136 E Broadway Bel Air, MD 21014 (410) 838-6222

Archive:

  

Posts for: November, 2018

By Broadway Oral and Maxillofacial Surgery
November 21, 2018
Category: Oral Health
Tags: oral cancer  
NewSalivaTestmayHelpIdentifyOralCancerEarlier

A half million people are diagnosed every year with oral cancer. While other cancers are more prevalent, oral cancer is among the most dangerous with only a fifty percent five-year survival rate.

A major reason for this low rate is because this fast growing cancer is difficult to detect early — diagnosis comes far too often after the disease has already well advanced. In an effort to detect cancer earlier many dentists visually screen for oral abnormalities during checkups, especially patients over fifty, tobacco or heavy alcohol users, patients with a family history of cancer or a medical history of exposure to the sexually transmitted human papilloma virus, HPV-16.

If they detect an abnormality, the dentist often refers the patient to an oral surgeon or other specialist for a possible biopsy. In this procedure the surgeon removes a sample of the abnormal tissue, which is then examined microscopically for cancer cells. A biopsy remains the most effective way to diagnose oral cancer.

Because of the disease's aggressive nature, many dentists lean to the side of caution when referring patients for biopsy. As a result 90% of oral biopsies reveal no cancer. Reducing the number of biopsy referrals is highly desirable, especially for the patient undergoing the procedure. Tissue samples tend to be large to ensure complete detection of any cancer cells. Depending on the size and location of the sample, there may be a risk for loss of function or disfigurement.

A new screening tool using a sample of a patient's saliva could help reduce the number of biopsy referrals. Besides DNA, saliva also contains dormant genes called biomarkers that activate in response to the presence of a specific disease. This particular saliva test identifies those biomarkers for oral cancer if they're present.

A sample with a low score of biomarkers indicates no cancer present (with a statistical confidence of 99%). A medium or high score indicates cancer may be present, but only a biopsy can determine for sure. Using this test, dentists might be able to reduce the number of biopsy referrals and instead be able to employ watchful waiting in certain cases. Because of its simplicity and non-invasiveness, saliva screening could help identify oral cancer earlier.

If you would like more information on early detection and treatment for oral cancer, please contact us or schedule an appointment for a consultation.


By Broadway Oral and Maxillofacial Surgery
November 11, 2018
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”


By Broadway Oral and Maxillofacial Surgery
November 01, 2018
Category: Dental Procedures
Tags: x-rays  
TheSimpleBitewingX-RayisaGameChangerforMaintainingDentalHealth

X-rays are such a routine part of dental care that it's easy to overlook how much this technology has revolutionized detecting and treating tooth decay. It's safe to say x-rays have helped save hundreds of millions of teeth over the last hundred years.

Thanks to its unique properties these invisible electro-magnetic waves give us precise images of the interior structure of teeth and gums. It's so precise that we can clearly detect even a small spot of softened, decayed tooth structure on an exposed x-ray film, often before it becomes visible to the naked eye. As a result, we can begin treating the decay earlier, minimizing the damage and increasing the chances for preserving the tooth.

There are a variety of ways we can utilize x-ray technology in diagnosing dental problems. The one, though, that's used the most is called the bitewing. The name comes from wing-like tabs extending out from a thin frame holding a segment of unexposed film. A technician places the frame inside the patient's mouth with the film on the tongue side of the teeth, and has them bite down on the tabs to hold the frame still. They then aim a camera at the patient's outer cheek, which then emits a very short burst of x-ray energy to expose the film.

Bitewings are popular because they give a full view of the back and side teeth, where decay is often hard to detect, with very little radiation exposure to the patient. And as x-ray technology has progressed over the years with digital processing and more efficient equipment, we can acquire sharper images with even less exposure. We've also developed standard protocols for when and how often we perform x-rays, so that we're getting the most diagnostic benefit for the least amount of exposure time.

Those few minutes getting an x-ray may seem routine, but the benefits to your dental health are truly amazing. The bitewing and other forms of x-rays play a huge role in helping us keep your teeth as healthy as they possibly can.

If you would like more information on x-ray diagnostics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bitewing X-Rays.”