The Basics of Braces

Braces are used to correct misaligned jaws or teeth that are out of place. They’re most commonly applied to children, whose jaws are still growing and can thus be guided into proper alignment. But thanks to advancing orthodontic technology, it’s becoming increasingly possible to use braces to correct jaw alignment issues (also known as “malocclusions”) in adults. If you suspect that you or your child may need this procedure, here are some important things to know.

Are braces important?

One of the most common reasons cited for getting braces is to improve one’s appearance. While this is undoubtedly important, it is far from the whole story. When malocclusions are present in the teeth and jaw, it can make it difficult to maintain proper hygiene at sensitive spots in the mouth, which can lead to tooth decay and gum disease. Plus, when malocclusions prevent one from chewing food properly, this can lead to digestive problems.

Who can apply braces?

Only certified orthodontists are qualified to apply braces. Orthodontists are essentially dentists with a couple of extra years of training in advanced practices. Standard dentists without this advanced training are not qualified to work with braces.

What are the signs that braces might be necessary?

If any of these conditions are present, you might want to talk to your orthodontist about the possibility of braces:

1. • teeth that are crowded or out of position
2. • frequent cheek biting
3. • severe over-or under-bite
4. • difficulty chewing or swallowing
5. • an off-center bite
6. • teeth growing in behind others
7. • teeth out of proportion with others
8. • a too-prominent or too-weak chin
9. • strange teeth position as a result of tooth loss
10. • noises in the jaw
11. • large spaces between the teeth

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Symptoms Related to Bile Duct Cancer

Bile ducts, when functioning properly, drain bile into the small intestines during the digestion process. When there is an obstruction in this system of tubes, the bile will back up into the gallbladder or liver and the fats and lipids in the intestines will pass through undigested.

In the case of bile duct cancer, a tumor may obstruct the flow of bile. If this happens, the bilirubin (a brownish-yellow substance found in bile) builds up and causes jaundice, or the yellowing of the skin and eyes. Jaundice is not itself a disease, but rather a symptom of an underlying condition, typically affecting the liver or biliary system.

Cholangiocarcinoma is a rare and slow-growing cancer of the bile ducts. The bile ducts act as a conduit from the liver to the small intestines, delivering bile during the digestive process. The most common symptoms of bile cancer are characterized by abnormal liver functions such as jaundice, weight loss, and changes in stool or urine.

Some potential symptoms associated with bile duct cancer include the following:

• Jaundice (yellowing of the skin and whites of the eyes), sometimes accompanied by itchy skin
• Decreased appetite / weight loss
• Enlarged abdominal mass / bloated feeling
• Nausea and/or fever
• Changes in stool or urine

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Bile Duct Cancer Risk Factors

Chronic Inflammation or Diseases

• Sclerosing cholangitis (inflammation of the bile duct)
• Ulcerative colitis (inflammation of the large intestine)
• Bile duct stones
• Gallbladder stones
• Pancreatitis
• Irritable bowel syndrome

Chronic inflammation or irritation may also develop into diseases or conditions that are associated with bile duct cancer.

Inherited Causes of Bile Duct Cancer

There are a few rare inherited disorders, like Caroli disease (also called Caroli's syndrome), that may make some people more prone to infection, thereby increasing irritation of the bile ducts and the risk of cancer. However, most cases of bile duct cancer do not appear to a have a familial link.

Age

Bile duct cancer is not very common in young or middle-aged adults. Over 60 percent of bile duct cancer patients are 65 or older.

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Potential Bile Duct Cancer Risk Factors

This list of risk factors includes: certain disease of the liver or bile ducts; chronic irritation or inflammation of the bile ducts; parasite infections; obesity; family history; environmental factors (exposure to carcinogens or radioactive chemicals); and certain lifestyle behaviors.

Again, although all of these risk factors can increase your chances of developing bile duct cancer, having one or more of them does guarantee you will develop cancer. Open communication with your doctor will help you to better understand these risk factors as they relate to your overall health. Please discuss with your doctor any of these factors that you feel might put you at an increased risk for cancer.

Lifestyle, Environmental and Health Factors

• Excessive alcohol use and/or cirrhosis of the liver
• Smoking
• Exposure to hazardous chemicals
• Dioxins, nitrosamines, and PCBs
• Thorotrast (intravenous chemical previously used for certain X-rays, now banned)
• Water-borne parasitic infections
• Liver flukes (Clonorchis sinensis or Opisthorchis viverrini)
• Obesity
• Diabetes
• Choledochal cysts

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Understanding Bile Duct Cancer

Produced in the liver, bile (yellow-green fluid) is stored in the gallbladder and drains into the small intestines during digestion to help break down fats and lipids. Bile is transported to these organs through a system of ducts, known as the biliary system. This system delivers 50 to 100 tablespoons of bile every day. These small tube-like structures play a significant role in the digestive process.

The bile ducts function closely with other organs in the digestive system. Inflammation, irritation, or an obstruction within this system may cause digestive problems or jaundice, or develop into a chronic disease. Some of these conditions are considered risk factors for bile duct cancer. Having one or more of these risk factors does not guarantee that you will develop cancer. However, understanding your risk factors enables you to take proactive measures.

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