Most childhood sicknesses are highly treatable and quickly fade from memory afterward. But there's one viral infection that can reappear years later, albeit in a different form and this time it might not be as forgettable. It could even impact your dental care.
Varicella, more commonly known as chicken pox, is a viral infection that mainly affects children. Fortunately, the itchy blisters and other symptoms associated with it usually clear up on their own. But the virus itself, varicella zoster virus (VZV), can remain behind and become dormant.
Fast-forward a few decades, and the child once with chicken pox is now an adult, usually over 50. In 20-30% of former chicken pox patients, the virus reactivates as a new infection known commonly as shingles.
Shingles often begins with an itching, burning or numbing sensation on the skin that develops into a severe rash. Because of its effect on surface nerves, the rash often takes on a striped or belt-like pattern on the skin. A shingles outbreak can also cause fever, fatigue and pain, the latter of which in rare cases can be quite severe.
Shingles in its early stages is also highly contagious, transmitted easily through either physical contact with the skin lesions or through airborne secretions. This is especially troubling for certain groups: pregnant women, patients undergoing cancer or other serious disease treatment, or those with compromised immune systems. For them, shingles can pose a significant risk for complications.
Because of its easy transmission, and the danger it can pose to certain groups, dentists typically postpone treatment—even routine dental cleanings—for patients experiencing a shingles outbreak, especially a facial rash. Once their outbreak subsides, those procedures can be rescheduled.
If you develop what you think is shingles, you should seek medical attention as soon as possible. Certain prescribed antiviral medications can ease the symptoms and hasten recovery, but they're most effective if started within three days of the onset of the disease. There's also an effective vaccination for shingles recommended for people over 60 to help avoid the disease altogether.
One other thing! If you do develop shingles and have an upcoming dental appointment, let your dentist know. Better to reschedule your visit after you've recuperated than to put others' health at risk.
If you would like more information on shingles and dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Shingles, Herpes Zoster.”
A popular Sixties-era hair cream touted their product with the tagline, "A little dab'll do ya!" In other words, it didn't take much to make your hair look awesome.
Something similar could be said about fluoride. Tiny amounts of this "wonder" chemical in hygiene products and drinking water are widely credited with giving people a big boost in protection against tooth decay.
A Colorado dentist is credited with first noticing fluoride's beneficial effects early in the Twentieth Century. Although many of his patients' teeth had brownish staining (more about that in a moment), he also noticed they had a low incidence of cavities. He soon traced the effect to fluoride naturally occurring in their drinking water.
Fast forward to today, and fluoride is routinely added in trace amounts to dental care products and by water utilities to the drinking water supply. It's discovery and application have been heralded as one of the top public health successes of the Twentieth Century.
Fluoride, though, seems a little too amazing for some. Over its history of use in dental care, critics of fluoride have argued the chemical contributes to severe health problems like low IQ, cancer or birth defects.
But after several decades of study, the only documented health risk posed by fluoride is a condition called fluorosis, a form of staining that gives the teeth a brown, mottled appearance (remember our Colorado residents?). It's mainly a cosmetic problem, however, and poses no substantial threat to a person's oral or general health.
And, it's easily prevented. Since it's caused by too much fluoride in prolonged contact with the teeth, fluorosis can be avoided by limiting fluoride intake to the minimum necessary to be effective. Along these lines, the U.S. Public Health Service recently reduced its recommended amounts added to drinking water 0.7 milligrams per liter (mg/L) of water. Evidence indicated fluoride's effectiveness even at these lower amounts.
You may also want to talk with your dentist about how much fluoride your family is ingesting, including from hidden sources like certain foods, infant formula or bottled water. Even if you need to reduce your family's intake of fluoride, though, a little in your life can help keep your family's teeth in good health.
If you would like more information on the benefits of fluoride in dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”
Buffalo Bills wide receiver Stefon Diggs wrapped up the NFL regular season in January, setting single-season records in both catches and receiving yards. The Bills handily beat the Miami Dolphins, earning themselves the second seed in the AFC playoffs, and Diggs certainly did his part, making 7 catches for 76 yards. But what set the internet ablaze was not Diggs' accomplishments on the field but rather what the camera caught him doing on the sidelines—flossing his teeth!
The Twitterverse erupted with Bills fans poking fun at Diggs. But Diggs is not ashamed of his good oral hygiene habits, and CBS play-by-play announcer Kevin Harlan expressed his support with “Dental hygiene is something to take note of, kids! There's never a bad place to floss” and “When you lead the NFL in catches and yards, you can floss anytime you want.”
We like to think so. There's an old joke among dentists:
Q. Which teeth do you need to floss?
A. Only the ones you want to keep.
Although this sounds humorous, it is borne out in research. Of note, a 2017 study showed that people who floss have a lower risk of tooth loss over periods of 5 years and 10 years, and a 2020 study found that older adults who flossed lost an average of 1 tooth in 5 years, while those who don't lost around 4 teeth in the same time period.
We in the dental profession stress the importance of flossing as a daily habit—and Stefon Diggs would likely agree—yet fewer than 1 in 3 Americans floss every day. The 2016 National Health and Nutrition Examination Survey (NHANES), conducted by the CDC's National Center for Health Statistics, revealed that only 30% of Americans floss every day, while 37% floss less than every day and 32% never floss.
The biggest enemy on the football field may be the opposing team, but the biggest enemy to your oral health is plaque, a sticky film of bacteria and food debris that builds up on tooth surfaces. Plaque can cause tooth decay and gum disease, the number one cause of tooth loss among adults. Flossing is necessary to remove plaque from between teeth and around the gums where a toothbrush can't reach. If not removed, plaque hardens into tartar, which can only be removed by the specialized tools used in the dental office. Regular professional dental cleanings are also needed to get at those hard-to-reach spots you may have missed.
If Diggs can find time to floss during a major NFL game, the rest of us can certainly find a couple minutes a day to do it. While we might not recommend Diggs' technique of flossing from one side of the mouth to the other, we commend his enthusiasm and commitment to keeping his teeth and gums healthy. Along with good dental hygiene at home—or on the sidelines if you are Stefon Diggs—regular professional dental cleanings and checkups play a key role in maintaining a healthy smile for life.
After months or even years of radiation or chemotherapy, the words "cancer-free" is music to your ears. Your joy and relief, though, may be tempered by the toll these treatments can take on the rest of your body—including your mouth.
Both of these treatments can destroy healthy tissue along with targeted cancer cells. If the focus has been on the head and neck regions, they could damage the salivary glands to the point that they won't produce adequate saliva flow.
A lack of saliva can have a detrimental effect on your oral health. Saliva buffers and helps lower oral acid levels that soften and erode enamel and increase the likelihood of tooth decay. Saliva also supplies antibodies that fight disease-causing bacteria. Otherwise, bacteria—and the risk for disease—can rapidly grow.
If these or other scenarios occur, you may experience dental damage, even tooth loss. Fortunately, we can restore an injured smile in various ways, including dentures, bridges or dental implants. But we should also attempt to limit the potential damage by taking steps to prevent dental disease during cancer treatment.
The most important of these is to brush and floss daily. Everyone should practice these hygiene tasks to remove disease-causing dental plaque, regardless of their health status. But because some natural disease-fighting mechanisms in the mouth may be disrupted during either radiation or chemotherapy, it's even more important if you're a cancer patient.
It's equally important to maintain as much as possible regular dental visits during cancer treatment. Dental cleanings provided during these visits remove any residual plaque and tartar (hardened plaque), which further lowers your disease risk.
Your dentist can better monitor your overall dental condition during frequent visits and provide as much treatment as you can tolerate. They can also enhance your protection against disease by prescribing antibacterial mouthrinses, fluoride applications or products to boost saliva production.
Some teeth and gum problems may be unavoidable; in that case, you may need post-treatment dental care to restore your oral health as needed. But caring as much for your dental health as you're able during cancer treatment could help you realize a better outcome.
Although getting an implant requires surgery, it's usually a minor affair. Chances are good that after just a few days recuperation you'll be back completely to your normal activities.
But like many other minor surgeries, an implant procedure does pose a slight risk of post-op infection. That's especially so with any dental procedure like implant surgery, since the mouth harbors numerous strains of bacteria that could escape into the bloodstream. For most people, though, a post-op infection doesn't pose a major problem since their immune system kicks in immediately to defeat it.
But some patients with less than robust immune systems or other health problems can have serious complications from an infection. Among other things, infected tissues around an implant may not heal properly, putting the implant at significant risk for failure.
If you have a condition that makes a post-op infection problematic, your dentist or physician may recommend you take an antibiotic before your procedure. Known as prophylactic (preventive) antibiotic treatment, it's intended to give a weakened immune system a head-start on any potential infection after a procedure.
Using antibiotics in this way has been a practice for several decades, and at one time were recommended for a wide list of conditions. That's changed in recent years, though, as evidence from numerous studies seems to show the risk to benefit ratio isn't significant enough to warrant its use in all but a handful of conditions.
Both the American Dental Association and the American Heart Association recommend prophylactic antibiotics for patients with prosthetic heart valves, past infective endocarditis, a heart transplant and some congenital heart conditions. Some orthopedists may also recommend it for patients with prosthetic joints.
Even if you don't fall into these particular categories, prophylactic antibiotics may still be beneficial if you have a compromised immune system or suffer from a disease like diabetes or lung disease. Whether or not a prophylactic antibiotic is a prudent step given your health status is a discussion you should have with both your physician and your dentist.
If they feel it's warranted, it can be done safely in recommended doses. If your health isn't as robust as it could be, the practice could give you a little added insurance toward a successful implant outcome.
If you would like more information about dental implant surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implants & Antibiotics.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.