health

The Purpose of Oral Pathology and Benefits of Early Detection

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What is Oral Pathology?

Oral pathology is a specialized branch of dentistry that focuses on diagnosing and treating diseases affecting the mouth, jaws, and facial structures. From common issues like cavities to complex conditions such as oral cancer, oral pathologists play a crucial role in maintaining your oral health. Our team at Minnesota Oral and Maxillofacial Surgery dedicates its efforts to ensuring your smile stays bright and healthy through expert care and early detection.

The Oral Pathology Process: Unraveling the Mystery of Oral Diseases

Think of oral pathologists as detectives. They gather clues and analyze evidence to uncover the root cause of oral health issues. This is our process.

Symptoms and Examinations

Everything starts with an examination. Our oral surgeons assess your symptoms, like pain or swelling. Then we examine your mouth for any signs of abnormality. Examinations vary quite a bit in complexity depending on what we’re looking to uncover.

Diagnostic Tools

To get a clearer picture of your oral health, we might use advanced diagnostic tools such as imaging devices or biopsy procedures to collect samples of the affected tissue.

Analysis and Diagnosis

Once we have the information we need, our experts identify the problem and recommend the most effective course of treatment to restore your oral health.

Why Early Detection Matters

Catching oral health issues in their infancy can make a world of difference. Here are some reasons why early detection is essential:

Timely Treatment

As with all health issues, the sooner we catch a problem, the quicker we can address it. Early detection can significantly improve the outcome of your treatment and help prevent further complications. We can also discover the “why” in the equation.

Cost-Effective Care

Addressing issues early on can save you money in the long run. As the old saying goes, “You can pay me now or pay me later.” It’s much more affordable to tackle a small cavity than to wait until it develops into a more serious issue that requires a root canal or extraction.

Peace of Mind

Knowing that your oral health is in check is priceless. Regular checkups and early detection can alleviate stress and anxiety associated with potential oral health issues.

Prevention is Key: An Ounce of Prevention Beats a Pound of Cure

We can’t emphasize the importance of prevention enough when it comes to oral health. Here are some handy tips to keep your mouth in tip-top shape:

Don’t Ignore Symptoms

If you experience any unusual symptoms or discomfort, don’t wait to get it checked out. The sooner we can evaluate your oral health, the better your chances are for a quick and effective recovery.

Brush and Floss

It may sound simple, but brushing and flossing daily is the foundation of good oral hygiene. Keep those pearly whites sparkling by brushing twice a day and flossing once a day.

Regular Checkups

Schedule dental checkups and cleanings at least twice a year. These visits help detect and prevent potential oral health issues and keep your smile looking its best.

Watch Your Diet

A balanced diet is not only essential for your overall health but also for your oral well-being. Limit sugary snacks and acidic beverages to prevent tooth decay and enamel erosion.

At Minnesota Oral and Maxillofacial Surgery, we understand the importance of oral pathology and the benefits of early detection. Our team of experienced oral surgeons is committed to providing you with the highest quality care and ensuring that your smile remains bright and healthy. So, the next time you’re in need of an oral health checkup or have concerns about your oral health, don’t hesitate to reach out to us.

Uncommon Dental Issues After 40

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As you age, your body experiences natural changes, impacting your life. Some changes will occur in your mouth, and these changes present certain oral complications that need to be addressed to improve your quality of life. Fortunately, there are specific oral issues you won’t have to worry about when you reach a certain age. This article tells you about the uncommon dental problems after 40.

Impacted Wisdom Teeth

You’ll develop four additional molars at the back of your mouth. They usually erupt in your teenage years or early 20s. They usually erupt in your teenage years or early 20s. Most of them present serious dental complications because there isn’t enough room in the jaw for them to erupt fully.

This problem is commonly referred to as impacted wisdom teeth. It presents numerous oral complications, including sore gums, pain in the jaw, bacterial infections, and more. The only effective remedy for your impacted wisdom teeth is extraction. Oral surgeons advise their patients to extract their wisdom teeth to prevent future complications as soon as they erupt. Fortunately, you aren’t likely to develop the problem of impacted wisdom teeth after 40 because wisdom teeth don’t erupt at this age.

Overcrowded or Misaligned Teeth

Also referred to as malocclusion, the problem of overcrowded and misaligned teeth is very common in children because they are still going through various human development stages. A child’s mouth usually has 20 primary teeth that eventually fall off to give way to the permanent adult teeth. Unfortunately, sometimes losing the primary teeth and developing new ones doesn’t occur smoothly, resulting in overcrowded and misaligned teeth.

This problem normally occurs when a child’s teeth and jawbone don’t develop simultaneously, leading to a discrepancy in the size of the baby teeth and adult teeth. Sometimes a child will develop adult teeth before losing their primary teeth, resulting in overcrowded and misaligned teeth. Since all your 32 adult teeth should be fully developed in your late 20s, you are less likely to experience the problem of crowded or misaligned teeth after 40. At 40, your teeth should be fully developed and firmly attached to your jawbone and gums to avoid misalignment.

We’re Reopening for Elective and Emergency Cases on May 13th

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The last 6 weeks have been trying times for us as we were all dealing with the unprecedented issues surrounding the global pandemic.  The pandemic has affected all aspects of our lives and resulted in the closure of essentially all elective surgery except but emergency care. Through Governor Waltz’s leadership we are beginning to reopen our elective surgical and dental services as of May 13th. Although we are grateful and excited about returning to work, it is not the time to let down our guard and as a community we need to work together to ensure we continue to minimize the spread of the virus while resuming our daily activities.

We have carefully followed the progress of the pandemic and implemented recommendations for minimizing its spread. Based on guidelines from the Centers for Disease Control (CDC), Minnesota Department of Health Services (MDH), Centers for Medicare and Medicaid Services (CMS) and the Governor’s office we have formulated a plan that maximizes the safety of our patients and their families as well as our healthcare team. We would like to share with you the many changes that we have implemented. As time passes and recommendations change, our protocols will also change and evolve to encompass the best available evidence for our patients.

What will not change is our continued commitment to the safety of our staff and patients.

PATIENTS:

  • In an effort to minimize in-office time, when at all possible, prior to arriving at the office, patient registration paperwork should be completed online through our website.
  • A viral exposure intake form will be completed by any person, patient or escort that comes into the office.
  • All individuals entering the office to wear their own face mask.
  • Every person entering the office will have their temperature checked.

RECEPTION AREA:

  • Hand sanitizer will be provided in the office.
  • Our staff will be routinely cleaning chairs, tables and the general waiting area and bathroom.
  • There will be no magazines or books in the waiting area, so please bring any desired reading material.
  • No food or beverages will be permitted in the waiting room.
  • The number of chairs in the waiting room have been reduced. Each chair will be set a minimum of 6 feet apart.

APPOINTMENTS:

  • Whether it be a surgical consultation or a surgical procedure, we request that only necessary individuals be present.
  • We request that adult patients enter the waiting room alone and have others wait in the car or outside.
  • Only one escort for minor patients will be permitted. All others wait in the car or outside.
  • To minimize the amount of individuals in our waiting and surgical area, we will be staggering surgical and consultative appointments.
  • After every appointment, all areas and our equipment and areas will be thoroughly cleaned per our protocol.

STAFF/DOCTOR:

  • Any staff member feeling ill will stay at home.
  • Our entire staff will daily complete viral exposure intake forms and have their temperatures taken.
  • All staff will follow CMS and CDC universal source guidelines.
  • Masks will be worn in non-treatment and treatment areas.
  • Staff will adhere to regular hand washing and sanitizing.
  • All of our staff will arrive at our office in their personal clothing, change into work PPE, and upon completion of their work day, change back into personal clothing. All scrubs (PPE) will be thoroughly cleaned and sanitized.
  • Any staff member that comes in contact with a person texting positive or any person that is being tested will self-quarantine. They will not return to work without a note from their physician.

GENERAL GUIDELINES:

We thank you for your patience as these protocols are an adjustment for all of us. In order to ease the transition, the following will also be available.

  • If necessary, another individual can phone into a consultation via speaker phone to listen and ask questions.
  • If additional explanation of insurance, financial obligations, or options is needed, a follow up phone call can be made.
  • Virtual Consultations, with encrypted software, are available to minimize exposure. Please call for more information.

Our doctors and staff at Minnesota Oral and Facial Surgery Center appreciate your efforts and cooperation to limit the spread of the virus. We look forward to continuing to be of service to you and our community.

Sincerely,

Deepak Kademani DMD MD FACS and Rod VanSurskum DDS

Minnesota Oral and Facial Surgery

Partners for your Healthcare Journey-Providing Excellence in Surgical Care

Head and Neck Cancer Awareness Month

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Cancer-Awareness-Month-Dr-Kademani

Approximately 650,000 people worldwide are diagnosed with head and neck cancer each year, and more than 330,000 deaths are attributed to these diagnoses on an annual basis.1 More than 90% of these tumors arise from the mucosa of the oral cavity, oropharynx, and larynx, and the majority are histologically verified squamous cell carcinomas.2 Overall, in 2020 the 5-year survival rate of oral and oropharyngeal cancer is estimated to be approximately 65%. In the United States, these cancers account for about 50,000 new cancer diagnoses each year and almost 1 death every hour of every day. Risk factors for oral and oropharyngeal cancer include the use of smokeless and inhalational tobacco, use of alcohol, the synergistic interaction of tobacco and alcohol, human papillomavirus (HPV) and use of betel quid (paan).

Improved Survival Rates

Improved survival rates are noted when these cancers are diagnosed at early stages- approximately 84% for localized disease, 66% for regional disease, and 39% for distant disease. A delay in diagnosis has been shown to increase the risk of experiencing progression to advanced stages of disease and increased mortality. Thus, early detection of potentially malignant and overtly malignant mucosal disease will enhance the possibility for complete recovery and increase the quality of life for patients with oral and oropharyngeal cancers.

Oral health care professionals are the best suited among all health care professionals to perform effective screening for oral and oropharyngeal cancer, which should consist of an assessment of risk factors and a detailed oral and oropharyngeal examination. The reference standard for screening remains a clinical examination and tissue biopsy. Although, numerous adjunctive tests are available, all have shown a level of sensitivity and specificity that makes them ill-suited to be used for routine screening. As early diagnosis can decrease both morbidity and mortality of oral and oropharyngeal cancer, the oral health care community is in an ideal position to perform screening, and we need to understand our critical role in affecting the epidemiology of these devastating cancers, which unfortunately has not improved significantly in the past decades.

The management of oral potentially malignant disorders (OPMD) is an important step in the prevention and early detection of oral cancer. In 2018, the American Dental Association produced guidelines for the management of OPMD, which for high-risk lesions should involve monitoring for changes, followed by serial biopsies with histologic confirmation for high-risk lesions. It is important to recognize that all patients, and particularly those at high risk of developing OPMD, should be educated about the risk of experiencing malignant transformation and should be monitored in a structured follow-up program.

Recently, HPV has garnered a great interest as a virally induced variant of head and neck cancer. HPV is the most commonly sexually transmitted disease in the United States, and it has been identified in 70% of oropharyngeal cancers and 10% of oral cancers. In 1999, cervical cancer (13,125 new diagnosed cases) was the most common HPV-associated cancer with 3,750 more cases of cervical cancer diagnosed than oropharyngeal cancer. In 2015, oropharyngeal cancer (18,917 new diagnosed cases) was the most common HPV-associated cancer, including 15,479 cases in men and 3,438 cases in women, which represent a 2.7% increase in incidence in only 16 years. Several factors might account for the increase in oropharyngeal cancers, including changes in sexual behaviors, which include risk factors of early sexual debut and lifetime number of oral sex partners. The lack of routine tonsillectomies in the current Millennial generation might also explain the increased incidence of oropharyngeal cancer during this time.

Vaccination Strategies

Vaccination strategies for HPV have existed since 2006 when the US Food and Drug Administration licensed the quadrivalent Gardasil (Merck) vaccine to protect against HPV types 6, 11, 16 and 18. Thereafter, the US Food and Drug Administration licensed the bivalent Cervarix (GlaxoSmithKline) vaccine to protect against HPV types 16 and 18 in 2009 and the 9-valent Gardasil vaccine to protect against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in 2018. Although the Centers for Disease Control and Prevention established a target of 80% US HPV vaccination rate as part of its Healthy People 2020 initiative, the national HPV vaccination rate has fallen behind other vaccination rates. In 2018, 51.1% of adolescents aged 13 through 17 years were current with their HPV vaccine series, and 68.1% had received 1 or more doses.

Increased survival rates of oral and oropharyngeal cancer have been realized over the past 20 years, likely owing to earlier detection by providers, aggressive surgical and adjuvant chemoradiotherapy protocols, precautionary statements on smokeless tobacco and cigarette packages, and other public health measures. Just as routine cervical examinations and Papanicolaou tests (PAP smears) have led to a decrease in cervical cancer, oral health care and medical health care professionals alike must develop a sense of urgency regarding routine examination of the mucosa of the oral cavity and oropharynx to provide earlier detection of potentially malignant lesions and obvious cancers. With improved vaccination strategies and adherence outcomes with Gardasil 9, it is possible that oropharyngeal cancer rates will begin to decrease. Over time, hopefully, HPV vaccination will decrease the incidence of cervical cancer further. Therefore, all health care providers, including all oral health care professionals, must engage in conversation with young patients regarding the highly beneficial and safe nature of the HPV vaccination. HPV vaccination is recommended for boys and girls aged 11 or 12 years before HPV exposure occurs. The vaccine can be started as early as age 9 years and should be completed before the child’s 13th birthday. The vaccine is given in 2 injections with 6 through 12 months between injections. Three injections of the HPV vaccine are required for children who start the vaccine at age 15 years or older, and it can be administered up to age 26 years. The benefit of vaccinating after the age of 26 years is unclear.

Copyright 2020 American Dental Association. All rights reserved.

Eric R. Carlson, DMD, MD, EdM, FACS; Deepak Kademani, DMD, MD, FACS

Story of Oral Cancer Caused by HPV

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Shortly after getting married, Steve learned he had an oral cancer caused by HPV. Steve and his wife want parents to protect their children from HPV-related cancers by getting them vaccinated.