Posts for category: Oral Health
Your teeth’s hard, enamel coating protects them from environmental dangers or disease. But although it’s made of the hardest substance in the human body, enamel isn’t invincible — prolonged exposure to acid can cause dental erosion, a condition in which the enamel’s mineral content permanently dissolves, a process known as de-mineralization.
De-mineralization occurs anytime our mouth environment becomes too acidic due to eating or drinking items with high acid content. Saliva normally neutralizes mouth acid in thirty minutes to an hour after we eat, as well as restores mineral content to the enamel (re-mineralization). Danger arises, though, if the saliva’s buffering action is overwhelmed by chronic acidity, caused mainly by constant snacking or sipping on acidic foods and beverages throughout the day — in this situation, saliva can’t complete the process of buffering and re-mineralization.
As a result, the enamel may permanently lose its mineral content and strength over time. This permanent dental erosion leads to serious consequences: the teeth become more susceptible to decay; the dentin becomes exposed, which causes pain and sensitivity to pressure and temperature changes; and changes in the teeth’s size and color can negatively alter your appearance.
It’s important to take action then before dental erosion occurs. Along with daily oral hygiene, restrict your consumption of acidic foods and beverages to meal times and cut back on between-meal snacks. Rather than a sports drink after exercising, drink nature’s hydrator — water. You should also alter your brushing habits slightly — rather than brush right after you eat, wait thirty minutes to an hour. This gives saliva time to restore the mouth to its normal pH and re-mineralize the enamel. Brushing right after can remove even more of the minerals in softened enamel.
If significant erosion has occurred, there are a number of treatment options we can undertake to preserve remaining tooth structure and enhance your appearance. In moderate cases, we can reshape and cover damaged teeth using dental materials like composite resins or porcelain to fill decayed areas or cover teeth with veneers or crowns.
The key of course, is to identify dental erosion through clinical examination as soon as possible to minimize damage. Your enamel plays a critical role in protecting your teeth from disease — so take the right steps to protect your enamel.
If you would like more information on protecting your enamel, 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 “Dental Erosion.”
We’ve all had physical ailments that were more irritating than serious. The problem of skin cracking at the corners of the mouth fits into that category.
Both dentists and dermatologists encounter this condition often and have a name for it: perleche, derived from the French word lecher, meaning “to lick.” The term arises from patients’ tendency to excessively lick the broken skin to soothe the itching or burning.
Perleche most often arises from certain mouth conditions, although systemic problems like anemia or diabetes may also cause it. Children or younger adults, especially those with orthodontic braces or a tendency to drool as they sleep, often develop perleche; older adults with wrinkling around the mouth are also susceptible. Mouth dryness caused by reduced saliva flow may also irritate the skin and cause discomfort.
As the skin becomes irritated, the person may begin to lick the corners of the mouth to soothe them. This sets up conditions for an infection, most often caused by yeast known as candida albicans. The infection may become more acute and begin to affect the entire inside of the mouth or throat.
If you’ve developed perleche, our primary treatment goal is to reduce any infection with the aid of oral or topical antifungal drugs. One drug, Nystatin, is often taken as a lozenge that dissolves in the mouth and works its way from there through the rest of the body. You can also apply antifungal ointments several times a day to the corners of the mouth, often in combination with steroid ointments that reduce redness and swelling. You can also apply antifungal zinc oxide paste to the cracked skin, which also serves as a barrier between the skin and outer contaminants.
To reduce the chance of future outbreaks, we may recommend you rinse with Chlorhexidine, as well as replace missing teeth or refit loose dentures — these too are contributing factors to erupting yeast infections. You might also need to undergo dermatologic treatment for wrinkles if they’ve proven to be a factor in developing perleche.
Although not a major problem, perleche can be exceedingly uncomfortable and embarrassing. Thanks to a number of treatment options, you don’t have to put up with that discomfort for long.
If you would like more information on perleche (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 magazine article “Cracked Corners of the Mouth.”
You've been treating a persistent rash around your mouth with medicated ointments, but it's not going away. The problem may be the ointment — it could actually be sustaining the particular rash you have.
Peri-oral dermatitis is a scaly rash with small bumps (some filled with pus) around the mouth, eyes or nose. It's especially common among women ages 20-45, possibly due to hormonal factors or cosmetic use. Other than its unattractiveness you might not otherwise notice it, although it can cause stinging, itching or burning. There are ways to treat it effectively, though not necessarily the way you might think.
Many skin conditions respond well to topical steroids, like ointments or lotions containing hydrocortisone. But prolonged use of a steroid for skin irritations might actually increase risks for peri-oral dermatitis. Applying it to an existing rash may also deceive you — the steroid constricts some of the skin's tinier blood vessels, which will make the rash appear as if it's fading. The effect, though, usually doesn't last more than an hour. If you continue to use the steroid, the rash won't get better.
The key to alleviating peri-oral dermatitis requires treatment from a physician, dermatologist or dentist, who will also be able to accurately diagnose the specific skin condition you have. If it is peri-oral dermatitis, the first step is to stop using any topical steroids and only wash with mild soap or similar substitute. You'll have to be patient because the rash may at first appear to flare up and worsen before getting better.
Instead of steroids, we may prescribe antibiotics to help clear the rash, typically tetracycline. It may take several weeks of use before the rash begins to clear; as it does clear, you would either stop the antibiotic treatment or taper off over a four-to-five week period.
While some cases of peri-oral dermatitis will clear up and remain that way, some people may experience chronic reoccurrences. Even so, by using the same treatment approach we can still effectively manage the condition for the long-term.
Pregnancy is a very special and exciting time for expectant women and their families. At this time, many moms-to-be make careful choices to try and do what’s best for themselves and their babies. Wondering what’s the right way to take care of your oral health when you’re expecting? Here are answers to a few of the most common questions about dental care during pregnancy.
Q: Does pregnancy make a woman more susceptible to dental problems?
A: Yes. Pregnancy causes big changes in the levels of certain hormones, and these in turn have a powerful influence on your body. For example, many expectant moms experience food cravings and morning sickness at certain times. Changing hormone levels can also affect your oral health in various ways, including making your gums tender, swollen, and highly sensitive to the harmful bacteria in plaque.
Q: What are “pregnancy tumors” in the mouth?
A: These are benign (non-cancerous) overgrowths of tissue that sometimes develop on the gums during the second trimester. Often appearing between the teeth, these swollen reddish growths are thought to be caused by plaque bacteria. They sometimes go away on their own when pregnancy is over, but may be surgically removed if they don’t.
Q: Is it normal to have bleeding gums during pregnancy?
A: It’s not uncommon, but it does indicate that you need to pay careful attention to your oral hygiene at this time. Pregnancy hormones can cause the tiny blood vessels in your gums to become enlarged; when plaque bacteria are not effectively removed from the mouth, the gums may become inflamed and begin to bleed. This condition is often called “pregnancy gingivitis.” If left untreated, it can progress to a more serious form of gum disease called periodontitis. That’s one reason why regular brushing and flossing are so important during pregnancy — as are routine professional cleanings.
Q: Is it safe to have dental cleanings and checkups during pregnancy?
A: Yes; in fact, it’s a very good idea to have at least one. Studies have shown that women who receive dental treatment during pregnancy face no more risks to their developing babies than those who don’t. On the other hand, poor oral health is known to cause gum disease, and is also suspected of being linked to adverse pregnancy outcomes. Routine dental exams and professional cleanings can help you maintain good oral health and avoid many potential problems during this critical time.
Q: Should I postpone more complicated dental work until after I have a baby?
A: It depends. A study recently published in the Journal of the American Dental Association found it was safe for pregnant women to have routine procedures like fillings, root canals, and extractions, even if they require local anesthesia. So treatments that are essential to an expectant mother’s health shouldn’t be put off. However, if you’re planning to have cosmetic dental work, it might be best to err on the side of caution and wait until after your baby is born.
Have more questions about oral health during pregnancy? Contact our office or schedule a consultation — and be sure to let us know that you are pregnant, so we can make sure you get the extra attention you need. You can learn more in the Dear Doctor magazine article “Pregnancy and Oral Health.”
Teeth-replacing dental implants not only look life-like, they’re made to last. For one thing, the metals and dental materials used in them are impervious to bacterial infection.
But that doesn’t mean implants are impervious to failure. Implants depend on the bone and other natural mouth structures for support. If the bone becomes weakened due to disease, the implant could become unstable and ultimately fail.
Peri-implantitis, the condition that can lead to this kind of failure, is a major concern for implant longevity. It’s a type of periodontal (gum) disease triggered by plaque, a thin film of food particles that can build up quickly in the absence of adequate brushing and flossing. The gum tissues around the implant become infected and inflamed.
If the infection isn’t properly treated with renewed oral hygiene and clinical plaque removal, it could spread below the gum line and begin to damage the underlying gum tissues and bone. This could destroy the all-important connection between the titanium implant post and the bone. The implant could eventually loosen and become completely detached from the bone.
The key is early intervention before the bone becomes damaged. Besides plaque removal we may also need to apply antibiotics in some form to control the growth of disease-causing bacteria. If the disease has fairly advanced we may also need to consider surgical repair to strengthen the attachment between implant and bone.
You can help to avoid peri-implantitis altogether by practicing consistent daily brushing and flossing around all your teeth including the implant, and seeing your dentist at least twice a year for cleanings and checkups. And by all means see your dentist if you notice any signs of gum swelling, redness or bleeding. Staying on top of your gum health will help not only the natural tissues and remaining teeth in your mouth, it will help preserve your implants for decades to come.