Posts Under Oral Medicine

Bad breath (halitosis), well known for its negative social connotations, is a condition that may also be a sign of poor health.    Ninety percent (90%) of halitosis originates in the mouth, caused primarily by the sulfur containing by-products left from the digestion of protein by the bacteria found in plaque.  These are some of the same bacteria associated with gingivitis and periodontitis,  with most of the halitosis causing bacteria mainly found on the tongue.  The remaining causes of bad breath originate from sources outside of the mouth, including the upper and lower respiratory tract, the stomach, and intestines.

The halitosis that originates in the mouth is primarily due to inadequate plaque control, periodontal disease, dry mouth, faulty restorations, and in particular due to excessive bacterial growth on the back surface of the tongue.

The management of halitosis may involve a combination of specific treatments to maintain plaque control, including the elimination of active periodontal disease, the correction of older dental restoration that are acting as food traps, and the routine cleaning of the surface of the tongue.  Oral rinsing with a mouthwash may be indicated in some instances, but without proper oral hygiene to control plaque buildup (brushing, flossing and tongue cleaning), this would only be a temporary measure.

April is Oral Health Month in Ontario, an important time to become aware of the link between your oral health and your overall health.  The Canadian Cancer Society estimates that 3,400 new cases of oral cancer were diagnosed in Canada in 2010. It is also estimated that 1,150 of those Canadians diagnosed in 2010 will die from the disease.

As oral health experts, dentists are uniquely qualified to help in the early detection of many medical conditions, including cancer.  Being trained in medicine, dentists are able to recognize the relationships between oral and overall health.  Since most people see their dentists regularly, they are often the first health-care professionals to have an opportunity to detect the many health conditions that affect your mouth.  Many patients are not aware of the extent that a dental exam can play in disease prevention.  Without an examination by a dentist, most early signs of oral cancer are difficult to detect.  If you notice a mouth sore or anything out of the ordinary that does not go away or heal after a couple of weeks, discuss it with your dentist.

Risk Factors for oral cancer include:

  • Smoking and chewing tobacco - particularly if combined with heavy alcohol consumption
  • Heavy alcohol consumption - particularly if combined with smoking
  • Excessive sun exposure - particularly to the lip
  • Age - people over the age of 40 have a higher risk of developing oral cancer
  • Gender - men are more susceptible than women to developing oral cancer.  In the past, men had a 6:1 ratio of incidence of oral cancer compared to women.  However, this ratio is narrowing and is now closer to a 2:1 ratio
  • HPV - more research is emerging that connects human papillomavirus infection - especially HPV-16 - with oral cancers
  • A diet low in fruits and vegetables - fruit and vegetables have a protective factor that is believed to reduce the risk for oral cancers.


  • See a dental professional for a regular dental exam
  • Quitting (or reducing) your tobacco and alcohol use lowers your risk of developing oral cancer
  • When you are outside and exposed to the sun, use lip balm with UV protection and wear a hat
  • Eat a healthy diet rich in fruits and vegetables
  • Brush and floss your teeth daily

The mouth has long been recognized as a mirror reflecting the health of the body.  With regular visits to your dentist and good oral health routines, you will have lots to smile about!:)



Maclean's magazine reporting on the comments made by actor Michael Douglas during a David Letterman interview, that his type of throat cancer was due to a combination of alcohol and cigarettes.  Maclean's quoted Dr. Jonathan Irish, Chief of the Department of Surgical Oncology at the Princess Margaret Hospital:  "Smoking is by far the most important factor for oropharyngeal cancer, but alcohol alone increases the risk of this type of cancer, and smoking and alcohol together work synergistically." One of the leading theories about this "multiplier effect," says Irish, is that alcohol acts as a solvent, wearing away at the soft, mucosa-lined surface of the oral cavity, and increasing the ability of material-such as carcinogens in smoke-to flow into cells. Irish says, "The risk of a person developing cancer of the head and neck from alcohol alone is two to five times the rest of population, and smoking is 10 to 20 times. But you put the two together, the person will have about 40 times the risk of developing cancer."

For the complete article, click here:

A great interview by David Letterman with Michael Douglas, discussing his journey just after his first chemotherapy session.  His presence and story alone are a compelling argument against the lethal carcinogenic combination of alcohol and smoking.

Please take a look at the interview here:   

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