Monday, March 9, 2020

What Vaping, Smoking Do to Your Mouth’s Microbiome — and How That Affects Your Health


  • Researchers say they’ve discovered that vaping and smoking cause changes in the mouth’s microbiome.
  • Those changes can lead to an increased risk of infection, inflammation, and gum disease.
  • It’s the latest research that links oral health to the overall health of the body.
Vaping e-cigarettes could induce changes to the composition of the mouth’s microbiome, leading to increased risks of inflammation, gum disease, and infection.
That’s the conclusion of a study published today from the New York University College of Dentistry.
Researchers looked at a group of more than 100 cigarette smokers, e-cigarette users, and nonsmokers.
They found that smokers and e-cigarette users had significantly higher rates of gum disease and infection — 73 percent and 43 percent, respectively —than nonsmokers, who had a 28 percent rate of disease.
The researchers then used saliva samples from study participants to investigate what was driving these rates of disease and infection.
They found that smoking and e-cigarette use led to bacterial changes in the mouth, including increased levels of two different types of bacteria in e-cigarette users known to cause periodontal disease.
Just like in the gut, the composition of the microbiome in your mouth affects your propensity for infection and other diseases.
In general, healthier bacteria leads to healthier outcomes.
The bacterial changes among vapers indicate that there will be a favorable environment for opportunistic pathogens to grow more in the mouth much faster, as compared to the good bacteria [normally there] and change the whole microenvironment, which may be which may further lead to other complications.
 The pathogens that are known to be the most aggressive are all anaerobic, which means they thrive in an oral environment without the presence of oxygen. The dry oral environment and presence of nicotine, which reduces blood supply and oxygen levels, help create an environment that allows these bacteria to proliferate at an increased rate.
The mouth’s health is a leading indicator of other health complications.
Essentially, vaping creates and promotes an environment that allows the impact of these bacteria to be exacerbated and further promote complications associated with poor periodontal health such as increased risk for cardiovascular disease, Alzheimer’s, dementia, stroke, heart attacks, respiratory infections that can lead to pneumonia, osteopenia, rheumatoid arthritis, uncontrolled diabetes, and even preterm or low birth weight babies as well as exposing the fetus to infections.
The reality, is that the microbiome changes might not just be happening in the mouth — it’s simply harder to test the microbiome of the lungs, for instance — but equally possible these changes are happening elsewhere.
This may be happening down the respiratory tract or the GI tract, which we don’t know because there is no data available. Anybody who is planning to start using e-cigarettes, use with the caution that this can happen in the mouth. This can happen in the lungs. This can happen in the skin or nostrils or other places also.
According to the new study, traditional cigarette smokers still had significantly higher levels of infection and inflammation than vapers, but nothing beats stopping smoking altogether for oral health.
While some people vape as a way to smoke less frequently or smoke “healthier,” that assumption of lower health risks has been thrown into contention as more studies into the health effects of vaping surface.
Recent research shows negative health consequences of vaping may include cell dysfunction, damage to DNA, and compromised cardiovascular health.
In addition, most of those studies pre-date the appearance of a mysterious vaping-related respiratory illness that emerged last year.
Part of this is simply because e-cigarettes have not been on the market long, so scientists don’t have a full understanding of all their effects, Saxena said.
Research has shown how interconnected the mouth and the rest of the body are.
The oral bacteria that cause gum disease have been found in the clots of both stroke and heart attack victims, showing they enter the bloodstream from diseased gum tissue and cause damage elsewhere in the body.
Because it is so common, the infection and inflammation from untreated gum disease is one of the most studied connections between poor oral and overall health risks.
Experts say if you want to have a healthier oral microbiome and better overall health, there is a simple solution: Stop smoking, whether that’s vaping or cigarettes.
The microbiome is reversible. So, if you stop now and the cells are not in stress and there is a good saliva production, the oral ecology will become normal again.


Thursday, March 5, 2020

What is trismus?


Trismus, or lockjaw, is a painful condition in which the jaws do not open fully. As well as causing pain, trismus can lead to problems with eating, speaking, and oral hygiene.
Trismus occurs when a person is unable to open their mouth more than 35 millimeters (mm). It can occur as a result of trauma to the jaw, oral surgery, infection, cancer, or radiation treatment for cancers of the head and throat.
Most cases of trismus are temporary, typically lasting for less than 2 weeks, but some may be permanent.
In this article, we explore the causes and symptoms of trismus. We also look at the current treatment options for this condition.
Trauma and inflammation are possible causes of trismus.
There are many possible causes of trismus, including the following:
Trauma
Injury or damage to the jaw can lead to trismus. Examples of such trauma include fractured jawbones or tissue damage following dental surgery.
Others include:
  • contusion of the temporomandibular joint (TMJ)
  • hematoma, which is a collection of blood outside of blood vessels
  • injury to the muscles of mastication, which people use when chewing
Inflammation
Some medical conditions that cause inflammation in the mouth may cause trismus. One example is pericoronitis, which is inflammation of the soft tissue around a tooth, potentially leading to an impacted molar.
Others include:
  • arthritis in the jawbones
  • scleroderma, which is an autoimmune disease that affects connective tissue
  • soft tissue fibrosis, which occurs when excess fibrous connective tissue forms
Dental surgery
Oral surgery, including wisdom tooth extraction, may cause inflammation in the mouth, which can lead to trismus.
Hyperextension, which is having to open the mouth wider than its usual range of motion, during surgery may also lead to lockjaw.
Infection
Infections can contribute to trismus in some cases.
Types of infections that may do this include:
  • mumps
  • tetanus
  • tonsillitis
  • peritonsillar abscess
  • other types of abscess
Cancer or cancer treatment
Cancerous tumors in the head or throat can affect the function of the jaw.
Radiation treatment for these tumors can also cause trismus.
According to a small 2016 study consisting of 30 participants with oral cancer, trismus affected 53.3% of them at the time of diagnosis.
This number increased to 86.7% after surgery and 85.7% after radiotherapy.

While anyone can develop trismus, some factors may increase the chance of developing it.
These include:
  • having head or neck cancer
  • undergoing radiation treatment for head or neck cancer
  • recent oral surgery to remove a wisdom tooth
  • recent trauma to the mouth or jaw
  • having certain types of mouth infection
The defining symptom of trismus is the jaw not opening fully or opening to 35 mm or less.
Other symptoms include:
  • jaw pain and cramping
  • difficulty biting, chewing, or brushing the teeth
  • inability to swallow some foods
  • headaches
  • earache
Typically, treating the underlying condition should resolve many cases of trismus.
Generally, the earlier a person seeks treatment, the better the outcome.
Treatment options include:
Medication
It may be necessary to take medication to reduce pain and relax the jaw muscles. Common medications for trismus include muscle relaxers and nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain.
Depending on the severity of the symptoms, a doctor may prescribe oral medications or drugs that require injection into the jaw.
Some forms of NSAIDs are also available over the counter.
Jaw-stretching devices
A doctor or physical therapist may recommend the use of a jaw-stretching device.
In a 2014 study, people who used such a device when performing specific mouth exercises had an average increase in mouth opening of 5.5–7.2 mm.
Dietary changes
Individuals may need to make dietary changes until the condition improves.
For most people, moving to a soft foods diet is helpful because it is possible to eat these foods without opening the mouth too much.
Examples of soft foods include:
  • soup
  • smoothies
  • yogurt
  • mashed potatoes
  • oatmeal
  • beans
  • steamed vegetables
  • stewed fruits
  • cheese
  • fish
  • scrambled eggs
Until trismus resolves, it may be beneficial to avoid foods that are hard, crunchy, or chewy, such as candy bars, uncooked apples, and tough meats.
A doctor will carry out a physical examination and take a person’s medical history to diagnose trismus.
They may ask about recent injuries or dental work and look for signs of cancer or abnormalities in the bones or tissues of the jaw.
A doctor may use one or more of the following tests to help them diagnose or rule out trismus:
  • a measurement of the mouth opening
  • a CT scan
  • an MRI scan
Trismus may cause a variety of complications that can affect a person’s quality of life, including:
Oral hygiene problems
If a person cannot open their mouth fully, this makes maintaining oral hygiene more difficult.
Poor oral hygiene can lead to:
  • bad breath (halitosis)
  • dental caries (cavities)
  • infection
Trismus may also make it challenging for those wearing dentures to insert the dentures or remove them for cleaning.
Difficulty eating
If people cannot bite, chew, or swallow properly, there is a chance of malnutrition and dehydration.
Temporarily moving to a predominantly liquid and soft foods diet may help reduce these risks.
Many of the infectious and traumatic causes of trismus may also have associated complications. For example, an odontogenic infection that causes trismus may lead to further infection with facial cellulitis or mandibular osteomyelitis.
Infection
If an infection is the cause of trismus, there may be associated complications, such as cellulitis.
Cellulitis is skin inflammation that is often due to infection. The symptoms include:
  • edema, or swelling
  • reddening of the skin
  • warmth emanating from the infection site
  • pain
Trismus is a painful condition involving a reduction in the size of the mouth opening between the jaws.
Most cases are temporary, and medications, physical therapy, and other treatments can often effectively alleviate trismus and reduce or prevent complications. Early treatment typically provides the best outcomes.
Individuals who have concerns about trismus or their risk of developing it should speak to their doctor or dentist.