Mouth Matters

BY HOLLI MONCRIEFF - For the Free Press Keep a close eye on your pearly whites. If you detect signs of a cavity early enough, it may be possible to treat it before it requires a filling. Cavities, or dental caries, are holes in the teeth or damage to the tooth structure. They are very common, and most people have had at least one. "One of the first things you might see is a chalky white spot on the tooth. That means there's some demineralization going on. The tooth is not quite as strong as it should be," explains Winnipeg dentist Dr. Ben Yue. "It can then turn into a brown spot, and the last stage is a hole." Non-visual signs of a cavity include pain when eating or drinking. You might develop sensitivity to hot, cold or sweets. If you suspect you have a cavity, visit your dentist right away. "If we see something starting, we can catch it in the early stages," Yue says. "We can re-mineralize the tooth with a special toothpaste or a fluoride varnish. There are take- home varnishes available, but you still need to get them through a dental office." Once a cavity forms, the most common treatment is a filling. Your dentist may use an indirect filling or a direct filling. Indirect fillings, used when cavities are too large for a regular filling, may be formed from gold, porcelain or composite resin. Since they require the use of heat and chemicals, they're made outside of the mouth and generally require two appointments. Direct fillings are made in the mouth, from silver amalgam or from composite resin that can be matched to the colour of your tooth. "Composite resins are the white fillings. Their strength is getting a lot better now," Yue says. "Amalgam fillings are made of mercury, silver, tin and other metals. They're pretty durable and they have a good seal." If you do need a filling, don't delay treatment. Small problems can grow into large ones. "If the hole gets too large or it gets too close to the nerve, it can cause an infection. Then you need to have a root canal or have the tooth taken out. It can become impossible to fix the tooth anymore." There are three factors that typically cause cavities - time, bacteria and carbohydrates, particularly fermentable carbohydrates like sucrose, glucose, and fructose. "There's a type of bacteria in the mouth that produces acid when it comes into contact with these carbohydrates. That acid is what starts to dissolve the teeth," Yue says. "There is also a genetic factor. There are some people who never get cavities because they have more protective factors in their saliva." Brushing and flossing regularly will help prevent cavities from forming. "The key is keeping your teeth really clean – brushing and flossing, especially before bed. Saliva production goes down during sleep and bacteria can build a lot more," Yue says. "I recommend brushing and flossing after every meal. Also avoid really sticky, sweet foods that stay on the teeth longer. You can still enjoy them occasionally, but brush your teeth very thoroughly afterward." Those with dry mouths may want to ask their dentist for additional options, he adds. "A fluoride rinse can help those with drier mouths, especially those who've been treated for cancer, as radiation can destroy the saliva glands." The Manitoba Dental Association recommends you have a checkup and professional cleaning every six months if you're in good general health. Your dentist can detect changes in your teeth and spot problems early. "Regular checkups are one of the best ways to prevent cavities," Yue says. Once a cavity forms, the most common treatment is a filling. Your dentist may use an indirect filling or a direct filling. take care witH cavities 0 4 | Mouth Matters cHewinG tObaccO nOt wOrtH a pail Of spit CONTINuED ON NEXT PAGE > BY PETER CARLYLE-GORDGE – For The Free Press We all know that smoking cigarettes is bad for you. With the avalanche of anti-smoking propaganda smothering society for the past few years, you'd have to be blind, deaf and stupid not to be aware of that issue. But we hear very little about another known cancer causer and oral health risk: chewing tobacco. Commonly known as 'chew', the product is deadly. Sold in tins, it can cause various cancers, including oral, stomach, esophageal and pancreatic, as well as gum disease, high blood pressure and cardiovascular disease. Its widespread use in many male sports groups is becoming a major concern for sports organizations such as the Sports Medicine and Science Council of Manitoba. Spokesman Dean Kriellaars, who is also a professor at the University of Manitoba, says rugby, baseball, hockey and football teams are all involved and research has shown that a large percentage use it, or have used it. "About 25 per cent may try it once and hate it, but between 30 and 50 per cent acquire it as a habit," he says. "Chewing tobacco has serious health implications and it can have two to six times as much nicotine in it as cigarettes do." Kriellaars says chewing tobacco usage rates have tripled in the last five years and usage rates in hockey sometimes involve 50 per cent of a team. He knows for a fact that four of the top Winnipeg Jets players are regular users. "The problem is that chewing tobacco is a part of the sports culture now," he says. "The increase in usage isn't because of advertising but just because some of the top players and role models use it." Kriellaars says about three per cent of the general Canadian population uses the product. He says efforts to get athletes to quit have proven unsuccessful to date, so now the emphasis is on education and targeting messages about its ill effects to boys in the 12-to-14 age group. Those aged 15 to 21 are often chronic users, since it is addictive. "We've tried for five years to get chronic users to quit but it's very hard to stop it so now we're focusing on telling young players to just say 'no'," he says. "Manitoba is the only province that has been carefully monitoring chewing tobacco use and it's a very underreported problem. Many parents are shocked when they realize up to 20 per cent of a team may be using it." White lesions in the mouth are one clear sign that chewing tobacco is damaging tissue and changing cell structure — something that can later lead to widesPread use of 'Chew' a MaJor health ConCern for sPorts orGaniZations

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