Chewing tobacco, boys and baseball

Likely users of chewing tobacco are teenage boys who play baseball. But no matter who is using it, chewing tobacco and other forms of smokeless tobacco can harm oral health.

According to the Academy of General Dentistry (AGD), children, especially boys, may begin using chewing tobacco as early as grammar school. Approximately four percent of boys in grammar school use chewing tobacco. This percentage leaps to 20 percent for high school boys, half of whom develop pre-cancerous white patches in their mouths.

Many boys begin to use chewing tobacco when they become involved in sports, particularly baseball. Researchers believe that young people are influenced by seeing professional baseball players using chewing tobacco at the ballpark or during televised games.

It may be smokeless, but it’s still tobacco

One of the newest forms of smokeless tobacco that is gaining popularity in America is called snus (rhymes with “goose”). It's a Swedish type of smokeless tobacco that comes in teabag-like pouches that a user sticks between the upper lip and gum, leaves there for up to 30 minutes and discards without spitting.

This form of smokeless tobacco has become more popular because it’s not as messy as chewing tobacco, dipping tobacco and moist snuff, which often cause excess saliva during use. It does, however, still contain the active ingredients of chewing tobacco. Snus products are required to carry one of three warning labels that say the product is either "not a safe alternative to cigarettes," "may cause mouth cancer" or "may cause gum disease and tooth loss."

Smokeless tobacco and oral health

Just because chewing tobacco and other forms of smokeless tobacco aren't smoked as cigarettes does not mean they are harmless, especially when it comes to oral health. In fact, the American Cancer Society, in a study of 116,000 men, found that male smokers who gave up cigarettes for smokeless tobacco still had higher death rates from lung cancer, heart disease and strokes than men who quit all tobacco or never smoked.

Like cigarettes, smokeless tobacco can lead to higher incidences of cavities and oral cancer. A few of the known health dangers of smokeless tobacco include the following:

Smokeless tobacco products, just like cigarettes, contain at least 28 cancer-causing chemicals.
Smokeless tobacco is known to cause cancers of the mouth, lip, tongue and pancreas.
Users also may be at risk for cancer of the voice box, esophagus, colon and bladder, because they swallow some of the toxins in the juice created by using smokeless tobacco.
Smokeless tobacco can irritate your gums, causing gum (periodontal) disease.
Sugar is often added to enhance the flavor of smokeless tobacco, increasing the risk for tooth decay.
Smokeless tobacco typically contains sand and grit, which can wear down teeth.

What you can do?
If you are a smoker, a user of smokeless tobacco or a parent with a child or teen whom you suspect may be using tobacco, you can start by understanding that tobacco dependence is a nicotine addiction disorder.

There are four aspects to nicotine addiction: physical, sensory, psychological and behavioral. All aspects of nicotine addiction need to be addressed in order to break the habit. This can mean that tobacco users may need to try several times before they are able to successfully kick the habit.

Speak to your child directly about the risks associated with all tobacco products, including smokeless ones. If you have friends or relatives who have died of a tobacco-related illness, share the truth about it with your child, and discuss ways your child can say no to tobacco.

Information courtesy of the Academy of General Dentistry and the American Dental Association

Questions About Going to the Dentist

Whether you are 80 or 8, your oral health is important. Did you know that 100 million Americans fail to see a dentist each year, even though regular dental examinations and good oral hygiene can prevent most dental disease? Here are some frequently asked questions about going to the dentist.

Question: Why do regular dental visits matter?

Answer: Regular dental visits are important because they can help spot oral health problems early on when treatment is likely to be simpler and more affordable. They also help prevent many oral problems from developing in the first place. Visiting your dentist regularly is also important because some diseases or medical conditions have symptoms that can appear in the mouth.

Here are 15 signs you should see a dentist:

Your teeth are sensitive to hot or cold
Your gums are puffy and/or they bleed when you brush or floss
You have fillings, crowns, dental implants, dentures, etc.
You don’t like the way your smile or teeth look
You have persistent bad breath or bad taste in your mouth
You are pregnant
You have pain or swelling in your mouth, face or neck
You have difficulty chewing or swallowing
You have a family history of gum disease or tooth decay
You have a medical condition such as diabetes, cardiovascular disease, eating disorders, or are HIV positive
Your mouth is often dry
You smoke or use other tobacco products
You are undergoing medical treatment such as radiation, chemotherapy or hormone replacement therapy
Your jaw sometimes pops or is painful when opening and closing, chewing or when you first wake up; you have an uneven bite
You have a spot or sore that doesn't look or feel right in your mouth and it isn't going away.

Q: What if I don’t have any of these symptoms—do I still need to go to the dentist?
A: Yes. Even if you don’t have any symptoms, you can still have oral health problems that only a dentist can diagnose. Regular dental visits will also help prevent problems from developing. Continuity of care is an important part of any health plan and dental health is no exception. Keeping your mouth healthy is an essential piece of your overall health. It’s also important to keep your dentist informed of any changes in your overall health since many medical conditions can affect your oral health too.

Q: What can I expect during a dental checkup?
A: The dentist or hygienist will ask about your recent medical history, examine your mouth and decide whether or not you need x-rays. Depending on your treatment plan, the hygienist may use a special dental instruments to check your gums for gum disease. Your dentist will evaluate your overall dental health and conduct an oral cancer screening by holding your tongue with gauze, checking it and your whole mouth, then feeling your jaw and neck.

Q: How often do I have to go to the dentist? 
A: There is no one-size-fits-all dental treatment. Some people need to visit the dentist once or twice a year; others may need more visits. You are a unique individual, with a unique smile and unique needs when it comes to keeping your smile healthy.

Q: How do I find a dentist? 
A: The American Dental Association offers these suggestions in finding a dentist:

Visit ADA Find-a-Dentist to search dentists in your area.
Ask family, friends, neighbors or co-workers for recommendations.
Ask your family physician or local pharmacist.
If you're moving, your current dentist may be able to make a recommendation.
Call or write your state dental society.

Q: What should I look for when choosing a dentist? 
A: You may want to call or visit more than one dentist before making your decision. Dental care is a very personalized service that requires a good relationship between the dentist and the patient. During your first visit, you should be able to determine if this is the right dentist for you.

Consider the following:

Is the appointment schedule convenient for you?
Is the office easy to get to from your home or job?
Does the office appear to be clean, neat and orderly?
Was your medical and dental history recorded and placed in a permanent file?
Does the dentist explain techniques that will help you prevent dental health problems?
Is dental health instruction provided?
Are special arrangements made for handling emergencies outside of office hours? (Most dentists make arrangements with a colleague or emergency referral service if they are unable to tend to emergencies.)
Is information provided about fees and payment plans before treatment is scheduled?
Is your dentist a member of the ADA? All ADA member dentists voluntarily agree to abide by the high ethical standards reflected in the member code of conduct. You and your dentist are partners in maintaining your oral health. Take time to ask questions and take notes if that will help you remember your dentist's advice.

Here are some tips to help you take care of your smile:

Healthy habits.
   Brushing twice a day for two minutes and flossing daily are essential for everyone, no matter how   unique your mouth is. It’s the best way to fight tooth decay and gum disease.

Build a relationship.
  Continuity of care is an important part of any health plan and dental health is no exception. When your dentist sees you regularly, he or she is in a good position to catch oral problems early. For instance, catching gum disease when it’s still reversible, or cavities when they are small and are more easily treated.

Maintain.
  Keeping your mouth healthy is an essential piece of your overall health. It’s important to keep your dentist informed of any changes in your overall health as well.

Talk about it!
  Only your dentist can determine what the best treatment plan is for you. Have questions about your oral health or certain dental procedures? Start a conversation. Ask your dentist to explain step-by-step. Dentists love having satisfied, healthy patients.

Q: What is the difference between a DDS and a DMD?
A: If you’re looking to find a dentist you may notice that while most are listed with a “DDS”, some may be listed as “DMD”. They both mean the same thing—your dentist graduated from an accredited dental school. The DDS (Doctor of Dental Surgery) and DMD (Doctor of Dental Medicine) are the same degrees. Dentists who have a DMD or DDS have the same education. The level of education and clinical training required to earn a dental degree, and the high academic standards of dental schools are on par with those of medical schools. Upon completion of their training, dentists must pass both a rigorous national written exam and a state or regional clinical licensing exam in order to practice. In order to keep their licenses, they must meet continuing education requirements for the remainder of their careers so that they may stay up to date on the latest scientific and clinical developments.

Chemotherapy and Your Mouth

Are You Being Treated With Chemotherapy for Cancer? 

If so, this booklet can help you. While chemotherapy helps treat cancer, it can also cause other things to happen in your body called side effects. Some of these problems affect the mouth and could cause you to delay or stop treatment. 

This booklet will tell you ways to help prevent mouth problems so you’ll get the most from your cancer treatment. 

To help prevent serious problems, see a dentist ideally 1 month before starting chemotherapy.

How Does Chemotherapy Affect the Mouth?

Chemotherapy is the use of drugs to treat cancer. These drugs kill cancer cells, but they may also harm normal cells, including cells in the mouth. Side effects include problems with your teeth and gums; the soft, moist lining of your mouth; and the glands that make saliva (spit). 

It’s important to know that side effects in the mouth can be serious. 

• The side effects can hurt and make it hard to eat, talk, and swallow. 
• You are more likely to get an infection, which can be dangerous when you are receiving cancer treatment. 
• If the side effects are bad, you may not be able to keep up with your cancer treatment. Your doctor may need to cut back on your cancer treatment or may even stop it. 

What Mouth Problems Does Chemotherapy Cause? 

You may have certain side effects in your mouth from chemotherapy. Another person may have different problems. The problems depend on the chemotherapy drugs and how your body reacts to them. You may have these problems only during treatment or for a short time after treatment ends. 

• Painful mouth and gums. 
• Dry mouth. 
• Burning, peeling, or swelling tongue. 
• Infection. 
• Change in taste. 

Why Should I See a Dentist?

You may be surprised that your dentist is important in your cancer treatment. If you go to the dentist before chemotherapy begins, you can help prevent serious mouth problems. Side effects often happen because a person’s mouth is not healthy before chemotherapy starts. Not all mouth problems can be avoided but the fewer side effects you have, the more likely you will stay on your cancer treatment schedule. 

It’s important for your dentist and cancer doctor to talk to each other about your cancer treatment. Be sure to give your dentist your cancer doctor’s phone number. 

When should I see a dentist? 

You need to see the dentist 1 month, if possible, before chemotherapy begins. If you have already started chemotherapy and didn't go to a dentist, see one as soon as possible. 

What Will the Dentist and Dental Hygienist Do? 

• Check and clean your teeth. 
• Take x-rays. 
• Take care of mouth problems. 
• Show you how to take care of your mouth to prevent side effects. 

What Can I Do To Keep My Mouth Healthy? 

You can do a lot to keep your mouth healthy during chemotherapy. The first step is to see a dentist before you start cancer treatment. Once your treatment starts, it’s important to look in your mouth every day for sores or other changes. These tips can help prevent and treat a sore mouth:

Keep your mouth moist. 

• Drink a lot of water. 
• Suck ice chips. 
• Use sugarless gum or sugar-free hard candy. 
• Use a saliva substitute to help moisten your mouth. 

Clean your mouth, tongue, and gums. 

• Brush your teeth, gums, and tongue with an extra-soft toothbrush after every meal and at bedtime. If brushing hurts, soften the bristles in warm water. 
• Use a fluoride toothpaste. 
• Don’t use mouthwashes with alcohol in them.
• Floss your teeth gently every day. If your gums bleed and hurt, avoid the areas that are bleeding or sore, but keep flossing your other teeth. 
• Rinse your mouth several times a day with a solution of ¼ teaspoon each of baking soda and salt in one quart of warm water. Follow with a plain water rinse. 
• Dentures that don’t fit well can cause problems. Talk to your cancer doctor or dentist about your dentures. 

If your mouth is sore, watch what you eat and drink. 

• Choose foods that are good for you and easy to chew and swallow. 
• Take small bites of food, chew slowly, and sip liquids with your meals. 
• Eat soft, moist foods such as cooked cereals, mashed potatoes, and scrambled eggs. 
• If you have trouble swallowing, soften your food with gravy, sauces, broth, yogurt, or other liquids. 

Call your doctor or nurse when your mouth hurts. 

• Work with them to find medicines to help control the pain. 
• If the pain continues, talk to your cancer doctor about stronger medicines. 

Remember to stay away from 

• Sharp, crunchy foods, like taco chips, that could scrape or cut your mouth. 
• Foods that are hot, spicy, or high in acid, like citrus fruits and juices, which can irritate your mouth. 
• Sugary foods, like candy or soda, that could cause cavities. 
• Toothpicks, because they can cut your mouth. 
• All tobacco products. 
• Alcoholic drinks. 

Do Children Get Mouth Problems Too? 

Chemotherapy causes other side effects in children, depending on the child’s age. 

Problems with teeth are the most common. Permanent teeth may be slow to come in and may look different from normal teeth. Teeth may fall out. The dentist will check your child’s jaws for any growth problems. 

Before chemotherapy begins, take your child to a dentist. The dentist will check your child’s mouth carefully and pull loose teeth or those that may become loose during treatment. Ask the dentist or hygienist what you can do to help your child with mouth care. 

Remember: 

• Visit your dentist before your cancer treatment starts. 
• Take good care of your mouth during treatment. 
• Talk regularly with your cancer doctor and dentist about any mouth problems you have. 

Acknowledgments 

The individuals listed here provided assistance in developing and reviewing all of the publications in this series. The National Institute of Dental and Craniofacial Research and its partners would like to thank them for their contributions. 

Article originally appeared on the National Institute of Dental and Craniofacial Research website. Link.