Oral Cancer

Recent studies indicate that dental professionals detect oral cancer much earlier, giving patients a much better chance for survival. Oral cancer involves the entire oral cavity and can occur at any age. Every patient should get a head and neck examination, regardless of age, and we do this each time patients get a comprehensive oral exam. This is done for all new patients and yearly for existing patients. Those most at risk for head/neck cancer are heavy users of tobacco and alcohol.

Fluoride

Cavities or tooth decay is caused when the protein in your saliva combines with sugars and carbohydrates in food particles on or between your teeth. This bad combination creates plaque filled with bacteria. The acid from that bacteria eats away at the tooth enamel, creating dental caries or decay. Fluoride can keep this from happening, which is why it has been put into water systems throughout the United States. According to Oral Health America, a nonprofit organization whose goal is to raise awareness of oral health, cavity rates in school-aged children has declined significantly since 1970 due to more availability of fluoride sources. The ADA also says fluoridated water is very beneficial and cost effective for preventing decay.

The major source of topical fluoride in the mouth is saliva. Using fluoride-containing products, such as toothpaste, increases the concentration of it in saliva. Saliva neutralizes the acid produced by the bacteria, helping to keep the tooth from decaying. Eating a healthy diet and using good oral hygiene also increases the effectiveness of the fluoride.

Topical fluorides are used most often in children to prevent cavities in teeth as they come in. Researchers are now finding an increased rate of cavities in adults who are over 50, indicating it might be good to provide topical fluoride to these patients because it inhibits the growth of plaque bacteria.

Current recommendations by the ADA indicate that anyone with moderate risk of decay over the age of  6 should receive an application of topical fluoride twice yearly. These applications are available in three forms: gel, foam, and varnish.

Dentin Hypersensitivity

Caused by the exposure of dentinal tubules, dentin hypersensitivity can be the result of several things: gingival recession, cervical wear, erosion from diet (conditions like bulimia), or even after a patient has periodontal or restorative procedures. Applying a protective layer of calcium fluoride for this problem not only provides protection from tooth decay, it often relieves the pain caused by sensitivity.

Dry Mouth

It is estimated that up to 30 percent of those over age 65 have xerostomia or dry mouth. This is caused by a decrease in the function of the salivary gland.

Though it’s not directly caused by aging, it can be the result of certain health conditions or medications used by older persons. Health conditions that can cause some degree of dry mouth are poorly controlled diabetes, depression, eating disorders, gastrointestinal esophageal reflux disease (GERD), cystic fibrosis, obstructions or tumors of the salivary gland, and poor nutrition. Many prescription drugs list dry mouth as a side effect and some urinary dysfunction therapies can cause it. Research has shown that topical treatments of fluoride can effectively prevent the tooth decay that often accompanies dry mouth or xerostomia.

Heart medications are the number one cause of dry mouth we seen in our office. Therefore, we recommend fluoride treatments for all our patients, adults included.

We recommend Biotene by Laclede, which has an entire line of products designed for help with dry mouth. Check the company’s website, www.biotene.net, for information about these products and to sign up for their newsletter.

Keep Teeth and Gums Healthy

The American Dental Association (ADA) recommends these steps to ensure good oral hygiene:

• Brush teeth twice a day with an ADA-accepted fluoride toothpaste. Replace your toothbrush every three to four months, sooner if the bristles become frayed.
• Clean between teeth daily with floss or an interdental instrument. Decay-causing bacteria linger between teeth where toothbrush bristles can’t reach. This helps remove plaque and food particles from between the teeth and under the gum line.
• Eat a balanced diet and limit snacks.
• Visit us regularly for professional cleanings and oral exams.

Your oral health can be seriously compromised by gum disease. Here are the warning signs that can signal a problem:

1. Gums that bleed easily
2. Red, swollen, tender gums
3. Gums that have pulled away from the teeth
4. Persistent bad breath or bad taste
5. Permanent teeth that are loose or separating
6. Any change in the way your teeth fit together when you bite
7. Any change in the fit of partial dentures

If You’re Scheduled for a Procedure

Pre-Procedure Instructions

Be sure to take any prescribed medications as directed, especially antibiotics. Please brush and floss before any dental treatment. If you have any questions, please call us at 352-787-5919.

Post-Procedure Instructions

• Keep fingers and tongue away from surgical area.
• Use ice packs on surgical area (side of face) for first 12 hours. Use ice 20 minutes on, 10 minutes off. Bags of frozen peas work well.
• For mild discomfort take acetaminophen or ibuprofen every four to six hours.
• For severe pain, use the prescription given to you.
• Drink plenty of fluids. Do not use a straw
• If the jaw muscles become stiff, chewing gum at intervals will help relax them. The use of warm, moist heat applied to the outside of the face beginning on the second day after surgery will also help with relaxation of the muscle.
• Eat soft foods that can be easily chewed and swallowed. Recommended foods and recipes are below. No seeds, nuts, rice, popcorn, etc.
• A certain amount of bleeding will occur following surgery. Bleeding is controlled by applying pressure to the surgical area for 90 minutes. Then you may eat or drink. If bleeding persists, a moist teabag should be placed in the area of bleeding firmly for one hour.
• Please do not smoke for at least five days after surgery.
• If you are on other medications, be sure to discuss this with your doctor or pharmacist to minimize adverse drug interactions.

A certain amount of bleeding, pain and swelling is normal. Maintain a low level of activity for several hours. Eat on soft foods; sip drinks, do not use a straw; and avoid unnecessary talking. These activities may hinder proper healing in the first few hours. Immediately following procedure…begin taking medication as directed by your doctor to minimize discomfort when the anesthesia wears off and feeling is back to normal.

To control bleeding

Immediately following a procedure, keep a steady pressure over the surgical site. This helps reduce bleeding and allows formation of a clot. Gently remove the compress after one hour. If bleeding persists, place another compress and again keep steady pressure on the area for one hour.

Some oozing of blood may persist up to 24 hours after surgery. Once bleeding has stopped, cautiously remove oral compress.

To minimize swelling and discomfort

Immediately following your procedure, apply an ice bag to affected area. It should be on 20 minutes and off for 10 minutes for two to four hours to help prevent development of excessive swelling and discomfort. If an ice bag is unavailable, simply fill a heavy plastic bag with crushed ice. Tie end securely and cover with a soft cloth to avoid skin irritation. Frozen bags of peas make wonderful ice packs and can be refrozen and used repeatedly.

Cold applications should not be necessary after four hours. Expect some swelling for up to 10 days and possibly a low-grade fever of 99 to 100 degrees.

When taking anti-inflammatory medication prescribed by your doctor, take with soft food and continue it as directed. If you have significant pain, take the prescribed narcotic medication. If the doctor did not prescribe an anti-inflammatory, you may take 600 mg of ibuprofen every four to six hours to control mild to moderate pain.

Maintaining oral hygiene

24 hours after surgery, rinse your mouth gently with a solution of one-half teaspoonful salt dissolved in a large glass of warm water (tea temperature). Repeat after every meal or snack for seven days. This rinsing is important because it removes food particles and debris, which helps promote healing. Brushing your  tongue with a dry toothbrush keeps bacteria growth down, but be careful not to touch the surgical site. Resume your regular tooth brushing after two days, but carefully avoid disturbing the surgical site.

Maintaining proper diet

Have your meals at the usual time. Eat soft, nutritious foods and drink plenty of liquids with meals and in between. Be careful not to disturb the blood clot. Add solid foods to your diet as per the schedule below.

In case of problems

If have any problems such as excessive bleeding, pain, or difficulty opening your mouth, call our office immediately for further instructions at 352-787-5919.

Remember your follow up visit

A post-operative visit will be scheduled to ensure healing is progressing satisfactorily. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene, and call our office if you have any questions or concerns.

Instructions for extraction sites

• Do not smoke for two to three days following the extraction.
• Do not drink through straws for two to three days.
• Do not drink carbonated beverages.
• Do not take aspirin or drugs that will thin your blood.
• Keep gauze pack in place for one hour, then remove.
• Eat soft foods during the first 24 hours.
• If excess bleeding occurs, place Hemotrol Gauze (given to you by dental office) in extraction site and bite gently until bleeding subsides.
• You may use a moistened tea bag to soothe extraction site.
• TAKE PRESCRIBED MEDICATION AS DIRECTED.

Following the day of an extraction, you may rinse with warm salt water twice per day to aid in the healing process. DO NOT swish vigorously while doing so to avoid rinsing healing clot from site. Some swelling and possible bruising is normal following an extraction. If this condition worsens, call us at 352-787-5919 for further instruction.