gum disease

E-cigarettes ‘just as harmful as tobacco’ for oral health

Source: www.medicalnewstoday.com
Author: Honor Whiteman

Electronic cigarettes are often marketed as a safer alternative to conventional cigarettes. When it comes to oral health, however, new research suggests vaping may be just as harmful as smoking.

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Researchers suggest vaping may be equally – if not more – harmful for oral health than smoking.

In a study published in the journal Oncotarget, researchers found that the chemicals present in electronic cigarette (e-cigarette) vapor were equally as damaging – in some cases, more damaging – to mouth cells as tobacco smoke.

Such damage can lead to an array of oral health problems, including gum disease, tooth loss, and mouth cancer.

E-cigarettes are battery-operated devices containing a heating device and a cartridge that holds a liquid solution. The heating device vaporizes the liquid – usually when the user “puffs” on the device – and the resulting vapor is inhaled.

While e-cigarette liquids do not contain tobacco – a highly harmful component of conventional cigarettes – they do contain nicotine and other chemicals, including flavoring agents.

According to the Centers for Disease Control and Prevention (CDC), the use of e-cigarettes has increased in recent years, particularly among young people. In 2015, 16 percent of high-school students reported using the devices, compared with just 1.5 percent in 2011.

E-cigarettes are considered by many to be safer than conventional smoking, but because the devices are relatively new to the market, little is known about the long-term effects of vaping on health.

In particular, study leader Irfan Rahman, Ph.D., professor of environmental medicine at the University of Rochester School of Medicine and Dentistry in New York, and colleagues note that there has been limited data on how e-cigarette vapor affects oral health.

Flavored vapor worsens damage to gum tissue cells
To address this gap in research, the team exposed the gum tissue of nonsmokers to either tobacco- or menthol-flavored e-cigarette vapor.

The tobacco-flavored vapor contained 16 milligrams of nicotine, while the menthol flavor contained 13-16 milligrams of nicotine or no nicotine.

The researchers found that all e-cigarette vapor caused damage to gum tissue cells comparable to that caused by exposure to tobacco smoke.

“We showed that when the vapors from an e-cigarette are burned, it causes cells to release inflammatory proteins, which in turn aggravate stress within cells, resulting in damage that could lead to various oral diseases.” said Irfan Rahman, Ph.D.

The researchers note that nicotine is a known contributor to gum disease, but e-cigarette flavoring appeared to exacerbate the cell damage caused by e-cigarette vapor, with menthol-flavored vapor posing the most harm.

While further research is needed to investigate the long-term effects of e-cigarette use, Rahman and team believe their findings indicate that the devices may have negative implications for oral health.

“Overall, our data suggest the pathogenic role of [e-cigarette] aerosol to cells and tissues of the oral cavity, leading to compromised periodontal health,” they conclude.

E-cigarette vapor damaged, killed 53 percent of mouth cells in 3 days
Another study recently published in the Journal of Cellular Physiology builds on the findings from Rahman and colleagues, after finding a high rate of mouth cell death with exposure to e-cigarette vapor over just a few days.

To reach their findings, Dr. Mahmoud Rouabhia, of the Faculty of Dental Medicine at Université Laval in Canada, and colleagues placed epithelial cells from the mouth in a chamber that contained a liquid similar to saliva.

To simulate vaping, the researchers pumped e-cigarette vapor into the chamber at a rate of two 5-second puffs every 60 seconds for 15 minutes a day. This was performed over 1, 2, or 3 days.

On analyzing the vapor-exposed epithelial cells under a microscope, the researchers identified a significant increase in the rate of cell damage and death.

The rate of damage or death in unexposed cells is around 2 percent, the researchers note. However, they found that with exposure to e-cigarette vapor, the number of dead or dying cells rose to 18 percent, 40 percent, and 53 percent over 1, 2, and 3 days, respectively.

While the cumulative effects of the cell damage caused by e-cigarette are unclear, the researchers believe their findings are a cause for concern.

“Damage to the defensive barrier in the mouth can increase the risk of infection, inflammation, and gum disease. Over the longer term, it may also increase the risk of cancer. This is what we will be investigating in the future.” said Dr. Mahmoud Rouabhia

November, 2016|Oral Cancer News|

FDA Clears First Tobacco Product for Marketing

For the first time since it was given the power to regulate tobacco, the US Food and Drug Administration (FDA) has authorized marketing of a new product.

The agency said that eight new smokeless snus products, to be sold in the United States under the “General” brand name by Stockholm-based Swedish Match AB, are now authorized under the premarket tobacco application pathway, which was established by the 2009 Family Smoking Prevention and Tobacco Control Act. Snus cannot be marketed as “FDA-approved,” however.

“Today’s action demonstrates that the premarket tobacco application process is a viable pathway under which products can be marketed, as long as the public health can be protected,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products, in a statement.

This is the first time any tobacco maker has completed the rigorous premarket tobacco application review process at the agency; others have had products approved by proving they are substantially equivalent to what is already on the market.

The agency said that Swedish Match provided evidence that “these products would likely provide less toxic options if current adult smokeless tobacco users used them exclusively.” The agency also agreed with the company that snus’ availability would not result in substantial new use, delay quit attempts, or attract ex-smokers.

Swedish Match had been seeking separately to remove warnings that snus is harmful, but the agency has not yet ruled on that request.

In that separate application, Swedish Match was seeking to have the 10 types of snus it already sells in the United States designated as modified-risk tobacco products. The agency accepted the company’s application in August 2014 and held a meeting of its advisory panel to review the evidence in April 2015.

The company wanted to remove warnings that snus could cause gum disease and tooth loss or mouth cancer. It also sought to label its products with the statement that reads, “No tobacco product is safe, but this product presents substantially lower risks to health than cigarettes.” The advisory committee could not reach consensus on whether snus was a safer alternative to smoking, and also was not convinced that the product would not attract new users. At that meeting, Dennis Henigan, director of legal and policy analysis for the Campaign for Tobacco-Free Kids, said Swedish Match had failed to show that users would not use both cigarettes and snus, or that young people would not initiate use.

Snus, which is ground tobacco, salt, and water, comes in a pouch that users place under their upper lip. It can be used for up to 30 minutes, according to the company. It is popular in Sweden, but less so in the United States. Swedish Match says its General brand accounts for 11% of American convenience store snus sales. The 60 million cans it sells annually in the United States are dwarfed by the billion cans of smokeless tobacco sold.

The Centers for Disease Control and Prevention estimates that less than 4% of adults use smokeless tobacco, with rates highest among men aged 18 to 25 years (10%). A 2014 Centers for Disease Control and Prevention survey of high school students found that 5.5% of overall used smokeless tobacco, and an additional 1.9% reported current use of snus.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

November, 2015|Oral Cancer News|

Researchers Find Hookah Smoking Can Lead to Serious Oral Conditions – Equivalent To Smoking 100 Cigarettes

Source: www.multivu.com
Author: PR Newswire
 
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CHICAGO, Oct. 28, 2015 /PRNewswire/ — According to the Centers for Disease Control and Prevention, 2.3 million Americans smoke tobacco from pipes, and many of those who smoke waterpipes, or hookahs, believe it’s less harmful than cigarettes. However, research published in The Journal of the American Dental Association (JADA) suggests hookah smoking is associated with serious oral conditions including gum diseases and cancer.

“We found that waterpipe smoking is associated with serious health problems affecting the head and neck region,” said study author Teja Munshi, B.D.S., M.P.H of Rutgers University. “The public needs to know they are putting themselves at risk. They should be made aware of the dangers of smoking hookahs.”

The authors conducted a literature review that focused on waterpipe smoking and head and neck conditions. They found waterpipe smoking to be associated with gum diseases, dry socket, oral cancer and esophageal cancer among other conditions. According to the World Health Organization, smoking a hookah is the equivalent of smoking 100 cigarettes, based on the duration and number of puffs in a smoking session.

“This study sheds light on the common misconception that smoking from a waterpipe is somehow safer than smoking a cigarette,” said JADA Editor Michael Glick, D.M.D. “Whether you are smoking a cigarette, an e-cigarette, a cigar, or tobacco from a waterpipe, smoking is dangerous not only to your oral health but to your overall health.”

The American Cancer Society is hosting The Great American Smokeout on November 19, 2015, an annual event that encourages smokers of all kinds to give up the habit. The event asks smokers to quit even for just one day to take a step toward a healthier life.

Millions of Americans still use traditional methods of smoking, but emerging trends in the smoking industry, such as hookah smoking and e-cigarettes pose dangers as well. E-cigarettes are devices that turn liquid into a vapor containing nicotine. In an editorial in the September 2015 issue of JADA, authors warned readers of the potential dangers of e-cigarettes, indicating that oral health effects of their use has been inadequately investigated.

“Additional research is needed on the impact smoking has on overall health, but it’s clear that smoking of all kinds has the potential to be dangerous,” said Dr. Glick.

Dentists have an important role in advising patients of the dangers of smoking. The American Dental Association has long been a proponent of educating the public about its hazards and has urged for continued research into the adverse health effects of tobacco use. For more information on smoking and its oral health effects, visit MouthHealthy.org.

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This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

October, 2015|Oral Cancer News|

Five reasons to schedule a dental exam today

Source: www.theintell.com
Author: Raquel Braemer

Often times we can get caught up in our day-to-day life, neglecting things like routine check-ups. Until, of course, a problem arises. An aching tooth requiring an immediate appointment and possibly requiring time off from work or even an unexpected trip to the Emergency Room. We all know we should make time for routine dental exams. But – if you need some motivation to pick up the phone – here are 5 reasons to schedule that appointment today.

1. 9 in 10 Adults Have Cavities. A recent study from the Centers for Disease Control and Prevention found that 91% of adults ages 20-64 had cavities. Further, 1 in 4 adults had untreated tooth decay.

2. Complications with Diabetes. If you are one of nearly 30 million Americans reported to be suffering from diabetes according to the American Diabetes Association, you are also at risk of developing gum disease. Working with a dentist to develop and maintain good oral health practices could help you control your diabetes.

3. Early Detection of Oral Cancer. The American Cancer Society reports that 39,500 Americans are expected to get oral cancer in 2015. Your dentist’s chair is often the first place these cancers of the tongue, tonsils, and gums can be identified. Early detection and treatment are critical to survival.

4. Good Oral Health Means Good Overall Health. Studies continue to show that good oral health has correlations to reduced risk of diabetes, arthritis, stroke, and heart disease. In fact, the Surgeon General now reports on the state of Oral Health in America because of this.

5. Save Money. If the four previous health reasons aren’t concerning enough, then consider how much money you will save. If you don’t have dental insurance or qualify for free care at a clinic like HealthLink, you may be deterred by the out-of-pocket cost of a dental exam and cleaning. The median cost for a dental exam in the United States is currently $261, according to data from OKCopay. However, allowing problems to progress to the point of requiring a root canal could cost you between $700 and $900.

five-reasons

September, 2015|Oral Cancer News|

Mouth bacteria trigger oral cancer

Source: www.digitaljournal.com
Author: Tim Sandle

Chemicals released from two bacteria that cause gum disease can incite the growth of deadly lesions and tumors in the mouth, trigger oral cancer. This is according to a new study carried out by Case Western Reserve University.

High levels of certain bacteria found in the saliva of people are associated with the risk of oral cancer. The researchers were keen to understand why most people never develop oral cancer and what it is that protects them. Their answer related to most people not carrying a certain type of bacteria in their mouths.

The cancer of concern is Kaposi’s sarcoma-related (KS) lesions and tumors in the mouth. The bacteria associated with this are the species Porphyromonas gingivalis and Fusobacterium nucleatum. These species are associated with gum disease.

For the research, scientists recruited 21 patients, dividing them into two groups. All participants were given standard gum-disease tests. The first group of 11 participants had an average age of 50 and had severe chronic gum disease. The second group of 10 participants, whose average age was about 26, had healthy gums. The bacteria were common to those with gum disease.

By carrying out further tests, the researchers found that the bacteria produce fatty acids and these fatty acids then allowed oral cancer causing viruses to grow. The discovery could lead to early saliva testing for the bacteria. When such bacteria are found the mouth of a patient could be treated and monitored for signs of cancer and before it develops into a malignancy.

The findings have been reported in The Journal of Virology, in a paper titled “Short Chain Fatty Acids from Periodontal Pathogens Suppress HDACs, EZH2, and SUV39H1 to Promote Kaposi’s Sarcoma-Associated Herpesvirus Replication.”

February, 2014|Oral Cancer News|

Study links gum disease, HPV-status of head and neck cancer

Source: www.buffalo.edu/ubreporter
Author: Sara R. Saldi

Human Papilloma Virus (HPV), once almost exclusively associated with cancer of the cervix, is now linked to head and neck cancer. Furthermore, according to a new UB study just published in the Archives of Otolaryngology—Head & Neck Surgery, a JAMA publication, gum disease is associated with increased odds of tumors being HPV-positive.

Primary investigator Mine Tezal, assistant professor of oral biology in the School of Dental Medicine, and a team of scientists from UB evaluated data from 124 patients diagnosed with primary head and neck squamous cell carcinoma (HNSCC) between 1999 and 2007.

“The aim of the study was to test the presence of periodontitis, a persistent inflammatory process and HPV-status of HNSCC,” Tezal says.

Of the 124 tumor samples Tezal and her team studied, 50 were positive for HPV-16 DNA and that subjects with HPV-positive tumors had a significantly higher severity of periodontitis when compared to subjects with HPV-negative tumors.

According to the National Cancer Institute, there has been a steady increase in the prevalence of oropharyngeal cancers in the U.S. since 1973. This is despite the significant decline in tobacco use since 1965, a year after the U.S. Surgeon General issued the landmark Report on Smoking and Health. Tezal notes that this increase has mainly been attributed to oral HPV infection.

Understanding the natural history of the oral HPV infection and targeting factors associated not only with its acquisition but also with its persistence, says Tezal, will lead to more effective strategies, not only for prevention, but also for treatment.

“While there is an effective vaccine for cervical HPV infection if given prior to the exposure of the virus (females 9-26; males 9-21), oral HPV infection can be transmitted at or any time after birth, and the target population for a vaccine to prevent oral HPV infection has not yet been defined,” says Tezal.

Tezal pointed out that though many previous studies combined periodontitis and dental decay as indicators of poor oral health, dental decay was not significantly linked to tumor-HPV status in the present study.

“The fact that only periodontitis was associated with tumor HPV status points to the potential association of [this] inflammation with tumor HPV status,” she says.

When Tezal and colleagues started their research about eight years ago they were looking at the potential association between chronic inflammation and head and neck cancers because the importance of the local oral environment for malignant tumor growth was widely accepted. However there wasn’t research evaluating the role of local oral factors in the natural history of HNSCC, Tezal says.

“The next step in this research will be intervention studies to test whether treating the sources of inflammation, like gum disease, can reduce the acquisition and/or persistence of oral HPV infection and improve the prognosis of HPV-related diseases,” she says.

Tobacco use and baseball

Source: www.quitsmokingforyou.com

Like cigarettes, smokeless tobacco (snuff and chewing tobacco), cause mouth cancer, gum disease, and heart disease. Yet many think that chewing tobacco is safe or less so than smoking. This is not true!

In 1986, the Surgeon normal closed that the use of smokeless tobacco “is not a safe substitute for smoking cigarettes. It can cause cancer and a whole of noncancerous conditions and can lead to nicotine addiction and dependence.” Since 1991, the National Cancer institute (Nci) has officially recommended that the group avoid and desist the use of all tobacco products, including smokeless tobacco. Nci also recognizes that nitrosamines, found in tobacco products, are not safe at any level.
Chewing tobacco and baseball have a long tight affiliation, rooted in the cultural confidence among players and fans that baseball players chew tobacco and it is just part of the grand old game. This mystique is slowing changing with campaigns by ballplayers who have had or have seen friends with mouth cancer caused by chewing tobacco use.

Jeff Bagwell
Jeff Bagwell, retired first baseman with the Houston Astros and Joe Garagiola, a previous baseball player and commentator, campaign against tobacco use among children and addicted adults. In 1993, when Bagwell was 25-years-old, his dentist discovered leukoplakia, a whitish pre-cancerous sore in his mouth where he continually located chewing tobacco. About 5% of leukoplakias institute into cancer. Fortunately this did not happen to Jeff Bagwell due to the early detection by his dentist.

Rick Bender, The Man Without a Face
In 1988 Rick Bender, a 25 year old minor league baseball player advanced a large sore on the side of his tongue that would not go away for months. He began using ‘spitting tobacco’ when he was 12. After finding his dentist and then a biopsy by a specialist, he was diagnosed with mouth cancer.

Surgeons successfully removed the cancerous cells from Bender’s mouth and throat, taking a chunk of his tongue and the lymph nodes on the right side of his neck in the process. But removing the cancer also caused nerve damage that puny the use of his right arm, his throwing arm, which ended his baseball career. Later an infection occurred to the right side of Bender’s jaw after radiation therapy. As a result, it deteriorated and doctors had to remove his right jaw.

As a follow Rick Bender calls himself “the man without a face” and lectures on the dangers of ‘spitting tobacco’ throughout the nation. Bender visits schools and colleges over the country to dispel what he sees as the myths about chewing tobacco. He also addresses major and minor league baseball players each year at spring training.

Robert Leslie
Sonoma County has it own tragic baseball related, smokeless tobacco, and mouth cancer story. In June of 1998, Robert Leslie died at the young age of 31 from mouth cancer after years of chewing smokeless tobacco. He had been diagnosed four years prior and had bravely counseled youths against the use of smokeless tobacco after that point. Leslie, who was a star pitcher at Rancho Cotate High School, turned to coaching after a brief attempt at playing expert baseball. He was a popular coach at Casa Grande High School. He believed, rightly so, that the cancer had resulted from years of stuffing wads of smokeless tobacco between his gums and lower lip. He advocated against the use of chewing tobacco prior to his death. He is missed.

History Of Tobacco Use and Baseball
Tobacco has a long association with baseball. From the earlier beginnings of baseball in the late 1800′s, baseball players chewed tobacco to keep their mouths moist in dusty dirt parks of that era. Drinking water was thought to make one feel too heavy. Players also used tobacco spit to soften leather gloves and to give the spitball its wild gyrations canada viagra.

Chewing tobacco’s popularity among baseball players rose and fell with the times, most often trading places with cigarettes and cigars. The wrongful confidence that chewing tobacco caused the spread of tuberculosis lead to its reduction in use during the end of the nineteenth century. during the beginning of the twentieth century, it again rose to major use until after Wwii when cigarettes became more popular in the U.S.

During the 1950s, cigarettes reached their most prominence when teams legitimately had sponsored brands. For example, Giant’s fans (New York Giants that is) smoked only Chesterfield Cigarettes to show their team loyalty. during this era, baseball cards were often packaged with cigarettes. As a kid, I remember having my Dad buy Lucky Strikes so I could get the baseball cards.

In 1962, the Surgeon General’s record highlighted the cause and follow between smoking and heart disease and smoking and cancer. Believing that chewing tobacco was a safer product, baseball players took up smokeless tobacco again. Since then, smokeless tobacco has dominated the sport of baseball, from the major leagues down to the high school level. And similar to the targeted cigarette marketing of the 1950s, smokeless tobacco producers have promoted tobacco chewing straight through baseball players, even providing free samples in major and minor league clubhouses.

All tobacco, including smokeless tobacco, contains nicotine, which is addictive. The whole of nicotine absorbed from smokeless tobacco is 3 to 4 times the whole delivered by a cigarette. Nicotine is absorbed more slowly from smokeless tobacco than from cigarettes, but more nicotine per dose is absorbed from smokeless tobacco than from cigarettes. Also, the nicotine stays in the bloodstream for a longer time.

By giving players free samples of chew tobacco, the smokeless tobacco manufacturers were getting players hooked to the addictive drug nicotine in a tobacco goods that contains 28 cancer-causing substances. Even today, I saw a full-page magazine ad from R.J. Reynolds Tobacco Co. With a free coupon for Camel Snus. It was advertised as “Spitfree” and “Sold Cold” in large bold print, while in small print a warning stated, “this goods may cause gum disease and tooth loss.”

Big League Chew, a chewing gum aimed at children, is a goods that uses the deep association between baseball and chewing tobacco. Introduced in 1980, Big League Chew consists of shredded bubble gum, which resembles loose chewing tobacco. It is packaged in an aluminum foil pouch, similar to the containers of chewing tobacco, with the cartoon image of a baseball player on the outside. While candy cigarettes, other symbolic tobacco goods aimed at children, fell out of favor years ago, Big League Chew continues to be popular with kids.

Luckily, the love affair between baseball and smokeless tobacco seems to be subsiding. In 1993, minor league baseball banned all use of tobacco products among its teams. As follow fewer major leaguers are now coming up from those ranks using tobacco products. Campaigns are manufacture headway discouraging tobacco use and encouraging substitute habits like chewing gum or munching on sunflower seeds. Remember previous Giants employer Dusty Baker, setting an example for young players by stopping tobacco use and chewing sunflower seeds in the dugout?

Still an estimated 7.6 million Americans age 12 and older (3.4 percent) have used smokeless tobacco in the past month, and smokeless tobacco use is most common among young adults ages 18 to 25.

So if you use tobacco, please stop. It is the best thing you can do for your health. There are many tobacco cessation programs and nicotine change treatments. And make sure to have regular cancer screening examinations with your dentist. Early detection is indispensable for preventing mouth cancer.

If teeth could talk…

Source: wsj.com
Author: Melinda Beck

The eyes may be the window to the soul, but the mouth provides an even better view of the body as a whole.

Some of the earliest signs of diabetes, cancer, pregnancy, immune disorders, hormone imbalances and drug issues show up in the gums, teeth and tongue — sometimes long before a patient knows anything is wrong.

There is also growing evidence that oral health problems, particularly gum disease, can harm a patient’s general health as well, raising the risk of diabetes, heart disease, stroke, pneumonia and pregnancy complications.

“We have lots of data showing a direct correlation between inflammation in the mouth and inflammation in the body,” said Anthony Iacopino, director of the International Centre for Oral-Systemic Health, which opened at the University of Manitoba Faculty of Dentistry in Canada in 2008.

Recent studies also show that treating gum disease improves circulation, reduces inflammation and can even reduce the need for insulin in people with diabetes.

Such findings are fueling a push for dentists to play a greater role in patients’ overall health. Some 20 million Americans — including six percent of children and nine percent of adults — saw a dentist but not a doctor in 2008, according to a study in the American Journal of Public Health this month.

“It’s an opportunity to tell a patient, ‘You know, I’m concerned. I think you really need to see a primary care provider,’ so you are moving in the direction of better health,” said the study’s lead researcher Shiela Strauss, co-director of statistics and data management for New York University’s Colleges of Nursing and Dentistry.

George Kivowitz, a restorative dentist with offices in Manhattan and Newtown, Pa., said he has spotted seven cases of cancer in 32 years of practice, as well as cases of bulimia, due to the telltale erosion of enamel on the back of the upper front teeth — as well as methamphetamine addiction. “We call it ‘meth mouth,'” he said. “The outer surface of teeth just rot in a way that’s like nothing else.”

Some of the most distinctive problems come from uncontrolled diabetes, Dr. Kivowitz adds. “The gum tissue has a glistening, shiny look where it meets the teeth. It bleeds easily and pulls away from the bone—and it’s all throughout the mouth.”

An estimated six million Americans have diabetes but don’t know it—and several studies suggest that dentists could help alert them. A 2009 study from New York University found that 93% of people who have periodontal disease are at risk for diabetes, according to the criteria established by American Diabetes Association.

It’s not just that the same lifestyle habits contribute to both gum disease and high blood sugar; the two conditions exacerbate each other, experts say. Inflammation from infected gums makes it more difficult for people with diabetes to control their blood-sugar level, and high blood sugar accelerates tooth decay and gum disease, creating more inflammation.

Diabetes also complicates dental-implant surgery, because it interferes with blood vessel formation and bone growth. “When you put a dental implant in, you rely on the healing process to cement it to the jaw, so you get a higher failure rate with diabetes,” says Ed Marcus, a periodontist in Yardley, Pa., who teaches at the University of Pennsylvania and Temple University dental schools.

Dr. Marcus notes that about 50% of periodontal disease is genetic—and even young patients can have significant bone loss if they have an unusually high immune response to a small number of bacteria. Giving such patients a low dose of doxycycline daily can help modify the immune response. “It doesn’t really control the bacteria, but it helps reduce the body’s reaction,” he says.

There’s also growing evidence that the link between periodontal disease and cardiovascular problems isn’t a coincidence either. Inflammation in the gums raises C-reactive protein, thought to be a culprit in heart disease.

“They’ve found oral bacteria in the plaques that block arteries. It’s moved from a casual relationship to a risk factor,” says Mark Wolff, chairman of the Department of Cariology and Comprehensive Care at NYU College of Dentistry.

Bacteria from the mouth can travel through the bloodstream and cause problems elsewhere, which is why people contemplating elective surgery are advised to have any needed dental work performed first.

The American Heart Association no longer recommends that people with mitral valve prolapse (in which heart values close abnormally between beats) routinely take antibiotics before dental procedures, since it’s now believed that oral bacteria enter the bloodstream all the time, from routine washing, brushing and chewing food.

But the American Heart Association, the American Medical Association and the American Orthopedic Association all urge people who have had a full joint replacement to take an antibiotic one hour before any dental visit for the rest of their lives to reduce the risk of post-surgical infections. “I have my guidelines taped to the door in my hygienists’ room,” Dr. Kivowitz says.

Dentists say they also need to stay up to date with all medications, supplements and over-the-counter drugs their patients are taking. Blood thinners can create excess bleeding in the mouth. Bisphosphonates, often prescribed for osteoporosis, can severely weaken jaw bones. Both should be stopped temporarily before oral surgery.

Antihypertensive drugs, calcium-channel blockers and some anti-inflammatory drugs can cause painful ulcerations of the gums. Many medications, from antidepressants to chemotherapy drugs, cause dry mouth, which can cause cavities to skyrocket, since saliva typically acts as a protective coating for teeth. Additional fluoride treatments can help.

Some proactive dentists have glucose monitors for another check on blood-sugar levels if they suspect diabetes. Some also take patients’ blood pressure and hold off on invasive procedures if it’s extremely high.

The Centers for Disease Control and Prevention recommends that dentists offer HIV testing, because some of the first symptoms appear in the mouth, including fungal infections and lesions. Dentists can do the HIV test with a simple mouth swab and get results in 20 minutes.

Breaking the bad news is often more difficult. “I went into oral surgery because I didn’t think I would have to deliver that kind of news to patients,” says Clifford Salm, an oral and maxillofacial surgeon in Manhattan who has found leukemia, lymphoma, AIDS and metastatic breast cancer after performing biopsies on suspicious spots. “It can be a difficult conversation,” he says, “but most patients are very grateful.”

Don’t Be Fooled by White, Shiny Teeth
A gleaming, white smile is a sign of a healthy mouth, right? Not necessarily.

“Whiteness and the health of your teeth are totally unrelated,” says Mark Wolff, an associate dean at New York University College of Dentistry.

In fact, many dentists worry that people who whiten their teeth may have a false sense of complacency, since their teeth can still be harboring tooth decay and serious gum disease.

Even people who have no cavities can still have inflamed and infected gums. It could be that their saliva is particularly protective of their tooth enamel, while their brushing and flossing habits, needed to keep gum tissues healthy, could be lax.

“I get these patients in their mid-30s who don’t have cavities, so they haven’t been to a dentist in 10 years. But they have full-blown periodontal disease,” says George Kivowitz, a restorative dentist in Manhattan. “They are losing all the supporting structure, and I have to tell them that these gorgeous teeth will fall out of your head if we don’t turn this around.”

Using whitening products more often than recommended can erode some of the enamel and cause teeth to appear translucent. But whether that actually harms teeth is controversial. “No one has really shown that it’s damaging, but no one knows the long-term results,” says Dr. Marcus, the periodontist in Yardley, Pa.

January, 2012|Oral Cancer News|

Smokeless tobacco may be on its way out of Major League Baseball parks

Source: www.latimes.com
Author: Karen Kaplan, Los Angeles Times

Major League Baseball begins the 2011 season in two days, and if public heath officials have their way it will be the last season during which players will be able to chew and spit smokeless tobacco on the field.

The leaders of 15 public health departments in cities with professional baseball teams sent a letter Monday to MLB Commissioner Bud Selig and Michael Weiner, executive director of the union representing major league players, urging them to forbid the use of smokeless tobacco products. Tobacco has been banned in baseball’s minor leagues since 1993.

“The use of smokeless tobacco endangers the health of Major League ballplayers and sets a terrible example for the millions of young people who watch baseball at the ballparks and on TV,” the health chiefs wrote. The letter continues:

Tobacco use is the number one cause of preventable death in the United States, killing more than400,000 people each year. As cigarette smoking has declined, the tobacco industry has increased its marketing of smokeless products and is spending record sums to promote them. But smokeless tobacco use is itself very dangerous, causing serious diseases of the mouth, including oral cancer. In addition, there is reason to worry that smokeless tobacco use by young persons may serve as a gateway to cigarette smoking, this nation’s leading preventable cause of premature death and disease.

As officials in Major League cities around the country, we know that baseball is important to civic life and that ballplayers are local heroes. They should provide positive role models and not associate themselves with a product that causes disease and death.

Signatories include Dr. Jonathan Fielding, director of the Los Angeles County Department of Public Health; Dr. Thomas Farley, commissioner of the New York City Department of Health and Mental Hygiene; Dr. Bechara Choucair, commissioner of the Chicago Department of Public Health; Barbara Ferrer, executive director of the Boston Public Health Commission; Dr. Oxiris Barbot, commissioner of the Baltimore City Health Department; and 10 others representing cities from Seattle to the District of Columbia.

It’s certainly hard to argue that smokeless tobacco is good for public health. The products cause oral cancer and pancreatic cancer, and have been linked with other types of cancer. They also contribute to heart disease, gum disease and other problems.

The “Knock Tobacco Out of the Park” campaign was initiated by the American Academy of Pediatrics, the American Medical Assn., the American Cancer Society, the American Dental Assn., the American Heart Assn., the American Lung Assn., Oral Health America, Legacy, the Campaign for Tobacco-Free Kids and the Robert Wood Johnson Foundation. They are urging action now because Major League Baseball and the players union are negotiating a new contract that will take effect next year and is expected to remain in force for five seasons.

The prohibition would apply to managers, coaches and other baseball staff in addition to players.

The issue has received significant attention from members of Congress, with Democratic Senators Richard Durban of Illinois and Frank Lautenberg of New Jersey pressing the players union and the league to include a smokeless tobacco ban in their new contract. They were motivated in part by a Washington Post story in which Nationals pitching ace Stephen Strasburg explained why be began dipping tobacco and why he has resolved to quit:

“I was one of those kids that picked it up based on seeing ballplayers do it,” Strasburg said. “It’s not a good thing, and I don’t want to represent myself like that. That’s one of the big reasons. Another reason is, when I do have kids, I don’t want my kids to be like that, too.”

Among the role models Strasburg imitated was Hall of Famer Tony Gwynn, the former San Diego Padres star who coached Strasburg at San Diego State University. Last summer, Gwynn was diagnosed with cancer of the parotid gland, a salivary gland on the jawline. The tumor had wrapped itself around a crucial nerve that controlled movement on the right side of his face. Treatment was no picnic.

“Surgery to remove a tumor resulted in paralysis in the right side of his face, compromising his ability to smile or laugh,” according to this Los Angeles Times story. “He couldn’t blink his right eye. Radiation and chemotherapy left him so weak that he had to use a walker to get around. He estimated that he lost about 80 pounds from his 300-plus-pound frame.”

Gwynn has blamed his tumor on smokeless tobacco, which he has been addicted to since his rookie days with the minor league Walla Walla Padres in Washington State.

For more on the campaign against smokeless tobacco, you can visit the coalition’s website here.

March, 2011|Oral Cancer News|

Tobacco ‘mints’ tied to kids’ poisoning

Source: msnbc.com
Author: JoNel Aleccia


Smokeless, flavored tobacco products that look like candy and come in packages shaped like cell phones may be contributing to accidental poisonings in very young children, new research suggests.

Nicotine-laced pellets, strips and sticks that dissolve completely in the user’s mouth — dubbed “tobacco candy” by critics — have joined chewing tobacco and snuff to become the second-most common cause of unintentional tobacco ingestion in kids younger than 6.

Between 2006 and 2008, nearly 1,800 U.S. youngsters — almost 600 a year —accidentally consumed smokeless tobacco products, according to an analysis of 13,705 tobacco-related reports to the nation’s poison control centers. That’s a fraction of the nearly 3,600 poisonings a year that involved cigarettes and filter tips, but it worries authors of the new study published in the journal Pediatrics.

“Novel smokeless tobacco products, including dissolvable, compressed tobacco products … are now of major concern, with their discreet form, candy-like appearance and added flavorings that may be attractive to children,” the authors write.

Potential poisonings add to the growing list of worries from those who fear that tobacco makers thwarted by anti-smoking laws are trying to peddle their addictive products to a new generation of users. Tasty flavors and packaging that resembles Tic Tac mints could be a powerful draw to young users, critics say.

“Our response has been one of dismay,” said Cathryn Cushing, a spokeswoman for the Oregon Tobacco Prevention & Education Program. Oregon is one of three states, along with Ohio and Indiana, tapped as a test market for Camel Orbs, tobacco pellets that contain mint and other pleasant flavors.

“They lost the battle of second-hand smoke and they’re trying to make up for that.”

Not so, said a spokesman for R.J. Reynolds Tobacco Company, which makes Orbs along with Camel Strips and Camel Sticks. David P. Howard, director of communications, said the firm is only trying to offer an alternative for legal smokers who can’t or don’t want to quit and who prefer to enjoy tobacco use without violating laws or social norms.

“They provide adult tobacco consumers options to do it without bothering others,” said Howard, who noted that the products are not only smokeless, but also spit-less and litter-free.

The Camel products are packaged in child-resistant packages, sold only to adults 18 and older, and marketed on websites that include strict age verification safeguards, he said.

“Adult tobacco consumers should be diligent about keeping tobacco and all nicotine products away from children,” said Howard, who added that other household items, such as vitamins and cosmetics, poison far more children each year.

But that doesn’t convince public health officials like Alfred Aleguas Jr., managing director of the Northern Ohio Poison Center and co-author of the Pediatrics study. Even a single Orb, which contains about 1 milligram of nicotine, is enough to sicken a small child, he said, adding that a handful of pellets potentially could be lethal.

A 3-year-old in Oregon ingested Orbs last summer, according to the state’s poison center. In Indiana, two toddlers suffered mild poisoning after ingesting “snus,” small packages of flavored smokeless tobacco.

“To have this be relatively new on the market and to already have exposure, I think that’s significant,” said Aleguas.

Snus is among several products marketed in the past few years by Reynolds and Philip Morris USA as the tobacco makers expanded their smokeless holdings in response to a changing climate.

Should tobacco ‘mints’ be allowed to be sold?
Smoking rates down, tobacco consumption up

Cigarette consumption has plummeted in the United States, even as smokeless tobacco consumption has gone up. Howard estimated that cigarette volumes have fallen between 10 percent and 11 percent in recent years, while the smokeless tobacco market has risen between 5 percent and 6 percent.

Between 1996 and 2006, the average per-capita number of cigarettes smoked fell from 2,355 a year to 1,650 a year, according to the United States Department of Agriculture. During that same period, consumption of snuff rose from .31 pounds to .38 pounds a year.

Critics charge that attracting young users through more palatable smokeless tobacco products is the goal of the new marketing efforts. In the U.S., 13.4 percent of high school boys and 2.3 percent of high school girls use smokeless tobacco, according to the Campaign for Tobacco-Free Kids, based in Washington, D.C.

Slick advertisements for Camel Orbs, Camel Sticks and Camel Strips appear to directly target high school students and pre-teens said Terry E. Pechacek, associate director for Science in the Office on Smoking and Health at the Centers for Disease Control and Prevention in Atlanta.

“Underage children are being reached by this advertising,” said Pechacek, who co-authored the new study. “They can use it in school settings, they can use it around their parents, they can use it in other social settings.”

Howard denied that the tobacco firm targets young users.

At issue, of course, is the health harm from tobacco use. Because there’s no burning, the risk of lung cancer may be lower with smokeless products, but the products are linked to oral cancers, gum disease, nicotine addiction and heart disease. Even the Camel site carries a bold reminder that the dissolvable products can cause mouth cancer.

“All tobacco products carry risk,” Howard said. “We are marketing them as tobacco products.”

Another worry, Pechacek said, is that two-thirds of young smokeless tobacco users are increasingly combining the products with cigarettes, and more than half of users aged 12 to 17 are using both.

“The real potential is that those types of dual users, if they maintain that pattern, may have lifelong risks very similar to smokers,” he said.

The new products didn’t sit well with Ohio Sen. Sherrod Brown and Oregon Sen. Jeff Merkley, who were outraged when Camel Orbs were test-marketed in their states.

“Tobacco candies are clearly designed to appeal to children through both packaging and taste,” Merkley said in a press release. “Congress and the FDA must act quickly to ensure our children do not become victims of the tobacco companies’ latest efforts to hook new generations of Americans on deadly products.”

FDA restricts tobacco marketing to kids
Nicotine builds up slowly in the brain
Panel to examine menthol cigarettes’ impact

Together, Brown and Merkley authored an amendment that was included in groundbreaking legislation last year that gave the FDA new power to regulate tobacco products. It put dissolvable tobacco on the inaugural agenda of the Tobacco Products Scientific Advisory Committee, which met for the first time last month. The committee must issue a report on the public health impact of the products within two years, according to the new law.

In the meantime, the good news for anti-tobacco groups is that interest in the new smokeless products, which retail for between $4 and $5 a pack, hasn’t set sales on fire. Howard says the company is optimistic about early response, but there are no immediate plans to roll out the product nationwide.

“For a tobacco product, it’s been quite slow,” said Tim Cote, vice president of marketing for Plaid Pantry, based in Beaverton, Ore., a grocery chain that first sold Orbs.

“While we carry them, they’re an item that would be borderline dropped,” Cote said. “How good has the trial been? Not very good.”

April, 2010|Oral Cancer News|