Posts for category: Oral Health
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.”
Mention “bacteria” and people begin looking for the germicide. The truth is, though, only a few strains cause disease — the rest are benign or even play a beneficial role.
This may shock you, but your body both inside and out is home to around 100 trillion single-celled organisms, exceeding the number of your native cells by 10 to 1. You won't notice them, though: bacteria are so small they only make up 1 to 3% of your total body mass. And each of us has a unique “microbiome” of micro-organisms: they influence a variety of processes like digestion and metabolism, and some even “teach” our immune systems to distinguish between helpful and harmful bacteria.
Of the 10,000 or more species of bacteria that inhabit the body, perhaps the most studied and understood are in the mouth. We even have a database that catalogs the gene sequences of oral bacteria. And what we've learned has enlarged our understanding of dental disease and how to prevent or treat it.
This new knowledge, for example, confirms that many of our modern lifestyle habits adversely affect oral health. For example, researchers have found higher concentrations of Streptococcus mutans, the bacteria most responsible for tooth decay, in current samples of biofilm than in those from preindustrial eras. The culprit seems to be the modern diet rich with carbohydrates like sugar that bacteria eat. Cigarette smoking can also make the mouth friendlier to disease-causing bacteria.
On the bright side, our growing knowledge of oral bacteria is helping us devise better prevention and treatment strategies. One example is the use of antibiotics to reduce the populations of disease-causing oral bacteria.
The broad, traditional approach kills not only malevolent bacteria, but beneficial strains as well. The approach may also be helping bad bacteria become resistant to common antibiotics. A newer approach targets specific bacteria with custom-designed antibiotics that won't kill other bacteria. There's also increased focus on ways to re-balance a person's normal microbiome if it's become skewed.
As we come to understand bacteria better — both good and bad species — these and other dental care efforts will benefit. With our increasing knowledge of these microorganisms that surround us the future looks bright for better oral health.
If you would like more information on the role of bacteria in oral health, 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 “New Research Shows Bacteria Essential to Health.”
Did you ever brush your teeth and find that your gums were bleeding slightly? This unwelcome discovery is more common than you might think — and it might have something to tell you about your oral health. Here are five things you should know about bleeding gums.
- As much as 90% of the population occasionally experiences bleeding gums. It happens most often while brushing — and it’s often a sign of trouble, indicating that your gums are inflamed and/or you aren’t brushing or flossing optimally.
- Bleeding gums can be an early warning sign of gum disease. In its earliest stages, this malady is called gingivitis, and it’s quite common. About 10 to 15 percent of people with gingivitis go on to develop a more serious form of gum disease, called periodontitis. If left untreated, it can lead to gum recession, bone loss, and eventually tooth loss.
- A professional exam is the best way to tell if you have gum disease. Your dentist or hygienist may use a small hand-held instrument called a periodontal probe to check the spaces between your teeth and gums. When gum tissue becomes detached from the teeth, and when it bleeds while being probed, gum disease is suspected.
- Other symptoms can confirm the presence of gum disease. These include the presence of pus and the formation of deep “pockets” under the gums, where gum tissues have separated from teeth. The pockets may harbor harmful bacteria, and need to be treated before they cause more damage.
- Several factors may influence the health of your gums. How effectively you brush and floss has a major impact on the health of your gums. But other factors are important too: For instance, women who are pregnant or taking birth control pills sometimes have bleeding gums due to higher hormone levels. Diabetics and people with compromised immune systems often tend to have worse problems with periodontal disease. Certain drugs, like aspirin and Coumadin, may cause increased bleeding; smoking, by contrast, can mask the presence of gum disease by restricting blood flow.
It’s never “normal” to have bleeding gums — so if you notice this problem, be sure to have an examination as soon as you can. If you have questions about bleeding gums or periodontal disease, contact us or schedule a consultation. You can read more in the Dear Doctor magazine article “Assessing Risk For Gum Disease.”
It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.
“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”
While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)
When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.
Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.
But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.
Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
If your child has a toothache, there’s good news — and not so good news. The good news is the pain rarely indicates an emergency. On the downside, though, it may definitely be something that needs our attention.
Here, then, are 4 things you should do as a parent when your child tells you their tooth hurts.
Try to find out exactly where the pain is and how long it has hurt. Ask your child which tooth or part of the mouth hurts. You should also find out, as best you can, when the pain started and if it’s constant or intermittent. Anything you learn will be useful information if you bring them to the office for an examination. And, any tooth pain that keeps your child up at night or lasts more than a day should be examined.
Look for signs of recent injury. Your child may have suffered a blow to the mouth that has damaged the teeth and gums. Besides asking if they remember getting hurt in the mouth, be sure to look for chipped teeth, cracks or other signs of trauma. Even if there aren’t any outward signs of injury, the tooth’s interior pulp may have been damaged and should be checked out.
Look for signs of dental disease. Take a close look at the tooth your child’s complaining about: do you see brown spots or obvious cavities? You should also look for swollen gums or sores on the inside of the mouth. If there’s been no apparent injury, these could be signs of infection related to tooth decay.
Try to relieve pain symptoms. If you don’t see anything unusual, there may be a piece of candy or other hard food debris between the teeth causing the pain — gently floss around the tooth to dislodge it. If the pain persists give appropriate doses of ibuprofen or acetaminophen (not aspirin). If there’s swelling, you can also apply an icepack on the outside of the jaw. In any case, you should definitely schedule a visit with us for an examination.
If you would like more information on dental care for your child, 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 “A Child’s Toothache.”