Buffalo Bills wide receiver Stefon Diggs wrapped up the NFL regular season in January, setting single-season records in both catches and receiving yards. The Bills handily beat the Miami Dolphins, earning themselves the second seed in the AFC playoffs, and Diggs certainly did his part, making 7 catches for 76 yards. But what set the internet ablaze was not Diggs' accomplishments on the field but rather what the camera caught him doing on the sidelines—flossing his teeth!
The Twitterverse erupted with Bills fans poking fun at Diggs. But Diggs is not ashamed of his good oral hygiene habits, and CBS play-by-play announcer Kevin Harlan expressed his support with “Dental hygiene is something to take note of, kids! There's never a bad place to floss” and “When you lead the NFL in catches and yards, you can floss anytime you want.”
We like to think so. There's an old joke among dentists:
Q. Which teeth do you need to floss?
A. Only the ones you want to keep.
Although this sounds humorous, it is borne out in research. Of note, a 2017 study showed that people who floss have a lower risk of tooth loss over periods of 5 years and 10 years, and a 2020 study found that older adults who flossed lost an average of 1 tooth in 5 years, while those who don't lost around 4 teeth in the same time period.
We in the dental profession stress the importance of flossing as a daily habit—and Stefon Diggs would likely agree—yet fewer than 1 in 3 Americans floss every day. The 2016 National Health and Nutrition Examination Survey (NHANES), conducted by the CDC's National Center for Health Statistics, revealed that only 30% of Americans floss every day, while 37% floss less than every day and 32% never floss.
The biggest enemy on the football field may be the opposing team, but the biggest enemy to your oral health is plaque, a sticky film of bacteria and food debris that builds up on tooth surfaces. Plaque can cause tooth decay and gum disease, the number one cause of tooth loss among adults. Flossing is necessary to remove plaque from between teeth and around the gums where a toothbrush can't reach. If not removed, plaque hardens into tartar, which can only be removed by the specialized tools used in the dental office. Regular professional dental cleanings are also needed to get at those hard-to-reach spots you may have missed.
If Diggs can find time to floss during a major NFL game, the rest of us can certainly find a couple minutes a day to do it. While we might not recommend Diggs' technique of flossing from one side of the mouth to the other, we commend his enthusiasm and commitment to keeping his teeth and gums healthy. Along with good dental hygiene at home—or on the sidelines if you are Stefon Diggs—regular professional dental cleanings and checkups play a key role in maintaining a healthy smile for life.
Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.
Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).
Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.
It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.
A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.
For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.
The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.
An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.
If you would like more information on eating disorders and dental care, 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 “Bulimia, Anorexia & Oral Health.”
Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.
From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.
Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.
These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.
Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.
Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.
If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown. If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.
Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.
If you would like more information on osteoporosis and dental health, 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 “Osteoporosis Drugs & Dental Treatment.”
If you live an average lifespan, you'll spend more than 200,000 hours in blissful slumber. It's not a waste, though: You absolutely need this much sleep to maintain optimum physical and mental health. That's why the National Sleep Foundation recognizes each March as Sleep Awareness Month to highlight the obstacles to a good night's sleep. One such obstacle is obstructive sleep apnea (OSA)—and if you have it, we may be able to help you reduce the harm it may be causing you.
OSA is the blockage of the airway during sleep, usually when the tongue relaxes against the back of the throat. As the oxygen level falls, the brain arouses the sleeper to restore airflow. This only takes a few seconds before the person slips back into sleep, but it can occur several times an hour.
As this scenario repeats itself night after night, the person becomes deprived of the deeper stages of sleep they need to stay healthy. The long-term effect can even be life-threatening: Besides chronic fatigue and “brain fog,” there's also an increased risk of high blood pressure, disease or other serious health conditions.
But there are ways to reduce chronic OSA, the most common being a therapy known as continuous positive airway pressure (CPAP). A CPAP machine, prescribed by a medical doctor, consists of a small pump that streams pressurized air into the mouth through a hose and facemask; the increased air pressure in the mouth helps keep the airway open. It's a proven method, but not always a favorite with some patients who find it uncomfortable and restrictive to wear every night.
If you're in that camp regarding CPAP therapy, an alternative may be possible: oral appliance therapy (OAT), which dentists can provide. Worn in the mouth during sleep, this custom-fitted mouthguard-like appliance repositions the tongue so that it doesn't block the airway. There is a variety of mechanisms, but most involve a hinge that positions the lower jaw forward, which in turn pulls the tongue away from the back of the throat.
These less invasive OAT devices may be an alternative to CPAP therapy for people who have mild to moderate OSA and find CPAP machines difficult to use. If you've been diagnosed with OSA and CPAP therapy hasn't been a good fit for you, speak with us about an OAT device. It could help you overcome this common disorder and get the deep sleep you need for a healthy mind and body.
If you would like more information about a dental approach to obstructive sleep apnea, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
Fans everywhere were recently saddened by the news of musical legend Eddie Van Halen's death. Co-founder and lead guitarist for the iconic rock group Van Halen, the 65-year-old superstar passed away from oral cancer.
Van Halen's rise to worldwide fame began in the 1970s with his unique guitar style and energetic performances, but behind the scenes, he struggled with his health. In 2000, he was successfully treated for tongue cancer. He remained cancer-free until 2018 when he was diagnosed with throat cancer to which he succumbed this past October.
Van Halen claimed the metal guitar picks he habitually held in his mouth caused his tongue cancer. It's more likely, though, that his heavy cigarette smoking and alcohol use had more to do with his cancers.
According to the American Cancer Society, most oral cancer patients are smokers and, as in Van Halen's case, are more likely to beat one form of oral cancer only to have another form arise in another part of the mouth. Add in heavy alcohol consumption, and the combined habits can increase the risk of oral cancer a hundredfold.
But there are ways to reduce that risk by making some important lifestyle changes. Here's how:
Quit tobacco. Giving up tobacco, whether smoked or smokeless, vastly lowers your oral cancer risk. It's not easy to kick the habit solo, but a medically supervised cessation program or support group can help.
Limit alcohol. If you drink heavily, consider giving up alcohol or limiting yourself to just one or two drinks a day. As with tobacco, it can be difficult doing it alone, so speak with a health professional for assistance.
Eat healthy. You can reduce your cancer risk by avoiding processed foods with nitrites or other known carcinogens. Instead, eat fresh fruits and vegetables with antioxidants that fight cancer. A healthy diet also boosts your overall dental and bodily health.
Practice hygiene. Keeping teeth and gums healthy also lowers oral cancer risk. Brush and floss daily to remove dental plaque, the bacterial film on teeth most responsible for dental disease. You should also visit us every six months for more thorough dental cleanings and checkups.
One last thing: Because oral cancer is often diagnosed in its advanced stages, be sure you see us if you notice any persistent sores or other abnormalities on your tongue or the inside of your mouth. An earlier diagnosis of oral cancer can vastly improve the long-term prognosis.
Although not as prevalent as other forms of cancer, oral cancer is among the deadliest with only a 60% five-year survival rate. Making these changes toward a healthier lifestyle can help you avoid this serious disease.
If you would like more information about preventing oral cancer, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “How a Routine Dental Visit Saved My Life” and “Strategies to Stop Smoking.”
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