How Do I Get A Cavity? by Dona Fujioka, R.D.H.

Dental caries (cavities) stems from a dental disease that can be prevented. With the combination of biofilm (dental plaque) and fermentable carbohydrates, with an acidic (low pH) environment in the mouth, dental caries occur.

Tooth surface goes through a process of demineralization (mineral loss) and remineralization (mineral gain) several times a day. When dental plaque is present, its presence creates a condition of unsaturation and supersaturation. Unsaturation occurs during acidic conditions (low pH) in the biofilm when there is less minerals present. This is common in the presence of fermentable carbohydrates. Supersaturation happens when there is an increase in minerals (from saliva or calcium fluoride formulations) and an increase in pH due to reduced or lack of fermentable carbohydrates present or different buffering systems. The increase in the saturation level stops the mineral loss of the enamel and allows minerals to return to the partially demineralized enamel. This process is essential in the development of a cavity. A cavity develops when more minerals are lost than gained during the demineralization and remineralization process. The good news is that an early carious lesion (cavity) can be stopped as long as it is non-cavitated.

Non-cavitated carious lesion can be reversed in several ways; decreasing the amount of dental plaque, reducing the frequency of carbohydrate ingestion and increase in the amount and concentration of fluoride.

Understanding the disease process rather than just treating the condition is a better way of looking at dental caries. With a better understanding, it allows for a preventive approach, especially for those who are at high risk.

Biomarkers in Saliva Help Detect Early Stage Pancreatic Cancer by Dona Fujioka, R.D.H.

Research and studies are ongoing using saliva and its constituent biomarkers to aid in early disease detection, the monitoring of its progression and the prediction of therapeutic outcomes. Salivary biomarkers for disease detection, such as oral and systemic, is showing promise where blood markers are still proving ineffective.

An example sited by Dr. Wong is in pancreatic ductal adenocarcinoma. This is the most common, and also one of the most deadly forms of pancreatic cancer. His studies have shown that salivary diagnostics may be helpful in the fight against this form of pancreatic cancer.

In a study published in Gastroenterology, changes in the molecular signatures were found in the human saliva with an early stage pancreatic cancer. By analyzing the altered gene expression, biomarkers in saliva were found to be different between a patient with pancreatic cancer and one who did not have the disease.

One surprising finding is that various systemic diseases that were studied (pancreatic cancer, breast cancer, lung cancer, gastric cancer, ovarian cancer) have yielded highly discriminatory salivary biomarkers; particularly using their diagnostic tools. More studies are needed to confirm this early promise of using saliva samples, and its ease of obtaining samples, to identify diseases.

Snoring and Sleep Apnea by Douglas Urban, DDS

We all know what snoring is and how it affects those around us. Half of snorers may suffer some level of sleep apnea or sleep “without breath”. A simple test can be conducted at home in your own bed that can screen your sleep pattern and help determine if a monitored sleep study test should be ordered.

Sleep apnea is characterized by pauses in breathing from a few seconds to a minute. These pauses can occur a few times during the night or over a hundred times an hour. It can result in low blood oxygen saturation levels causing oxygen starvation of the body organs. The pulse rate will rise as the heart tries to pump more oxygenated blood to the body. This stress can result in strokes, hypertension, heart disease, weight gain, depression, diabetes, impotence, GERD, liver disease, memory dysfunction and death.

Your dentist can help detect screen sleep apnea patients by checking for worn or flattened teeth, scalloped tongue, enlarged tongue and uvula, extra boney growths and excessive gum recession. Your dentist can order a diagnostic at-home test (this can be free of charge) and have a sleep center read and interpret the results with you to help determine your risk for sleep apnea.

Sleep study tests can determine the incidence of breathing cessation. A medical doctor can confirm a diagnosis of sleep apnea after carefully reviewing the results of a sleep study test. These tests monitor such things like the blood oxygen level, REM cycles, and the frequency of obstructive episodes per hour.

You can ask yourself these questions to see if you should seek help. What are my chances of dozing when I sit and read, watch TV, sit in public places, wait for red lights while driving or sit as a passenger in a car? What is the likelihood of falling to sleep after lunch? If you are tired or fatigued easily during the day it would be very prudent to consult with your physician for advice.

Treatments for OSA can vary from anti-snoring devices made by dentists, sleeping on specially tilted pillows, neck slings, or wearing nasal cushions attached to positive pressure air pumps (CPAP). As with all treatment options these CPAP pumps cannot be tolerated by everyone and may have a limited success with some individuals. 

I recently tested the at-home device for diagnostic screening of sleep apnea. It was discovered that during my sleep cycles my blood oxygen levels were dropping below acceptable levels and my heart rate climbed to the high eighties. No wonder I would occasionally wake up sweating!  A sleep study test is currently being ordered and I will keep you updated.

If you know you’re snoring or your loved one is keeping you awake at night please talk to your physician or dentist to help determine the seriousness of the problem.

For answers to your dental questions, contact

                                                    Douglas Urban, D.D.S.

                                                    Cerritos, CA 90703

                                                    562 924-1523       

                                                    DrDouglasUrban.com