Monday, February 18, 2008

Tooth Loss: Filling in the Gaps

Losing one's possessions can be both a good and a bad experience in today's world. For instance, losing weight is typically a happy occasion, but losing one's car keys is never an enjoyable experience. The same principle is true when discussing oral health. As a child, losing baby teeth is something to be celebrated (A magical fairy often comes late at night and trades an old tooth that will never be used again for legal tenders. That is cause for celebration in any circumstance). However, at an old age, losing teeth is an embarrassing and life-style changing affair (Corn on the cob is traded for apple sauce and other mushy foods). Luckily, for current dental patients replacing lost teeth is easier than ever before. Breakthroughs in technology provide a wide array of tooth restoration from implanting titanium, synthetic teeth directly into the jaw bone to a standard dental bridge that was invented during the height of the Roman Empire. Obviously, certain procedures can cost a patient more in addition to being more extensive. I was curious to see what kind of people in the United States lose their teeth, and what type of dental implant makes the most sense. Lucky for me, Google is a great search engine.
As I am a virgin to the blogosphere realm, I went exploring to see if there was a blog on the World Wide Web that addressed my curiosities concerning tooth loss. Expecting to find a single blog that was many years out of date, I was shocked when there were a plethora of posts and articles discussing all aspects of tooth loss (albeit the majority were out of date and plugging cosmetic dentistry, but a plethora nonetheless). The first blog that I discovered, World Dental, consists mostly of posts by writer, alias Alex Bo, who frequently updates the sire with dental news of all types. The pose i investigated, entitled "Replacing Missing Tooth with Dental Bridge" address the use of dental bridges as well as different types available to the public. The other blog I found, Fullosseous Flap's Dental Blog, shares the opinions of D.D.S. Gregory Cole, on any subject from dentistry to current politics. The post i was most intrigued by was entitled "Tooth Loss Statistics by State" and showed which state's citizens most commonly lost teeth, and also begged the question, why. I commented on both of these posts, sharing my stance on the topic and asking thought-provoking questions of the authors' The paragraphs following these are my actual comments.

Comment:

First, I would like to say that this post was both informative and thorough. While I have obtained a wealth of knowledge about dental bridges, from reading your work I have learned even more. Replacing missing teeth is key to maintaining one’s dental health. Your discussion of the benefits of dental bridges, made me realize that besides fixing your bite, they also help to sustain the shape of your face, and prevent drifting and loss of other teeth in your mouth. As all of these benefits are physical, I wonder what effect they have on people mentally. It is an easy assumption that those with replacement teeth have more confidence, and therefore are better able to contribute to society by means of a job etc. I think that conducting an experiment where people of the same age group are separated based on whether they are missing teeth or not, and then they are observed and compared, would result in more evidence supporting the use of dental bridges and the other restorative methods you acknowledged in your article e.g. implants and dentures. In addition, I think the experiment would expose a topic that you covered briefly in the post, the socioeconomic class of people who have dental bridges. Being less expensive than an implant, but more expensive than dentures, bridges seem to be the middle ground treatment for tooth loss. The experiment would probably show that people in lower income classes are ones that lose the most teeth because it is assumed they have the lowest overall health. Sadly, without aide, these people cannot afford bridges or any other form of tooth replacement. A question spurred from this fact, is whether or not there is the technology to mass produce a cheap, yet effective dental bridge for those who need the treatment, but are held back from it because of their income. Ultimately my question to you is if affordable tooth replacement treatments are going to be available in the United States (as many other countries are practicing “dental tourism” as you mentioned in your article) in the near future?

Comment:

While I enjoyed reading your post concerning tooth loss, I found that it was a bit disturbing. As a hopeful future dentist, seeing figures like nearly half of adults over 65 in West Virginia have lost all their natural teeth makes me wonder if there will even be any teeth left for me to clean. Your post made me consider the reasons for such high percentages of people who have lost all their teeth. While I agree with you that it could be because of dental IQ and dental treatment plans gone awry, I think that the problem is much deeper. As amazing as new dental treatments are, perhaps the public thinks it is very easy to replace teeth, so maintaining the health of their own teeth is not as high a priority to them. If a person is knowledgeable enough about implants (and rich enough to afford them), they may find it easier to just lose their teeth and get them replaced with long-lasting synthetic ones. As far-fetched as it sounds, I really do consider the possibility that one of the causes of tooth loss can be attributed to the dental world’s constant efforts to make tooth care easier for patients. While meant to help people improve their dental health, new advancements with old treatments like bridges and dentures can have an adverse effect and give people a more nonchalant attitude about losing teeth. The problem that needs to be solved is how to communicate with the public the importance of keeping their own teeth as opposed to not caring and getting them replaced. While people who are a part of the dental world understand, it is difficult for them to explain to patients, the majority of which can barley even manage to brush and floss twice a day. Ultimately, my question is whether dentists will be able to reverse the percentages of tooth loss in the United States, through a new means of communication with patients, or do they simply need to invest more time in tooth replacement research and technology so that they can help maintain their patients’ oral health? While I wish it to be the former, it seems the more lucrative decision is the latter.

Wednesday, February 6, 2008

Marijuana: Even Your Teeth Dislike the Smell

In a recent study by the school of dentistry at The University of Otago, New Zealand, periodontal disease was linked to over nine-hundred people who smoked marijuana at least forty times a year since they were eighteen years old. The study was published February sixth in the Journal of the American Medical Association, and can be added to the ever augmenting evidence that cannabis use is not as risk-free as it seems. There are many people who extol the numerous uses of illegal drugs for their medical benefits, as many drugs, especially marijuana, can help people in certain ways. However, research projects concerning the negative impact of illegal drugs on bodily health are a constant hindrance to anybody in support of drugs as treatments or cures. Although marijuana enthusiasts have a legitimate argument that the drug has many uses that are effective in treating certain types of medical disorders, past research and the aforementioned study clearly depict that the possible damage smoking pot can cause to the human body, particularly the mouth, if abused or overused makes treatment based on the drug very dangerous.

To understand marijuana's potential medical benefits, one must first understand how it works. Essentially, the components of the drug act as neurotransmitters, and are especially reactive to sensors in the brain that control body movement, memory, and vomiting to name a few (thus why people when under the influence of pot have decreased coordination, impaired learning, and increased hunger). By stimulating these specialized receptors, one can induce certain reactions from the body that will help treat specific disorders. For example, if a person were to undergo chemotherapy and acquire the typical side-effects of the treatment; weight loss, nausea, and pain, smoking marijuana afterwards would stimulate their appetite as well as reduce or remove the other effects. However, its beneficial qualities are not limited to just cancer patients. A 1986 study in the United States, found that after treating three patients suffering from Huntington’s disease with cannabidiol (a major chemical in marijuana) for two weeks, the spastic movements that are associated with the disease had decreased by 20% - 40%. The drug has also been proven to help people with glaucoma (by lowering the pressure in the eyeball and therefore counter acting the disease’s negative effects), as well as other very virulent diseases such as multiple sclerosis and Alzheimer's disease. Studies like “Marijuana and Medicine: Assessing the Science Base” contain even more trials and research that are evidence for the health benefits of medical marijuana, however, they fail to cite the negative effects that medical and non-medical marijuana users face.

The amount of research performed by those hoping to see the optimistic side of cannabis use is shadowed by an equal amount of projects aiming to expose marijuana as a deadly substance. Risks of smoking marijuana even as treatment for specific conditions are very large, and provide enough evidence to deem its use unsafe. According to the National Institute on Drug Abuse in 2005 44.8% of twelfth graders had smoked marijuana at least once during their lifetime. This is a scary thought considering these students probably do not suffer from a disease where marijuana use is an acceptable treatment (of course teen drug use in America is a completely different issue all together, but it begs the question of whether non-medical professionals support marijuana for its health benefits or simply because they enjoy using it). The figure is even more startling when one considers the negative side-effects marijuana can have on users. When high on marijuana, immediate effects on the body are a decrease in coordination, distorted perception, and difficulty problem solving. Imagine if a person who was under the influence of marijuana were to perform an everyday task such as driving., the drug would negatively affect that person, and make them a danger to the rest of the drivers on the road due to their inability to react or think quickly. In addition to these side-effects, marijuana also disrupts the circulatory system; blood pressure drops, and heart rate speeds up, more than quadrupling the risk of heart failure. Long term effects of the drug are even more detrimental to one’s health.

Chronic users who smoke the drug are putting themselves at the highest risk possible. Marijuana smokers essentially face the same problems that plague long-term tobacco smokers. Obstructed airways, increased phlegm production, and exposure to carcinogens are among the most prevalent. However, the most serious side-effect of the drug is that even teeth are put at risk by habitual smoking of marijuana. Periodontal disease, or the regression of one’s gum line for laymen, can lead to loss of teeth and infection in the mouth. Recent studies have linked oral health to bodily health, and even proved that bacteria in the gums and mouth can travel through the blood stream and into the heart to cause cardiovascular disease. The fact that the drug already increases the risk of heart attack is even more likely because of the negative effects it has on oral health. With enough exposure, smoking the drug can cause irreversible damage that dental professionals can not fix. As a future dentist, it is worrisome that many users do not need to smoke marijuana for its benefits and curative powers, but do anyway, and in turn put their mouth in jeopardy.

Although there are positive results from using marijuana medically, the risks one takes when using it for “recreational” purposes completely outweigh the benefits. When taken on a strict regiment created by a doctor, and in pill form, marijuana is an excellent treatment for many ailments. However when smoked, and abused whether through medical means or not, pot is dangerous and can be very detrimental to overall health. While chemotherapy is a treatment that has many side-effects, it is still in use because it is one of the only ways to combat cancer. Although one can argue that the same can be said about smoking marijuana, this is not entirely true as the medical world has developed pills and other methods to cure symptoms that marijuana can also treat. In any case, in order to maintain good dental health, smoking pot in general should be avoided because it puts teeth and the body as a whole at risk.

 
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