Common Causes of Root Cavitis due to medications and older Age

Use of many Antidipressents and related diabetic conditions contribute to root cavities.

Cavities are common in older adults both on the crown surface, the portion of the tooth covered by enamel, and the root surface. Recent research suggests that older adults are more likely to develop new cavities on the crown and root surfaces at a greater rate than younger populations. To understand why this is happening consider the following facts:
1. Older adult’s gums tend to “pull away” or recede from the teeth showing more root surfaces. This usually results from years of scrubbing the teeth vigorously with a stiff toothbrush.
2. Many older adults are keeping their natural teeth longer than past older generations making them more likely to develop cavities.
3. The saliva in an older adult’s mouth changes in amount and composition.
4. Chronic illness and disabilities make daily mouth care more difficult to perform, leaving behind damaging bacteria on the root surfaces.
5. Root cavities can grow rapidly if there is a lack of sufficient home care such as daily brushing and cleaning between the teeth.
6. Dry mouth, known as xerostomia, contributes to the development of root cavities. Food and plaque stick much more readily to teeth in a dry mouth. The side effect of many medications is a dry mouth.
7. Poor gum and bone health also contribute to the formation of root cavities.
8. Eating a diet high in fermentable carbohydrates; carbohydrates that turn to simple sugars in the mouth, such as cookies, cakes, soft drinks, candy, bread, crackers, bananas and breakfast cereals may also result in cavities on the root surfaces.

HEALTHY GUMS AND A HEALTHY HEART: THE PERIO-CARDIO CONNECTION

Cardiovascular disease, the leading killer of men and women in the United States, is a major public health issue contributing to 2,400 deaths each day. Periodontal disease, a chronic inflammatory disease that destroys bone and gum tissues that support the teeth affects nearly 75 percent of Americans and is the major cause of adult tooth loss. And while the prevalence rates of these disease states seems grim, research suggests that managing one disease may reduce the risk for the other.

A consensus paper on the relationship between heart disease and gum disease was published concurrently in the online versions of two leading publications, the American Journal of Cardiology (AJC), a publication circulated to 30,000 cardiologists, and the Journal of Periodontology (JOP), the official publication of the American Academy or Periodontology (AAP). Developed in concert by cardiologists, the physicians specialized in treating diseases of the heart, and periodontists, the dentists with advanced training in the treatment and prevention of periodontal disease, the paper contains clinical recommendations for both medical and dental professionals to use in managing patients living with, or who are at risk for, either disease. As a result of the paper, cardiologists may now examine a patient’s mouth, and periodontists may begin asking questions about heart health and family history of heart disease.

The clinical recommendations were developed at a meeting held earlier this year of top opinion-leaders in both cardiology and periodontology. In addition to the clinical recommendations, the consensus paper summarizes the scientific evidence that links periodontal disease and cardiovascular disease and explains the underlying biologic and inflammatory mechanisms that may be the basis for the connection.

According to Kenneth Kornman, DDS, PhD, Editor of the Journal of Periodontology and a co-author of the consensus report, the cooperation between the cardiology and periodontal communities is an important first step in helping patients reduce their risk of these associated diseases. “Inflammation is a major risk factor for heart disease, and periodontal disease may increase the inflammation level throughout the body. Since several studies have shown that patients with periodontal disease have an increased risk for cardiovascular disease, we felt it was important to develop clinical recommendations for our respective specialties. Therefore, you will now see cardiologists and periodontists joining forces to help our patients.”

For patients, this may mean receiving some unconventional advice from their periodontist or cardiologist. The clinical recommendations outlined in the consensus paper advise that periodontists not only inform their patients of the increased risk of cardiovascular disease associated with periodontal disease, but also assess their risk for future cardiovascular disease and guide them to be evaluated for the major risk factors. The paper also recommends that physicians managing patients with cardiovascular disease evaluate the mouth for the basic signs of periodontal disease such as significant tooth loss, visual signs of oral inflammation, and receding gums.

While additional research will help identify the precise relationship between periodontal disease and cardiovascular disease, recent emphasis has been placed on the role of inflammation – the body’s reaction to fight off infection, guard against injury or shield against irritation. While inflammation initially intends to have a protective effect, untreated chronic inflammation can lead to dysfunction of the affected tissues, and therefore to more severe health complications.

“Both periodontal disease and cardiovascular disease are inflammatory diseases, and inflammation is the common mechanism that connects them,” says Dr. David Cochran, DDS, PhD, President of the AAP and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio. “The clinical recommendations included in the consensus paper will help periodontists and cardiologists control the inflammatory burden in the body as a result of gum disease or heart disease, thereby helping to reduce further disease progression, and ultimately to improve our patients’ overall health. That is our common goal.”

Eating Disorders , Anorexia & Bulimia

More than 10 million Americans currently are affected by serious eating disorders such as anorexia, bulimia and binge eating, according to the National Eating Disorders Association. While anyone can suffer from an eating disorder, they are most common in teenagers and young adult women. In addition to having a negative impact on an individual’s health and quality of life, eating disorders also affect self-image, relationships with families and friends, and performance in school or at work. If you suffer from an eating disorder, it’s important to talk to your health care provider.

Eating disorders can also affect a person’s oral health. Without the proper nutrition, gums and other soft tissue inside the mouth may bleed easily. The glands that produce saliva may swell and individuals may experience chronic dry mouth. Throwing up frequently can affect teeth too. That’s because when strong stomach acid repeatedly flows over teeth, the tooth’s enamel can be lost to the point that the teeth change in color, shape and length. The edges of teeth become thin and break off easily. Eating hot or cold food or drink may become uncomfortable.

Types of eating disorders:

Anorexia. This typically involves an extreme fear of gaining weight or a dread of becoming fat. Even though these individuals may be very thin or even extremely underweight, they see themselves as “fat.” They may attempt to reach or maintain what they think is their perfect body weight by literally starving themselves. They may also exercise excessively. Others may eat excessive amounts of food in one sitting and then attempt to get rid of the food and calories from their bodies by forcing themselves to “throw up” or by the misuse of laxatives or enemas.
Bulimia. Like anorexia, bulimia also includes the fears of being overweight. But it also includes hidden periods of overeating (binge eating) which may occur several times a week or even several times a day. While overeating, individuals may feel completely out of control. They may gulp down thousands of calories often high in carbohydrates and fat–in amounts of food that would be greater than what an average person would eat at one sitting. After they overeat, the individuals try to “undo” the fact that they ate too much as quickly as possible by forcing themselves to “throw up” or by the misuse of laxatives or enemas. This is often referred to as “binging and purging.”
Binge Eating or Compulsive Overeating. This may affect almost as many men as women. In the past, these individuals were sometimes described as “food addicts.” They overeat (binge eat) as noted in bulimia above, but do not regularly try to get rid of the food immediately by throwing up or by misusing laxatives or enemas. Feelings of guilt may make it easier for the person to overeat again.
Prevention

Eating disorders arise from a variety of physical, emotional and social issues all of which need to be addressed to help prevent and treat these disorders. Family and friends can help by setting good examples about eating and offering positive comments about healthy eating practices. While eating disorders appear to focus on body image, food and weight, they are often related to many other issues. Referral to health professionals and encouragement to seek treatment is critical as early diagnosis and intervention greatly improve the opportunities for recovery.

If you suffer from an eating disorder these practices can reduce oral health problems associated with it:

Maintain meticulous oral health care related to toothbrushing and flossing.
Immediately after throwing up, do NOT brush but rinse with baking soda to help neutralize the effects of the stomach acid.
Consult with your dentist about your specific treatment needs.
See your dentist regularly.

The symptoms of mouth or throat cancer

The National Cancer Institute estimates that about 40,000 people in the United States will be diagnosed with mouth or throat cancer in 2012.

The oral cavity includes your lips, cheek lining, gums, front part of your tongue, floor of the mouth beneath the tongue and the hard palate that makes up the roof of your mouth. The throat (pharynx) starts at the soft part of the roof of your mouth and continues back into your throat. It includes the back section of your tongue as well as the base where the tongue attaches to the floor of your mouth.

During your dental visit, your dentist can talk to you about your health history and examine these areas for signs of mouth and/or throat cancer. Regular visits to your dentist can improve the chances that any suspicious changes in your oral health will be caught early, at a time when cancer can be treated more easily.

The symptoms of mouth or throat cancer can include:

sores that bleed easily or do not heal
a thick or hard spot or lump
a roughened or crusted area
numbness, pain or tenderness
a change in the way your teeth fit together when you bite down
Make sure to tell your dentist about any problems you have when chewing, swallowing, speaking or moving your tongue or jaw.
Keeping your mouth healthy during treatment:

According to the National Institute of Dental and Craniofacial Research, the first thing you should do before beginning cancer treatment is to see your dentist. After your treatment begins, be sure to check your mouth every day for sores or other changes.
Other NIDCR tips to keep your mouth moist:

Keep your mouth moist.
Drink a lot of water.
Suck ice chips.
Use sugarless gum or sugar-free hard candy.
Use a saliva substitute to help moisten your mouth.
Tips for cleaning your mouth:
Brush your teeth, gums, and tongue with an extra-soft toothbrush after every meal and at bedtime. If it hurts, soften the bristles in warm water.
Use a fluoride toothpaste.
Use the special fluoride gel that your dentist prescribes.
Don’t use mouthwashes with alcohol in them.
Floss your teeth gently every day. If your gums bleed and hurt, avoid the areas that are bleeding or sore, but keep flossing your other teeth.
Rinse your mouth several times a day with a solution of 1/4 teaspoon each of baking soda and salt in one quart of warm water. Follow with a plain water rinse.
Dentures that don’t fit well can cause problems. Talk to your cancer doctor or dentist about your denture.