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HPV, or human papillomavirus, is the most common sexually transmitted infection in the country. There are over 100 strains of HPV, and, while most of these infections leave our systems on their own with no long-term ill effects, some cancers have been linked to certain “high risk” strains of the virus. One of these strains, HPV16, increases the risk of oral cancer.

HPV-related oral cancer most often appears in the oropharynx. This area of the mouth includes:

• The base, or back, of the tongue
• The soft palate
• The tonsils
• The back and sides of the throat

While HPV-related oral cancers can appear in other parts of the oral cavity, they most typically occur at the back of the throat and tongue and near the folds of the tonsils. Because of this location, oropharyngeal cancer can be difficult to detect. This is one more important reason to maintain a regular schedule of dental exams. Our examination doesn’t focus only on your teeth and gums. We are trained to look for cancerous and pre-cancerous conditions in the mouth, head, and neck to make sure you have the earliest treatment options should they be needed.

If you discover any potential symptoms of oropharyngeal cancer, call us for a check-up. These symptoms can include:

• Trouble moving the tongue
• Trouble swallowing, speaking, or chewing
• Trouble opening the mouth completely
• A red or white patch on the tongue or the lining of the mouth
• A lump in the throat, neck, or tongue
• A persistent sore throat
• Ear pain
• Unexplained weight loss
• Coughing up blood

Not every symptom is caused by cancer, but it is always best to be proactive. HPV-related oral cancer is rare, but it is on the increase. While HPV-positive oral cancers generally have a better prognosis than HPV-negative oral cancers, early diagnosis and treatment are still essential for the best possible outcome.

Finally, if you are a young adult or have an adolescent child, talk to Dr. Dale Scharine and Dr. Alissa Edwards and to your doctor about the HPV vaccine, which is effective before exposure to the virus occurs. Most HPV vaccines, while not designed specifically to prevent oral cancer, prevent the HPV16 strain from infecting the body—the very same strain that causes the majority of HPV-related oral cancers.  Although no studies have shown definitive proof yet, there is strong feeling in the scientific community that these immunizations might protect against HPV-positive oral cancer as well as cervical, vaginal, and other cancers. It’s a discussion worth having at your next visit to our Appleton, WI office.

Let’s face it, by now, brushing our teeth is something we pretty much do on auto-pilot. A quick brush after breakfast, a minute or so at night, floss when we think of it. Done. But take a few minutes to review these cleaning tips, and see if a few small adjustments to your routine could make all the difference at your next checkup at our Appleton, WI office.

• Tools

Some of us prefer brushing with a manual brush. Some like the electric brush for ease and comfort. Whichever form of brush you choose, be sure that it fits comfortably in your mouth, reaches everywhere it needs to, and has a handle that is easy to grip. There are many bristle options available, so if you are an energetic brusher, or if you have sensitive gums, try a soft bristled brush for gentler brushing.

If you haven’t been exploring the floss aisle lately, there are now many varieties available to suit your particular needs. Besides the traditional floss, there are coated flosses for easy gliding between teeth that fit closely together, dental tape-style flosses to fit teeth with wider spacing, and even flosses designed just for braces that thread between the wires and brackets. Talk to Dr. Dale Scharine and Dr. Alissa Edwards at your next cleaning for product suggestions if you think there’s an easier, more comfortable option out there for you.

• Technique

With proper technique, any toothbrush and floss you choose will do a fine job of removing plaque.

Brushing? There’s a tried and true method for success. Place the toothbrush at a 45° angle at the gum line. Be sure to brush the outside, inside, and chewing surface of each tooth thoroughly. Remember the expression, “Massage, don’t scrub.” Over-vigorous brushing can actually irritate gum tissue and damage enamel. An electric toothbrush should provide a continuous brushing motion without needing any pressure from the brusher. This might be the model for you if you have a too-vigorous approach to brushing, or sensitive teeth and gums. If you like your manual brush, again, give a soft-bristled brush a try!

As for flossing? That harmless-looking little string can cause gum damage if used too forcefully. You can accomplish the placement and cleaning power you need by easing the floss down to the gumline and flossing with gentle pressure against the tooth surface. If you have any questions about technique, remember—we are always happy to let you know the best cleaning methods for your specific needs.

• Timing

Of course, the best tools and the best technique in the world won’t be effective unless you put the right amount of time into brushing and flossing.

The standard rule is two minutes of brushing in the morning and two minutes at night. If you wear braces or have other special circumstances, we might recommend brushing after every meal. And if you brush after breakfast, give your teeth half an hour or so to remineralize. This natural process uses the calcium and phosphate ions in your saliva to strengthen tooth enamel after it’s been exposed to any acidic foods in your breakfast.

Thorough flossing can be accomplished in a few minutes, and might be needed only once a day. But again, depending on your individual needs, we might have other recommendations. Let’s review what works for you at your next visit—we can tailor suggestions for a brushing routine to your unique needs.

It’s a great idea to review your brushing habits periodically to make sure you are getting the most out of those minutes you spend cleaning your teeth. There won’t be a test at the end of this review, and you won’t get a gratifying grade or a gold star. What you will get is much more important—better checkups, fewer cavities, and healthy teeth and gums. Happy cleaning!

In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr. Dale Scharine and Dr. Alissa Edwards suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

• A history of infective endocarditis
• Certain congenital heart conditions (heart conditions present since birth)
• An artificial heart valve
• A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our Appleton, WI office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

When your child loses a tooth for the first time, you both have a lot to look forward to. Sharing in the “I’m a big kid!” excitement. Tales of the Tooth Fairy or other traditions to mark the occasion. Seeing the start of a beautiful grown-up smile.

But before that baby tooth wiggles all the way out of your child’s mouth, let’s talk about how to handle a loose baby tooth.

• Be mindful of your children’s feelings. Reassure them that this is a normal part of growing up. If they are anxious about losing a tooth, there are children’s books which can help ease their fears in a soothing and entertaining way.
• Crunchy and healthy foods like carrot sticks and apple slices can help the tooth fall out naturally—and nutritiously!
• Encourage careful wiggling. No need for children to yank or pull—time, and a child’s own gentle wiggling with tongue or clean hands, should do the trick. If wiggling the tooth is painful, it might not be ready to come out just yet.
• If a tooth absolutely is ready, but just won’t come out, you can help your child without resorting to a string and a doorknob. Give our Appleton, WI office a call for some suggestions for helping that baby tooth on its way to the Tooth Fairy in a timely—and gentle—fashion.

And if a tooth is clearly loose before its time? Should you encourage its exit?

Probably not. Baby teeth are temporary, but they’re important for your child’s development. They help with speech production, eating and chewing, and serve as placeholders so that permanent teeth can erupt in the right spot at the right time.

There are some situations when a loose baby tooth means a visit to the dentist is in order:

• Baby teeth usually fall out over a period of years, generally from ages 6 through 12. Since children’s teeth tend to fall out in the same order they arrived, if a molar is loose before the front teeth start to wiggle, give your dentist a call.
• If your child suffers a fall, or a sports injury, or any kind of accident that leaves a tooth or teeth loose, call your doctor or dentist right away to make sure there are no serious injuries or chance for infection.
• Any time you feel a tooth is loose that shouldn’t be, make an appointment with your child’s dentist.

Finally, we’ve been talking about loose baby teeth, but loose permanent teeth are another matter entirely.

If you child has a loose permanent tooth due to an injury, or a bad bite, or night-time bruxism (tooth-grinding), or for any other reason, it’s important to call for an appointment immediately. Dr. Dale Scharine and Dr. Alissa Edwards will be able to pinpoint the cause of the problem and can offer some solutions. In the meantime,

• Make sure your child eats soft foods, and tries to eat on the opposite side of the loose tooth.
• Keep the area clean with gentle rinsing instead of brushing and flossing.
• Tell your child not to wiggle it! If the bone or ligaments holding the tooth in place have been damaged, playing with the tooth can make it looser.

A loose baby tooth is a step in your child’s journey to a beautiful, healthy adult smile. Reassure, encourage, and help your child through this rite of passage—and don’t hesitate to call on Dr. Dale Scharine and Dr. Alissa Edwards for advice!