You're probably aware of some of the adverse side effects of treatment for cancer. Unfortunately, one of these side effects is the health of your mouth. In fact, more than one third of people treated for cancer develop oral side effects.

Cancer treatments, such as chemotherapy and radiation, attack cancer cells, but normal cells are also affected. Chemotherapy can affect the lining tissues of the mouth and the salivary glands, and radiation treatment can affect all tissues in its path, which will put you at higher risk for dental diseases, such as tooth decay and gum disease. You may also develop painful mouth sores as well as dry mouth.

The best approach to take when it comes to protecting yourself from these potential side effects is prevention. Here are a few steps you can take to defend yourself:

• Get a Comprehensive Dental Examination. While in the planning stages for your cancer treatment, you should schedule an appointment with our office for a complete dental exam. We will ensure that you oral health is optimal before you undergo treatment. We will also provide detailed instructions on how to care for your teeth during treatment and how to recognize the problem signs. Some solutions we may recommend are a fluoride treatment or antibacterial rinse.
• Keep up with your Oral Hygiene Routine. While cancer treatment may cause you to feel fatigued, it will be more important than ever for you to take good care of your teeth. Remember to brush twice daily with a soft brush and fluoride toothpaste. You should also floss once a day to clean between your teeth.
• Keep your Mouth Moist. Dry mouth is a common side effect of radiation and chemotherapy, and along with dry mouth comes a higher risk for tooth decay. We may recommend salivary stimulating medications to fight against this condition. You should also avoid mouth rinses with alcohol, which tend to further dry out your mouth. Make sure to drink plenty of water and consider chewing gum with xylitol, which promotes salivation and actively prevents tooth decay.
• Remain Alert. Throughout treatment, you should continue to look for signs of oral discomfort in the teeth, jaws and lining of your mouth. Notify both your oncologist and our office if you experience any side effects involving your mouth.

If you would like more information about oral health and cancer treatment, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Oral Health During Cancer Treatment.”

Remember Matthew Lewis? You've seen him in all of the Harry Potter movies, where he played the bumbling Neville Longbottom: a pudgy, teenage wizard-in-training whose teeth could best be described as... dodgy. We won't spoil the movie by telling you what happens to him in the end — but in real life, let's just say his awkward phase is over. Today, he looks more like a young Ryan Gosling. How did this transformation happen?

Well, in part it was some “Hollywood magic” that made his teeth look worse in the films than they really were. But Lewis acknowledges that he also had cosmetic dental work performed. If you've ever considered getting a smile makeover yourself, you may wonder: What kinds of “dental magic” might it take to change an awkward grin into a red-carpet smile? Here are a few of the treatments we might utilize.

Orthodontics
It's possible to correct tooth crowding, protrusion, gaps between teeth, and many other bite problems with orthodontic appliances like braces or clear aligners. While some may think orthodontics is just for teens, that isn't so — you're never too old to get the smile you've always wanted! In fact, right now about one in five orthodontic patients is an adult.

Teeth Whitening
This is a popular (and surprisingly affordable) option that can effectively lighten your teeth by six shades or more. We can do in-office whitening for the fastest results, or prepare a take-home whitening kit with a custom-made tray to fit your teeth perfectly and a supply of the proper bleaching solution. How well it will work for you (and how long it will last) depends on various factors, including the original cause of the discoloration, and your preferences for foods and beverages (such as coffee or red wine) that may cause stains.

Porcelain Veneers
Sometimes, even professional bleaching isn't enough to get the kind of permanent, “Hollywood white” smile you'd like; that's where porcelain veneers come in. By placing a fingernail-thin layer of ceramic over the tooth's enamel, veneers offer a permanent, pearly white finish that looks just like your natural teeth — only more dazzling! Veneers, long the first choice of celebrities, are gaining popularity with plenty of “regular” folks.

Tooth Restorations
This category covers a wide variety of different methods and materials — like cosmetic bonding, crowns, bridges, and dental implants — which we use to repair or replace teeth that are damaged or missing. Beginning with the simple repair of small chips or cracks with tooth-colored resins, we can progress to more permanent crown restorations when more of the tooth structure needs replacement. To restore missing teeth, we have the option of using the tried-and-true bridge — or, the current gold standard in tooth replacement: the lifelike, permanent dental implant.

Of course, this is just a bare outline of the many tools and techniques cosmetic dentistry offers. We would be happy to talk with you about which ones are right in your individual situation. Will a smile makeover land you a red-carpet role? Maybe... but one thing is for sure: It will help you get the smile youâ??ve always wanted.

If you would like more information about smile makeovers and options in cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Cosmetic Dentistry,” “Porcelain Crowns & Veneers,” and “Dental Implants.”

Most dental treatment has a cosmetic aspect to it since in the act of “restoring” teeth they are made to look better. The word “cosmetic” comes from roots meaning, “to adorn, dress and embellish.” Here are some terms and cosmetic dental techniques that could change your smile.

• The best and easiest way to remove stains on your teeth? Make an appointment to see a dental hygienist to remove unwanted stains from coffee, tea, red wine, that can discolor the outer surfaces of your teeth. Your teeth will look better and be healthier as a result.
• Dental office or home whitening? Dull, dingy and discolored teeth can be whitened with over-the-counter products at home, or professionally in our office. If you use the home method, be sure to follow the manufacturers' instructions carefully to make sure you don't overdo it. In our office we can use stronger bleaching solutions with special precautions to protect your gums and other tissues and achieve whiter teeth more quickly.
• Cosmetic change for back teeth? Tooth-colored composite resin filling materials are a relatively inexpensive way to replace tooth structure that has been damaged (by decay or otherwise) with non-metallic materials that bond to your natural teeth, match their color and make them stronger. (Sometimes metal restorations, like gold are advised for people who grind their teeth.)
• Cosmetic change for front teeth? Tooth-colored composite resin restorative filling materials — can be bonded directly to natural tooth structure becoming “one” with it. Used to replace tooth structure damaged by decay or injury such as chipped teeth, they are especially useful for front teeth in the smile zone. And they actually strengthen the teeth as well as providing highly cosmetic tooth restorations. In artistic hands nobody will know your teeth have been changed, except you and your dentist.
• Porcelain Veneers are thin layers of glass-like ceramic material that replaces the original tooth enamel. Veneering a tooth often involves some enamel reshaping or removal to accommodate the veneer. Veneers are bonded to the underlying tooth, but can be made brighter and whiter than your own enamel to cosmetically enhance your smile.
• Porcelain Crowns are similar to veneers in their cosmetic appearance but they cover the entire surface of a tooth, replacing tooth structure that has been damaged, lost or has become very discolored.
• Clear Aligners are a newer technique used in orthodontics (tooth movement) to move teeth into better position to enhance cosmetic change and improve biting function. A series of clear plastic trays is used to gradually move teeth to more attractive and functional positions.
• Dental Implants replace the roots of missing teeth. They are placed into the jawbone and become fused with it. Once implants have integrated with the bone, crowns are attached that look, function and feel just like stand alone natural teeth.

Contact us today to schedule an appointment or to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry: A time for change.”

The ailment we commonly called gum disease is actually series of related diseases, all of which involve the tissues that surround the teeth. It's sometimes thought of as a “silent” malady, because its symptoms — bad breath, soreness, or bleeding of the gums — may be masked by other conditions. Or, they may simply be disregarded.

But don't ignore these symptoms! Left untreated, periodontitis can have serious health consequences. Here are five things you should know about this disease.

Gum disease is a chronic inflammatory disease.

That means it's a disease related to a natural response of the body's immune system (inflammation), and it develops over time (chronic). Gingivitis, an inflammation of the gums, may be the first step in the disease's progression. Left untreated, it can be followed by destruction of the periodontal ligament (which helps hold the tooth in place), loss of the supporting bone, and ultimately tooth loss. But it doesn't stop there.

The effects of gum disease aren't confined to the mouth.

In fact, recent research has suggested a connection between periodontal disease and chronic diseases in the whole body. There is evidence that severe periodontal disease is linked to an increased risk of cardiovascular diseases (like heart attack and stroke), pregnancy complications, and other conditions. It is also believed to have an adverse effect on blood-sugar control in diabetics.

Gum disease is caused by the bacteria in dental plaque.

Oral bacteria tend to build up in a colony of living organisms called a biofilm. Of the many types of bacteria that live in the mouth, only a relatively few are harmful. When oral biofilms are not regularly disturbed by brushing and flossing, the disease-causing types tend to predominate. Once it gains a foothold, treating gum disease can become more difficult.

Prevention is the best defense.

Good personal oral hygiene, carried out on a daily basis, is probably the best defense against many forms of periodontal disease. Proper brushing and flossing is effective in disrupting the growth of dental plaques. Lifestyle changes — like quitting smoking and reducing stress — are also associated with lessening your chance of developing the disease. Genetics also seems to play a part, so those with a family history of periodontitis should pay special attention to preventive measures.

Prompt, effective treatment is critical.

Bleeding of the gums is never a normal occurrence. But sometimes this (and other symptoms of gum disease) may be overlooked. During routine dental checkups, we can detect the early signs of periodontal disease. We can then recommend an appropriate treatment, from routine scaling and root planing (a cleaning of the teeth) to other therapies. So, besides brushing and flossing regularly, don't neglect regular examinations — they're the best way to stop this disease before it becomes more serious.

If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”

If you would like to improve the appearance of your smile, porcelain laminate veneers can whiten, brighten and even help straighten your teeth! Made of a thin layer of dental ceramic, porcelain veneers are physically bonded directly to the surface of your teeth, immediately enhancing your smile.

If you are considering a smile makeover, here are some other facts about porcelain laminate veneers that you might find interesting:

• Dental porcelain is used to create veneers that mimic natural tooth enamel perfectly. They require the removal of a minimal amount of surface enamel before application — about 0.5 millimeters to be exact. Because of this reduction, porcelain laminates are considered to be an irreversible treatment. The end results are high-strength, durable, and natural looking translucent tooth-like restorations.
• Fabricating a set of porcelain laminate veneers typically takes about a week, although times can vary. We will work closely with you and our dental laboratory technician to determine the exact color, shade and brightness that will best match your expectations for a new smile.
• Porcelain laminate veneers are the best restorative option if you have teeth that are in good position and alignment. They are also an excellent solution if you have small gaps between your teeth, or if your teeth are asymmetrically shaped or discolored. Porcelain laminate veneers cannot correct poor tooth position, bite relations or a poor profile. In these cases, orthodontic treatment may be necessary first.
• Porcelain laminate veneers can last anywhere from 7 to 20 years especially if the teeth they are bonded to don't undergo any major changes like gum line shrinkage, which may expose the root surfaces of the teeth.
• Due to their glass-like structure porcelain veneers can break. You should avoid doing things that might stress them, like opening pistachio nuts with your teeth or eating candy apples.

If you would like to discuss improving your smile with us using these impeccable restorations, please call our office today to schedule a consultation. To learn more about porcelain laminate veneers, read the Dear Doctor magazine article “Smile Design Enhanced With Porcelain Veneers.”