How A Toothache Can Turn Deadly

A Toothache Can Turn Deadly

EVEN MILD PAIN SHOULD NEVER BE IGNORED

It’s hard to imagine how a toothache could turn deadly—but it can. Even mild or moderate discomfort (for example, pain while chewing…sensitivity to hot and cold…and/or redness and swelling of the gums) can quickly turn into a potentially serious condition, known as an abscess, a pus-filled infection inside the tooth or between a tooth and the gum. Though the pain may be merely annoying in the beginning, within a day or so, it can turn into the intense, throbbing pain or sharp, shooting pain that is the telltale sign of an abscess.

Dangerous trend: The number of Americans hospitalized for dental abscesses is on the rise. Over a recent eight-year period, hospitalizations for periapical abscesses (infections at the tip of the tooth root) increased by more than 40%.

No one has a precise explanation for the trend, but some experts speculate that the high cost of dental insurance is preventing many people from seeking routine dental care and perhaps delaying treatment when a problem occurs. Medicare does not cover routine dental care, and many private health insurance plans offer very limited coverage.

WHAT GOES WRONG

If there’s a breach in a tooth’s protective enamel—from tooth decay, a chip or even gum disease, for example—you’re at risk for an abscess. Some cracks can be taken care of with bonding or a crown (see below). Some don’t need treatment at all because they don’t go through to the tooth pulp (the soft tissue inside the tooth). But if bacteria get inside the tooth, an abscess can form.

Other signs to watch for: In addition to the symptoms described earlier, other red flags of a dental abscess may include persistent foul breath, a swollen face, jaw and/or neck glands and a fever.

Once the pain kicks in, people who have dental abscesses will often describe it as the worst they’ve ever experienced. If you’ve ever had a root canal (see below), you might have had an abscess.

• Get help immediately. An abscess will not go away on its own. Worse, the infection can spread as quickly as overnight (in some cases, however, it can take years to spread). An abscess can cause death when the infection spreads to the brain or heart or when swelling cuts off the airway.

When to be especially suspicious: If you have pain in one of your back teeth. They’re the ones that do most of the chewing, and they’re also the ones that are harder to reach with dental floss and a toothbrush. If you crunch something hard, such as a popcorn kernel, piece of ice or even an almond, a back tooth is the one most likely to be cracked.

GETTING PROMPT TREATMENT

Your dentist can diagnose an abscess in just a few minutes. All he/she has to do is gently tap on the suspected tooth with a small metal device and see if you wince. A tooth abscess will be very sensitive to pressure. An X-ray will confirm if there’s a pus-filled pocket near the tooth root.

You might be given penicillin or another antibiotic if the infection has spread beyond the tooth. In addition, your dentist will treat the abscess in one of three ways…

• Incision and draining. If the abscess is between the tooth and the gum, your dentist will make a small incision, drain out the pus and clean the area with saline. The pain will start to diminish almost immediately. Your dentist also can drain an abscess that occurs inside a tooth, but this won’t cure it—the infection will probably come back.

• Root canal. This is the most widely used treatment for an abscess near the tooth root. Your dentist will drill into the infected area, scrape away damaged tissue and drain the pus. After that, the canal will be filled with sealant, and the tooth will be crowned (a porcelain or metal cap is put over the tooth). If you get a root canal, there’s a good chance that the tooth will survive. The drawback is cost. Root canals usually are done by an endodontist (a dentist with advanced training). Expect to pay from $300 (for a front tooth) to $2,000 for a molar. The crown is an additional $500 to $3,000 (prices depend on where you live and whether you go to a specialist or your regular dentist).

• Extraction. This is the most permanent treatment for a deep abscess. It costs about $75 to $300 to remove a tooth—and once the tooth is gone, the abscess goes away with it.

Some patients save money by choosing not to replace an extracted tooth. But there are health risks associated with not replacing a tooth, such as increased chance of additional decay and infection, bone loss, poor chewing function and speech disturbances.

Better: Replace the tooth with an implant (at least $2,400) or a bridge (at least $1,100).

If you can’t see a dentist immediately: Consider going to an ER if you have severe pain and/or swelling. If you are having trouble breathing, go to an ER right away.

PREVENTING AN ABSCESS

If you take care of your teeth, there’s a good chance that you’ll never have an abscess.

In addition to regular brushing and flossing and avoiding a lot of sugar-filled foods and drinks…

• Use fluoride toothpaste. It remineralizes tooth enamel and makes it stronger. This is particularly important for older adults, whose receding gums can expose parts of the tooth and leave it vulnerable to decay.

Also helpful: A fluoride mouth rinse. There are many brands in drugstores. They strengthen the enamel and reduce tooth decay.

• Don’t slack off on dental visits. Most people should have dental checkups and cleanings every six months. If you smoke or have gum disease, diabetes or any other condition that increases your risk for dental problems, it’s usually a good idea to schedule even more frequent dental visits.

Source: Samuel O. Dorn, DDS, chair of the department of endodontics and program director at The University of Texas Health Science Center at Houston, where he holds the Frank B. Trice, DDS, Professorship in Endodontics. He is the president-elect of the International Federation of Endodontic Associations and the 2013 recipient of the Coolidge Award given by the American Association of Endodontists for lifetime achievement.


Multiple Sclerosis…. Information You Should Know

27 MS Facts for World MS Day

By Editorial Team—May 27, 2015

Multiple sclerosis affects more than 2.3 million people around the world. In honor of World MS Day today, we have gathered 27 important facts about multiple sclerosis, to help our community raise awareness about MS.

We will be updating Facebook and Twitter with new facts throughout the day using the hashtag #strongerthanMS. To help spread awareness, please feel free to like, share, retweet, and/or comment on any or all of these 27 topics!

  1. Experts recognize 4 courses of MS: progressive-relapsing, secondary-progressive, primary-progressive, and relapsing-remitting.
  2. Of those diagnosed with MS, progressive-relapsing affects about 5% of people, about 10% are diagnosed with primary-progressive, about 85% are diagnosed with relapsing-remitting initially, and about 50% of people with relapsing-remitting develop secondary-progressive within 10 years of diagnosis.
  3. There is greater prevalence of MS in higher northern and southern latitudes.
  4. MS is much more common in females than males.
  5. MS is most commonly diagnosed in people between the ages of 20 and 50 years.
  6. The lifespan of a person with MS is just about as long as the lifespan of a person without the condition.
  7. While much effort and research has gone into finding out hat causes MS, there are still no clear answers.
  8. In MS, a person’s immune system attacks the central nervous system, causing inflammation that damages myelin, the fatty coating that insulates and protects nerve fibers.
  9. To understand the central nervous system, it’s easiest to picture the nervous system as a tree. The CNS is the tree’s roots and truck.
  10. Out of the approximately 400,000 people who live with MS in the US, about 8,000 to 10,000 are children or adolescents.
  11. Fatigues the most common and potentially most disabling symptom, affecting between 75% and 90% of people who have MS. Another common, yet less understood symptom of MS is pain, and this pain exists in many different forms.
  12. Numbness or tingling are common symptoms and the result of damage to nerves that transmit sensations from body surfaces to the brain.
  13. relapse is when new symptoms or worsening of symptoms that persist for at least 24 hours and occur at least 30 days since a previous relapse.
  14. During a relapse, immune cells that normally circulated harmlessly in your blood stream attack and breakdown the blood-brain barrier.
  15. While there is no cure for relapses, treatment may help in speeding up recovery time.
  16. Magnetic resonance imaging (MRI)is an important tool used for diagnosing MS and monitoring disease progression.
  17. MRI scans reveal abnormalities in the majority (90% to 95%) of people with MS.
  18. Radiologists and neurologists will use MRIs to look for evidence of new damage, primarily lesions, and evidence of chronic damage to the CNS.
  19. Disease-modifying treatments (DMTs)have been shown to be effective in decreasing the frequency of relapses or exacerbation’s.
  20. DMTs are given either orally or by injection or IV.
  21. While DMTs are effective in the majority of cases of MS, they have not proven to be effective in cases of primary-progressive MS.
  22. People with MS may experience emotional problems, such as depression, anxiety, mood swings, pseudo bulbar affect (PBA), and stress.
  23. Clinically significant depression affects up to 50% of people with multiple sclerosis over the course of their lifetime.
  24. No specific diet has been scientifically proven to slow progression. Specialists promote the same low fat, high fiber diet recommended for all adults.
  25. Stress is a trigger for MS. It comes in many shapes and sizes from emotional and physical, to the stress on the body by extremes in temperature.
  26. Regular exercise, including exercises for strengthening, stretching, and coordination and balance, can be useful in managing many common MS symptoms.
  27. Scientists still have a lot to learn about the immune system and autoimmune diseases, but they do know it plays a role in the development of MS

There’s so much more to understand about multiple sclerosis beyond what we have in our list. We hope you will continue to be a part of our community and share stories and spread awareness about MS.


The Relationship Between Diabetes and Heart Disease

If you’re aware of your heart health, you’ve probably read and heard a lot about risks for people who have diabetes.  That’s because there’s a major connection between the two types of disease.

In fact, people who are diabetic are twice as likely to have heart disease than those who aren’t diabetic.  It’s also true that someone who is diabetic who has a heart attack is also more likely to die from that heart attack.

Some of the reason for this may be the common characteristics of people who are diabetic and those who are at risk for heart disease.  For example, many people who are diabetic are overweight, which is also a risk factor for heart disease. downloadDiabetics are also more likely to be sedentary and to have high blood pressure.  This combination of risk factors would make anyone at risk for heart disease. What may make diabetes a more special case for cardiac risk is the insulin-resistance that’s characteristic of it.

Insulin resistance is known to increase LDL and triglyceride levels (the bad cholesterol) and also cause HDL (good cholesterol) to be lower.  This causes the advancement of hardening of the arteries. Continue reading “The Relationship Between Diabetes and Heart Disease” »


How the Budget Deal Blunts Medicare Cost Increases, & Tweaks Social Security

620-medicare-social-security-cards-wallet[1]The bipartisan budget agreement reached by the White House and congressional leaders wards off a spike next year inMedicarepremiums and deductibles for millions of older Americans as well as ensures full Social Security disability benefits to millions who had faced steep cuts. The accord went to President Barack Obama after being adopted by the House of Representatives Oct. 28 and by the Senate Oct. 30.

In a letter to Congress, AARP CEO Jo Ann Jenkins applauded the agreement: “Your efforts to reach across the aisle and together find sensible solutions to significant problems are appreciated and commended.”

Newsletter: Get the latest on AARP advocacy programs affecting you »

Here’s a look at measures in the deal that affect the pocketbooks of older Americans.

Limits Medicare premium deductible increases. With no Social Security cost-of-living adjustment (COLA) for 2016, 70 percent of Medicare beneficiaries will see no increase in their monthly Part B premiums next year, despite the program’s increased costs. But because of a wrinkle in federal rules, the burden of paying for the increased costs was to fall on the other 30 percent of Medicare beneficiaries through an increase in premiums from $104.90 to $159.30. The budget deal softens the blow to $120 a month.

The reduction is financed by a $7.5 billion loan that will begin to be repaid through an additional $3 monthly surcharge on many of these same beneficiaries and a surcharge of up to $12 a month on higher-income beneficiaries. In years when there is a Social Security COLA, all beneficiaries will be subject to the surcharge. The loan is expected to be repaid within five years.

Limits the deductible increase in traditional Medicare. The deductible for everybody with traditional Medicare, which had been projected to increase by more than 50 percent in 2016, from $147 to $223, will be held to $167.

Replenishes the Disability Trust Fund. The fund that pays Social Security disability benefits was expected to run out of reserves late next year without a fix. Eleven million Americans — 7 out of 10 of them age 50 or older — would have seen a nearly 20 percent decline in benefits.

The budget deal prevents this cut by diverting a larger share of payroll taxes over the next three years to the disability fund, allowing it to pay full benefits through 2022. Currently, workers and employers pay a total of 12.4 percent of wages in the Social Security tax, most of which goes to retirement benefits. But for the next three years, 2.37 percent of wages — an increase of .57 percentage points — will be allocated for disability benefits.

Congress has approved similar reallocation of the payroll tax in other years.

Eliminates certain Social Security claiming strategies.Some couples have taken advantage of a strategy that arose from changes to the law in 2000 and maximized their benefits through Social Security’s “file and suspend” option. Here’s an example of how it works: A husband files for Social Securityat full retirement age and then immediately suspends his benefit. This allows his benefit to continue growing at 8 percent for every year he keeps his benefit on hold until age 70. Meanwhile his wife, who may not have qualified for benefits on her own, can collect a spousal benefit — worth up to half of her husband’s benefit.


AARP Sent the Following Letter to Congress on Oct. 14th, 2015

AARP has deep concern that for only the third time in over 40 years, there will be no Social Securitycost-of-living adjustment for 2016. To make matters worse, as a result, 30 percent of Medicare beneficiaries will see their monthly Medicare Part B premium dramatically increase, and all Medicare beneficiaries will experience an increase in their Part B deductible.

Congress should protect the 16.5 million Medicare beneficiaries — which includes new enrollees, people not collecting Social Security, and beneficiaries dually eligible for Medicaid — from the harmful effects of dramatically increasing premiums, due to there being no Social Security cost-of-living adjustment (COLA) as well as protect all Medicare beneficiaries from the large increase in their deductible.

The Social Security Trustees announced Oct. 15 that there will be no Social Security COLA in 2016, due to unusually low energy prices. However, the impact of very low energy prices on Social Security recipients may be overstated in the current cost of living formula, and as a result, the need for a COLA may be understated in this week’s announcement. Continue reading “AARP Sent the Following Letter to Congress on Oct. 14th, 2015” »


Breaking Free from Your Alcohol Addiction

At some point, having a drink with friends becomes more than a social event. You find that you don’t even go out with the group unless they plan to drink. You’ve fooled yourself into believing that when you are drinking alcohol, you have more fun and you’re more outgoing.

What your friends talk about is how outrageous you behave and how you’ll say anything to anyone. They’re laughing at you, not with you.  When you’re sober, you regret what you said or did.10846141_10152878994164400_2949797533172704497_n

You also ran up the credit card buying rounds for everyone and you lost money being too hung over to go to work the next day.  No matter how tired you are of listening to your family or friends tell you that you have an alcohol problem, in your sober moments you know that drinking is taking over your life. Continue reading “Breaking Free from Your Alcohol Addiction” »


How to Avoid a Heart Attack in Extreme Weather…

4682

The arctic blast that brought tundralike temperatures to much of the country this winter has left behind more than frozen pipes and frost-nipped noses. During a typical winter, there are up to 36% more circulatory-related deaths than during warmer months.

And it’s not just cold weather that puts you at risk. Researchers have identified other types of weather—throughout the year—that trigger spikes in hospitalizations and death.

For details on the effects that weather can have on your heart, Bottom Line/Healthspoke to Barry A. Franklin, PhD, a leading expert in cardiac rehabilitation.

We hear a lot about cold weather being hard on the heart. At what temperature does this really become an issue? When it’s cold enough to wear a winter jacket, it is cold enough to think about the health of your heart. In fact, research that was recently presented at the European Society of Cardiology Congress 2013 shows that the risk of having a heart attack increases by 7% for every 18°F drop below 73°F.

Why exactly is cold weather so dangerous? Cold temperatures cause blood vessels throughout the body to temporarily constrict, raising blood pressure. Since the arteries that supply the heart are only about the thickness of cooked spaghetti, even a slight narrowing can cause reduced blood flow.

Winter temperatures aren’t generally a problem if you are young and active. But risk rises as you hit middle age and beyond. The risk is highest for adults who are ages 65 and older, particularly those with underlying health problems, such as diabetes, obesity or preexisting heart disease. For people in these groups, spending even a few minutes in below-freezing temperatures can trigger a 20- to 50-point rise in blood pressure.

That’s why I advise older adults, in particular, to stay indoors on the coldest days if possible. When you do go outdoors, don’t depend on a light jacket—you should really bundle up by wearing a hat and gloves and dressing in multiple loose layers under your coat. Each layer traps air that’s been heated by the body and serves as insulation.

And what about hot weather—does it harm the heart? Actually, heat kills more people every year than any other type of weather.

High temperatures, generally above 80°F, but especially greater than 90°F, can cause heat syncope (sudden dizziness and/or fainting)…heat edema (swelling in the feet/ankles)…and heat stroke, in which the body’s core temperature can rise above 104°F. People with atrial fibrillation or dementia are at a 6% to 8% increased risk of dying on hot days. Dementia affects the brain’s ability to regulate the body’s heat response.

Why is strenuous exertion so dangerous for many people during weather extremes? Snow shoveling provides a good example. This activity creates a “perfect storm” of demands on the heart. With snow shoveling, the real danger—particularly for those who are older and/or sedentary—is the exertion itself.

Moving snow is hard work. Each shovelful weighs about 16 pounds (including the weight of the shovel). If you lift the shovel once every five seconds and continue for 10 minutes, you’ll have moved nearly one ton of snow. This exertion can have adverse effects on the heart.

Here’s why: Snow shoveling involves isometric exercise and unaccustomed muscle tension, which increases heart rate and blood pressure. Your legs may stay “planted” when you shovel, which allows blood to pool and reduces circulation to the heart.

Also, people tend to hold their breath (this is known as a Valsalva maneuver, and it often occurs when people are straining to lift heavy loads) when they are wielding a shovel, which causes a further rise in heart rate and blood pressure. That’s why every year, we read or hear about people who dropped dead while shoveling snow.

Is there any way to reduce the risk associated with snow shoveling? If you have or suspect you have heart disease, I suggest that you don’t shovel your own snow. Hire someone to do it for you.

If you are in good shape and want to shovel your own snow, it may be safer in the afternoon. In general, most heart attacks occur between —-6 am and 10 am, when heart rate and blood pressure tend to be higher. You’re also more likely to form blood clots early in the day.

Then be sure to shovel slowly…work for only a few minutes at a time…and keep your legs moving to circulate blood. And remember, it’s best to push snow rather than lift it. This helps keep your legs moving and takes less exertion than lifting. There are snow shovels designed for pushing snow.

What types of exertion are especially dangerous during hot weather? Racket sports, water skiing, marathon running and certain highly competitive sports seem to be associated with a greater incidence of cardiac events in hot, humid weather. Why? Heart rates are disproportionately increased. Electrolytes, such as sodium and potassium, also are lost, which can lead to dangerous heart rhythms.

What steps should people take to protect themselves in hot weather? Everyone knows to drink water when it’s hot. But even people who are consciously trying to stay hydrated often do not drink enough. Drink plenty of cool liquids before, duringand after heat exposure. If you’re sweating a lot, you might want to drink an electrolyte-rich sports drink such as Gatorade or Powerade. And be sure to wear lightweight, loose-fitting clothing when you go outdoors.

In addition, think about any medications you may be taking. Many common drugs, including certain antihistamines and antidepressants, have anticholinergic effects—they inhibit your body’s ability to cool off.

To help your body adapt to heat and humidity: As the weather grows hotter, gradually increase your daily exposure to the heat. The body’s circulation and cooling efficiency increases, generally in eight to 14 days. Afterward, the body is better able to cope with extremes in heat and humidity.

Source: Barry A. Franklin, PhD, director of preventive cardiology and rehabilitation at William Beaumont Hospital in Royal Oak, Michigan. He has served as president of the American Association of Cardiovascular and Pulmonary Rehabilitation and the American College of Sports Medicine. Dr. Franklin is coauthor of 109 Things You Can Do to Prevent, Halt & Reverse Heart Diseases.