HPV, which causes cervical cancer can also fuel oral cancer

WASHINGTON — A prolonged sore throat once was considered a cancer worry mainly for smokers and drinkers. Today there's another risk: A sexually transmitted virus is fueling a rise in oral cancer.
The HPV virus is best known for causing cervical cancer. But it can cause cancer in the upper throat, too, and a new study says HPV-positive tumors now account for a majority of these cases of what is called oropharyngeal cancer.

If that trend continues, that type of oral cancer will become the nation's main HPV-related cancer within the decade, surpassing cervical cancer, researchers from Ohio State University and the National Cancer Institute report Monday.

"There is an urgency to try to figure out how to prevent this," says Dr. Amy Chen of the American Cancer Society and Emory University, who wasn't part of the new research.
While women sometimes get oral cancer caused by the HPV, the risk is greatest and rising among men, researchers reported in the Journal of Clinical Oncology. No one knows why, but it begs the question of whether the vaccine given to girls and young women to protect against cervical cancer also might protect against oral HPV.

HPV vaccination is approved for boys to prevent genital warts and anal cancer, additional problems caused by human papillomavirus. But protection against oral HPV hasn't been studied in either gender, says Dr. Maura Gillison, a head-and-neck cancer specialist at Ohio State and senior author of the new research. That's important, because it's possible to have HPV in one part of the body but not the other, she says. A spokeswoman for Merck & Co., maker of the HPV vaccine Gardasil, said the company has no plans for an oral cancer study.

Monday's research was funded by the NCI and Ohio State. Gillison has been a consultant to Merck.
There are nearly 10,000 new cases of oropharyngeal cancer a year, and overall incidence has risen by 28 percent since 1988 even as other types of head-and-neck cancer have been declining.

Tobacco and alcohol have long been the main causes of these tumors, which occur in the tonsils, base of the tongue and upper throat. But over the past few years, studies have shown HPV is playing a role in that rise, probably due to an increase in oral sex even as tobacco use was dropping.

The new study took a closer look, tracking HPV over time by directly testing tumor tissue from 271 patients that had been stored in cancer registries in Hawaii, Iowa and Los Angeles. The proportion that were HPV-positive rose from just 16 percent in the late 1980s to nearly 73 percent by the early 2000s.
Translate that to the overall population, and the researchers concluded that incidence rates of the HPV-positive tumors more than tripled while HPV-negative tumors dropped by half.

Oral cancer has always been a bigger threat to men than women. Gillison says women account for only about 1 in 4 cases, and their incidence is holding steady while men's is rising. That raises questions about gender differences in sexual behavior or whether oral HPV infection is likely to linger longer in men.

While HPV is the most common sexually transmitted infection, studies show women's bodies usually clear the virus from the cervix quickly; only an infection that persists for years is a cancer risk. It's not known if oral HPV acts similarly or even is as common.

Nor is it clear if oral sex is the only way it's transmitted, cautions Dr. Gregory Masters of the American Society for Clinical Oncology, an oncologist at Delaware's Helen Graham Cancer Center.
Regardless, just over 11,000 cases of cervical cancer will be diagnosed this year, a number that has been dropping steadily thanks to better Pap smears. (It's too soon to know what difference vaccination will make.) Gillison's team calculated that annual cases of cervical cancer will drop to 7,700 by 2020 – compared with about 8,700 cases of HPV-positive oropharyngeal cancer by then, about 7,400 of them in men.

The cancer society's Chen urged caution about those numbers, saying more data is needed. But she says two things are clear: First, patients with HPV-linked oral tumors have better survival odds than those with other types of this cancer, possibly because they tend to be younger. Studies are beginning to test if they can scale back today's treatment and thus suffer fewer long-term side effects such as problems with speech and swallowing.

And "just because you're not a smoker or drinker doesn't mean you can't get throat cancer," Chen says – so get checked for symptoms like a throat that's sore for longer than two weeks.

~ Lauran Neergaard - Huffington Post

Our office offers The OraRisk^® HPV Salivary Diagnostic Test

Human papillomavirus (HPV) is one of the most common virus groups in the world. According to the Centers for Disease Control, at least 20 million people in the United States are infected with HPV and there are approximately 6 million new cases each year.

Oral HPV is a manifestation of the HPV virus in the mouth, and is primarily found in the oropharyngeal complex. Specific types of oral HPV are now considered to be separate and serious risk factor for developing oral cancers. Early detection and identification of the presence or absence of oral HPV is important, as early oral HPV infections do not typically cause any clinical signs or symptoms.
The OraRisk^® HPV test is a non-invasive, easy-to-use screening tool to identify the type(s) of oral HPV, a mucosal viral infection that could potentially lead to oral cancer. OraRisk^® HPV enables the clinician to establish increased risk for oral cancer and determine appropriate referral and monitoring conditions.

Who should be tested?

• Patients with traditional risk factors for oral cancer
• Patients who are sexually active
• Patients with signs and symptoms of oral cancer
• Patients with suspicious oral lesions

Schedule an appointment for your OraRisk^® HPV Salivary Diagnostic Test

Oral Cancer survivor urges tax increase for smokeless tobacco

Gruen von Behrens's first surgery took 13 hours when he was 17 years old. Two years later, maxillofacial surgeons transplanted bone from his back to his face to give him a mandible. The transplant lasted two days before his body rejected it.

Now 34, Behrens is cancer-free, but he has no teeth, has a hard time eating and speaking, and his face is disfigured.

He began chewing tobacco at the age of 13, a common practice in the rural farming community in Illinois where Behrens grew up. As a teenager, he thought about "baseball, food, and women, in that order," he recalled in a DrBicuspid.com interview. "Everybody used tobacco; they really didn't think it would hurt us if your grandfather or uncle was using it."

But after developing squamous cell carcinoma in his lymph nodes, surgeons removed half his tongue and neck muscles. Still, von Behrens feels lucky to be alive.

"Eighty percent of the people with that diagnosis die within five years of surgery," he notes.

Last month von Behrens testified at a Maryland legislative hearing, urging lawmakers to increase the tobacco tax on cigars and smokeless tobacco to 70%, the same level as the tax rate on cigarettes.

"Tobacco is tobacco is tobacco, and I believe having a lower tax on some tobaccos and a higher tax on the smoking tobaccos -- that's basically saying this is a safe alternative when it is not," von Behrens said.

In 2010, he testified before a U.S. Senate hearing about the dangers of tobacco in professional sports.

White spot lesion

Three years after von Behrens began chewing tobacco, he noticed a white spot on the side of his tongue where he kept it.

"After passing the tobacco with my tongue, it became raw and it hurt at first but then it became kind of tough, and I started to see white spots," he recalled. "I was terrified."

von Behrens kept it secret from his mother because she had warned him about the dangers of chewing tobacco.

“Spit tobacco seemed harmless, but it has ruined my life.”— Gruen von Behrens

"I kept telling her it was my wisdom teeth that was making my speech slurred and making me drool on myself," he recalled.

When von Behrens went in to get his primary molars removed, he knew what the maxillofacial surgeon's diagnosis would be.

"I told him I had cancer before he put the gas mask on me," he said. "I was scared to death of what they were going to do to me. I was afraid of needles, let alone having surgery done."

von Behrens said his mother's anguish was the worst part. "I've never seen my mother cry like that before, and the pain that it inflicted on her hurt me more than the surgeries," he said.

34 surgeries

To date, von Behrens has had 34 surgeries and was a college sophomore when radiation treatments burned his face and forced him to have all his teeth removed.

He now serves as a spokesman for Oral Health America's National Spit Tobacco program and travels to schools around the U.S. to warn young people about the dangers of smokeless tobacco.

"I want kids to have a fair shot with their lives and know what the effect of tobacco use is," von Behrens explained. "If I had known then what I know now, I never would have put a dip in my mouth."

He says he has traveled to 46 states and spoken to 3 million children.

"I know how to talk to kids and relate to them, and I think that has even more of an impact than my face," von Behrens observed. "My face is an attention-getter for the first five rows, but for the rest it's my story that captivates them."

He also addresses health organizations and health departments, often at the request of dentists.

Cosmetic surgery costly

He would like to have plastic surgery and was heartened by the recent story of a man who had a total face transplant.

"Oh man, that would be my dream, but I just can't afford to do that," von Behrens said.

Maxillofacial surgeons would have to replace his mandible before a face transplant could be done, he noted. von Behrens cannot wear dentures because after surgeons reconstructed his face in the last surgery, they removed his mandible and replaced it with fibula bone from his leg. They also used pectoral muscles from his chest to recreate the floor of his mouth.

Implants would require drilling into the fibula bone that now serves as a replacement for his mandible.

Today von Behrens lives in central Illinois with his wife and two young daughters. "I met an angel," he said of his wife. "It's amazing she picked me in spite of the way I look."

He also works with the National Spit Tobacco Education Program to correct the false belief that smokeless tobacco is a safe alternative to smoking.

"Spit tobacco seemed harmless, but it has ruined my life," von Behrens said.

 In honor of Oral Cancer Awareness Month     

In honor of Oral Cancer Awareness Month, Brian S. Nylaan, D.D.S. will be offering complimentary oral cancer screenings on Thursday, April 26th from 2 – 5 pm. Oral cancer is not a rare disease. Approximately 37,000 people will be diagnosed with oral cancer every year in the US. It kills one person every hour of every day, and over 100 new individuals will be diagnosed with it each day. The good news is that it can often be found early in its development, through a simple, painless, and quick screening.

Who should get screened?
Every adult. Oral cancer can often be caught early, even as a pre-cancer. With early
detection, survival rates are high and the side effects are from treatment are at their lowest. Like other screenings you engage in such as cervical, skin, prostate, colon and breast examinations, oral cancer screenings are an effective means of finding cancer at its early, highly curable stages. Make them part of your annual health check‐ups.

What are the risk factors?
There are two distinct pathways by which most people come to oral cancer. One is through the use of tobacco and alcohol, a long term historic problem and cause, and the other is through exposure to the HPV16 virus (human papilloma virus version 16), which is now the leading cause of oral cancers in the US, and the same one, which is responsible for the vast majority of cervical cancers in women. The quickest growing segment of the oral cancer population are young, healthy, non-smokers due to the connection to this virus.

Early Indicators:
Red and/or white discolorations of the soft tissues of the mouth.
Any sore which does not heal within 14 days.
Hoarseness which lasts or a prolonged period of time.

Advanced Indicators:
A sensation that something is stuck in your throat.
Numbness in the oral region.
Difficulty in moving the jaw or tongue.
Difficulty in swallowing.
Ear pain which occurs on one side only.
A sore under a denture, which even after adjustment of the denture, still does not heal.
A lump or thickening which develops in the mouth or on the neck.

An oral cancer screening should be conducted every year, so take advantage of this offer and get screened today.

 Call our office at (616) 361-7317, or click here to make an appointment for your complimentary screening.

For more information about oral cancer screenings click here; VELScope oral cancer screenings click here or general dental information visit our website.
 references:

Dr. Bicuspid

Oral Cancer Foundation

Tru Stories

"Look Mom - no cavities!" remember that Crest advertisement?

Are you one of the people that have never had a cavity in your lifetime, or are you the person that feels lucky to only have a few cavities at each dental visit?

So what's the difference between the "no-cavity" person and the multiple cavity person?  In general the "no-cavity" person has reduced risk factors compared to those who need a lot of dental treatment. These risk factors can include hereditary factors, dietary factors, anatomic factors and personal habits. There isn't necessarily a single reason that will put you at risk for dental problems. It is almost always a combination.

• The grooves in your back teeth, or molars, can be deep or shallow. This is determined by genes. People with deeper grooves are at a much greater risk to develop cavities in the grooves, or chewing surface of the teeth.
• You almost always get your oral bacteria from your mother. If she suffered from a lot of cavities and gum disease, you probably inherited the same troublesome oral bacteria.
• If you have reduced saliva flow, or dry mouth, you are more likely to have dental problems. Reduced saliva flow can come with age, illness, and is a side-effect of some medications.
• If you grind your teeth you are much more likely to have dental problems. Most tooth grinding takes place while you sleep. Tooth damage depends on how hard and how often you grind your teeth. Your level of stress, size of your jaw and chewing muscles can influence tooth grinding.
• Your diet also has a lot to do with dental problems. If you eat a lot of sticky, sugary foods, drink a lot of sugary drinks or consume a lot between meal snacks your dental problems can increase. The oral bacteria turn sugar into acid and that acid causes cavities. If you eat a lot of acidic foods this can cause the enamel to errode as well.

If you brush correctly and often you are less likely to have cavities. If you are a regular flossser your gums will be more healthy and you will have less cavities. You can control a few of these factors and there are things you can do to change the hereditary factors. You can have dental sealants placed to fill in the deep grooves, wear a bite splint to alleviate nighttime grinding, and control your diet.

If you are a "Look Mom - no cavities" person that is awesome. Everyone tries to be just like you! Does this mean you do not need to visit your dental office as frequently ? No, it does not. Your dental history makes you a lower risk for dental problems, but things can change and finding a problem while it is small or much better than finding it later, or too late.

• Medication changes can cause changes in your mouth. Dry mouth is a side-effect of many medications.
• Changes in your diet effect your mouth and can cause dental problems to start occuring.
• Aging. Unfortunately we all get older. Your natural saliva flow decrease as you age and medications usually increase causing changes in your oral bacteria and further reducing saliva flow. This increases your risk for tooth decay.

Moral of this story: Visit your dental office and work with your dentist or hygienist to maintain your smile which helps to maintain your overall health.

For more information visit our website.

How long will this new crown last?

We are often asked this question and in a perfect world your new crown would last for the rest of your life. However, in the same perfect world you would not have to change the oil in your car, replace your roof or mow your lawn.

 Let’s look into this further.

 If you chew every bite of food 10 times before you swallow and at each meal you eat 20 bites you have used your crown 200 times during this meal alone. Now multiply that by 3 meals per day, plus some snacks. You are looking at using your crown 600 times, at least, per day.

 Many dental restorations will handle chewing pretty easily, even at 600 times per day. It is the kernel of unpopped popcorn, cherry or olive pits, tooth picks, ends of pencils and other hard objects we tend to put in our mouths that can do in a restoration, tooth, or crown. Plus, your crown will have to tolerate temperatures ranging from 150 – 170 degrees (for hot coffee or tea) to 20 – 30 degrees (for ice cream and the dreaded ice chewing). Sometimes you may even have ice cream and coffee in the same setting causing your tooth to expand with the heat and contract with the cold in rapid succession. Your crown will also have to tolerate being attacked by acid after each meal, snack or beverage (unless you drink only water), being covered by bacterial biofilm and probably tooth grinding while you sleep.

The mouth is a pretty tough environment. So, what is a realistic expectation for the life of your crown? Well, a lot of it depends on you. If you avoid sweets and sodas, take very good care of your teeth by brushing and flossing regularly, don’t take medications that dry your mouth, don’t grind your teeth at night, or invest in a bite splint while visiting our office regularly in an effort to find concerns while they are small, you could see your crown last for 15 – 20 years. Insurance companies for years have expected crowns to last 5 years before they would pay for a new one. Regular wear and tear will probably wear out your dental work if you live long enough, but you can make your dental treatment last as long as possible if you:

      Brush 2 – 3 times per day with a soft bristled toothbrush, or Sonicare brush.

      Floss or use a Water Flosser once per day.

      Chew sugarless gum, or eat sugarless candy, or mints after meals to stimulate saliva flow. Make sure your sugarless treat is sweetened with Xylitol.

      Avoid sugary, sticky foods and reduce any in between meal snacking.

      Maintain regular dental visits.

      Contact our office right away if you have any problems or concerns

 If you ever have any questions about your dental health contact our office. We are here to take care of you and your health!

 For more information visit our website or send us an email

Stay Healthy ~ Thyroid Cancer: Why Is It on the Rise? Could it dental x-rays be the culprit?

New diagnoses have shot up over the past decade. Here’s what you need to know.
While new cases of some cancers— including breast, lung, and prostate— are leveling off, cancer of the thyroid (an endocrine gland in the neck) is spiking; diagnoses rose a whopping 173 percent between 2002 and 2012, making thyroid cancer one of the fastest-growing types in the U.S.

“Better screening and detection may explain part of the increase,” says Robert Smallridge, M.D., chairman of the division of endocrinology at the Mayo Clinic in Jacksonville, Fla. “Still, research suggests other factors must be at play.” One of the few known causes of thyroid cancer is radiation, and some experts believe excess exposure may be behind the increase. Smallridge is less certain. “The most common radiation sources, such as dental X-rays and airport security scanners, provide extremely low doses,” he says. For its part, the American Thyroid Association says it does not believe that routine dental X-rays, for example, lead to thyroid cancer. Still, a large cumulative exposure over a lifetime may raise your risk. Smallridge recommends always asking your doctor whether an X-ray or a CT scan is truly necessary. He also advises wearing a thyroid collar (a small lead bib that deflects radiation) before dental X-rays. The good news: Thyroid cancer is highly curable and still rare—less than 1 percent of Americans will be diagnosed in their lifetime. To further lower your odds, maintain a healthy weight and load up on vegetables.

reference: Grand Rapids Parade ~ Camille Noe Pagán

What is our office doing to keep you healthy while maintaining the highest level of dental care and diagnosis?

Our office offers digital dental x-rays, commonly called dental films. Digital films are better for you, the patient, because there is 90% less radiation than traditional films and they are better for explaining our findings because you can view the films along with us on the computer monitor. Digital films are also better for the environment, because no harsh chemicals are needed to process this type of film.

When dental films are needed a lead apron with a thyroid collar is used to further reduce any radiation exposure from occurring.

If you ever have a question about the need for a dental film, or your health in general, ask us. This is why we are here. Our goal is to serve you to the best of our ability.

For more information visit our website.

Finding dental decay with Spectra vision

Tooth decay can be extremely painful and puts the teeth at risk. Many extractions and restorative treatments are performed every single day because tooth decay has become too severe for the dentist to save the tooth. Diagnodent^® is a safe fluorescent laser that detects hidden tooth decay accurately, quickly, and in its earliest stages.

All dentists are advocates for healthy, natural teeth. Restoration devices like crowns and bridges are popular because they allow the natural tooth to remain in the mouth. Diagnodent^® accurately exposes areas of tooth decay without scratching, probing or “opening up the tooth.” This provides a greater chance of identifying, treating and retaining a natural tooth without the need for expensive and time-consuming restorations.

How can Spectra vision help me?

Spectra vision accurately exposes more caries than X-rays and examinations. In fact, this revolutionary diagnostic tool is over 90% accurate. Sometimes, caries “go underground” due to fluoridation. This essentially means that lesions that once lay on the surface of the tooth bed down, and remain invisible to the naked eye. Because Spectra vision exposes caries earlier, more treatment options are possible.

Here are some of the other benefits associated with Spectra vision:

• Allows dentists to perform treatment with greater confidence.
• Allows for the investigation of suspicious areas.
• Completely safe.
• Cost effective.
• Empirically measurable results.
• Helps reduce future dental procedures.
• More accurate than any other diagnostic tool.
• No exposure to X-rays.
• No need for invasive investigations.
• No pain or scratching.

What does the Spectra vision process involve?

The Spectra vision process is performed within the scope of a regular dental checkup. It is strikingly similar to having a laser pointer aimed at the teeth. Spectra vision is a hi-tech tool, which first scans a clean tooth surface with a laser beam. This scanning procedure serves to calibrate the instrument by providing information about the tooth structure.

The Spectra vision System is actually measuring the amount of laser fluorescence within the tooth. As each tooth is scanned, the amount of reflected laser light is recorded to produce a digital readout. If the tooth contains little or no decay, little or no laser light will be reflected back to the instrument. However, if a tooth contains caries of any significance, more laser light is reflected back. High readings (compared to the tooth originally scanned) indicate that caries are present within the structure of a particular tooth. The amount of laser light reflected back correlates with the amount of decay within the tooth.

Once the dentist determines which teeth are suffering from decay, a plan can be formulated and treatment options can be discussed. In most cases, the early detection of caries means more treatment options and a greater chance of saving the affected tooth.

For more information visit our website.

Chronic Illness is related to Mouth Germs !

What You Need to Know.

The dental profession has known for decades that the condition of a person’s mouth is directly related to their overall, general health and well-being. Now it appears that the medical community at large is recognizing and even encouraging more research into this connection. It turns out that inflammation and bacterial infections in the mouth are linked to conditions such as diabetes, heart disease, stroke, and even pregnancy issues! Taking care of your teeth and gums is not just about having an attractive smile, it can be essential in staying healthy.

What do we know?
We know that bacterial infection and tissue inflammation are important factors in the development of gum and bone (periodontal) disease. We know that inflammation is also a major factor in the development or worsening of many chronic illnesses. Ironically, inflammation is the first response of a healthy immune system to injury, infection or irritation. It is only when the inflammation spreads or the source of the injury, infection or irritation is allowed to continue, that the entire body suffers.

Here’s why:
Blood vessels dilate around the site of an infection, often causing swelling, redness and heat. White (infection killing) cells rush to an affected area with the purpose of surrounding the bacteria and preventing their spread.
If the infection and the source of the infection is eliminated by the white cells, the situation is resolved. If the cause of the inflammation does not go away or gets worse, the inflammatory process continues.
If the inflammatory process is overwhelmed by infection, the white cells just keep trying. The body recognizes trouble in the system and continues to ignite defenses. If nothing is done about the source of an infection, the swelling, heat, and attack of the white cells will affect more than just the bacteria. Damage can occur to organs, blood vessels, joints and even nerves.
An overstressed inflammatory system also does not do its job of killing bacteria. They can spread and eventually travel throughout the body, doing even more damage.
So, if bacteria in the mouth are not controlled, which is what can happen in chronic gum and bone (periodontal) disease, the body may never shut down the “full body” inflammatory process. Why, because the cause of the inflammation, the bacteria in the mouth, continue to incite the process. It can just go on and on.
The longer bacteria and the inflammation they cause are allowed to spread from the mouth, the higher the chance for damage to the body as a whole.

What can we do?
Here at our office we have many methods of helping people control bacteria in the mouth. We actively look for and treat periodontal disease so that our patients can maintain a healthy immune system. This may include more frequent professional cleanings, or more extensively; root planing and scaling of the teeth to remove diseased tissues and bacteria. In some cases certain medicines may be recommended, and we will provide you with detailed home care instructions and help with your daily mouth cleaning routines. With the mouth germs brought under control, the body’s immune system can begin the healing process.

Even if no dentist has ever previously told you that you need gum and bone care, new conditions require new treatment. It is not uncommon for even “regular” patients to develop mouth infections from time to time and need more than “just a cleaning” such as they have had in the past. Just as a person may develop high blood pressure, having never had it in the past, so may a person develop gum and bone disease. Our bodies change and face challenges all the time.

We are here to help you maintain the health of your mouth, which in turn will make you a healthier person.

Reference: Carrington Dental News