HPV – How The Virus Relates To Oral & Throat Cancers

Posted on Feb 17, 2022 by William J. Claiborne, DDS MS

Every April, a number of oral health and cancer organizations come together to recognize Oral Cancer Awareness Month on a national basis. This is meant to expand awareness of this cancer, which takes a victim every hour of every day. Of those individuals, 43 percent will not survive longer than five years. Those who do survive may suffer from problems, such as severe facial disfigurement or difficulties with eating and speaking.

Oral cancer includes cancer of the mouth and upper throat, known as oropharyngeal cancer. The death rate associated with oral and oropharyngeal cancers is particularly high largely because detection typically occurs late in its development. However, when oral cancer is detected and treated early, treatment-related problems are reduced and with improved survival rates.

Annual oral cancer examinations during regular dental check-ups are the best method for detecting oral cancer in its early stages. It is also important to respond immediately to signs and symptoms of oral cancer, which include:

• A sore or ulceration that does not heal within 14 days;
• A red, white, or black discoloration of the soft tissues of the mouth;
• An abnormality that bleeds easily;
• A lump or hard spot in the tissue, usually border of the tongue;
• Raised tissue or a newly emerged growth;
• A sore beneath a denture or partial that does not heal;
• A lump or thickening that develops in the mouth; and
• A painless, firm, fixated lump on the outside of the neck that does not go away within two weeks.

Historically, factors that can contribute to having a higher risk of oral and oropharyngeal cancers have been heavy drinkers and smokers older than age 50. However, in recent years the cancer is occurring more often in nonsmoking people due to HPV 16, the virus most commonly associated with cervical cancer.

The human papilloma virus 16 (HPV) is sexually transmitted, although it is a different virus than HIV or (HSV) herpes. HPV is now the most common sexually transmitted infection (STI) in the United States.

Exposure can occur by having vaginal, anal, or oral sex with someone who has the virus. It most commonly spreads during anal or vaginal sex. It can also spread through close skin-to-skin touching during sex. HPV can spread even when a person with the infection has no signs or symptoms.

There are many different types of HPV; most do not cause any health problems. Most individuals who get HPV never have symptoms and the virus goes away by itself. But, if HPV does not go away, it can cause genital warts or certain kinds of cancer. Symptoms can appear years after having sex with someone who has the infection.

Approximately 99 percent of people who develop HPV will clear the virus on their own. In approximately 1 percent of individuals, the immune system will not clear the virus and it can lay dormant for decades before potentially causing a cancer.

HPV itself isn’t a cancer but it can cause changes in the body that lead to cancer. Because of the growing rate of HPV, the increasing incidence of oropharyngeal cancer have been particularly concerning for younger age groups. Within the age range of 15 to 59, 40 percent will have HPV. This is an alarming rate for people with no other risk factors.

HPV-related oral cancer most commonly involves lymphoid tissue in the tonsils or the base of the tongue. Signs and symptoms of HPV-caused oropharyngeal cancer may include one or more of the following:

• Hoarseness or sore throat that does not resolve within a few weeks;
• A swollen tonsil on one side (usually painless);
• A painless, firm, fixated lump felt on the outside of the neck, which has been present for two weeks or more;
• A persistent cough that does not resolve after many days;
• Difficulty swallowing or feeling something is caught in your throat; and/or
• An earache on one side that persists for more than a few days.

https://oralcancerfoundation.org/april-is-oral-cancer-awareness-month-2021/

https://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm

Cervical cancer is the most common HPV-associated cancer among women (48 percent), and oropharyngeal cancers (82 percent) are the most common among men. The diagnosis may not be until years, or even decades, after a person gets HPV. Currently, there is no way to know who will get cancer after getting HPV.

https://www.cdc.gov/cancer/uscs/about/data-briefs/no26-hpv-assoc-cancers-UnitedStates-2014-2018.htm

HPV vaccines can prevent some of the health effects HPV causes. Once acquired, however, there is no specific treatment for HPV although there are treatments for health problems that develop from HPV, such as genital warts. Your healthcare provider can treat genital warts with prescription medication.

Because cancers from HPV are more treatable when found and treated early, it is important for those who acquire the virus to be especially diligent in having oral cancer screenings and promptly responding to any signs or symptoms (as mentioned above).

The HPV vaccine is safe and shown to be effective at preventing the virus. Like any vaccine, side effects can occur, which are typically short-lived and mild, such as headache, fatigue, fever or nausea. Most people have no side effects at all.

You are also urged to be committed to your 6-month dental exams. This provides your dentist an opportunity to note any suspicious areas in the mouth or on the lips. If you have not had regular dental check-ups, you may need to begin by seeing a periodontal specialist.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease (a chronic inflammatory disease that affects the gums and bone supporting the teeth also known as gum disease), and in the placement of dental implants. Periodontists receive extensive training in both of these areas and more, including three additional years of education beyond dental school.

As a periodontal specialist in Asheville for over 25 years, I take great pride in making our patients feel comfortable and understanding of their particular oral health status. If oral problems exist, we are able to resolve many with conservative treatment measures. Our Western NC periodontal dental office features some of the most advanced technology available to minimize treatment needs, treatment time, and speed healing with comfort always a priority. Oral and IV sedation are available.

To schedule an appointment, call 828-274-9440. New patients are always welcome and a referral is not required.

The Hazards of Vaping Now Include Bone Health

Posted on Jan 12, 2022 by William J. Claiborne, DDS MS

If you’ve switched to vaping (e-cigarettes) as a “safer” alternative to smoking cigarettes, you may have heard that researchers have found this to be a misleading claim, in many regards.

Based on a study published in the American Journal of Preventive Medicine, people who vape have higher risk of developing asthma and chronic obstructive pulmonary disease (COPD). The European Journal of Preventive Cardiology also reports an increased risk of heart problems. Further, the American Lung Association warns that vaping causes a potentially higher cancer risk due to their dangerous mix of chemicals, including acrolein. (Acrolein is toxic to humans when inhaled, resulting in irritation to the upper respiratory tract.)

Now, another health risk has been revealed through research: bone health. In a study of over 5,500 adult users of e-cigs, it was noted that electronic cigarettes may be detrimental to bone health, even in young people. The study, published in the American Journal of Medicine Open, found that people who vape had a 46 percent greater rate of bone fractures.

To make matters worse, the study also found that people who vape in addition to smoking cigarettes have a greater fracture risk than those who are conventional smokers only.

A review in Bone Biology suggests there is negligible difference between vaping and cigarette use when it comes to bone health. It showed that nicotine exposure, regardless of the source, impairs the production of essential cells. Add to that the flavoring chemicals in e-liquids (often known as vaping juice), which are suspected to alter the body’s ability to form new bone.

https://www.thehealthy.com/addition/smoking/does-vaping-affect-your-bone-health/

How this occurs has to do with the inflammatory effects of the nicotine. To retain strength and mass, bones need a sufficient supply of minerals (such as calcium and phosphorus) and nutrients (such as vitamin D). In-depth research published by the European Journal of Clinical Nutrition revealed that smoking interferes with how the bones absorb these essentials. The result is the body’s reduced ability to maintain skeletal strength.

What is frustrating is that vaping hit the market touting itself as a “safer” option than tobacco cigarettes. In 2019, the U.S. Food & Drug Administration took issue with these claims, especially those by the vape pen manufacturer Juul, who marketed its product as a “modified risk” tobacco product, although research did not exist to back its “safer” claim. To the contrary, as research digs deeper and deeper into the risks associated with vaping, data continually stacks up as anything but.

https://www.usnews.com/news/health-news/articles/2021-10-20/switch-to-vaping-wont-help-ex-smokers-quit-for-good-study

Certainly, there are other contributing factors to compromised bone health. These include:

• Heavy alcohol use
• Being inactive
• A diet low in nutrients like calcium, phosphorus, and vitamin D
• Excessive dieting

Age, menopause, and having a family history of osteoporosis also affect your risk. Too, people with medical conditions (such as hyperthyroidism or anorexia), or taking medications (such as long-term corticosteroids) have a higher risk of bone thinning.

As a dental specialist, the findings associated with bone health are particularly concerning because teeth are enamel-covered bones that protrude above the gum line. Teeth are anchored by bone sections below the gum (tooth roots) and embedded into more bone – the upper or lower jaw bones.

For those who want to quit smoking and have turned to vaping as an aid, the odds aren’t good for successful results. Researchers found that among Americans who’d recently quit smoking, those who were using e-cigarettes were just as likely to relapse in the next year as non-users were.

Findings of one study reported that not only does vaping fail to help former smokers abstain from traditional cigarettes, the risk of relapse was actually slightly higher.

In order to maintain good oral health, it is especially important for smokers and vapers to be committed to a thorough at-home oral care regimen. This includes twice daily brushing, daily flossing and drinking plain water throughout the day. To combat dry mouth, consider using an oral rinse that is specifically formulated to replenish moisture (available OTC).

This should be coupled with having regular dental checkups and cleanings, starting with an examination by a periodontal specialist. A periodontist is a dentist who has received advanced training in the diagnosis and treatment of all stages of gum disease as well as in the placement of dental implants.

Symptoms of gum disease include tender gums that may bleed when brushing, swollen gums that turn red in color, receded gums, and persistent bad breath. As gum disease worsens, pus pockets can form on the gums at the base of teeth and the gum tissues become spongy. Teeth may loosen and may require removal.

Because the initial symptoms of gum disease are not always obvious, a periodontist can determine if gum disease does exist. If it does, he or she can discuss the most conservative treatment necessary to restore your gums to good health and then develop a program to help keep them so.

Our goal is to help each patient achieve a healthy smile for life. For patients who wish to achieve this, we work with each according to individual needs. Through a customized treatment plan, your oral health can be a positive part of your overall health. Call 828-274-9440 for an appointment.

 

Cut Dental Costs With Simple Steps

Posted on Dec 15, 2021 by William J. Claiborne, DDS MS

In order to avoid costly repairs on our vehicles, we rotate our tires, have the oil changed periodically, and make sure certain fluids are at sufficient levels. This is why our annual inspections are so important; risks can be pointed out to keep us safely on the road.

The same is true with our family’s health. We stay proactive by eating healthy, staying active and having regular check-ups along with periodic screenings.

It simply makes sense to be committed to preventing problems or catch any that do arise at early stages. Research has shown that your oral health deserves the same commitment you give to maintaining a healthy body.

Studies have found a correlation between the bacteria of periodontal (gum) disease and serious problems elsewhere in the body. These include heart disease, stroke, diabetes, arthritis, preterm babies,  impotency and more.

Another reason to maintain a healthy smile is to save money. By devoting about 5 minutes per day to your oral hygiene routine, coupled with having dental exams and cleanings every six months, you can prevent many problems from occurring in the first place. The reward is a savings in time and expense that may be needed for repairs – repairs that may have been prevented from occurring in the first place.

Your twice-a-year dental check-ups are opportunities to remove tartar. Tartar is a cement-hard mass of oral bacteria that forms when plaque (the sticky film that coats teeth and gums) is not removed thoroughly attaches to teeth and can no longer be brushed or flossed away.

Both plaque and the hardened mass of tartar are the result of accumulated bacteria. Oral bacteria continually reproduce in the mouth, which provides a warm, dark and moist environment. As they thrive and reproduce, they attack gum tissues.

As they amass to levels beyond what the immune system, oral bacteria can lead to gingivitis (an early stage of gum disease). Unresolved, gingivitis can develop into periodontal disease, an infection. Eventually, periodontitis develops, which is an advanced level of gum disease. At this level, teeth often loosen and must be removed.

While gingivitis causes tender gums to bleed when brushing, periodontal disease symptoms are more severe, including persistent bad breath, sore gums that bleed easily, gums that darken in color, receded gums, and pus pockets that form between teeth.

As devastating as adult tooth loss can be, the potent bacteria of gum disease can enter the bloodstream through tears in disease gum tissues. Research has shown the infectious bacteria of gum disease can activate or worsen the development of certain pathogens.

Obviously, oral bacteria is highly potent. However, it’s easy to control with twice daily brushing and daily flossing combined with regular dental checkups. For added protection, limit sugary snacks and either swish after eating or chew sugarless gum when brushing is inconvenient. Not only will you help to reduce your risk for cavities and gum problems, you’ll be able to enjoy fresher breath and smiling confidence.

It is also important to respond early to signs and symptoms of gum disease. As mentioned above, things like frequent bad breath or seeing blood in the sink when brushing are warning signs that something is wrong.

A periodontist is a dentist who has specialized skills in the diagnosis and treatment of all levels of periodontal disease. He or she can also recontour the shape of gums and place dental implants for optimal results.

If you have not seen a dentist on a regular basis, you may be experiencing symptoms that indicate gum disease. As you would respond to a warning sign with your overall health, so should you with your oral health.

Begin with a thorough examination to determine what your needs are and the best way to achieve and maintain good oral health. You’ll be supporting your overall health in addition to having a confident smile.

If dental fear has prevented you from having regular dental care, ask about sedation options. We offer both oral sedation and IV sedation (twilight sleep). Both are safely administered and you are closely monitoring throughout treatment.

You may wish to begin with a consultation. To schedule, call 828-274-9440.

Even OTC Pain Relievers Have Risks.

Posted on Dec 09, 2021 by William J. Claiborne, DDS MS

When we see new patients in our Asheville periodontal dental office, it’s common to hear comments about how the appointment was the most thorough they have ever experienced. We pride ourselves on our dental hygienists’ skills for dental cleanings, exams of gum tissues, and in advising patients of ways to maintain good oral health at home.

As a periodontal specialist, I perform a thorough examination of the teeth and oral tissues, both visually and through digital imaging (x-rays). In some cases, we use Cone Beam 3D imaging. Our goal is to have an in-depth view of each patient’s oral anatomy and intricate areas that can reveal problems, both potential and existing.

Our hygienists also work to consider the patient’s whole health so we can tailor their treatment to unique needs. They typically begin by noting any medications the patient takes, both over-the-counter or prescription. Herbal supplements taken regularly are also noted. Why?

The number of American adults who regularly use medications for pain relief has significantly expanded. For most mild to moderate pain, preferences for non-prescription pain relievers (analgesics) now lean towards non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen.

There are a wide variety available over-the-counter (OTC), which means they are readily available without a prescription. Because these can be purchased right off the shelf, many people assume these medications are safe.

What consumers often miss, however, is the fact that many of these can have side effects. They can also interact with other medicines, dietary supplements, and alcohol consumption. Because pain medications contain the same ingredients found in a number of prescription drugs, adults may actually be taking a risky dose when combining medications.

According to a report from NBC News, Americans are taking too much of over-the-counter pain relief meds. In a study conducted by a Boston University School of Health researcher, nearly one in five users of popular headache remedies like Advil or Aleve admitted exceeding the recommended daily maximum dose during a one-week period.

Due to the side effects and without medical oversight, this can lead to higher risk for serious health problems, including gastrointestinal bleeding and heart attacks.

https://www.nbcnews.com/storyline/americas-heroin-epidemic/americans-are-abusing-over-counter-drugs-well-opioids-study-shows-n846401

Before taking these meds, it’s important to get to know the types of pain medications (also known as analgesics) and how they work.

NSAIDs are an acronym for non-steroidal anti-inflammatory drugs. In this category are pain relievers that include aspirin, ibuprofen (Advil, Motrin), and naproxen sodium (Aleve, Naprosyn), and ketoprofen (Orudis).

Non-steroidal anti-inflammatory drugs reduce pain and inflammation by inhibiting production of prostaglandins, which are the hormone-like substances that cause them. Unfortunately, NSAIDs also block other prostaglandins that protect the stomach lining, regulate blood flow to the kidneys, and support blood clotting.

This is bad news for people who are regular users of NSAIDs or those who take high doses since they increase the potential for stomach inflammation, peptic ulcers, and intestinal bleeding. This is especially true for older adults. Taking NSAIDs in high doses or for an extended time can increase this risk even more.

An alternative is acetaminophen (Tylenol, Anacin-3, etc.), which relieves pain by affecting the areas of the brain that receive pain signals. Acetaminophen is best when the need is to reduce pain and fever, but is essentially ineffective in calming inflammation. The up side, however, is it will not cause the bleeding or clotting problems that have been associated with NSAIDs.

Yet, just as NSAIDs have a down side, so does acetaminophen. This analgesic is metabolized by enzymes in the liver. Taking too much can lead to liver damage in susceptible people, such as those who drink alcohol regularly. This is why it is important to read the labels of any medication so you don’t exceed the maximum daily dose of acetaminophen.

For most, taking non-prescription pain relievers – as directed on the label – is generally safe. The potential for trouble arises when you combine the following:

• Some NSAID and acetaminophen products, as well as cold, sinus, and allergy remedies, contain a blend of pain relievers. Kidney damage can result from extended use of painkillers that combine analgesics from different sources.

• A wide number of prescribed painkillers contain acetaminophen, such as Darvocet and Vicodin. Some prescriptions contain NSAIDS, including Celebrex and Percodan. Before you combine prescription medications with over-the-counter painkillers, be sure to check with your prescribing doctor first.

• NSAIDs can interact with other drugs, especially ACE inhibitors, anticoagulants, beta blockers, lithium, and methotrexate. Aspirin interacts with anticonvulsants, corticosteroids, insulin, and sulfa antibiotics. If you take any of these prescription medicines, check before using NSAIDs or aspirin.

• People are often surprised to learn that some herbal supplements, including garlic, ginger, feverfew, ginkgo, and ginseng, can thin blood. You should avoid taking these supplements while taking NSAIDs. When having procedures that may involve bleeding gums, these supplements, or combining them with NSAIDs, can complicate your procedure and the healing process.

One of the reasons we request updates on the medications you take at each visit is to provide you with optimal care. We want your oral health to support your overall health, and vice versa. Be a careful consumer of the medications you take, whether OTC or prescribed.

If you have questions, call 828-274-9440. You may want to begin with a free consultation to get to know us, or schedule complete periodontal examination, especially if you have signs or symptoms of periodontal (gum) disease. These include:

• Sore, tender gums that bleed easily while brushing teeth
• Frequent bad breath
• Gums that recede from the base of teeth, exposing darker, more sensitive sections of the tooth’s root
• Gums that are swollen
• Gum tissues that darken to more of a red color versus a healthy pink

If these signs exist, it is important to seek a periodontal evaluation as soon as possible. Gum disease will only worsen without treatment and is the nation’s leading cause of adult tooth loss.

At Biltmore Periodontics in Asheville, we are always happy to see new patients. A referral is not always needed.