Helaine Smith DMD

I write another blog for dentists on Dr. Bicuspid.com and was shocked to read last week that one dentist is advocating that all dentists should treat children on Medicaid.

This statement shocked me because not all dentists are geared toward treating children — even those not on Medicaid. This is certainly the case for me. As I’ve written before in an interview with my colleague, Dr. Lance Kisby, about the David After Dentist video, treating children comes with its own challenges.

I’m not a pediatric dentist nor have I received the specialized training required to be one, so when my patients ask me to treat their children as well, I have to tell them no.

However, the dentist that made this statement does have a point. It’s been well-documented that parents on welfare do not take their children to the dentist. It’s also well-documented that poor oral hygiene and oral health lead to other complications in children.

Children, whether they’re on Medicaid or live in $1 million dollar homes, need good dental care from the time their baby teeth begin coming in.

What this country really needs are dental clinics where low-income people can go for good basic dental care — i.e. routine check-ups, fillings, etc. These clinics could be staffed by newly minted graduates of dental schools and hygienists who earn a salary versus subsisting on Medicare reimbursements.

These clinics would help lower the abuse low-income people receive at the hands of dentists whose practices are based on seeing high numbers of Medicaid patients. They would also help lower the incidence of caries and other oral health problems in children — saving money in the long run as children would then not have to visit the doctor for complications due to poor oral health.

What do you think? Am I right or wrong?

Estelle, a lovely woman, came to my practice on the advice of two 90-year old women in her senior club.

Over a year ago she had been experiencing pain in her mouth, which her general dentist diagnosed as an infection.

As she describes in the video below, the dentist sent her on to a periodontist and after realizing her infection wasn’t responding to antibiotics, the periodontist sent her to an oral surgeon. The oral surgeon did a biopsy and, realizing she had oral cancer, sent Estelle to Dana Farber for treatment.

Estelle didn’t drink or smoke and definitely did not have multiple partners (her exact words!), so she definitely was low-risk with regard to oral cancer.

She also had all her teeth, which were in great shape, and perfect bone.

Due to the advanced state of her cancer, Estelle had to have more than half of her maxilla (upper jaw) removed and underwent radiation treatment every day for months.

In the video she describes how oral cancer has affected her life.

Despite her travails, she remains upbeat.

But here’s the deal: Every single dentist in the United States should be performing an oral cancer screening every single time he or she sees a patient for a routine checkup.

And, any type of sore or “infection” that looks even slightly suspicious should be checked — pronto. It’s a shame that a woman as beautiful as Estelle lost half of her upper jaw bone due to her cancer not being caught in time.

Don’t let this happen to you. It’s your right to insist on oral cancer screenings. If your dentist doesn’t do them, find a new dentist.

Dental Implants: The Five Questions to Ask Your Dental Professional – Download now. No registration required.

As the “new” thing in dentistry, dental implants have received considerable press of late. And it’s no wonder. With implants, dentists can replace patients’ missing teeth with strong, stable devices that look and feel just like real teeth.

Many medical procedures are now marketed directly to consumers, including liposuction, laser eye surgery and cosmetic surgery, which means you need to do your homework in order to safeguard your health.

The same is true for dental implants as having one or more placed in your mouth is not a trivial matter.

Dental implants require know-how and expertise that can’t be obtained in a weekend continuing education course. In an effort to educate you, Dr. Favaloro, a board certified periodontist, and I developed this e-book.

In it you’ll learn the technical details about dental implants and how the procedure is performed. Most important, we give you the five questions you must ask your dentist before agreeing to dental implant surgery, including:

• Am I dental candidate? – Not everyone can accept dental implants. You’ll learn why.
• What is your training? – Not all dentists are qualified to perform implant surgery. We tell the differences between the various dental specialties and the training each type of professional received in order to help you choose the right professional.
• Where will the CT scan be performed? – Qualified dentists use CT scans to properly place your implant — we tell you why they’re important.
• How many implant procedures have you performed? – You’ll learn the difference between those who took weekend “mill” courses and those who really know what they’re doing.
• Do you have pictures of previous cases? – A picture speaks a thousand words – and we tell you why you shouldn’t settle for “smile” photos.

Download your copy of Dental Implants: The Five Questions You Must Ask Your Dental Professional, forward it to your friends, and post it to your blog. It’s information you need to make good medical choices.

If you like this e-book, please let me know. And, if you have questions about dental implants or other procedures, please post them below and I’ll answer them.

Undergoing local anesthesia at the dentist office means one thing: numb gums for hours after your appointment. As a dentist, I know you hate when you feel like your lower lip is hanging down past your chin.

I’m very pleased to announce that our office now offers OraVerse. In official language, it’s an “anesthesia reversal agent.” In regular English, it means you can reverse the numbness associated with local anesthetics in about 30 minutes.

Average numbness can last 3 – 5 hours and can make it difficult to speak, smile, and eat or drink. If you’re a professional and need to get back to work to make a presentation or attend a meeting, you don’t want the after effects of local anesthesia.

OraVerse is a new product released earlier this year. In clinical trials with over 700 patients, there was no significant differences in adverse events versus control.

Be sure to ask for it the next time you’re in my office (or your own dentist’s office). I’m pleased to offer yet another way to increase my patients’ comfort.

As a dentist, I can tell quite a bit about you just by looking at your tongue.

A heavy white coating, for example, tells me you might have dry mouth, as this coating is dead bacteria that used to thrive in the moist environment of the mouth.

Dentists look at your tongue for signs of stress, gum disease and other disorders. A healthy tongue is pink with some texture to it. This article, Tongue Terror: What is Your Tongue Telling You? from AOL Health explains what else your tongue can tell you. Be sure to read it — it’s fascinating!

A tongue with a sore on it that doesn’t heal is a warning sign of possible oral cancer . . . which is a great segue into the topic of the week. It’s Oral, Head & Neck Cancer Awareness Week and as one of 230 participating medical facilities around the world, we offered free oral cancer screenings on Monday.

Participation from the local community was hmmmm . . . limited, but we still had a great time. Suzy (pictured above, right) our hygienist, explained how she teaches her patients about oral cancer and gave us a demonstration of how she does an oral cancer screening.

She has a patient stick out their tongue, for example, so that she can look at the back and sides, where oral cancer often begins — unnoticed. She also looks below the tongue and at the back of the mouth. In addition, she advises patients to wear Chapstick or lip balm with sunscreen, as the lips are susceptible to skin cancer, and she feels the back and sides of the neck for any swelling or lumps.

“All hygienists and/or dentists should be performing oral cancer screenings as a matter of course,” said Suzy. “If your dentist isn’t doing it — then he/she is shirking his duty and is missing an important patient education opportunity.”

If you’re still not convinced, be sure to read this article from CNN Health — Oral Cancer’s Toll Cruel.

Thank you, Suzy, for your enthusiasm and support. And thank you to the OHANCAW folks who sent us some really nice posters, buttons and T-shirts. We had a great time and while it would have been nice to see more support for this important event from the local media, we’re happy to have participated and look forward to next year!

(And remember, when the Boston media starts covering oral cancer in the next year or two, you can pat yourself on the back for already being educated as you read about oral cancer and HPV infection on this blog first. I’ve been talking about it since 2008!)

As part of Oral, Head & Neck Cancer Awareness Week, April 12 – 18, 2010, my Dedham Family Dental office is offering free oral cancer screenings.

We’re one of 200 medical centers throughout the world that’s participating in this fabulous event!

If you’re in the Dedham, MA area, please feel free to drop by between 9:00 and 1:00 PM on Monday, April 12, and our hygienist, Suzy (whom you’ll love), will do the screening. This is absolutely free — and you do not have to be a patient.

The Head and Neck Cancer Alliance (HNCA) has expanded its list of at-risk populations for oral, head and neck cancers to include sexually active adults who engage in common sexual behaviors, such as open-mouth kissing and oral sex.

The HNCA is urging all who may be at risk for these cancers to take advantage of free screenings during the 13th annual Awareness week.

For a full list of participating medical centers, visit the OHANCAW Website. You can also follow them on Twitter.

Dedham Family Dental is located at 30 Milton Street in Dedham. We have plenty of free parking, so come on by! I and my staff look forward to meeting you.

Day: Monday, April 12
Time: 9:00 AM to 1:00 PM
Location: Dedham Family Dental, 30 Milton Street, Dedham, MA
Phone: 781-326-4600

Oral cancer — and how people contact it through sexual activity — is traditionally associated with men over the age of 40 who smoke. However, as this May 2007 Time article points out, young men and women are at risk for oral cancer due to the transmission of HPV during sexual activity.

As part of my effort to educate consumers, I’ll be posting information about oral cancer through April as April 12 – 18 is Oral, Head and Neck Cancer Awareness Week. Over 140 medical offices across the U.S. are offering free oral cancer screenings — including my own (more details forthcoming!).

Today I’m happy to introduce Dr. Robert Miller, M.D. of WellSpring Oncology Cancer Center from Pinellas Park, Florida. He took some time to answer basic questions about oral cancer.

Dr. Miller, are you seeing more oral cancer patients and are these patients young, older, male or female?

Dr. Miller: Yes, we’re seeing more oral cancer patients who are a little bit younger –- due to smoking. The patients tend to be younger but are equal in male and female.

In the patients that you see with oral cancer, is the cancer advanced? What brought the patients in to see you? Had they seen a dentist first who performed an oral cancer screening?

Dr. Miller: In the patients that we’re seeing, they do tend to be more advanced because they were not screened. Unfortunately, a lot of patients who have oral cancer are heavy smokers and/or drinkers. They are socially disadvantaged because of this and are pretty advanced in the disease.

By the time they see us, an oral surgeon or an ENT (ear, nose and throat) physician has already made the diagnosis.

Of the patients that you’re seeing, do they know about oral cancer? Are they shocked when you tell them they have oral cancer — esp. if they’re young and don’t smoke?

Dr. Miller: Most patients are surprised. It didn’t occur to them that they had cancer in the mouth. They may have had concerns over lung cancer [due to smoking and such] but not oral cancer.

In addition to oral sex and HPV, what other risk factors exist and what can young women do to reduce their risk?

Dr. Miller: Mainly smoking and alcohol. Those are the two biggies. Obviously, to not smoke or drink excess amounts of alcohol. Having multiple sexual partners is a risk, so practicing safe sexual behavior by using condoms and protection would reduce the risk.

Do you think that getting screened annually by a dentist who uses tests such as ViziLite (or any other test) is one thing they can do?

Dr. Miller: Yes, if a person thought they were particularly at a high risk, they should be screened because dentists are trained to inspect the mouth for anything suspicious. Competent dentists will inspect for white lesions or leukoplakia.

Early signs of irritability or continuing to smoke are high risk factors, oral surgeons or dentist should be encouraged to perform a thorough screening in these cases.

The problem with oral cancer is that no standard or official screening is in place. What I mean is that when you go for your yearly physical, the doctor doesn’t look in your mouth and check for any signs of cancer. It’s not like breast cancer that can be screened with mammograms, prostrate cancer which can be caught with a prostate exam or colonoscopy which can catch colon cancer.

No oral cavity screening exists as a separate exam. A patient has to pay attention to changes on their own skin (skin cancer) or mouth — and then call a doctor or dentist if he/she notices anything unusual.

Have you found that your patients know about tests that exist for oral cancer?

Dr. Miller: In short: No.

I have found that the media is simply not addressing this issue. Why do you think that is?

Dr. Miller: The media has so many diseases to cover; if a disease is not on the radar because it’s not that common, then it won’t be discussed.

High volume diseases like breast cancer, colon cancer or prostate cancers are covered because of the amount of people those diseases affect. The media doesn’t pay attention to the others.

And too, topics about oral cancer that include oral sex may be uncomfortable to talk about and therefore the topic is avoided, although the media will cover it indirectly by discussing the dangers of smoking for example.

Some diseases that have began to get attention were due to celebrities that experienced it i.e. Farah Fawcett who succumbed to anal cancer. However, if it’s an “uncomfortable” cancer, you won’t see much about it in the media.

Another example is Katie Couric who lost her husband to colorectal cancer in 1998. Because of this, colorectal cancer was mentioned more in the media.

Dr. Miller, thank you for your time and insight!

Do you have a question about oral cancer and HPV that isn’t answered here? Please post it in the comments section below and if I don’t know the answer, I’ll find someone who does.

Amber Olinger, a 911 dispatcher in Tennessee, suddenly lost her voice in September 2006 at the age of 24. The diagnosis? Oral cancer, which proved to be the beginning of Amber’s journey with cancer. This is her story:

When she lost her voice, Amber looked to her doctor, who referred her to ear, nose and throat doctor Jack Byrd. Dr. Byrd initially prescribed a steroidal treatment for the “beefy red lesion” he detected at the back of Amber’s throat. One week later the lesion had doubled in size, prompting Dr. Byrd to surgically remove the lesion. Immediately after the surgery, her voice returned.

Two days later, Dr. Byrd called with the test results: “It’s malignant.”

Dr. Byrd referred Amber to Emory University otolaryngologist William Grist, who diagnosed her with small cell carcinoma of the larynx, a condition typically found in older male smokers. Thankfully, Dr. Grist reported, Amber’s throat was now clear of cancer cells, but they could not provide any medical reason why a person as young as Amber had gotten this type of cancer.

Throughout the end of 2006 and the beginning of 2007, at her doctors’ recommendation, Amber underwent chemotherapy and radiation treatment. When she lost her hair as a result of treatment, her husband Todd shaved his head to match hers. Throughout treatment, Amber’s tests came back clear of cancer cells, but she persisted in finishing the treatment as her doctors prescribed.

As faithful Southern Baptists, Amber and Todd Olinger, their 16-month-old son and their relatives turned to their church throughout Amber’s treatment for support and hope.

Fueled by her faith and her optimism, Amber’s dedication to her treatment paid off. In March of 2007, the month of her wedding anniversary, she was officially diagnosed as being cancer-free. To honor the faith that helped her through such a trying time, Amber got angel wings tattooed on either side of her spine where burn marks had appeared from the radiation treatment. The tattoo on her right side, where the malignant lesion was first detected, symbolically resembles a “wounded wing.”

For Amber, March 2010 signifies three years of being cancer-free. She feels stronger now than ever before for having gone through the process and has learned not to take life for granted.

Amber wants young adults to know that tobacco and smoking aren’t the only causes of oral cancer and to realize how sex can impact their lives. Recent research indicates a link between oral cancers and the human papillomavirus (HPV) infection, which can be spread by oral sex.

To promote awareness and early detection of these potentially life-threatening but highly treatable cancers, Amber is organizing a free cancer screening as part of Oral, Head and Neck Cancer Awareness Week (OHANCAW) taking place across the U.S. April 12-18, 2010.

Amber’s screening will take place at the Bradley County Relay for Life event on April 30 — May 1 at the Team Relentless “campsite.” The Relay is held around the courthouse square in downtown Cleveland, TN. The complete list of more than 100 OHANCAW nationwide screening sites is available at www.OHANCAW.com.

Amber, thank you for sharing your story and for helping to educate young women and men about the increased risks associated with oral sex and oral cancers.

If you have any kind of sore or other abnormality in your mouth, see your dentist immediately. He or she can perform a fast and inexpensive procedure to test for oral cancer. It takes only a few minutes and costs less than $100 — and it can save your life.

According to a February 26, 2010 press release, OralDNA has released its OraRisk HPV Salivary Test to help dentists assess the risks of certain types of oral cancer.

This is a HUGE HUGE medical advance. As OralLab’s Medical Director Dr. Ronald C. McGlennen stated in the release, “. . . the at-risk profile for oral cancer is rapidly changing . . . and a new profile has emerged. Research studies have identified several high-risk strains of the human papillomavirus (HPV), especially the variant known as HPV-16, as potential etiologic agents in the development of squamous cell carcinoma of the head and neck (SCCHN).”

SCCHN can be found in the oral cavity, tongue, tonsils oropharynx, and larynx — and affects approximately 40,000 individuals in the US each year.

Even more important, it is estimated that 50% of all diagnosed cases of oral cancer in the US are attributed to HPV — which is transferred via sexual activity.

As I’ve stated repeatedly in the last two years, if you have multiple sex partners, the risk of contacting oral cancer is higher than if you smoke!

Because this issue is so important to me, I’ll be spending the next few weeks presenting information about oral cancer — including interviews from oncologists as well as oral cancer survivors.

I’m doing this because no one in the mainstream media seems to be doing it — despite my sending out press releases, emails, story pitches, and other information regarding this important health issue.

If you’re a sexually active young women, please do not ignore this message. Call your dentist today and ask to be tested for oral cancer and/or HPV. Many dentists across the US (myself included) now have access to tests such as ViziLite, which is a simple wash that takes 90 seconds and can help save your life.

You can learn more about oral cancer by visiting my Squidoo page and by viewing the ViziLite demo below:

It’s not often that really astounding news crosses my desk, so I am really excited to report that DMG America has introduced a product that gives dentists an option in treating cavities — one that requires no filling and drilling!

When I see decay on a patient’s tooth, I have two options: either “wait and see” if the decay develops further and if it does, “drilling and filling,” or I can offer patients a fluoride treatment to help delay the onset of a cavity.

Now with Icon(r), I can treat surface tooth enamel — without having to remove healthy tooth structure! According the company’s press release, Icon is a “micro-invasive infiltration technology that can be used to treat [the tooth's] surface. . . . In just one patient visit, Icon can arrest the progression of early enamel lesions” [dental speak for caries or cavities].

I know this information doesn’t sound that extraordinary, but trust me, it is!

You can learn more about Icon by visiting the company’s Website — using the aptly named URL, www.drilling-no-thanks.com. After you choose your country, click on the “For Patients” button where you’ll find animated illustrations of how the product works.

I’m very excited about this and will be ordering my supply this week!