Toothfully Blog

Each time you come in for your dental cleaning, you'll notice I start with a lower jaw massage. Then I'll look around at your lips and cheeks and gums and make you do some tongue gymnastics. So all those actions are for oral cancer screening. I am looking for lumps (lymph nodes ) by your jaw line, red or white bumps or markings on your gums, tongue and cheeks. Cancer in the mouth 5-year survival rate is about 57%, which is rather low. Early detection helps increase survival rate tremendously, and that's why I'm doing the oral screening each time you come in for your checkup. It's like having your dermatologist re-evaluate all your sun spots and skin discolorations for any changes. Definitely let me know if you've noticed changes in your mouth.

Oral cancer used to be a seen more in higher risk patients with a history of alcohol and tobacco abuse, but now it's seen in population that never smoked or drink much. Studies have shown an increase in oral cancers linked to human papilloma virus (HPV), which is a sexually transmitted disease. Up to 80% of Americans will have had HPV infection in their lifetime, but didn't know they had it because it cleared up and didn't need treatment. The good news is that there is a HPV vaccine, but it works best for children 11-12yo (before they become sexually active). They also recommend the vaccine for those 13-26 yo, so if you fall in that age range ask your doctor about it. If you can decrease your chances of getting oral cancer and HPV, why not take advantage of that! More info here.

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A patient asked me about sodium lauryl sulfate in toothpaste- if it's safe to use. I couldn't find any articles in my dental journals, so these findings are from what I can find on the internet. Sodium lauryl sulfate in toothpaste (also known as SLS) is a common ingredient found in shampoo and toothpaste. Its main use is a surfactant, to produce foam and thicken the paste. There are reports of SLS being linked to cancer, but these claims are unsupported. There are reports that SLS can hinder the release of fluoride in the toothpaste, which is not great because you want the fluoride the strengthen your enamel. There are also studies which show SLS can increase incidence of aphthous ulcers (canker sores) in the mouth. So what to do? I wouldn't consider SLS harmful, but if your mouth does get irritated or you get canker sores easily, consider getting SLS-free toothpaste such as the natural toothpaste like Tom's of Maine, or ProNamel.

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That is the question many are asking after the Department of Health and Human Services stopped recommending flossing as part of healthy living guideline. A review of 12 trials showed that flossing helped minimally with removing plaque after 1-3 months of study. So is this a free pass for you to throw away that floss? Sorry, NO. This study only look at short term 3 months effect of removing plaque, and does not look at the long term like 12 months. It didn't look at flossing in reducing gingivitis (gum inflammation & bleeding) and gum disease. It didn't look at flossing in reducing cavities in between the teeth. Those benefits are known to you and I. We've all experienced how our gums are more tender and bleeds more when we don't floss often. It's true there are conflicting studies about health out there- none of these studies are perfect. One can cherry-pick to believe in which studies to fit our outlook and preference. As your dentist, I will still recommend daily flossing so don't even think about skipping it! And personally, I floss before I brush- just feels cleaner that way.

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I've talked quite a bit about soda in the past. Soda can be very acidic and sugary, and they cause cavities by eroding the enamel and allowing bacteria to cause damage to the teeth. Some people drink diet soda instead, since at least there'd be no sugar. Well, a new research study shows that some diet sodas are worse in causing teeth erosion. The results showed that 5 out of 7 of the top erosive soft drinks were diet drinks. The top 3 were Sprite Zero (diet), Mountain Dew Voltage (regular), and Mellow Yellow Zero (diet). I was surprised too. There was no correlation between ingredients or pH to explain why some diet sodas are worse than regular ones. Regular Coke is more acidic than Diet Coke, yet it is less erosive than the diet version. There are ways to lessen the harm of drinking sodas. Drink quickly instead of sipping over hours, drink it cold, drink with a straw to minimize the exposure of teeth to the acid, and drink water or milk right after to decrease acidity of your mouth. Probably the best bet is to drink less frequently or cut out soda completely! For more information, click here.

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Damaging Diets & Drinks

With the new year, many of us embark on new exercise regiments and diets to a healthier year. But be aware that some weight loss drinks & supplements, and sport energy drinks can be very acidic.  This can cause enamel erosion and cavities. Certain juice cleanses can contain a lot of lemon juice (very acidic), and can make teeth sensitive. Battery acid has pH of 1, and lemon juice has pH of 2, so ingest lemon juice sparingly! For those who like to drink Gatorade after/ during exercise, be aware that those drinks are also very acidic, similar to sodas. The ingredient citric acid is the culprit for low pH, so look for that on labels. Energy drinks such as Red Bull and Rockstar also have pH from 2.5-3.5. Diet sodas, while doesn't have the sugar, still has citric acid (used as flavor enhancer) and are as acidic as regular soda. I see a fair amount of patients getting cavities from drinking diet soda. So what can you drink - seems like everything is off limits! The answer is everything in moderation. Rinse out with water after consumption of something acidic, or drink milk or eat cheese- it will neutralize the acid more quickly. Click on this to see the pH chart of popular drinks.

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