In addition to the usual tooth and gum problems, dentists also see patients with soft tissue infections in and around the mouth. One of the more common of these is the irritation or "cracking" of the corners of the mouth.
Formally known as angular cheilitis (or perleche, a French word, meaning "to lick"), cracked mouth corners are localized irritations made worse by saliva accumulation or an accompanying yeast infection. They're prominent among children and young adults who drool during sleep or while wearing orthodontic braces.
Older adults can also develop cracked mouth corners because of deep wrinkle lines around the mouth ("marionette lines") or tissue irritation from wearing dentures. Teeth loss, especially in the back of the jaws, can weaken facial support leading to collapse of the bite, which can contribute to angular cheilitis.
The condition can cause anything from minor discomfort at the mouth corners to a yeast infection that spreads throughout the mouth and throat. Whatever the symptoms, treatment usually begins with antifungal medication in the form of a mouthrinse or a topical ointment. The dentist may also prescribe a steroid ointment like zinc oxide paste to control inflammation and serve as a barrier against infection.
If the infection has spread beyond the mouth corners, patients may also need to use an antibacterial mouthrinse (usually chlorhexidine) to clear up the infection and help prevent a relapse. Besides cleaning their appliances with chlorhexidine, denture wearers with angular cheilitis should also take their dentures out at night to reduce the chances of a reoccurrence.
Along the same vein, patients who contend with frequent cracked mouth corners and who have missing teeth should have those teeth replaced by some form of restoration. If that involves dentures, it's important to maintain a good fit with them to reduce the chances of tissue irritation. And patients with deep wrinkle lines around their mouth may be able to lessen them through dermatological treatment.
Even though cracked mouth corners rarely pose a major health problem, the discomfort they cause can be a drag on your daily life and activities. Remember that you don't have to suffer—a visit to your dentist could start you on your journey toward relief from this irritating problem.
If you would like more information on angular cheilitis and similar mouth conditions, 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.”
October 20th is World Osteoporosis Day, putting the spotlight on this degenerative bone condition and the impact it has on millions of people. Not only does it significantly increase the risk of potentially life-threatening fractures, but it can also indirectly affect dental health.
This connection arises from the use of certain treatment drugs that ultimately could lead to complications following some forms of dental work. These particular drugs, mainly bisphosphonates like Fosamax™ and RANKL inhibitors like Prolia™, destroy bone cells called osteoclasts, whose function is to clear away worn out regular bone cells (osteoblasts). With fewer osteoclasts targeting them, more older osteoblast cells survive longer.
In the short-term, a longer life for these older cells helps bones afflicted by osteoporosis to retain volume and density, and are thus less likely to fracture. Long-term, however, the surviving osteoblasts are less elastic and more brittle than newly formed cells.
In the end, these longer living cells could eventually weaken the bone. In rare situations, this can result in parts of the bone actually dying—a condition known as osteonecrosis. The bones of the body with the highest occurrences of osteonecrosis are the femur (the upper leg bone) and, of specific concern to dental care, the jawbone.
The effect of these medications on the jawbone actually has a name—drug-induced osteonecrosis of the jaw (DIONJ). Fortunately, there's only a 1% risk of it occurring if you're taking these drugs to manage osteoporosis. It's also not a concern for routine procedures like cleanings, fillings or crown placements. But DIONJ could lead to complications with more invasive dental work like tooth extraction, implant placement or periodontal surgery.
It's important, then, that your dentist knows if you're being treated for osteoporosis and the specific drugs you're taking. Depending on the medication, they may suggest, in coordination with your physician, that you take a "drug holiday"—go off of the drug for a set period of time—before a scheduled dental procedure to ease the risk and effects of osteonecrosis.
Because infection after dental work is one possible consequence of osteonecrosis, it's important that you practice thorough oral hygiene every day. Your dentist may also prescribe an antiseptic mouth rinse to include with your hygiene, as well as antibiotics.
You may also want to talk to your doctor about alternative treatments for osteoporosis that pose a lower risk for osteonecrosis. These can range from traditional Vitamin D and calcium supplements to emerging treatments that utilize hormones.
Osteoporosis can complicate dental work, but it doesn't have to prevent you from getting the procedures you need. Working with both your dentist and your physician, you can have the procedures you need to maintain your dental health.
If you would like more information about osteoporosis and dental care, please contact us or schedule a consultation.
During election season, you'll often hear celebrities encouraging you to vote. But this year, Kaia Gerber, an up-and-coming model following the career path of her mother Cindy Crawford, made a unique election appeal—while getting her wisdom teeth removed.
With ice packs secured to her jaw, Gerber posted a selfie to social media right after her surgery. The caption read, “We don't need wisdom teeth to vote wisely.”
That's great advice—electing our leaders is one of the most important choices we make as a society. But Gerber's post also highlights another decision that bears careful consideration, whether or not to have your wisdom teeth removed.
Found in the very back of the mouth, wisdom teeth (or “third molars”) are usually the last of the permanent teeth to erupt between ages 17 and 25. But although their name may be a salute to coming of age, in reality wisdom teeth can be a pain. Because they're usually last to the party, they're often erupting in a jaw already crowded with teeth. Such a situation can be a recipe for numerous dental problems.
Crowded wisdom teeth may not erupt properly and remain totally or partially hidden within the gums (impaction). As such, they can impinge on and damage the roots of neighboring teeth, and can make overall hygiene more difficult, increasing the risk of dental disease. They can also help pressure other teeth out of position, resulting in an abnormal bite.
Because of this potential for problems, it's been a common practice in dentistry to remove wisdom teeth preemptively before any problems arise. As a result, wisdom teeth extractions are the top oral surgical procedure performed, with around 10 million of them removed every year.
But that practice is beginning to wane, as many dentists are now adopting more of a “wait and see” approach. If the wisdom teeth show signs of problems—impaction, tooth decay, gum disease or bite influence—removal is usually recommended. If not, though, the wisdom teeth are closely monitored during adolescence and early adulthood. If no problems develop, they may be left intact.
This approach works best if you maintain regular dental cleanings and checkups. During these visits, we'll be able to consistently evaluate the overall health of your mouth, particularly in relation to your wisdom teeth.
Just as getting information on candidates helps you decide your vote, this approach of watchful waiting can help us recommend the best course for your wisdom teeth. Whether you vote your wisdom teeth “in” or “out,” you'll be able to do it wisely.
Along with fessing up to cherry tree surgery and tossing silver dollars across the Potomac River, George Washington is also famously known for wearing wooden dentures. Although we can't verify the first two legends, we can confirm Washington did indeed wear dentures, but not of wood—hippopotamus ivory and (yikes!) donated human teeth—but not wood.
Although they seem primitive to us today, Washington's dentures were the best that could be produced at the time. Still, the Father of Our Country suffered mightily from his dentures, both in physical discomfort and social embarrassment. Regarding the latter, our first president's dentures contorted his lips and mouth in an unattractive way, faintly discernable in Gilbert Stuart's famous portraits of our first president.
If only Washington had lived in a later era, he might have been able to avoid all that dental unpleasantness. Besides better versions of dentures, he might also have benefited from an entirely new way of replacing teeth—dental implants. Just four decades after this state-of-the-art restoration was first introduced, we now recognize implants as the "Gold Standard" for tooth replacement.
In recognition of Dental Implant Month in September, here are 4 reasons why dental implants might be the right tooth replacement choice for you.
Life-like. While other restorations provide a reasonable facsimile of natural teeth, implants take like-likeness to another level. That's because the implant replaces the root, which then allows for a life-like crown to be attached to it. By positioning it properly, implants and the subsequent crown can blend seamlessly with other teeth to create an overall natural smile appearance.
Durable. Implants owe their long-term durability (more than 95% still functioning after ten years) to a special affinity between bone and the titanium post imbedded in the jaw. Bone cells readily grow and adhere to the implant's surface, resulting over time in a more secure hold than other restorations. By the way, this increased bone growth around implants can help slow or even stop progressive bone loss.
Low impact. Dental bridges are another well-regarded tooth replacement option, but with a major downside: The natural teeth on either side of the missing teeth gap must be crowned to support the bridge. To prepare them, we must permanently alter these teeth. Implants, though, don't require this form of support, and so have a negligible effect on other teeth.
Versatile. Although implants are a practical choice for individual tooth restorations, multiple teeth replacements can get expensive. Implants, though, can also be incorporated into other restorations: Four to six implants can support an entire removable denture or fixed bridge. Implant-supported restorations are more durable than the traditional versions, while also encouraging better bone health.
If you need to replace teeth and would like to consider dental implants, see us for a complete examination. You may be an ideal candidate for this "best of the best" dental restoration.
Self-improvement is an estimated $10 billion annual market—smartphone apps, one-on-one coaching and, of course, books that instruct and inspire people on everything from selling yourself to increasing your self-esteem. But as helpful as these resources might be, don't overlook the self-improvement opportunities that could be awaiting you at a familiar place: your dentist's office.
Cosmetic dental techniques can enhance more than your physical attributes. Because of the importance of smiling in everyday life, improving the appearance of your teeth and gums can fill you with a renewed sense of confidence. A transformed smile might just be a game changer in social and career settings, not to mention your romantic life.
Many cosmetic techniques also improve oral health. It's a double benefit! A more attractive smile is more likely to be a healthy smile.
So, in recognition of Self Improvement Month this September, here are 4 ways you could improve your smile appearance.
Teeth whitening. One of the simplest and most affordable ways to improve your smile appearance is with a teeth-whitening procedure. Years of eating, drinking and (for some) tobacco use can leave teeth yellowed and dull. A professional whitening can brighten your teeth and take years off your smile. With proper care and occasional touch-ups, your brighter, more attractive smile could last for years.
Dental veneers. Chipped, discolored or slightly gapped teeth can detract from an otherwise beautiful smile. Dental veneers could completely change all that. Thin wafers of dental porcelain, veneers bond to the front of teeth and mask all manner of imperfections. And because they're custom designed and colored to blend with other teeth, only you and your dentist need know you're wearing them.
Dental implants. Missing tooth gaps, especially in the visible "smile zone," stand out like a sore thumb. Dental implants, the premier method for tooth replacement, can fill those unsightly gaps and restore your smile. Implants are titanium metal posts imbedded in the jaw that develop strong attachments with the bone. This makes them durable and long-lasting for a truly life-like result.
Orthodontics. Realigning teeth through braces or removable clear aligners is first and foremost therapeutic—it's primarily performed to improve overall dental health. But a huge secondary benefit is a more attractive display of perfectly aligned teeth. That's why orthodontics is widely regarded as the "Original Smile Makeover."
To see if any of these or other procedures—or a combination of them—could transform your smile, make an appointment with us for an exam and consultation. Self-improvement might actually be as close as your teeth.
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