The U.S. Army Center for Health Promotion and Preventive Medicine has developed a Bite Site to enhance dental wellness. MAJ Georgia DelaCruz, DMD, MPH Dental Staff Officer, Wellness Resource Program, Directorate of Health Promotion and Wellness U.S. Center for Health Promotion and Preventive Medicine (USACHPPM) hosts the H4H Clinician's Corner column every month to bring you clinical information, studies, and readiness commentary. She is the Fit 2 Bite dental subject matter expert! USACHPPM risk communications staff members support the review of Fit 2 Bite content.

If you have a question or comment related to dental wellness visit the dentist's chair, flash your smile, and fire away!

by MAJ Georgia DelaCruz, DMD, MPH Dental Staff Officer
U.S. Army Center for Health Promotion and Preventive Medicine

"My grill is jacked up, Ma'am," the Soldier said as he sat back in my chair. Sadly, he was right. This young man had about a dozen cavities, the beginnings of gum disease around most of his teeth, and what looked like a pelt of dark brown fur growing on the back of his tongue. Let's not even talk about the way his mouth smelled. We discussed his daily habits and identified the two main culprits: sports drinks and smoking. The good news for him was that he hadn't developed oral cancer - yet...

Most people know that smoking can cause heart disease, stroke, lung cancer or other respiratory diseases. However, they don't consider what smoking does at the site where they actually place the end of the cigarette-in their mouth. Stained teeth, brown hairy tongue and bad breath are the least of their problems, but few people ever think about what else smoking might be doing to their mouth.

In this Soldier's case, sugar in the sports drink wasn't the only thing contributing to his tooth decay. Many studies show that smokers tend to have more tooth decay than non-smokers. Smoking compromises your saliva flow and function. Saliva is important for cleaning the lining of the mouth and teeth and protecting teeth from decay. More disturbing, however, are recent studies that show that children who are raised in households where one or both adults smoke are more likely to develop tooth decay.

Long-term studies have shown that smoking can cause gum disease and bone loss and eventually tooth loss. Smoking reduces blood flow to the gums and cuts the supply of vital nutrients. It can also reduce vitamin C levels by half! Vitamin C helps gums to stay healthy. These two factors, reduced blood flow and vitamin C levels, make attempts to treat gum disease in smokers less likely to succeed.

Smoking also raises the mouth's temperature, damaging and killing important oral tissue cells. When you combine this with the cancer-causing compounds found in tobacco, you have a recipe for disaster: oral cancer (cancer of the mouth). Smokers are 2 to 18 times more likely to develop oral cancer than non-smokers. It depends on how heavily they smoke. Oral cancer strikes more Americans annually than some better known cancers such as brain, thyroid, stomach, cervical, and ovarian. The numbers of young people experiencing oral cancer have risen over the past decade.

Worse yet, the overall survival rate for oral cancer is low-nearly half of all oral cancer patients die within five years. The survival rate is probably low because more than half of all oral cancers are not detected until they reach an advanced stage. Early warning signs of oral cancer include - -
      • a swelling, lump, or growth in the mouth that does not heal
      • white or red patches inside the mouth that don't go away
      • loose teeth for no apparent reason
      • pain when swallowing
      • persistent sore throat
      • difficulty swallowing or in opening your mouth
      • a nagging cough or persistent hoarseness
      • unusual bleeding in your nose or mouth
      • and numbness or tingling in your lips or tongue.

At least the Soldier mentioned at the beginning of this article came in for his annual exam. The most treatable form of oral cancer is a small, early lesion, which may only be detectable by a health professional. As highly trained specialists in oral diseases, dentists are the healthcare providers of choice for detecting oral cancers. Your best defense against oral cancer is to stop smoking, and make sure you receive an oral cancer examination at your annual dental visit. Take this little quiz to see where you stand in the battle against oral cancer: