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HPV- Men and Oral Cancer- the link

This is a very informative article written by Marie McCullough of Philly News- we think it is well worth the read!

Five years ago, when actor Michael Douglas candidly revealed that his throat cancer was linked to having oral sex, two things happened.

He made headlines that mortified his family. And he helped publicize the fact that a pervasive, sexually transmitted virus called HPV was unleashing an epidemic of oral cancer among men.

Since then, scientists have made headway in figuring out why HPV, the human papillomavirus, has this glaring gender bias. Men are four times more likely than women to be diagnosed with oral cancer, a hard-to-detect, hard-to-treat disease that has overtaken cervical cancer as the most common HPV-related malignancy in the United States.

To be sure, changes in sexual norms over the last few generations have played a role in this alarming trend. But research increasingly shows the real problem is something men have practically no control over: their immune response.

Compared with women, men are more likely to get infected with HPV — including “high-risk” cancer-causing strains. They also are less able to wipe out infection on their own, and more likely to get reinfected. The reasons are unclear.


“There is good evidence that men acquire oral infections more readily than women, even if they have similar sex practices,” said Ashish A. Deshmukh, a University of Florida HPV researcher.  “And more than the acquisition, it’s the persistence of the virus. The clearance rate is not that fast in men.”

Michael Becker of Yardley has stepped up as the face of this immunological inequity. The 49-year-old former biotech executive is health-conscious, clean-living, happily married for 26 years – and battling terminal oropharyngeal cancer, the medical term for malignancies in parts of the mouth and throat.

He’s also battling the misconceptions and ignorance that keep too many parents from protecting their pubescent children — especially boys — against HPV-driven cancers. Two shots. That’s all it takes for the leading vaccine, Gardasil, to prevent most cervical cancers, less common genital malignancies, and the disease that is killing Becker.

“I can’t tell you how many emails I got from parents after the CBS segment,” he said, referring to a national television interview last month. “They said, ‘What do you mean this vaccine is for boys?’ and ‘What do you mean oral cancer incidence has eclipsed cervical cancer?’ ”

An inescapable virus

HPV is a family of more than 100 virus types that can live in the flat, thin cells on the surface of the skin, cervix, vagina, anus, vulva, penis, mouth, and throat.

The virus is spread through contact with infected skin, mucous membranes, and bodily fluids. Some types can be passed during intercourse or — as Douglas pointed out — oral sex.

While virtually all sexually active people will get infected at some point, the virus is usually wiped out by the immune system without so much as a symptom.

But not always.

In the cervix, persistent infection with high-risk HPV types can lead to precancerous changes that, left alone, slowly turn malignant. Fortunately, the Pap smear enables the detection and removal of abnormal cells before cancer develops. What’s more, age-related changes in cervical cells reduce the risk that HPV will take hold there as women get older.

No such screening test exists for oropharyngeal sites – the tongue, soft palate, tonsils, the throat behind the nasal cavity – and symptoms usually don’t appear until cancer is advanced. Becker, for example, had metastatic disease by the time he noticed a lump under his jaw line in late 2015.

Traditionally, smoking and heavy alcohol use are the big risk factors for oral cancer, but the non-HPV tumors linked to these bad habits have been declining in recent years.

HPV-related tumors, in contrast, have increased more than 300 percent over the last 20 years. The virus is now found in 70 percent of all new oral cancers.

About 13,200 new HPV oral cancers are diagnosed in U.S. men each year, compared with 3,200 in women, according to federal data. Treatment — surgery, chemotherapy, radiation — can have disfiguring, disabling side effects. About half of late-stage patients die within five years.

Natural defenses go awry

Oral HPV infection rates are skewed by gender, just like the resulting cancers. The latest national estimates of this disparity, published in October, come from Deshmukh and his University of Florida colleagues. They used a federal health survey that collected DNA specimens to estimate that 7.3 percent of men and 1.4 percent of women have oral infections with high-risk HPV types. That translates to 7 million men and 1.4 million women.

The chance of oral infection increases for women as well as men who have simultaneous genital HPV infections or a history of many sex partners, but male infection rates still far surpass female rates.

Patti Gravitt, an HPV researcher at George Washington University, believes these estimates are a bit oversimplified because women counted as uninfected may actually have undetectably low virus levels, or HPV may be hiding in a dormant state in their cells.

Still, Gravitt said the study is in line with others that suggest “men are more susceptible to HPV viral infection than women.”

In women, an HPV infection usually sets off the body’s defense mechanisms. The immune system makes antibodies that kill off the invader, then immune cells remain on guard, ready to attack if the virus reappears.

But in men, something goes awry. The HIM study — for HPV in Men — documented this by collecting genital, anal, and oral samples from 4,100 unvaccinated men in Florida, Mexico and Brazil between 2005 and 2009. The samples were tested for the presence of two high-risk HPV types and two that cause genital warts.

Among 384 men who developed infections during a 24-month period, only 8 percent produced antibodies. But this response rate varied depending on the site of infection; none of the small number of orally infected men produced antibodies.

Rather than putting the immune system on guard and protecting men from the virus, infection sharply increased the chance of getting infected again with the exact same HPV type. And many men who got reinfected were celibate at the time.


How could this be? Anna R. Giuliano, the researcher at the Moffitt Cancer Center in Tampa, Fla., who led the HIM study, said recurring infections may be due to reactivation of dormant virus, or to auto-inoculation – the man spreads infection from one part of his body to another. Or to something else entirely.

While the scientific understanding of this puzzle is evolving, one implication is clear. “HPV vaccination is the only reliable method to ensure immune protection against new HPV infections and subsequent disease in males,” Giuliano and her co-authors declared in a recent paper.

Becker hammers that message – when he is not being hammered by chemotherapy – using his self-published memoir and his blog. This week’s blog gave a shout-out to Sunday’s first-ever International HPV Awareness Day, declared by Giuliano and other members of the International Papillomavirus Society.

Christine Monahan for BioNJ

Michael Becker and his wife, Lorie, joined “Good Morning America” anchor Robin Roberts, a two-time cancer survivor, at a recent event.


Becker realizes that the novelty of the vaccine, the complexity of HPV, and its link to sex are obstacles to immunization. But he focuses on the life-saving aspect.

“Parents are being asked to vaccinate their 11-year-old child and they can’t imagine 30 or 40 years down the line, it will prevent cancer,” Becker said. “If you don’t know it’s connected to six cancers, you’re not going to care. So it really should be cast as an anti-cancer vaccine.”

Staff writer Marie McCullough with Philly

New advanced service for our patients- Laser Bacterial Reduction

Our team is constantly learning and striving to advance the standard of patient care in our office.  As such we have recently added a new procedure to help fight periodontal disease, laser bacterial reduction(LBR).

Understanding of periodontal disease has increased greatly over the last few years, and we know that this disease is a bacterial infection in the gum tissues around the teeth.  We now not only treat periodontal disease with the removal of mechanical irritants and disease tissue with your periodontal cleanings, but are also addressing the underlying infection that causes it with LBR.  We recommend that our periodontal patients have their teeth and gums decontaminated with the diode laser during their cleaning appointments for three major reasons:

  1. To reduce or eliminate bacteria from your mouth getting into your blood stream
  2. To prevent cross contamination of infection in one area of your mouth to other areas
  3. To kill periodontal disease bacteria and stop the infection before they cause physical destruction or loss of bony support around your teeth.

The laser bacterial reduction (LBR) process is painless and normally takes about 5-10 minutes. We highly recommend you take advantage of this service at your next visit.

Can I chew gum?

Many of our patients ask if they can chew gum and the answer is yes, as long as it is one with the ADA seal.  When you are short on time and can’t brush after a meal chewing gum can help to rid teeth of debris by increased salivary flow in the mouth.  There are 2 catches, it must be a sugar free gum that is ADA approved and we recommend chewing no longer than 20-30 minutes.  Why only 20-30 minutes you gum lovers ask- well many times the acting of chewing gum can make issues with TMJ flare up by the increased movement of your jaw.
A company earns the ADA Seal of Acceptance by producing scientific evidence that demonstrates the safety and efficacy of its product, which the ADA Council on Scientific Affairs carefully evaluates according to objective requirements- so chew away, sparingly!orbit

Diabetes and Your Smile


Blood sugar monitor for someone with diabetes

By Laura Martin, Case Western Reserve University School of Dental Medicine

Did you know that 29.1 million people living in the United States have diabetes? That’s 9.3% of the population. Approximately 1.7 million new cases are diagnosed each year—and 8.1 million people living with diabetes don’t even know they have it.

Diabetes affects your body’s ability to process sugar. All food you eat is turned to sugar and used for energy. In Type I diabetes, the body doesn’t make enough insulin, a hormone that carries sugar from your blood to the cells that need it for energy. In Type II diabetes, the body stops responding to insulin. Both cases result in high blood sugar levels, which can cause problems with your eyes, nerves, kidneys, heart and other parts of your body.

So what does this have to do with that smile of yours — and how can you protect it? First, it’s important to understand the signs of diabetes and the roles they play in your mouth.

The Symptoms of Untreated Diabetes

The warning signs of diabetes affect every part of your body. After a blood test, you may be told by a doctor that you have high blood sugar. You may feel excessively thirsty or have to urinate a lot. Weight loss and fatigue are other common symptoms. Diabetes can also cause you to lose consciousness if your blood sugar falls too low.

If diabetes is left untreated, it can take a toll on your mouth as well. Here’s how:

  • You may have less saliva, causing your mouth to feel dry. (Dry mouth is also caused by certain medications.)
  • Because saliva protects your teeth, you’re also at a higher risk of cavities.
  • Gums may become inflamed and bleed often (gingivitis).
  • You may have problems tasting food.
  • You may experience delayed wound healing.
  • You may be susceptible to infections inside of your mouth.
  • For children with diabetes, teeth may erupt at an age earlier than is typical.

Why People with Diabetes Are More Prone to Gum Disease

All people have more tiny bacteria living in their mouth now than there are people on this planet. If they make their home in your gums, you can end up with periodontal disease. This chronic, inflammatory disease can destroy your gums, all the tissues holding your teeth and even your bones.

Periodontal disease is the most common dental disease affecting those living with diabetes, affecting nearly 22% of those diagnosed. Especially with increasing age, poor blood sugar control increases the risk for gum problems.  In fact, people with diabetes are at a higher risk for gum problems because of poor blood sugar control. As with all infections, serious gum disease may cause blood sugar to rise. This makes diabetes harder to control because you are more susceptible to infections and are less able to fight the bacteria invading the gums.

How Your Dentist Can Help You Fight Diabetes

Regular dental visits are important. Research suggests that treating gum disease can help improve blood sugar control in patients living with diabetes, decreasing the progression of the disease. Practicing good oral hygiene and having professional deep cleanings done by your dentist can help to lower your HbA1c. (This is a lab test that shows your average level of blood sugar over the previous three months. It indicates how well you are controlling your diabetes.)

Your Diabetes Dental Health Action Plan

Teamwork involving self-care and professional care from your dentist will be beneficial in keeping your healthy smile as well as potentially slowing progression of diabetes. Here are five oral health-related things you can do to for optimal wellness:

Download this helpful infographic to learn more:


This article is reposted from the ADA

Hookah’s Not As Safe AS You May Think


Many Hookah and Vapor Smokers believe that they are safer using these methods than traditional cigarettes- however in recent research and articles published by the JADA- Journal of the American Dental Association, this type of “smoking” is just as bad if not worse- here is a recent excerpt from an article published this past fall…

We found that waterpipe smoking is associated with serious health problems affecting the head and neck region,” said study author Teja Munshi, B.D.S., M.P.H of Rutgers University. “The public needs to know they are putting themselves at risk. They should be made aware of the dangers of smoking hookahs.”

The authors conducted a literature review that focused on waterpipe smoking and head and neck conditions. They found waterpipe smoking to be associated with gum diseases, dry socket, oral cancer and esophageal cancer among other conditions. According to the World Health Organization, smoking a hookah is the equivalent of smoking 100 cigarettes, based on the duration and number of puffs in a smoking session.

“This study sheds light on the common misconception that smoking from a waterpipe is somehow safer than smoking a cigarette,” said JADA Editor Michael Glick, D.M.D. “Whether you are smoking a cigarette, an e-cigarette, a cigar, or tobacco from a waterpipe, smoking is dangerous not only to your oral health but to your overall health.”


As always if you have specific questions about Hookahs or Vape Smoking feel free to ask us at your next dental visit with Dr. Mullaney

2016 Patient Appreciation Party

May 5th was our 2nd Annual Patient Appreciation Party.  This evening is for our patients, a way of saying thank you for your continued support and referrals to our office.  This year we offered our patients mini-massages from Dr. Ginger Lowe and  health assessments from Ellen Reilly of Sport and Health.   Our patients were treated to catering from Bittersweet Café and fabulous wine.  Door prizes include a $50.00 Amazon Gift Card, $150.00 Bottle of Italian Wine and a $600 In-Office Whitening, each guest also left with a SWAG full of goodies to include a pocket mirror, emergency cell phone charger, a full size tube of Flouridex Toothpaste ,event only saving coupons, and a coupon for Duchess M Boutique.  We had so much fun and we look forward to next year’s  event!

Here are a few photos from the evening!


The Truth about Dental Myths

We loved this article from the Huffington Post and thought we would share it with you!

Did you hear the one about the flying spirit who traded cash for old molars? Myths abound when it comes to dentistry:

• Put an aspirin next to a tooth to treat a toothache:
Don’t — it will burn your gum and do nothing for your toothache.

• Use a hard bristle toothbrush to best remove plaque.
Don’t — the abrasiveness can damage your gum line.

• George Washington’s wooden teeth were prone to termite infestation.
Don’t — believe it; while Washington was an early denture adopter, his false teeth were not made of wood, but merely stained metal and ivory that gave his smile a grainy appearance.

Here are the best of the dental tall tales:

Myth: Baby teeth all fall out eventually so there is no need for dental care for young children.

Fact: Baby, or primary teeth can decay, become infected and painful, if routine dental care isn’t sought early on.

Baby teeth act as space maintainers allowing the permanent teeth to come into the mouth properly. Prematurely losing baby teeth (from decay) could cause teeth to drift and block out permanent teeth from growing in. A child’s first dental visit should take place by age one. Your child’s dentist should be monitoring and discussing with you, your youngster’s diet, hygiene, and oral habits.

Myth: Natural fruit juices won’t cause tooth decay like candy or soda will.

Fact: Westchester County, New York Pediatric dentists Dr. Jeffrey Ginsberg and Dr. Benjamin Dancygier advise on baby teeth and decay:

“Even 6-month-old infants can get decay, from going to sleep with a bottle or constant breast-feeding throughout the night,” says Dr. Ginsberg.

“All juices contain sugar which can cause tooth decay. The only safe drink for children is water,” says Dr. Dancygier.

Myth: It’s best to wait until my child loses all his baby teeth before seeing the orthodontist.

Fact: Waiting until all the permanent teeth arrive can result in two irreversible consequences: the need to extract permanent teeth due to the inability to correct crowding and missing a growth spurt without which extractions or jaw surgery is necessary. The American Association of Orthodontists recommends that children see an orthodontist at age 7 for early detection of problems and to assure proper and timely planning for optimal care.

Myth: My child will grow out of it.

Fact: The majority of orthodontic problems do not-self correct.

Myth: The orthodontist will correct this problem with a retainer just worn at night.

Fact: Retainers are removable devices meant to retain, or hold teeth in place not designed to make active corrections. Tooth movement requires at least 20 hours of force applied daily over a period of time for teeth to safely reposition in a stable manner.

Myth: Wisdom teeth will cause other teeth to shift positions after orthodontics.

Fact: It’s a natural assumption to think that wisdom teeth (which commonly erupt in late adolescence) can cause post orthodontic changes, but the real cause of shifting or relapse is a late adolescent growth spurt of the lower jaw for a patient not wearing retainers.

Myth: Once teeth are straightened, no other follow-up is needed.

Fact: Teeth shift over varying degrees over a lifetime. Retainers mitigate these changes and are as important a part of orthodontic treatment as is wearing braces. Your child needs to be an active participant throughout treatment and retention in order to ensure a successful outcome.

Floss Like a Boss!


untitledWe thought this recent article from had some great reminders about flossing and we wanted to share with you- brushing alone does not take care of everything , floss like a boss and see some real improvements with your teeth and gums!

A national survey conducted by Harris Poll for the American Academy of Periodontology (AAP) recently discovered that a lot of us are lying to our dentists. No, it’s not about how much sugar-laden candy we’re eating or how often we brush (or don’t brush) our teeth. It’s about something that potentially has more impact on our health than that.

Twenty-seven percent of us lie about how often we floss.

The reason is fairly simple: People don’t like to floss. In fact, they’d rather wash dishes, clean a toilet or even spend time doing their taxes than floss. The American Dental association reports that only 50 percent of Americans floss daily, 31 percent less than daily and 18 percent don’t floss at all.

But when you consider that flossing helps prevent gum disease and cavities and not flossing is the leading cause of tooth loss in adults, it makes you wonder why more people don’t do it.

Flossing Facts

1. Maybe you’re too tired at the end of the day to bother with flossing. Yet, it doesn’t really matter when you do it. The most important thing is to just do it—once a day. Whether you floss before or after you brush doesn’t much matter, either.

2. Here’s a no-brainer tip for easy flossing: Try storing floss in your car, in your bag or in your office drawer—then break it out when you have time (just don’t floss in public—your friends and coworkers will thank you). There’s no need to floss in front of a mirror, either. (And there’s no need for an excuse if you keep the floss handy and within reach!)

3. Flossing removes plaque from areas between your teeth that your toothbrush can’t reach. If this plaque is not removed, it can eventually harden into calculus or tartar, leading to gum disease. There’s also evidence that periodontal bacteria can attach to the fatty plaques in blood vessels and set off an inflammatory process, which can lead to heart attack or stroke. Other research has shown that infections in the mouth may be associated with diabetes, pneumonia and other health problems.

4. You need not use only dental floss to clean between your teeth. There are other options specifically made for the purpose, like pre-threaded flossers, tiny brushes that can reach between your teeth, pointed rubber tips or wooden plaque removers.

5. Flossing should not be painful. It’s normal for it to be uncomfortable when you first start, but within a week or two, that discomfort should ease.

6. Be aware of flossing too hard—it could damage the tissue between your teeth. But don’t be too gentle either, which might not result in a complete job.

7. Children should start to floss as soon as they have two teeth that touch

Redheads’ and Pain Sensitivity

We found this article via CNN and wanted to share with all of you!


(CNN) — Despite two injections of anesthetic, Amy Anderson felt like her dentist was jamming rods into her tooth during a root canal. She writhed in pain as her infected tooth was hollowed with a drill, its nerve amputated, and then sealed.

Studies say redheads avoid dental care after having painful experiences and may require more anesthetics.

Studies say redheads avoid dental care after having painful experiences and may require more anesthetics.

“I knew this time something was wrong. I could feel my lips,” said the Syracuse, New York, resident, who told her dentist the drugs weren’t working.

Her doctor kept assuring her she had given her a proper dose and said: “I’m almost done.”

“I was hurting so bad, I was hitting myself in the stomach,” said Anderson, a redhead. “I almost wanted to hit her.”

Studies have indicated that redheads may be more sensitive to pain and may need more anesthetics to numb them.

New research published in this month’s Journal of American Dental Association found that painful experiences at the dentist might cause more anxiety for men and women with red hair, who were twice as likely to avoid dental care than people with dark hair.

“Redheads are sensitive to pain,” said Dr. Daniel Sessler, an Outcomes Research Department chair at The Cleveland Clinic, in Cleveland, Ohio, who is one of the authors.

“They require more generalized anesthesia, localized anesthesia. The conventional doses fail. They have bad experiences at the dentist and because of the bad experiences, they could avoid dental care.”

Sessler, an anesthesiologist, began studying redheads’ sensitivity to pain after hearing chatter from colleagues.

“The persistent rumor in the anesthesia community was that redheads were difficult to anesthetize,” Sessler said. “They didn’t go under, had a lot of pain, didn’t respond well to anesthesia. Urban legends usually don’t start studies, but it was such an intriguing observation.”

This led to two studies. In 2004, research showed that people with red hair need 20 percent more general anesthesia than blonds and brunettes.

A 2005 study indicated that redheads are more sensitive to thermal pain and are more resistant to the effects of local anesthesia.

Researchers believe variants of the melanocortin-1 receptor gene play a role. This MC1R gene produces melanin, which gives skin, hair and eyes their color.

While blond, brown and black-haired people produce melanin, those with red hair have a mutation of this receptor. It produces a different coloring called pheomelanin, which results in freckles, fair skin and ginger hair. About 5 percent of whites are estimated to have these characteristics.

While the relationship between MC1R and pain sensitivity is not entirely understood, researchers have found MC1R receptors in the brain and some of them are known to influence pain sensitivity.

Non-redheads can also carry a variant of the MC1R gene. In this dental study that had 144 participants, about a quarter of the non-redheads had variants of the MC1R gene. These people also experienced heightened anxiety and avoided dental care compared with others who did not have the variant.

There is no commercial test available for variations of the MC1R gene.

After Sessler and his colleagues published the first studies about redheads and pain susceptibility, he received nearly 100 e-mails from redheads around the country who complained of terrible experiences at the dentist’s office.

Dr. Catherine Binkley, an associate professor at the University of Louisville’s School of Dentistry, in Kentucky, also observed the same phenomenon in her 25 years of practice.

Her redheaded patients seemed “anxious and didn’t get numb. It’s a difficult experience for them,” said Binkley, one of the study’s authors.

But this doesn’t seem to affect all people with red hair.

“I have a [redheaded] hygienist that I have to numb up a lot more than normal, ” said Dr. Peter Vanstrom, an Atlanta, Georgia, dentist. “She’s very sensitive. I have another redheaded patient who is tough as nails, but his father is extremely difficult to numb.”

Binkley said the best tip for dentists is to “pay more attention, evaluate everyone for dental anxiety, and ask them about previous experiences.”

“If you know someone’s anxious, do different things,” she said. “Make sure they’re numb before you start working on them.”

Patients who’ve had bad experiences with pain should inform their dentists.

The next phase of research is to evaluate whether more anesthesia is needed for people with red hair and those with variants of the MCR1 gene for dental procedures.

The authors say an unpleasant incident — much like the one Anderson had this January — could cause patients to postpone dental care and exacerbate any problems they might have.

Anderson got a root canal because she dreaded the dentist after a bad experience of getting cavity fillings. Inevitably, Anderson has to return to her dentist to follow up on her root canal and this fills her with apprehension.

“I have wicked dread of the dentist,” she said. “I was up for two hours in the middle of the night because of the dentist.”