this development. In May 2008, the American Academy for Pediatric Dentistry (AAPD) found that anything traceable in blood can also be traced in saliva. This allows for a reliable and fast way to diagnose diseases – dental and otherwise – and implement treatment. David Wong, DMD, DMSCc, of the School of Dentistry and Dental Research Institute, UCLA theorizes that infant stem cell samples could be used to create dental pulp tissue and a full tooth in the near future.

25 MILLION WOMEN INFECTED WITH THE HUMAN PAPILLOMA VIRUS (HPV)

he skyrocketing incidence of oral cancers, now the world’s sixth largest killing cancer, has been linked to oral sex with HPVinfected women. Of the 25 million women infected with HPV, three million carry the sexually transmitted virus that causes cervical cancer in women and oral cancer in both women and men. HPV can also cause genital warts, penile and anal cancers. The National Cancer Institute has studied HPVrelated oral cancers from 1973 to 2004, concluding that such cancers are about as common as those caused by tobacco and alcohol use. Gardasil, a vaccine given in three doses and costing $360, is currently given only to girls and women, although Merck, the vaccine’s manufacturer, has asked governmental approval to offer the vaccine to boys in hopes of reducing both cervical and oral cancers. ORAL CANCER FAST FACTS

* 35,000 new cases annually in U.S. * 7,500 deaths * Incidence of oral cancer is 3X greater than cervical cancer w/ 2X more deaths * 5 year survival rate 59%, with early detection 80% * Sixth most common cancer worldwide * 75% of patients use tobacco and/or alcohol * Average oral cancer screening test $35-$65 Source(s): Academy of General Dentistry, 2008 American Cancer Society, 2008

Can anything relieve oral mucositis and dryness caused by radiation and chemotherapy?

Caphosol Can ®

(supersaturated calcium phosphate rinse)

Oral mucositis (damage to the lining of the mouth) and xerostomia (dry mouth) are common with: ! Radiation for cancers of the head and neck1,2 ! Certain types of chemotherapy1,2 Caphosol treats these problems. If you are experiencing oral discomfort as a result of cancer therapy speak with your doctor before the problem becomes serious. Caphosol is indicated for dryness of the mouth or throat regardless of the cause and regardless of whether the conditions are temporary or permanent. Caphosol is also indicated as an addition to standard oral care in treating the oral mucositis that may be caused by radiation or high dose chemotherapy.

Safety Information

—Reported side effects have been rare and generally mild —If Caphosol is swallowed accidentally, no adverse effects are expected —There are no known interactions with other medicines3 —Patients should avoid eating or drinking for at least 15 minutes after use. Caphosol contains sodium (71 mg per 30mL dose). Patients restricted to a low-sodium diet should consult their physician before use3 For additional Caphosol product information, visit www.caphosol.com or call 1-800-833-3533. Please see full Prescribing Information below.

References: 1. Stack KM, Papas AS. Xerostomia: etiology and clinical management. Nutr Clin Care. 2001;4:15-21. 2. Pico J-L, Avila-Garavito A, Naccache P. Mucositis: its occurrence, consequences, and treatment in the oncology setting. Oncologist. 1998;446-451. 3. Caphosol (supersaturated calcium phosphate rinse) prescribing information. October, 2008.

Caphosol®

supersaturated calcium phosphate rinse Prescribing information Ingredients: Dibasic Sodium Phosphate 0.032, Monobasic Sodium Phosphate 0.009, Calcium Chloride 0.052, Sodium Chloride 0.569, Purified Water qs ad (%w/w) Pharmaceutical form: Aqueous solution. Caphosol is a preparation comprising two separately packaged aqueous solutions, a phosphate solution (Caphosol A) and a calcium solution (Caphosol B) which, when both ampule solutions are combined in equal volumes, form a solution supersaturated with respect to both calcium and phosphate ions. Actions: Caphosol is an electrolyte solution resembling human saliva, designed in part to replace the normal ionic and pH balance in the oral cavity. It is intended as a mouth rinse to moisten, lubricate and clean the oral cavity including the mucosa of the mouth, tongue and throat. Caphosol facilitates chewing and speaking; loosens tough mucus and prevents mucous membranes from sticking together. Indications: Caphosol is indicated for dryness of

the mouth or throat (hyposalivation, xerostomia), regardless of the cause and regardless of whether the conditions are temporary or permanent. Caphosol is also indicated as an adjunct to standard oral care in treating the mucositis that may be caused by radiation or high dose chemotherapy. Relief of dryness of the oral mucosa in these conditions is associated with an amelioration of pain. Special precautions for use: Avoid eating or drinking at least 15 minutes after use. Do not use if the seal of the ampule is broken or the ampule shows sign of leakage or damage. Contains sodium (71mg per 30mL dose). Patients restricted to a low sodium diet should consult their physician before use. Store at room temperature, do not refrigerate. KEEP OUT OF REACH OF CHILDREN. Caution: Federal law restricts this device to sale by or on the order of a physician or dentist. Interaction with other medicinal products and other forms of interaction: There are no known interactions with medicinal or other products. How Supplied: Item Code 30 Dose1 Box 0-8489-8000-1 120 Dose1 Box 0-8489-8000-4 1 One Dose = 2 ampules, each 15mL, mixed together.

Directions for use: (1) Mix 1 blue (Caphosol A) and 1 clear ampule (Caphosol B) in a clean glass. (2) Swish the mouth thoroughly for 1 min with 1/2 of the solution and spit out. (3) Repeat with the remaining 1/2 of the solution and spit out. Use immediately after mixing the ampules. s &OR use during high dose chemotherapy or radiation treatment: 4 doses per day from the onset of the cancer treatment. Up to 10 doses per day if pain from mucositis is experienced. Use for the duration of the treatment or as instructed by physician. s 2ELIEF OF DRY MOUTH TIMES PER DAY OR AS instructed by physician. If Caphosol is swallowed accidentally, no adverse effects are anticipated. Manufactured by Holopack GmbH, Germany for: EUSA Pharma (USA), Inc. USA Princeton, NJ 08540 mail@caphosol.com, www.caphosol.com, 1-800-833-3533 Caphosol® is a registered trademark of EUSA Pharma (USA), Inc., USA NHRIC Labeler Code 8596 US patents no. 5993785, 6387352, patents pending Date of revision: October 2008

ONE PERSON DIES EVERY HOUR IN THE US FROM ORAL CANCER The typical risk factors for oral cancer may be commonly known, however, a new risk factor called HPV, is now changing the face of oral cancer. HPV has long been known to cause cervical cancer in women and recent studies show that it may play a role in more than 25% of oral cancer cases. When oral cancer is found early, treatment can be successful 82% of the time. Unfortunately, when compared to the survival rate of other cancers, the survival rate of oral cancer has not improved greatly over the last 30 years. Because early detection is a key to survival, it is important to see your dentist regularly. An annual screening exam called ViziLite Plus with TBlue, used in conjunction with a routine head and neck examination performed by your dentist, can help to find abnormalities that could lead to cancer. That’s the kind of screening that could help save lives. To learn more about oral cancer and to find a ViziLite Plus provider near you, please visit: http://www.vizilite.com/cancer_ad.asp or contact:

ZILA-243-2008 3

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DENTAL HEALTH

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Ask the experts

Q: What is one overlooked issue in oral hygiene and how would you fix it?

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Dr. Jason Kasarsky, DDS Dr. Jason S. Kasarsky graduated from New York University College of Dentistry and attended North Shore University Hospital, a Cornell University teaching hospital. Since 1975, he has incorporated the latest developments in dentistry into his practice so that the care offered to patients is of the highest quality.

www.jkdds.com

With the average American living to 78 years and our wellness mentality to live longer and better, we need our teeth to last. That requires periodontal care at home and a long lasting partnership with your dentist. Dental work done at age 35 or 40 may have to be replaced at age 6075; it’s like driving on bald tires. Moderate to severe periodontal disease, affecting 35 percent of adults, can lead to tooth loss, and other serious problems, so preventing it is important. Rinsing for 45-60 seconds before bed time with an inexpensive, simple home remedy is conservative periodontal therapy that produces fabulous results. Swish several times and then spit out a rinse that is an inch of liquid consisting of a third each Listerine, hydrogen peroxide and water. This is in addition to regular brushing and flossing. Teeth scaling and root planning every three months, plus tongue scraping, laser periodontal therapy, and antibiotics in infected gum pockets are other methods your dentist can use to mitigate the effects of moderate periodontal disease, which can start impacting oral health between ages 3550. So rinse your way to a healthy old age.”

Cosmetic dentistry: the perfect smile BY MARLENE PITURRO

fter greeting every new patient in his private office rather than first encountering them in the dental chair, Jan Linhart, DDS, a dentist specializing in cosmetic and restorative dentistry, puts them at ease and begins work on achieving the perfect smile. Backed by an inter-disciplinary team of oral health care professionals including an implant specialist, a periodontist, an orthodontist, a root canal

specialist, three hygienists and three general dentists, Dr. Linhart uses a variety of techniques including gum sculpting with a laser to create a more favorable gum line, immediate implants to replace lost teeth, and porcelain veneers to create more beautiful smiles. “Porcelain veneers are a particularly useful procedure in cosmetic dentistry,” says Dr. Linhart, adding that “we complete this smile makeover process in two visits.” Starting with taking pictures of the patient’s

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Dr. Jan Linhart Dr. Jan Linhart has been practicing the art and science of dentistry since 1980 and provides cutting edge, quality dental care. Dr. Linhart received his Dental Education from New York University College of Dentistry in 1979 and completed his residency in General Dentistry at Mountainside Hospital in Montclair, New Jersey.

www.drlinhart.com

teeth, Dr. Linhart then discusses what type of look the patient wants, natural versus dynamic, for example. He makes a wax model of what the patient’s new smile will look like and applies a temporary veneer so they can try the new look. On the second visit he applies the permanent veneer in which the veneer is bonded to the tooth enamel. The procedure is popular with patients ranging in age from 17 to 80 years, and costs approximately $1800 to $2200 per tooth. Thanks to cutting edge technologies and his team’s expertise, Dr. Linhart produces natural-look-

In the last few years we’ve seen an association being made between oral health and general health. While there’s never been conclusive concrete evidence we now see a relationship between periodontal disease and heart disease, stroke and low birth weight babies. Evidence shows that bacteria in dental plaque and in the heart are the same, indicating that unhealthy and untreated gums can lead to heart disease and also diabetes. Swallowing plaque and tarter in the bacteria causes inflammation elsewhere in the body. People should take care of the health of their gums. If there’s any bleeding they should see their dental hygienist. One concern of patients with heart murmur or other cardiac conditions is the use of prophylactic antibiotic before periodontal treatment. The American Heart Association has changed this recommendation quite a few times and there is no agreement that pre-treatment antibiotics improve outcomes. Common sense argues that people with bleeding gums are swallowing bacteria anyway, but check with your dentist before periodontal treatment if cardiac issues are of concern.”

ing teeth with durable dental materials that can last approximately 12 to 15 years.

To learn more about cosmetic dentistry or find a local provider visit the American Academy of Cosmetic Dentistry’s web site.

www.aacd.com

Other popular cosmetic dentistry treatments include: * Composite bonding for chipped, broken, discolored or decayed teeth * Teeth Whitening through bleaching stained teeth * Dental implants-artificial tooth root replacements for lost teeth * Full mouth reconstruction to improve not only teeth’s appearance but necessary treatment to correct underlying functional problems with bite, muscles, teeth and bone structure