Healthy Halloween Habits

It’s Halloween!  Or, as I like to call it, Job Security Day.  It is estimated that we eat almost 3.5 pounds of candy on Halloween; that’s a lot of sugar!  I love sugar (many of my patients know that I love a frozen Snickers), but it has the potential to damage your teeth.  Below are a few things you and your family can do to enjoy the Halloween bounty and stay mouth healthy.

• Eat more chocolate!  Hard candies prolong the amount of time the sugar stays in your mouth.  As it mixes with saliva, it is almost bathing your teeth in sugar.  Sticky and gummy candies increase risk of cavities by sticking to your teeth for a long time.  Sticky candies are also more difficult to wash away from the tooth surface.  Sour candies might be the worst type, though, as the added citric acid weakens tooth enamel.  However, chocolate is more easily washed away, so think of this as another benefit of eating chocolate (well, at least as compared to other candies).

• Eat Halloween candy with or shortly after main meals.  More saliva is produced when eating, so the increased salivary flow can help wash away the sugary treats.

• Limit your intake.  Like almost everything else, sugary foods are best enjoyed in moderation.

• Drink water after eating Halloween candy.  If you can’t easily get to a toothbrush and toothpaste, drinking water after eating can help wash away food particles.  It helps clean your mouth AND has no calories!

• Brush and floss your teeth.  Obviously, it is still important to brush and floss.

Of course, you can always ask me any questions you have about how your diet can affect your teeth.  And if you want, check out the American Dental Association’s tips on having a mouth-healthy Halloween.  Have a good Halloween and stay safe.  And don’t forget to brush and floss!

Sex! .... And Oral Cancer

A recent article in the Washington Post that oral cancer is becoming more prevalent in men.  The data, culled from insurance claims, shows a 61% increase in oral cancer in men from 2011 to 2015.  The article suggests that the prevalence of Human Papilloma Virus (“HPV”) is part of the reason. 

HPV is a group of viruses named for the warts (papillomas) it can sometimes cause.   There are some strains of HPV that can also lead to cervical, anal, penile, and even oral cancers.  HPV is the most common sexually transmitted infection, or STI; in fact, it is so common, that most sexually active men and women have been exposed to it.  Oftentimes, there are no symptoms of HPV infection, and one can exhibit symptoms long after exposure.  The good news is that many HPV infections do go away, and do not cause cancer.

The Post’s article reports that although smoking rates have fallen, oral cancer incidence has increased.  (Smoking, drink, and the two combined have traditionally been thought of as the main risk factors of oral cancer.  There is no discussion of vaping or e-cigarettes in this article.)  The article reports the findings of a study following young people that found a higher prevalence of oropharyngeal squamous cell carcinoma caused by HPV16 in men compared to women, and that men were less likely to clear HPV infection.  (There are other data from this study that I won’t discuss here.)

One of the reasons for the rise in oral cancer is that more young men and women engage in oral sex, thinking that it is safer, and, of course, oral sex cannot result in a pregnancy.  The Post also discusses that younger men are also more likely to have more partners than older men.  

The most important takeaway from this data and article is that disease does not discriminate.  Risk factors such as tobacco use and drinking, while still important, are not the sole predictors.  It’s also important to recognize that HPV affects men, too (remember: HPV is an equal opportunity infector).  I am happy to discuss more about oral cancer and HPV with all my patients, and strongly encourage you to also consult with your physicians as well should you have any questions.

You can read more information about HPV at the Center for Disease Control’s Fact Sheet.  And you can purchase the original study through the Journal of Infectious Disease’s website here

Do I Really Need to Floss?

Since the summer, many patients have been asking me if they really need to floss.  No doubt encouraged by the many articles suggesting that flossing may not be necessary, I instantly broke the hearts of men and women when I highly encouraged my patients continue flossing.  I’m not a researcher, but I can tell you that, anecdotally, I can usually tell when my patients don’t floss or when they’ve been lax about it.  My coworkers have memorized what I tell patients about flossing: it’s like weight lifting; it hurts at first, but the more you do it, the stronger your gums get.  They know I tell my patients how I myself keep spools of floss scattered about my apartment to remind me to floss because I don’t like flossing either.

            But flossing your teeth is important because it helps remove food and plaque between teeth, where toothbrushes have difficulty reaching.  Floss also helps remove food trapped under the gums between these teeth as well.  So flossing, like brushing, helps break up the colonies of plaque that stick to your teeth.  Once this gunk, or biofilm, is removed, however, the bacterial colonies start to repopulate your teeth again, which is why my colleagues and I recommend you brush and floss your teeth daily. 

The recent mainstream articles seem to gloss over periodontitis.  Periodontitis is a disease affecting the gums and bone surrounding teeth.  Periodontitis can lead to infections and loss of teeth and its surrounding bone.  While flossing cannot cure periodontitis, it can help arrest the disease process at gingivitis, which is another reason I still encourage flossing.

While perhaps most of these studies are flawed, by design or execution, I want to make clear that the studies have not proven that flossing is not beneficial.  (Unless, of course, you are cutting into your gums with the floss; don’t do that!)   The Associated Press’s story contains links to the original studies if you’re interested in reading them.  Also worth mentioning is that the main review consulted in the AP’s article finds that flossing in conjunction with brushing is more effective in reducing gingivitis than brushing alone.  There has also been a study showing a decrease in cavities between teeth when professionals routinely flossed children’s teeth and administered fluoride, so maybe we just aren’t flossing effectively at home.