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News & Events

Oral Cancer: Your Dentist is Your First Line of Defense

Dr. Jeremy Peyser

Oral cancer is a disease which impacts thousands of people in the United States, and which unfortunately has been growing in scale. The Oral Cancer Foundation estimates that 42, 000 Americans will contract oral cancer this year, the fifth year in a row of growth in this disease.

What's most unfortunate is that 75% of oral cancer cases can be traced back to behavioral issues like smoking, excessive alcohol consumption, poor dental hygiene, bad nutrition and other controllable activities. The good news is that early detection can lead to control of the disease: this makes your dental professional your first line of defense against oral cancer.

Why is this? The reasons are simple: dental professionals can spot the early stages of the disease and deal with them before they seriously impact a patient's health. In addition, the simple act of having a professional hygienist clean your teeth leads not only to improved appearance and better overall oral health, but can also prevent mouth cancer. These easy actions can yield significant results, which makes the rise in oral cancer rates since 2007 all the more unfortunate as so much hardship can be so easily prevented.

Oral cancer has many symptoms, most of them visible to patients. Any problems with swallowing, or discomfort in the tongue are early signs. Any sustained appearance of sores or lesions over a two-week period is also a signal. An important thing to recognize is that the initial signs of oral cancer do not involve pain, but visual tells like sores and ulcers. These may not be immediately apparent to non-professionals, which is all the more reason for regular visits with dental professionals, especially for higher risk groups like smokers.

Once an oral cancer event has been identified, how is it treated? As the Oral Cancer Foundation notes, treatment is a multidisciplinary effort involving surgeons, oncologists and dental professionals. Before the cancer itself is dealt with, however, other oral problems may be resolved as not dealing with simpler matters, such as decayed teeth, may make recovery more difficult. As such, basic issues will be dealt with first in an effort to avoid more complicated surgeries down the line, especially radiation therapies.

Once basic maintenance on the mouth, including a thorough cleaning, has been completed, surgeons will remove the diseased tissues. It is possible, depending on the nature and severity of the cancer, that oncologists may elect to treat the disease with radiation or chemotherapy. In addition, as noted by the professional support organization Cancer Care, some newer drugs, different from traditional chemotherapies, appear to be promising. These new drugs, known as Blocking Agents, inhibit the growth of cancer by blocking the receptors on a cancer cell, which is the mechanism through which cancer grows.

The exact treatment options will vary by patient, of course, but all of these options are available to the multidisciplinary team that will over see the treatment and recovery.

The postoperative process is also extremely important. Depending on the processes chosen by the patient's team, reconstructive dental surgeons may be brought in to rebuild the mouth and to restore the patient's appearance. Frequently, reconstructive surgeons may use what is called a "flap", a piece of tissue taken from another part of the body, to restore the mouth and or the tongue. In addition, reconstructive work can be done on the jaw, which is vital to rebuilding the patient's mouth. Physical therapists may be brought in to help the patient regain basic motor skills.

Oral cancer is a tragic disease as it is one of the easiest things we can prevent. Smoking, excess alcohol consumption and poor oral health are all controllable behaviors. The fact that much has been made of the impact of smoking on the mouth makes the growth of oral cancer so unfortunate. The good news is that with early detection, treatments can be comprehensive and life saving. But with proper dental care, there is no reason to get to that point. As noted at the beginning of this article, your dental professional is your first line of defense against this painful disease. He or she can provide you with the basic care needed to ward off oral cancer. At the same time, your dental professional can observe early signs of the disease that laypeople may not see. Perhaps in no other medical space can such a small amount of prevention lead to so much of a cure.


Why Should I Take My Child to a Pediatric Dentist?

By: Martha Miqueo, DDS

Have you ever thought about taking your child to your Internist instead of the Pediatrician? Probably not, because your Pediatrician is someone who specializes in the growth and development of children.

Just like your Pediatrician, a Pediatric Dentist, is a doctor that has 2 to 3 years of specialty training beyond dental school. A Pediatric Dentist also specializes in growth and development and how to deal with and engage the child psyche. This specialist has the tools necessary to treat special needs patients, and the hospital experience to provide care in different settings when necessary.

Pediatric Dentistry is mostly about prevention. The earlier you start, the greater the chances that you will have a strong, healthy, caries free, life-time smile. An expectant mother should seek a Pediatric Dentist to receive prenatal recommendations of what to expect and how to manage feeding, suckling, teething, and oral hygiene. You want to prevent developing nursing caries. Here are a few points to keep in mind as your child grows:

  • The American Academy of Pediatric Dentistry and the American Dental Association recommend that a child see a dentist by the age of one. At that time there are usually 8 teeth in the mouth. Parents should make sure that they have the information necessary to protect these teeth and the developing bone structures. By the age of 2.5 or 3, all 20 primary teeth have erupted. At this time fluoride toothpaste should be introduced, but it is necessary that the child be comfortable rinsing and spitting. Toothpaste should not be swallowed.

  • If you do not live in a community that has water fluoridation, your pediatrician may have given your child a multivitamin containing fluoride. If not, your pediatric dentist can prescribe a fluoride supplement. Children from the ages of 6 months through 16 should receive fluoride supplements if it is not in their drinking water. The surgeon general has released a statement in April discussing the many benefits of fluoride. It is available online at ADA.org

  • Unless there is a problem, the first set of radiographs is taken when a child is 5. The radiographs consist of a film to view if there are any extra teeth that prevent normal eruption of the anterior permanent dentition and 2 films taken to check for cavities between the posterior teeth.

  • Permanent teeth can start growing into the mouth as early as 4 years old, but the average age is 6. This is why the first permanent molars that grow in behind the baby teeth are called 6 year molars. Sometimes you see two rows of teeth in the mandibular anterior part of the mouth. That happens because the permanent tooth buds develop in the bone behind the roots of the primary teeth. Those roots may not have resorbed enough for the baby teeth to exfoliate before the eruption of the permanent teeth that will take their place.

  • Sealants are a protective coating applied to the occlusal or top surface of the tooth. These are usually recommended when the six year molars are fully erupted. One of the reasons that most adults have fillings on these molars or have lost these teeth is because they grow in so early, when as a child they lacked the knowledge and dexterity to brush properly.

  • At Age 7, a child should be evaluated by an orthodontist. It is important to check and compare the growth of the maxilla and mandible as they relate to one another. There are techniques that can be used to guide the growth and prevent surgery in the future. The dentition is also evaluated at this time since the child has mixed permanent and primary teeth. Space maintainers can be used to preserve room and to prevent extraction of permanent teeth later on. Bone expanders can also be used to create more space for the adult dentition. Since children’s bones are so malleable at this young age, this is possible without discomfort.

  • Trauma to the oral cavity should be evaluated promptly for the effects on the permanent dentition. Primary teeth are not replanted, but permanent teeth should be in a timely manner.

  • Between the ages of 12 and 16 most of the permanent dentition should have erupted, except for the third molars. They can appear between ages 18 and 25. These teeth are often missing, impacted, and often cause misery when they erupt. These should be monitored radiographically.


About the author:

Dr. Martha Miqueo is an Orthodontist and Pediatric Dentist. She is a graduate of New York University College of Dentistry and has been in practice for 20 years. She has three children ranging in ages from 11 to 18 and lives in Tenafly with her family.

Orthodontic Specialty #06134

Pediatric Specialty #06248


Giving Through Smiles

Mission Trip to Neltume Chile

January 26- February 3, 2013

Academy Members Drs. Jon Zamzok, Charles Lennon and Anthony Randi recently returned from Neltume Chile where they spent nine days helping set up and run a dental clinic for an underprivileged population of adults and children. They were a part of a team that consisted of several prosthodontists and general dentists from NY, a post graduate resident, Shavari Karande from Queens Hospital, and a dental technician, Vincent Verdosa from Stoneybrook University School of Dental Medicine. This team joined forces with dentists and dental students from Chile to construct 50 dentures and treat 150 children with rampant tooth decay.

The dental clinic was set up in a school in the logging village of Neltume in the foothills of the Andes. The dental equipment the doctors worked with was extremely limited. Some of the patients were treated on school desks that substituted for dental chairs.

This was the second outreach trip for the not-for-profit foundation, " Giving Through Smiles." This foundation has high hopes of doing many more dental missions abroad, and in the United States. Their goal is to bring dental health and education where there is the greatest of need.

Drs. Zamzok, Lennon and Randi want to extend a special thanks to fellow academy members Drs. George Tysowsky and Frank Lauciello of Ivoclar for their generous donation of dental materials. "The Giving Through Smiles" Team wants to thank the GNYAP for their generous gift to the mission outreach program.

Contact Dr. Jon Zamzok @ tfzsb@aol.com

for additional information about "Giving Through Smiles"

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