Posts for category: Oral Health
If you’ve noticed redness or small skin cracks at the corners of your mouth, you may have a common infection known as perleche or angular cheilitis. Depending on its cause, there are ways to treat the redness and skin cracking to lessen your discomfort.
The term perleche comes from the French word “lecher,” meaning to lick. This is derived from the tendency of perleche patients to constantly lick the area to ease irritation; unfortunately, this also helps perpetuate the inflammation. Once the skin is broken the area is commonly infected by yeast called candida albicans.
Initially, perleche may arise from a variety of sources, most of them locally from either inside or around the mouth, although it can be triggered by a general body infection or disease like diabetes or cancer, or vitamin or iron deficiencies. Inside the mouth reduced saliva flow, tissue inflammation under a rarely cleaned denture (denture stomatitis), pressure on the mouth corners caused by a collapsed bite due to missing teeth and similar conditions can elevate the risks for infection. Around the mouth wrinkling or “marionette lines,” deep lines that extend from the mouth to the chin due to aging or environmental exposure, can contribute to crack formation. Drooling during sleep or as a result of orthodontic treatment is also a contributing cause.
The main focus of treatment for perleche is to bring any infection under control. This can be accomplished with a course of oral or topical antifungal (yeast-attacking) medication. If the infection has spread into the mouth or throat we might then prescribe a troche, a small lozenge designed to dissolve, which you would rinse with and then swallow to affect other portions of the mouth. Steroid or zinc oxide ointments applied directly to the skin can control inflammation and serve as a barrier agent with antifungal properties to promote healing.
If the cause is more related to dental problems (ill-fitting dentures or missing teeth), then it’s important to have these addressed and treated. You may also consult a dermatologist for treatments to lessen wrinkling around the mouth that might also contribute to chronic cases of perleche.
If you would like more information on cracked mouth corners, 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.”
Now that we’re into the New Year, it’s a good time to look over your list of resolutions. Did you remember to include dental health on your list? Here’s one simple resolution that can help keep your smile bright and healthy through the New Year and beyond: Floss every day!
Your oral hygiene routine at home is your first line of defense against tooth decay and gum disease. While brushing your teeth twice a day effectively removes much of the food debris and dental plaque from your teeth, brushing alone is not sufficient to remove all the plaque that forms on your teeth and around your gums. For optimal oral health, flossing once a day is also necessary.
Which teeth do you need to floss? Any dentist will tell you, “Only the ones you want to keep!” And yet according to a national survey of over 9,000 U.S. adults age 30 and older, nearly 70% don’t floss every day, and nearly one third admit that they don’t floss their teeth at all. Unfortunately, if you don’t floss, you’ll miss cleaning about a third of your tooth surfaces. When plaque is not removed, this sticky film of bacteria releases acids that cause cavities and gum disease. With dental floss, however, you can clean between the teeth and around the gums where a toothbrush can’t reach.
Flossing is an essential component of good oral hygiene. Still, daily flossing seems to be a harder habit to get into than brushing. Some people tense up their cheek muscles while flossing, making it harder to comfortably reach the back teeth, so remember to relax as you floss. If unwaxed floss doesn’t glide easily between teeth, try waxed floss. If you have trouble using traditional dental floss, you can try threader floss, which has a rigid tip, interdental brushes, floss picks, or a water flosser, which cleans by way of pressurized water.
It’s not too late to add one more resolution to your list, and flossing is a habit that will go a long way toward keeping you in the best oral health. And along with good dental hygiene at home, regular professional dental cleanings and checkups are key to a healthy smile. If you would like more information about maintaining excellent dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Flossing—A New Technique.”
If you’ve ever heard your dentist or hygienist talk about “calculus,” they’re not referring to a higher branch of mathematics. The calculus on your teeth is something altogether different.
Calculus, also called tartar, is dental plaque that’s become hardened or “calcified” on tooth surfaces. Plaque begins as soft food particles and bacteria that accumulate on the teeth, and more so if you don’t properly clean your teeth every day. This built-up plaque becomes both home and food source for bacteria that can cause tooth decay or periodontal (gum) disease.
Because of this direct link between plaque and/or calculus and dental disease, we encourage everyone to perform two important oral hygiene tasks every day. The first is to floss between your teeth to remove plaque as you are unable to effectively reach those areas with a toothbrush. Once you loosen all the plaque, the other really important task is a thorough brushing of all of the tooth surfaces to remove any plaque that may have accumulated since the last brushing. Doing so every day will catch most of the softer plaque before it becomes calcified.
Once it forms, calculus is impossible to remove by brushing and flossing alone. That’s why you should have regular cleanings performed by a dental professional. Dentists and hygienists have special tools called scalers that allow them to manually remove plaque and calculus, as well as ultrasonic equipment that can vibrate it loose to be flushed away with water.
In fact, you should undergo dental cleanings at least twice a year (or as often as your dentist recommends) even if you religiously brush and floss daily. Calculus forms so easily that it’s nearly inevitable you’ll accumulate some even if you have an effective hygiene regimen. Your dental team can remove hardened deposits of calculus that may have gotten past your own hygiene efforts.
If you haven’t been consistently practicing this kind of daily hygiene, see your dentist to get a fresh start. Not only will they be able to check for any emerging problems, they can clean your teeth of any plaque and calculus buildup so that you’ll be able to start with a “clean” slate.
Calculus can be tenacious, but it not impossible to remove. Don’t let it set you up for an unhealthy experience with your teeth and gums.
For a lifetime of healthy teeth and gums, it takes a lifetime of personal and professional care. Starting your child’s daily hygiene with the first tooth eruption is a must; but you should also consider beginning regular dental visits in their early years, around or before their first birthday.
There’s evidence that early dental visits hold a number of benefits that could lead to reduced oral care costs over their lifetime.
Familiarity with professional dental care. Children need to feel comfortable and safe in their surroundings, especially new places. Beginning dental visits early improves the chances your child will view the dentist’s office as a regular part of their life. It’s especially helpful if the dental professional has training and experience with young children to put them at ease.
Early monitoring for dental disease or other problems. A young child’s teeth are highly susceptible to tooth decay. Dental visits that begin early in a child’s life increase our chances of detecting any developing dental problems early. In addition to treating decayed teeth, your child may also need preventative actions like sealants or additional fluoride applications to protect teeth if they are at a higher risk for disease. As the child develops, we may also be able to catch early bite problems: with interventional treatment, it may be possible to reduce future orthodontic costs.
Parental help and support. As we discuss your child’s dental care with you, we’ll be able to provide essential information and training for how to care for their teeth and gums at home. We’ll also be able to ease any common concerns you may have, such as thumb sucking or other oral habits, as well as give you sound advice and techniques for dealing with these problems.
As with other areas of childhood development, starting off on the right foot with oral care can make all the difference to their future dental health. The sooner you begin regular dental visits with your toddler, the better their chances for a lifetime of healthy teeth and gums.
If you would like more information on dental care for children, 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 “Taking the Stress out of Dentistry for Kids.”
Just like other parts of your physical body, teeth naturally wear as we get older. Just the effect from chewing during hundreds of thousands of meals in a lifetime can take its toll.
But there are some factors that can make tooth wear worse. By addressing them promptly should they arise, you can keep age-related tooth wear to a minimum.
Here are 3 areas to watch for to avoid excessive tooth wear.
Dental disease. Tooth decay and periodontal (gum) disease are most responsible for not only the loss of teeth but for compromising tooth health overall. But the good news is they’re largely preventable through proper oral hygiene practices to remove bacterial plaque, the main trigger for these diseases. Prompt treatment when they do occur can also minimize any damage and help your teeth and gums stay strong and healthy.
Your bite. Also known as occlusion, the bite refers to how the upper and lower teeth align with each other when you bite down. When they don’t align properly, regular chewing and biting can create abnormally high forces in the teeth and cause them to wear unevenly and more rapidly. Correcting the bite through orthodontic treatment won’t just improve your smile, it can improve bite function and decrease accelerated tooth wear.
Bruxism. This is a general term describing habits like teeth clenching and grinding in which the teeth forcefully contact each other beyond normal parameters. There are a number of causes for bruxism, but for adults it’s typically related to stress. Over time, bruxism can accelerate tooth wear and cause other problems like TMD. There are a number of ways to stop or at least reduce the effects of bruxism like relaxation techniques or a night guard worn during sleep that prevents the teeth from making forceful contact.
If you suspect you’re experiencing any of these factors, see us for a full examination. We’ll then be able to discuss your condition, the potential impact on tooth wear, and what we can do to protect your teeth.
If you would like more information on protecting your teeth as you age, 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 “How and Why Teeth Wear.”
In October, the American Dental Hygienists’ Association sponsors National Dental Hygiene Month to remind everyone that having good oral health is directly related to practicing good oral hygiene at home. This includes brushing twice each day with fluoride toothpaste and flossing at least once per day. But sometimes we forget that dental hygiene applies not just to your teeth but also to anything you regularly wear in your mouth. This includes removable dentures (full or partial), clear aligners, nightguards, mouthguards and retainers. If you (or your kids, or seniors you know) wear any of these, please review the three appliance-care tips below.
1. CLEAN IT. Just like natural teeth, an oral appliance worn every day needs daily brushing. But toothpaste isn’t an appropriate cleanser for these devices; it’s too abrasive. The grainy particles it contains are great for scrubbing plaque and bits of food from the hard enamel coating of teeth—but they can actually leave little nicks in the plastic of your oral appliance, creating areas for bacteria to hide. This can eventually cause odors and stains. Instead, clean appliances with liquid dish soap or denture paste. Buy a separate brush for your appliance—don’t use the same one that you use on your teeth. It can be a very soft regular toothbrush, nail brush or denture brush.
2. RINSE IT. After cleaning your appliance, rinse it thoroughly. But don’t use hot water—and never boil an oral appliance to sterilize it! Your device was custom-made for your mouth, and it needs to fit precisely to do its job. Hot water can warp the appliance and change the fit, possibly rendering it useless or even harmful. For example, a warped orthodontic aligner might not move teeth into the correct position. Remember: the goal is to kill bacteria, not your appliance!
3. STORE IT. Keep your appliance in a safe place—away from curious pets and toddlers. When you are not wearing it or cleaning it, your device should be packed away in its case or soaking overnight in water or a cleaning solution according to your original instructions.
If you have any questions about oral appliance care or oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “10 Tips for Cleaning Your Oral Appliance” and “10 Tips for Daily Oral Care at Home.”
Brushing and flossing are foundational to good oral health and an essential part of daily life. Practicing both these habits removes most disease-causing bacterial plaque from tooth and gum surfaces.
It doesn’t take much to manually perform them — a quality soft-bristle toothbrush, fluoride toothpaste and string floss. But what if you have a physical impairment that makes performing these tasks difficult to perform — or your mouth condition requires a little more “power” to adequately access and clean surfaces?
You do have power options for both brushing and flossing. Electric toothbrushes, of course, have been available since the 1950s. As with other technology, they’ve improved in quality and affordability over the last few decades. They’re available in various sizes, rechargeable or battery, and each with their own claims of cleaning ability.
The ultimate question, though, is: are they as effective at removing plaque as manual brushing? That’s been the subject of a number of comprehensive studies, including one conducted by the Cochrane Collaboration, a research organization. They evaluated a number of powered toothbrushes over various lengths of time. They concluded that some powered toothbrushes with a rotation-oscillation action had a statistically significant (though modest) reduction in plaque compared with manual toothbrushes.
As to flossing, admittedly it does take some dexterity to accomplish effectively. Traditional string flossing is also difficult if not impossible for people with braces or similar access restrictions to the teeth. An oral irrigator (or water flosser) is a viable alternative. Water flossers work by pulsating water at high pressure through special tips at the end of a handheld or countertop device. The pressurized stream penetrates between teeth and below the gums to flush away plaque.
Are water flossers effective? According to one recent study orthodontic patients were able to remove up to five times the plaque between teeth as those who used only a manual toothbrush.
When considering alternatives to your manual toothbrush or string floss, speak with us first. We’ll be happy to guide you toward the best form of brushing and flossing to do the most good in your situation.
Bacteria are bad… right? They can cause diseases like pneumonia, strep throat, and tooth decay. They are the reason we wash our hands with soap (or antibacterial gels) and cook (or refrigerate) our food. Yet it turns out that bacteria are also necessary to keep our bodies healthy — and new research is showing just how important these tiny microorganisms are to our well-being. Here are five facts you should know about bacteria.
The bacteria in our bodies outnumber our cells by a factor of 10 to 1. An estimated 100 trillion bacteria live inside the average human — but because they’re so small, they make up only 1-3 percent of our body mass.
The collection of bacteria we harbor is called our “microbiome.” Like the groundbreaking study of human DNA called the Human Genome Project, recent research is leading to a “map” of our bacterial makeup. This revolutionary study is called — you guessed it — the Human Microbiome Project.
No two people have exactly the same microbiome. But in general, the bacteria that live in a particular spot on the body (the mouth, for example) play the same roles in different individuals. Research has also shown that a healthy microbiome looks very different from a diseased microbiome.
In terms of bacteria, the mouth is one of the best-understood areas of the body. It has long been known that tooth decay can result when “bad” oral bacteria begin to outnumber their “good” counterparts. Now we are gaining a better understanding of how certain lifestyle factors — like cigarette smoking — may influence the bacterial balance in the mouth.
Understanding the microbiome may lead to new treatments for disease. Researchers hope that one day, certain serious diseases could be controlled by bacterial “transplants” that re-balance an individual’s microbiome. Maintaining a healthy microbiome could also help prevent many diseases.
So by all means, don’t stop brushing your teeth or washing your hands — this helps control bacteria that could harm you — but do remember that not all bacteria are harmful. One day, an infusion of bacteria might just cure your illness.
Among the “to-do” items on your pre-dive checklist like “Pack wetsuit” or “Fill scuba tanks,” be sure to add one other: “Check my dental health status.”
While that may seem like an odd concern, the changes in atmospheric pressure you encounter while diving (or flying, for that matter) could amplify oral sensitivity and intensify pain if you have pre-existing teeth or jaw problems.
The reason for this is the effect of basic physics on the body. All anatomical structures, including organs, bones and muscles, equalize external pressures the body encounters. We don’t notice this at normal atmospheric pressure, but when we encounter an extreme — either lower pressure during air flight or higher pressure during a scuba dive — we may feel the effects of the pressure on any structure with a rigid-walled surface filled with either air or fluid. These structures can’t equalize the pressure as fast as other areas, resulting in pain or discomfort. This is known medically as “barotrauma,” or more commonly as a “squeeze.”
One structure in particular could have an effect on your upper teeth and jaws: the sinus cavities of the skull, particularly the maxillary sinuses just below the eyes. Their lower walls are right next to the back teeth of the upper jaw and, more importantly, share the same nerve pathways. It’s quite possible, then, for pain from one area to be felt in the other, commonly known as “referred pain.” A toothache could then be felt in the sinus region, and vice-versa.
During a squeeze, then, pain levels from existing problems in the teeth and jaws that were previously tolerable (or even unnoticed) may well become amplified as the pressure from the sinus cavity impinges upon the jaw. That dull toothache you’ve been having may suddenly become excruciating at 30,000 feet — or 30 meters under the surface.
That’s why it’s important to see us if you’ve experienced any signs of tooth decay, gum disease or TMD, including pain, before your next dive or air flight. And, if you encounter any significant pain while flying or diving, be sure you consult with us as soon as possible when you return. Taking action now could help you avoid a miserable, and potentially dangerous, flying or diving experience in the future.
If you would like more information on pressure changes and dental 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 “Pressure Changes can Cause Tooth and Sinus Pain.”