As dentists, we often see other mouth problems besides those with teeth and gums. One of the most common is cracking around the corners of the mouth. Although usually not serious, it can be irritating and uncomfortable.
Medically known as angular cheilitis (literally “an inflammation of the angles of the lip”), it’s also called perleche, derived from the French lecher, “to lick.” The latter moniker aptly describes the tendency of sufferers to compulsively lick the sores to relieve irritation, which actually can make things worse.
Perleche has a number of possible causes, mostly from in or around the mouth (although systemic diseases or medications can cause it on rare occasions). It’s often found among younger people who drool during sleep or older people with deep wrinkles along the sides of the mouth that increase the chances of dryness and cracking. Long-term wind or cold exposure, ill-fitting dentures or a lack of back teeth (which help support facial structure) may also contribute to the condition.
Patients with perleche can also develop yeast infections from a strain called candida albicans. The infection can spread through the whole mouth, significantly increasing the chances of physical discomfort.
Treating perleche often involves topical ointments with inflammation-reducing steroids and zinc oxide, which has antifungal properties, to provide an environmental barrier during the healing process. If a yeast infection occurs, we may treat it with oral or topical antifungal medication like Nystatin for the whole mouth and chlorhexidine rinses, which has antibacterial properties.
It also helps to adopt a few preventive measures that can minimize the occurrence of perleche. If you wear dentures, for example, cleaning them often (including, if necessary, with chlorhexidine) and leaving them out at night reduces bacterial and fungal growth. We can also see if your dentures are fitting properly. Replacing missing teeth provides better facial support and could minimize wrinkling around the mouth. And, of course, keeping up daily brushing and flossing helps ensure a healthy and disease-free mouth.
If you’re experiencing cracked mouth corners, let us know at your next appointment. With our help and of other medical professionals we may be able to give you relief from this irritating condition.
If you would like more information on gaining relief from angular cheilitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Cracked Corners of the Mouth.”
Dental caries (tooth decay) is a leading cause of tooth loss. But with prompt diagnosis and care we can often stop it before it causes too much damage.
The traditional treatment approach is simple: remove all diseased tooth structure and then restore the tooth with a filling. But this otherwise effective treatment has one drawback: you may lose significant healthy structure to accommodate a suitable filling or to make vulnerable areas easier to clean from bacterial plaque.
That's why a new treatment approach called minimally invasive dentistry (MID) is becoming more common. The goal of MID is to remove as little of a tooth's natural enamel and dentin as possible. This leaves the treated tooth stronger and healthier, and could reduce long-term dental costs too.
Here's how MID could change your future dental care.
Better risk assessment. MID includes a treatment protocol called caries management by risk assessment (CAMBRA). With CAMBRA, we evaluate your individual tooth decay risk, including oral bacteria levels, the quality of saliva flow to neutralize mouth acid, and sugar consumption. We then use our findings to customize a treatment plan that targets your areas of highest risk.
New detection methods. The real key to fighting tooth decay is to find it before it can destroy tooth structure with the help of new diagnostic technology. Besides advances in x-ray imaging that provide better views with less radiation exposure, we're also using powerful dental microscopes, lasers and infrared photography to show us more about your teeth than we can see with the naked eye.
"Less is More" treatments. In contrast to the dental drill, many dentists are now using air abrasion rather than a dental drill to remove decayed tooth material. Air abrasion emits tiny material particles within a pressurized air stream that leaves more healthy tooth structure intact than with drilling. We're also using new filling materials like composite resin that not only resemble natural tooth color, but require less structural removal than other types of fillings.
Using MID, we can treat tooth decay while preserving more of your natural teeth. This promises better long-term outcomes for future dental health.
If you would like more information on new treatments for tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Minimally Invasive Dentistry: When Less Care is More.”
Facing extensive dental treatment can be stressful—and even more so when you realize what it will cost. It’s a hard fact of life, but some dental work can be expensive.
The good news, though, is that it’s possible to keep your costs at a manageable level, even with limited finances. And your best first step is to become proactive with dental care now, before problems appear or get worse.
There are good reasons for making room in your budget for regular dental cleanings and checkups: for one, dental cleanings coupled with your own daily hygiene help keep bacterial plaque, the main cause of dental disease, from causing gum disease or damage to the tooth surfaces. And seeing us regularly makes it more likely we’ll detect a problem before it inflicts too much harm.
Regular visits are also important for establishing a relationship with us. As we become more familiar with you and your own individual risk factors for dental problems, we can then develop a treatment strategy to minimize those risks or take action to decrease their impact.
The latter point has direct bearing on the financial side of your care. It’s tempting to postpone a recommended treatment for a mild to moderate issue because of the expense. But receiving treatment now could save you from major expense later.
Perhaps, though, you’re actually facing that major expense now and the full weight of what it will cost is bearing down. Even in this situation, you may actually find there are less expensive ways to deal with the problem, at least temporarily until you can afford a more permanent solution.
For example, if you’ve lost a tooth or have had it extracted, you may be able to opt for a partial denture or similar less costly restoration—at least for the time being. Eventually, when you’re prepared financially, you can replace it with a dental implant or another permanent restoration. In the meantime, you’re able to regain a reasonable level of dental health.
The key is to invest in your teeth and gums now whatever their state of health. The efforts you make today could save you from a greater health and financial burden tomorrow.
A woman as gorgeous and funny as Sofia Vergara surely planned to be a model and actress from the get-go, right? Wrong! Sofia’s first career choice actually was to be… a dentist! That’s right, the sexy star of TV’s Modern Family actually was only two semesters shy of finishing a dental degree in her native Columbia when she traded dental school for the small screen. Still, dental health remains a top priority for the actress and her son, Manolo.
“I’m obsessed,” she recently told People magazine. “My son thinks I’m crazy because I make him do a cleaning every three months. I try to bribe the dentist to make him to do it sooner!”
That’s what we call a healthy obsession (teeth-cleaning, not bribery). And while coming in for a professional cleaning every three months may not be necessary for everyone, some people — especially those who are particularly susceptible to gum disease — may benefit from professional cleanings on a three-month schedule. In fact, there is no one-size-fits-all approach to having professional teeth cleanings — but everyone needs this beneficial procedure on a regular basis.
Even if you are meticulous about your daily oral hygiene routine at home, there are plenty of reasons for regular checkups. They include:
- Dental exam. Oral health problems such as tooth decay and gum disease are much easier — and less expensive — to treat in the earliest stages. You may not have symptoms of either disease early on, but we can spot the warning signs and take appropriate preventive or restorative measures.
- Oral cancer screening. Oral cancer is not just a concern of the middle aged and elderly — young adults can be affected as well (even those who do not smoke). The survival rate for this deadly disease goes up tremendously if it is detected quickly, and an oral cancer screening is part of every routine dental visit.
- Professional teeth cleaning. Calcified (hardened) dental plaque (tartar or calculus) can build up near the gum line over time — even if you brush and floss every day. These deposits can irritate your gums and create favorable conditions for tooth decay. You can’t remove tartar by flossing or brushing, but we can clear it away — and leave you with a bright, fresh-feeling smile!
So take a tip from Sofia Vergara, and don’t skimp on professional cleanings and checkups. If you want to know how often you should come in for routine dental checkups, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “Dental Hygiene Visit” and “Dental Cleanings Using Ultrasonic Scalers.”
There are a lot of reasons (including a blow to the mouth) why one of your permanent teeth might become loose. The most common: advanced periodontal (gum) disease that has weakened the gum attachment to the tooth.
There's also another, less common reason: you have a grinding habit that's producing higher than normal biting forces. Besides accelerating tooth wear, the constant jaw movement and teeth clenching can stretch periodontal ligaments and loosen their attachment to a tooth.
If the gums are disease-free, teeth grinding is most likely the main culprit for the damage, what we call primary occlusal trauma. Our treatment goal here is to reduce the effect of the grinding habit and, if necessary, secure the teeth with splinting while the ligaments heal. We can often reduce the grinding effect with a custom bite guard worn while you sleep. We may also prescribe minor muscle relaxants and mild pain medication like aspirin or ibuprofen.
Sometimes we may need to perform other measures like re-shaping your teeth's biting surfaces so they don't generate as much biting force. You may also benefit from counseling or other psychological treatment to help you address and cope with stress, a prime driver for teeth grinding.
Even if you don't have a grinding habit, biting forces may still contribute to tooth looseness if you have advanced gum disease. Advanced disease results in excessive bone loss, which in turn reduces the remaining amount of ligaments attached to the tooth. This type of damage, known as secondary occlusal trauma, and ensuing tooth looseness can occur even when your biting forces are normal.
It's necessary in these cases to treat the gum disease, primarily by manually removing plaque and calculus (hardened plaque deposits), which causes and sustains the infection. Once removed, the gums can begin to heal and strengthen their attachment. We may also need to apply splinting or perform surgical procedures to encourage gum and bone reattachment.
Whatever has caused your loose tooth, our goal is to remove the cause or lessen its effects. With your tooth secure and the gums regaining their healthy attachment, we have a good chance of saving it.
If you would like more information on teeth grinding and other potentially damaging oral habits, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Teeth: Biting Forces can Loosen Teeth.”
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