Getting to the Root of Teeth & Gum Sensitivity

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Does the thought of biting into something cold or drinking a hot beverage make you wince? You aren’t alone! According to a survey published in the Journal of the American Dental Association, as many as one in eight Americans suffer from oral sensitivity.
The good news? With some TLC, regular dental visits, and proper oral hygiene, gum and/or teeth sensitivity can be treated. 
Let’s start by identifying which form of sensitivity you are experiencing. 
Sensitive teeth 
The outermost layer on the exposed part of your teeth is the enamel. It is a hard surface which serves to protect the inner layers. Just beneath the enamel layer are the dentin layers, which are bone-like structures, made up of microscopic tubules. 
When your enamel is damaged, the dentin layer is exposed, allowing hot, cold and acidic foods to stimulate the nerves and causing pain or sensitivity. 
Enamel erosion causes
There are many factors that can cause enamel to erode, exposing the dentin layer and resulting in tooth sensitivity. The primary causes are abrasion due to aggressive brushing, tooth decay or gums recession.
Tooth decay (cavities)
Cracked teeth
Worn fillings
Gastric reflux (GERD)
Gum disease
Exposed roots
Brushing too hard 
Gum recession
Acidic foods
Teeth grinding or clenching
Plaque buildup
Long-term use of mouthwash
If tooth sensitivity is noted primarily when chewing, the cause could be a cracked tooth. A cracked tooth is vulnerable to infection and even nerve damage, and should be repaired with a crown or bonding to avoid breakage.   
Treatment of sensitive teeth
The good news is that sensitive teeth are often easily treated. Based on the cause of the sensitivity, the following treatments may be recommended:
De-sensitizing toothpaste
Switching to a soft bristle toothbrush
Utilizing a daily fluoride rinse treatment at home
Treatment of the exposed area to reduce sensitivity 
Application of a fluoride gel to strengthen enamel 
Daily flossing, to remove bacteria and reduce inflammation
Use of a nightguard appliance to mitigate the effect of clenching or grinding teeth
Bonding along the tooth root, at the gum line 
If necessary, referral to a periodontist for a gum graft
Gum sensitivity
Gums include the layer of soft tissue that cover the bone and surrounds the root of the tooth, protecting your teeth’s nerve endings. As you age, your gums begin to wear down and recede. This recession can leave the roots of your teeth exposed, and can also make you more vulnerable to gum disease and infections. If your teeth are suddenly more sensitive than they used to be, and eating hot or cold foods makes you cringe, gum recession could be the culprit.
For many, gum sensitivity is a mild annoyance that can be relieved somewhat easily. However, if not treated it can become a sign of a serious problem. It’s important to understand why sensitivity occurs, as well as the symptoms and treatments for soreness.
If you have sensitive gums, in addition to soreness, you may observe redness or bleeding when you brush or floss your teeth, as well as bad breath. 
Treating sensitive gums
Sensitive gums are easily treated and can often be relieved at home. Some at home and over-the-counter methods are:
Improve your dental hygiene — brush your teeth regularly and floss daily
Use antiseptic mouthwash to kill the bacteria in your mouth
Make sure you are getting enough Vitamin C
Drink more water to help wash food and bacteria from your teeth and mouth
Quit smoking to heal your gums 
Practice stress management to reduce teeth clenching or grinding 
Use over-the-counter medications such as Orajel, to help ease sensitivity 
Sensitive teeth and/or gums can become painful if not treated. If you have tried the above recommendations and symptoms persist, you may need to see us for an evaluation to determine the cause and recommended treatment. 
As always, we encourage you to maintain routine dental hygiene appointments to best manage your oral health.  To schedule an appointment, please call the office at 978 664 3141, or complete the Contact form here: Contact Us.

Diabetes, Inflammation and Dental Care

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There are 29.1 million Americans living with diabetes. That’s almost 10% of the population! For diabetics, high blood sugar can take a toll on the entire body — including the teeth and gums. High blood sugar may also cause dry mouth and make gum disease worse. Because having less saliva allows more tooth-decaying bacteria and plaque to build up, it is essential for diabetics to control their blood sugar and get routine dental checkups. With good blood sugar control and dental care, you can minimize these problems. 
A diabetes primer
Diabetes occurs when a person’s blood glucose (or blood sugar) is too high. Blood glucose is your main source of energy and comes from the food you eat. If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as efficiently as it should. Insulin is a hormone that is made by cells in the pancreas. It controls the amount of sugar in the blood. When there isn’t enough insulin, too much blood sugar stays in your bloodstream, potentially causing serious health problems. An A1C test is a relatively simple blood test that gives you a picture of your average blood sugar level over the past few months. The higher the levels, the greater your risk of developing diabetes complications.
Oral health effects of inflammation
Researchers have learned that diabetics tend to have higher levels of inflammation in their bodies. Inflammation, high blood sugar, and therefore a higher A1C result can increase your body’s risk of infections and dental-related problems, including:
– Tooth decay (cavities)
– Early gum disease (gingivitis)
– Advanced gum disease (periodontitis)
– Thrush (yeast)
– Dry mouth
An assessment by the ADA based on substantial research notes that diabetes is a risk factor for gingivitis and periodontitis, and it may also increase risks of ongoing periodontal damage over time. Research also shows that gum disease can make it more difficult to control blood sugar. And thus begins a vicious cycle. Infections can cause your blood sugar to rise. This rise in blood sugar increases inflammation. The increase in inflammation can increase risk of infection.

Getting oral infections and gum disease under control can help treat diabetes and lower A1C levels. Patients with both gum disease and high levels of A1C will see a reduction in their A1C once the gum disease is treated — even if nothing else is changed. 
Diabetes and … {gulp}… the holidays!
During the holidays it is easy to be tempted to partake in fare including fatty meats and cheeses, fried foods and sweets. While restraint is advisable for everyone, making smart choices can help prevent inflammation and related risks associated with diabetes. With minor adjustments to standard recipe ingredients or creative diabetes-friendly recipes, you can relax and enjoy the holidays. View this selection of healthy and festive alternatives.
Minimizing inflammation
Patients with diabetes should be monitored more frequently to minimize inflammation and control gum disease or oral infections. Regular dental visits are the single most important thing diabetics can do for their oral health. In fact, those with diabetes should have dental checkups at least twice per year.
If you are concerned about visiting our office during these challenging times, we want to provide assurance that your safety is our number one priority. We have implemented extra safety measures to keep you safe and healthy, including installation of Surgically Clean Air’s JADE Air Purifier Systems, the most advanced medical grade systems on the market. And we abide by strict protocols for everyone in our office. 
Call us today to schedule your next dental exam.  978-664-3141

Social Distancing is for People – NOT Your Teeth!

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Kids aren’t the only ones to lose teeth. Adults can suffer tooth loss for various reasons, including trauma/accidents, gum disease, tooth decay and bruxism (grinding), as well as severely misaligned teeth. A lost tooth isn’t just bad for your smile, it is bad for your overall oral health. Losing one tooth actually makes it more likely that you’ll eventually lose more teeth … because the empty space results in increased reliance on the surrounding teeth, which can lead to fracture from overuse. You’re also more likely to develop infections with the newly empty space in your gums.
If you find yourself with a new space in your mouth, know you are not alone! It is estimated that 178 million Americans are missing at least one tooth. Losing a tooth doesn’t have to be a traumatic or terrible experience, and it can be easily fixed with dental implants, in most cases.
An implant is generally the preferred option for replacing a missing tooth because implants help to maintain facial contours and preserve the alignment of the surrounding teeth. Implants are also the only dental restoration option that preserves natural bone, actually helping to stimulate natural bone growth.
What is an implant and how does the process work?
Placing an implant requires careful preparation to assess the amount of bone where the implant will be placed, which ensures that there will be adequate support for the implanted tooth. The implant itself is essentially an artificial tooth root made of titanium. Over several months, the implant begins to fuse with the bone. After the fusing process, known as osseointegration, abutment posts are inserted into the implant, to allow for the permanent attachment of the replacement tooth.
Once the dental implant is sufficiently anchored in the bone, a crown can be placed onto it. A precise impression is taken of the implant, which will convey to the dental lab the size of the implant and its position in the jaw. With our in-office mill unit and dental lab, we are able to fabricate the crown on-site, saving time, improving oversight and providing tighter control of work quality. 
An abutment post is fabricated to enable permanent attachment of the replacement tooth. The customized crown is then seated onto the abutment and secured with either cement or via a screw. 
When multiple teeth are missing, implants can be utilized to create a dental bridge or even to restore an entire set of teeth in a way that is much stronger and retentive than a traditional denture.  
Are implants for everyone?
Almost! Implants are recommended for adults over the age of 18, because jaws and facial bones aren’t fully developed until adulthood. There’s a common misconception that there is an older age limit as well, but if you’re healthy and your jaw can support implants, you most likely are still eligible for dental implants, even as a senior. Age isn’t the only factor we consider when evaluating if implants are the correct way to go. We look at overall health and lifestyle as well. Some questions to ask yourself when deciding if implants are the right choice for you:
Do you regularly brush and floss? You need to maintain good oral hygiene to prevent bacteria from causing decay, cavities and, eventually, periodontal diseases like gingivitis.
Do you smoke or chew tobacco? Smokers are twice as likely to lose their teeth, compared with non-smokers. If you are considering getting implants, you will want to kick the tobacco habit.
How’s your diet? Teeth need a number of essential nutrients — like calcium, vitamin D, phosphorus, potassium and vitamin C — to stay strong. A diet lacking in those vitamins means your body doesn’t have the building blocks to keep your teeth strong, leading to increased risk for decay, breakage and tooth loss. Foods high in acid, sugar and carbohydrates are also shown to increase the plaque on your teeth, eventually leading to cavities and weakened teeth.
Do you have an autoimmune disease (like diabetes)? Any disease that affects your immunity can also cause tooth loss, because your body can’t fight off inflammation well. 
Depending on your answers to the questions above, dental implants may be the perfect choice for your smile! While your smile may be hidden behind a mask for a while longer, YOU will know it’s bright, beautiful, and most importantly – HEALTHY under there!
We would be happy to meet with you about your suitability for an implant. We will explain the entire process and discuss what you can expect. 
Contact us today: (978) 664-3141.

Stress Side Effects and Your Jaw

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Have you recently noticed that your teeth are sore or sensitive to cold? Do your jaw muscles hurt in the morning? Does your face ache?
You’re not alone. As a result of the stress of our current circumstances, many of our patients are noticing symptoms that they haven’t had before. In particular, a significant uptick in facial muscle pain and temporomandibular joint dysfunction (TMJ).
Many transient cases of TMJ can be managed by simply being more aware of your own behavior (such as clenching during the day), and taking measures such as eating a soft diet, massaging affected muscles, and applying a warm compress at night. However, there are times when the symptoms arise or are exacerbated by discrepancies in the way that your teeth come together.
The temporomandibular joint is a actually highly complex set of two joints that connect your jaw to your skull. Any symptoms related to the function of the joint are collectively referred to as TMJ syndrome and may include the following:
Common symptoms of TMJ include:
Headaches with any pattern or consistency. For example, waking up in the morning with a headache, or every afternoon while you are working, or after exercising.
Increased cold sensitivity or spontaneous throbbing
Aching, tired feeling in your facial muscles
Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth — or when chewing
Difficulty chewing or a sudden onset of an uncomfortable bite – as if the upper and lower teeth don’t fit together properly
What causes TMJ?
Common causes of temporomandibular joint disorder include excess stress on the joint associated with clenching or grinding teeth. The effect of the excess stress on the joint may be exacerbated by discrepancies in your bite. 
Bruxism is a condition that occurs when you unconsciously clench or grind your teeth during sleep. It is often associated with morning headaches or a feeling of tiredness in your jaw upon waking.
While stress-induced TMJ is the most common, TMJ facial pain may also result from a variety of other factors, such as genetics, arthritis or jaw injury. 
You don’t have to live with TMJ pain
In most cases, the pain and discomfort associated with TMJ disorders is temporary and may be relieved with self-managed care or nonsurgical treatments.
You may be able to help yourself by following some simple steps:  
Make a conscious effort to avoid clenching your teeth during the day. Lips together and teeth apart should become your mantra!
Try a soft diet.
Avoid chewy foods, like bagels or gum.
Apply a warm compress to the jaw muscles before bed to help relax the joints.
Some of the worst strain on your jaw may occur while you sleep, causing these issues to be particularly noticeable in the morning.  A custom-fitted dental night guard is a helpful appliance for treating TMJ disorder, because it can eliminate discrepancies in your bite that may trigger your symptoms and will effectively simulate a perfect bite.
If you have tried the above recommendations and symptoms persist, you may need to see us for an evaluation. Please call the office at 978 664 3141 or complete the Contact form here: Contact Us
Photo attribution: Kate Mango Star,

Invisalign Case Study

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In situations with spacing issues between the teeth, there are typically two alternatives for treatment. The spaces can be closed orthodontically or with some type of restorative material, such as bonding, veneers or crowns. Frequently, a combination of these treatment modalities is needed to reach an ideal end-result.  
Before: The situation
At a routine cleaning, the patient mentioned that he was unhappy with the spacing present between his upper front teeth. He didn’t like how his smile looked and wanted to know what could be done.  
Clinical Assessment
The spacing present in this patient was too large to close using restorative material alone – the teeth would end up looking too wide and disproportioned.  The patient also expressed that he wanted to avoid restorations if at all possible.  
This led us to a conversation about Invisalign treatment, which uses a series of customized clear plastic aligner trays to gradually shift the teeth over time. The necessary impressions and photos were taken and submitted to Invisalign.  
From these records, Invisalign developed a digital plan called a Clincheck®.  The Clincheck is a simulation that shows: 
* The current placement of the teeth
* How they would move through treatment
* What they would look like at the end of treatment
* How long the process will take 
It’s a tremendous tool that allows people to actually see the end result, as opposed to trying to visualize it on their own.  
Invisalign Clincheck Before
Invisalign Clincheck After
Action Plan (Ready, Set, Align!)
The patient was eager to see what could be done with Invisalign and opted to move forward with treatment. His personalized aligners were provided, and he used a new set of aligners every two weeks to gently shift the teeth. Typically patients are seen at six-week intervals to check on the progress and to ensure the teeth are tracking properly. 
After completing the final set of aligners, there was a significant reduction in the spaces between his teeth. However, some residual spacing remained. 
Moving teeth is not an exact science and sometimes teeth can be stubborn to move.  Recognizing this concern, Invisalign provides an option for additional aligners if the teeth don’t fully “cooperate.” There is typically little (or no) fee for these extra aligners. 
Although the residual spaces could have been closed with some simple bonding, the patient opted to continue with Invisalign. Additional aligners were provided.  
Through the additional aligners, we were able to get the spaces to fully close. While the process took a bit longer than initially anticipated, this “patient patient” was very happy with the results he obtained.
As is protocol with all Invisalign patients, a final check of the bite and alignment of the teeth was performed to ensure that all teeth ended up where they should be, and that the bite is even and comfortable. 
Retainers were then made to keep his new smile in place. Retainers are worn only at night and are included as part of the Invisalign treatment. 
Here’s what Jeff had to say about his Dental Health Concepts Invisalign experience:

“I’ve been going to DHC for over 10 years and continue to even after moving away from the area. That’s because they are amazing. The practice is super professional with a highly skilled, warm and friendly staff. Every time you go, you feel like part of their family. 
Recently, I took advantage of their Invisalign services. I could not be happier with the results. My teeth look better than I had expected and the team was so much fun and attentive through the entire process.
Special shout outs to my Invisalign team of Dr. Brian Crowley, Kerry Lee, Angela and my long-time dental hygienist, Donna Reid.  I love my trips to Dental Health Concepts!”
Jeff S.
Ask us about Invisalign

10 Dental Resolutions (With Tips to Make Them Stick)

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Taking steps to improve dental health is a critical part of overall health and wellness. Without proper oral care, you may be more prone to develop issues such as tooth decay, gingivitis or gum disease. Because diseases of the mouth can affect the rest of your body, it is important to maintain good oral health. With the “New Year, New You” mentality top of mind as we begin a new year, consider adopting some of these healthier dental habits.
1. Don’t rush when you brush.
Of course brushing at least twice daily is a must, but for optimal care, make sure you brush for two full minutes each time. If that sounds excessive, think of spending 30 seconds on each quarter of your mouth. There are fun apps which play two minutes of music to help you stay on track. Check out BrushDJ or the Disney Magic Timer. Also – be gentle on your gums! Try holding the toothbrush with only three fingers.
2. Floss like a boss.
It seems like a dentist’s mantra: “Make sure you floss every day!” While it’s easy to say we will be better about daily flossing, building a habit takes time. Research says it takes about three weeks. Try baby steps to make the habit a little easier. Start by keeping floss sticks in your briefcase, handbag or car to make it easier to floss after meals or snacks. Technically, floss sticks don’t clean as nicely as good old fashioned floss string, but they are a good start to get into the flossing habit.
3. Be picky if it’s sticky!
Banish the gooey stuff! Jelly beans, gummies, fruit snacks and other sticky foods can wreak havoc on your teeth. While all sugary treats contribute to  tooth decay, these gummy treats stick in the teeth, keeping the sugar and resulting acids in contact with your enamel for hours. Consider healthier alternatives like raisins, trail mix, fresh or frozen fruit or dark chocolate.
4. Drink wisely.
We all know eating candy and sweets can cause cavities … but have you stopped to think about what you drink? Even “naturally” sweetened juices and citrus-flavored waters may contain acids that can soften your enamel, increasing the risk of cavities and tooth decay. 
The American Dental Association recommends enjoying citrus-flavored waters in one sitting or with a meal and then allowing your teeth an opportunity to recover. It takes about 15 minutes for your teeth to buffer back to a normal pH after putting anything in your mouth other than water.
In this new year, resolve to pay attention to how much exposure your teeth get to acidic or sugary drinks.
5. ‘Til the cows come home!
Eating dairy products isn’t just great for your bones, it’s also great for your teeth. When you eat cheese, it calls up saliva which scrubs away plaque and other food bits on your teeth.
When socializing at a party or get together, opt for the cheese platter over sugary snacks or chips and salsa … your teeth will thank you!
6. Wet your whistle.
Prevent bad breath by addressing one of the major causes: Dry mouth! When your salivary glands don’t make sufficient saliva to keep your mouth wet, dry mouth (and bad breath) happens. Dry mouth can be a side effect of various medications — or it could be as simple as not drinking enough water. Daily flossing, mouthwash and chewing sugarless gum all help to curb dry mouth, but if you feel it’s a bigger issue, please talk to your dentist.
7. Chew on this!
Do you have a habit of crunching on ice cubes? Chewing ice can damage tooth enamel and cause cracks or chips in your teeth, which can lead to further problems such as increased sensitivity to temperature and pain. Instead, try chewing sugarless gum. However, if you just can’t beat the ice craving, replace the ice cubes with crushed ice. Crushed ice pieces are much smaller so they pose less risk to your tooth enamel.
8. We aren’t neanderthals.
Don’t use your teeth as tools! From prying open packages to popping off bottle lids — your teeth are not meant to be your tools! These activities put strain on your teeth and can cause them to crack or chip, which can be painful and pricey to fix. The solution?  Keep scissors and bottle openers handy and save your teeth for eating!
9. Mind the Grind.
Consider getting fitted for a custom mouthguard. As we age (and life gets more stressful), it’s not uncommon to clench or grind your jaw while sleeping. Not only can this behavior cause headaches and jaw pain, over time, it can wear down your teeth (which is irreversible). Often, we aren’t even aware that we are clenching or grinding our teeth! A quick trip to the dentist can determine if your teeth show evidence of clenching or grinding, and your dentist can fit you for a custom night guard.
10. Your smile deserves it.
As you age, the outer layer of enamel on your teeth gets worn away and reduces the translucency of the tooth, which causes a darker or yellowed appearance. If you are planning on making big changes this year (job interview or a special occasion), consider boosting your self-confidence and appearance with a younger, brighter smile. Whiter teeth make you look more successful, employable, attractive and even five years younger, according to a recent study conducted by Oral B. 

A lot of New Year’s resolutions focus on losing things (such as bad habits or body weight). For 2020, let’s change things up and make yours about gaining good habits for healthy dental care.
Try all of these dental resolutions or start with one or two to work your way toward optimal dental health. 
If it has been more than six months since your last dental cleaning, start those healthy habits now. Contact us today to schedule your appointment with one of Boston’s Top Docs!

SMILE for Fluoridated Tap Water

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Water is a necessity. We are fortunate to live in a country where clean, safe water is available at the turn of a tap; yet some hesitate to take advantage of this resource. There are several reasons to choose tap water over bottled water, cost certainly being one of them. However, the added fluoride in our local water is the best reason to start drinking from your faucet. 
What is fluoride and why does it matter?
Fluoride is a naturally occurring mineral that is released from rocks into the soil, water and air. It helps protect against cavities by decreasing demineralization of enamel caused by certain oral bacteria. It also inhibits the growth of oral bacterial enzymes. 
Because of its known healing benefits, fluoride is added to oral hygiene products such as toothpaste and oral rinses. Fluoride is also added to many municipal and other local water supplies. 
Numerous studies report that the benefits of fluoride far outweigh any possible risks. The Centers for Disease Control (CDC) notes benefits of fluoride for children under eight years of age include strengthening the adult teeth developing under the gums. And a study of children in Juneau, Alaska (where the water supply is not fluoridated) showed increased tooth decay and dental costs resulting from the non-fluoridated water. 
The dark side of fluoride (miniscule risks)
As with many things in life, too much of a good thing can be a bad thing. In very rare cases, excessive ingestion of fluoride can accumulate in the bones, causing harmful effects including increased risk of osteosarcoma (a cancer that starts in the bones). However, to be at risk, one would need to ingest enormous amounts of fluoride, such as eating a full tube of toothpaste. 
We all use toothpaste: Do we need fluoride in our water?  
The short answer is yes. Here are a few reasons why we advocate for fluoride in our water supply:
Prevents tooth decay & protects against cavities. Fluoride in water is the most efficient way to prevent one of the most common childhood diseases – tooth decay. Community water fluoridation is so effective at preventing tooth decay that the Centers for Disease Control and Prevention named it one of 10 great public health achievements of the 20th century! Studies show that fluoride in community water systems prevents at least 25% of tooth decay in children and adults.
Safe and effective. For 70 years, the best available scientific evidence consistently indicates that community water fluoridation is safe and effective. When municipalities add fluoride to the water supply, they adhere to the recommended limit of .7mg of fluoride per liter of water. Fluoridation has been endorsed by numerous U.S. Surgeons General, and more than 100 health organizations recognize the health benefits of water fluoridation for preventing dental decay, including:The Centers for Disease Control and Prevention
American Medical Association 
World Health Organization
American Dental Association
American Academy of Pediatrics

Saves money. Aside from the obvious savings over purchasing buying bottled water, there are abundant savings in choosing to drink fluorinated tap water. The average lifetime cost per person to fluoridate a water supply is less than the cost of one dental filling. The CDC reports that for most cities, every $1 invested in water fluoridation saves $38 in dental treatment costs. 
It’s natural. Fluoride is naturally present in groundwater and the oceans. Adding fluoride to water supplies can be likened to fortifying other foods and beverages, such as fortifying salt with iodine, milk with vitamin D, orange juice with calcium and bread with folic acid. 
Is there fluoride in your tap water?
Despite the meaningful benefits of added fluoride to community water, some community water systems, including Wilmington and parts of Methuen, do not add fluoride to their town water supply. And many condominium and apartment complexes in Middlesex County with independent water systems to supply their residents do not fluoridate their water.
About 70% of Massachusetts towns do offer fluorinated water. The State Department of Public Health recommends a limit of .7mg per liter, to which Massachusetts strictly adheres. To find out if your community adds fluoride to the water supply, visit or check with the Department of Public Works in your town.   
If you have questions about fluoridated water and its impact on your oral health, please feel free to discuss with your dentist. 

Oral Health During Cancer Treatment

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The American Cancer Society reports that nearly 40% of us will be diagnosed with cancer at some point during our lifetime. While living a healthy lifestyle may improve your odds of avoiding cancer, other factors — such as genetics — may make a cancer diagnosis more likely.  
As anyone who’s undergone radiation or chemotherapy knows too well, cancer treatment can have effects on your entire body. According to the National Institutes of Health, almost 40% of all patients receiving chemotherapy have resulting oral complications. 
Complications can be caused by the treatment itself or can be side effects resulting from the treatment. And while the most acute effects typically dissipate or disappear when the treatment is completed, indirect complications can be longer lasting. The National Institute of Health recommends proactive treatment to address oral problems prior to commencing cancer treatment, if possible.
3 Common Oral Complications of Cancer Treatment
Oral Infections and Mouth Sores
When radiation and chemotherapy attack the cancer cells in your body, they don’t distinguish the good cells from the bad ones, which results in a weakened immune system. When your immune system is compromised, it’s less effective at killing off the harmful bacteria in your mouth. Oral infections and mouth sores can be the result.
Changes to Taste Buds and Loss of Appetite
Chemotherapy and radiation therapy may cause changes to your gums, tongue, lining of your mouth and salivary glands, which can upset the healthy balance of bacteria. Inflamed mucous membranes and taste bud changes often result and may cause decreased appetite and poor nutrition. 
Dry Mouth, Tooth Decay and Gum Disease 
Radiation treatment causes reduction of saliva or negatively impacts its quality, leading to dry mouth — which can cause discomfort, difficulty speaking and bad breath, as well as lifelong increased risk of cavities. Gum disease and tooth decay can occur due to chemical changes in the mouth resulting from chemotherapy. 
5 Ways to Minimize Oral Complications of Cancer Treatment
Routine preventative dental exams (including cleanings) are generally not recommended during most cancer treatment because of the mouth sores commonly seen in patients. However, good oral care can help you stay healthy during treatment. Here are some helpful tips:
Gently brush your teeth at least twice daily with an extra soft brush and fluoride toothpaste. Rinse the toothbrush in warm water first to soften the bristles. 
Use a different approach after vomiting:  Nausea is a common side effect of some cancer treatments. Do not brush your teeth immediately after vomiting. Stomach acid weakens the enamel on your teeth, so brushing them right away can cause the enamel to erode. Instead, after vomiting, rinse your mouth thoroughly with water and then use an over-the-counter mouthwash with fluoride or a fluoride rinse (like ACT). Also helpful are toothpastes with prescription levels of fluoride and application of fluoride varnish at hygiene visits.
Floss and rinse daily. If your gums bleed and hurt when flossing, avoid the areas that are sore but continue to gently floss your other teeth. Also rinse your mouth several times daily with a solution of ¼ teaspoon salt or one teaspoon of baking soda in 8 ounces of warm water to provide a neutral, soothing solution for the mucous membranes. Follow with a plain water rinse.     
Use alcohol-free mouthwash to remove food particles left after brushing and flossing. Mouthwashes with alcohol in them can upset the natural balance of saliva that is necessary to flush out bacteria. The alcohol can also be caustic and cause increased dry mouth symptoms.
Eat healthy foods and drink lots of water. Cancer treatment can alter your sense of taste, making foods seem too sweet, salty or entirely void of flavor. As it’s especially important to ensure good nutrition at this time, try a wide variety of foods to ensure you’re maintaining adequate calorie intake. During chemotherapy, frequent small meals that are light and bland tend to be tolerated the best.
When being treated for cancer, be sure to talk regularly with your oncologist and dentist about any mouth problems you have. And consider programs offered through LIVESTRONG and other organizations to help with the emotional effects of cancer diagnosis and treatment.

Athletics Are Not All Fun & Games

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Sports safety tips and equipment including mouthguards & sugar in sports drinks 
As parents, we want our children to thrive. We guide and encourage healthy choices and activities, including exercise. Whether your kids have athletic prowess or are part of the support team, involvement with a sport is beneficial in many ways – building strength and muscle tone, interacting with others, stress release and more. But athletics are not all fun and games. Sports safety is crucial.
With very young children, parents are essentially in control, ensuring our kids’ safety and overseeing their choices. Once kids are in school, we’re still very involved, often packing their gear and serving as parent taxis for activities, practices and games. Sitting on the sidelines of lacrosse matches or in the stands at the ice rink, we can stack the deck in our kids’ favor, making sure their helmet, water bottle and mouthguard are easily accessible.
These are the years to educate, to help your child build responsible habits for sports safety. Some kids listen and learn; others need scare tactics like photos or stories about life after a head injury, root canals due to broken teeth and potential lasting health effects due to dehydration. Whatever it takes. 
Once in middle school, many kids are inclined to shrug free of (possibly overbearing?) parental involvement and follow the lead of their peers. While we want to encourage our kids’ growth and foster their independence, we also know that those peers aren’t always making the best choices. And fitting in can prevail over personal safety and healthy choices. 
Five important facts about sports health and safety
1. Thumbs-down for sugars and sweeteners
The global sports drink industry is gigantic and growing … expected to reach $5.92 billion by 2021 (Reuters).
While the main ingredient in sports drinks is water, they also contain carbohydrates, mostly in the form of sugars like glucose, sucrose and fructose. These sugars provide unnecessary calories, are bad for teeth and can offset the positive calorie-burning benefits of exercise. Furthermore, high carbohydrate beverages take longer to actually hydrate you. Running expert Coach Jeff of RunnersConnect notes that as a general rule, the higher the carbohydrate content of your beverage, the slower the absorption rate will be. 
While low-calorie sports drinks have less sugar, they often contain artificial sweeteners and colors — both undesirable chemical additives.
2. Helicopter parents need not hover
In the greater majority of cases, simple common sense can help people to avoid dehydration. A player experiencing a cramp or pain needs to slow down and walk it off. Likewise, a player who is thirsty needs to drink. Dr. Francis Wang, the team physician for Harvard athletics, tells his athletes, “for most players, thirst is a good guide for hydration.” It’s as simple as that.
3. Most of us aren’t running marathons
Sports drinks include electrolytes (like sodium and potassium) and carbohydrates (sugars, including glucose, sucrose or fructose). Sports drinks “were originally developed for hard-core athletes to replenish electrolytes, such as sodium and potassium, that are lost in sweat, plus carbohydrates that muscles use for fuel,” notes Amy Keating, RD, a nutritionist for Consumer Reports. “The average exerciser needs to replace water, not electrolytes.” 
WebMD agrees, stating “for most outdoor activities, good old-fashioned tap water does the trick.” Bonus: In most towns, tap water is enriched with fluoride, a mineral that is beneficial for your teeth. 
Worth repeating: Water is the best method of hydration unless you’re an endurance athlete.
4. Teeth don’t grow back
Chances are one of your child’s teammates (or your own child) has suffered a sprained ankle, torn tendon or broken bone. And while any of those injuries may result in the end of a season or even a spot on the team, they generally heal in time or can be surgically repaired if necessary. 
Teeth, on the other hand, don’t heal. The National Youth Sports Foundation for Safety reports that an athlete is 60 times more likely to sustain damage to the teeth when not wearing a protective mouthguard. Damage can include broken or chipped teeth as well as nerve damage to a tooth, which could necessitate a root canal.
The Cleveland Clinic recommends use of mouthguards not only in organized sports (where they may be mandated), but also in non-contact sports and recreational activities such as mountain biking. Cleveland Clinic sports and exercise medicine physician Anne Rex, DO, FAOASM advises parents to require that their children wear mouthguards from a young age and to consider the mouthguard an essential element of their gear.
5. Concussions are not child’s play
Where the possibility of brain injury is involved, there’s no such thing as excessive caution. Concussion protocols are prevalent today in sports at every level. Sports and exercise medicine physician Anne Rex notes that “mouthguards may also reduce the severity of concussion, helping to redistribute forces from a blow to the head, which in turn can reduce the severity of a concussion.”  
Keep your kids and yourself healthy and safe with common sense practices about sports safety. 
Questions about mouthguards? Don’t hesitate to ask. We’re here to help. 

Men’s Health Month: Dental Exams and Healthy Sleep

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According to research published in the Journal of Periodontology, women are almost twice as likely to have received regular dental checkups in the past year, scheduled the recommended treatment and had better indicators of periodontal health.
Unfortunately for men, a casual approach to dental health could lead to some serious health issues. Routine visits to the dentist not only help prevent damage to the teeth, gums and mouth, but an exam of your mouth and teeth can also detect major (dental and medical) health conditions, so that they can be proactively addressed.
For instance, sleep disordered breathing affects almost 50% of men. If left untreated, sleep disorders like sleep apnea can lead to major health conditions including high blood pressure, stroke, heart problems, diabetes, depression and worsening of ADHD.
The good news is sleep disorders can often be detected and even treated at a routine dental exam. The mouth and teeth offer clues … here are some of the telltale signs that you should not ignore.
Worn Teeth
Worn or cracked teeth are often an indication of teeth grinding or bruxism.  This condition usually occurs while sleeping and is frequently linked to sleep apnea. Nearly one in four people with obstructive sleep apnea grind their teeth at night.
Enlarged Tonsils
Large tonsils are often a cause of obstructed breathing and snoring. A simple routine dental exam can determine if your tonsils are larger than normal and may be the first indication of a sleep disorder.

“It’s hard to overstate the value of a great dentist. Dr. Tonelli improved my quality of life and, possibly saved my life, with a simple visual exam. Even after religiously having annual physicals, Dr. Tonelli was the only professional to identify that I had a high risk of having sleep apnea due to my enlarged tonsils. Well, one primary care doctor visit, a visit to a throat specialist, a sleep study, a diagnosis of “severe obstructive sleep apnea” and a visit to a sleep specialist later, I am now the proud owner of a CPAP machine, experiencing the most restful sleep I’ve had in a very long time, and feeling energized all day long without the help of caffeine. My wife is just as thankful for Dr. Tonelli as I am, since now she can also get a good night’s sleep. A tradition of dental excellence, indeed!”
-R.D., patient

Repeated Cavities
Mouth breathing is common among those suffering from sleep apnea. While breathing through your mouth may sound harmless, this habit can lead to a dry mouth and a decrease in saliva, which helps to wash away food debris and reduce plaque. Less saliva also means higher levels of acidity in your mouth, an environment that’s beneficial for the growth of bacteria — increasing your likelihood for cavities.
In honor of June Men’s Health Month, please make an appointment for a routine dental exam for yourself or the special man in your life. Sleep apnea is a serious condition, but there are so many treatment benefits –including controlled risk for high blood pressure, heart disease, stroke, diabetes and memory loss, plus increased energy.