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.”
Finding out you have a cavity isn't the best of news. But finding out it's a root cavity is even worse: if not treated, the decay can spread more rapidly than a cavity occurring in the tooth's crown surfaces.
Our teeth are basically composed of two parts: the crown, the visible tooth above the gum line, and the roots, the hidden portion beneath the gums. The root in turn fits into a bony socket within the jaw to help hold the tooth in place (along with attached gum ligaments).
A tooth crown is covered by an ultra-hard layer of enamel, which ordinarily protects it from harmful bacteria. But when acid produced by bacteria comes into prolonged contact with enamel, it can soften and erode its mineral content and lead to a cavity.
In contrast to enamel, the roots have a thin layer of material called cementum. Although it offers some protection, it's not at the same performance level as enamel. But roots are also normally covered by the gums, which rounds out their protection.
But what happens when the gums shrink back or recede? This often occurs with gum disease and is more prevalent in older people (and why root cavities are also more common among seniors). The exposed area of the roots with only cementum standing in the way of bacteria and acid becomes more susceptible to cavity formation.
Root cavities can be treated in much the same way as those that occur in the crown. We first remove any decayed tooth structure with a drill and then place a filling. But there's also a scenario in which the cavity is below the gum line: In that case, we may need to gain access to the cavity surgically through the gums.
If you have exposed root areas, we can also treat these with fluoride to strengthen the area against cavity formation. And, as always, prevention is the best treatment: maintain a daily schedule of brushing and flossing and regular dental cleanings to remove bacterial plaque.
Because decay can spread within a tooth, dealing with a root cavity should be done as promptly as possible. But if we diagnose and initiate treatment early, your chances of a good outcome are high.
If you would like more information on treating root cavities and other forms of 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 “Root Cavities.”
It's been a rough year for all of us, but especially for Simon Cowell. The famous entrepreneur and brutally honest talent judge on American Idol and America's Got Talent underwent emergency back surgery in August after an accident on a new electric bike. But the good news is he's well on his way to recovery—and well enough in October to undergo another, less-stressful, procedure: a smile makeover with dental veneers.
This latest trip to the dentist wasn't Cowell's first experience with the popular restoration, wanting this time to update his smile to more closely resemble what he had when he was younger. He even brought along some older photos for reference.
Veneers aren't exclusive to celebrities like Simon Cowell, as thousands of people who get them every year can attest. These thin wafers of porcelain bonded to teeth can mask a wide range of defects, from chips, wear or discoloration to slight tooth gaps or misalignments. And every veneer is custom-made to match an individual patient's dental dimensions and coloring.
If you're thinking about a smile upgrade, here are a few reasons to consider dental veneers.
More bang for your buck. Compared to other transformative cosmetic options, veneers are relatively affordable, with the cost dependent largely on the extent of your dental needs. Still, dental veneers are an investment that can give long-lasting yields of a more attractive smile and even a completely new look.
Little to no tooth alteration. In most veneer cases, we need only remove a small amount of enamel so the veneers don't appear bulky (the alteration is permanent, though, so you'll need a veneer on the tooth from then on). It's also possible to get “no-prep” veneers requiring little to no alteration.
Durable and long-lasting. Continuing improvements in porcelain and other dental ceramics have led to stronger forms that can better withstand the biting forces your teeth encounter every day. Although you'll still need to be careful biting into hard items, your veneers can last for several years.
Easy to maintain. Veneer cleaning and maintenance is much the same as with natural teeth—daily brushing and flossing, and regular dental cleanings and checkups. Outside of that, you'll need to watch what you chomp down on: Veneers are strong, but not indestructible, and they can break.
As Simon Cowell knows, getting veneers isn't difficult. It starts with an initial visit so we can evaluate your dental health and needs. From there, we can present options on how to update your smile.
If you would like more information about dental veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “No-Prep Porcelain Veneers.”
If you think there's not much difference between toothbrushes, a quick look on a retail oral care aisle might change your mind. About the only thing toothbrushes really have in common are a handle and bristled head.
Choosing the right toothbrush, therefore, might seem overwhelming. But choose you must: Your toothbrush is an essential tool in the fight against tooth decay and periodontal (gum) disease. Without it, your odds for developing dental disease skyrocket.
Along with flossing, brushing is the best way to remove daily plaque buildup, that bacterial film most responsible for dental disease. Brushing also minimizes the buildup of tartar, the hardened form of plaque that's just as harmful as softer plaque. And, brushing stimulates your gum tissues to help prevent or lessen inflammation.
But back to all those brushes—with so many options to weigh, how do you come up with your best choice? Actually, there are some basic tips that can help you narrow things down.
Bristle stiffness. Considering other cleaning chores, you might think you'll need a stiff brush. The opposite—a soft-bristled brush—is usually true. Your toothpaste's mild abrasives and the mechanical action of brushing perform most of the plaque removal. And stiffer brushes could irritate and damage your gums or tooth enamel, leading to bigger problems.
Size and shape. Through a little trial and error (and advice from your dentist), you may find a brush with an angled or tapered neck helps you get into difficult places, especially around the back teeth. If you have problems with grip, you may also opt for a brush with a large diameter handle. Bottom line: Choose a brush you feel comfortable handling.
ADA Seal of Acceptance. Common on dental product packaging, this seal indicates that after rigorous testing the item meets the high standards of the American Dental Association, and that it does what the packaging says it does. Even so, some quality brushes don't have this seal, so ask your dentist their opinion on a particular brand.
There's one more critical component—how well you use your toothbrush. For that, ask your dentist or hygienist for tips on better brushing. Combining the right brush and technique goes a long way toward avoiding dental disease.
If you would like more information on choosing the right toothbrush for you, 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 “Sizing Up Toothbrushes.”
Your teeth naturally wear as you age, but you may be making it worse if you grind your teeth.
Teeth grinding is a behavior that causes the teeth to gnash, grind or clench against each other generating forces greater than those produced from normal biting. These forces often result in tooth wear that cause not only functional problems but result in a more aged appearance. Grinding occurs while a person is awake, but most often episodes occur while asleep at night.
Teeth grinding is quite common in children, but not usually of great concern since most grow out of it. There's even a school of thought that teeth grinding might even help readjust an uneven bite.
Among adults, though, other factors seem to contribute to teeth grinding. Many researchers believe nighttime grinding occurs as a person passes through different sleep phases including deep REM (Rapid Eye Movement) sleep. It may also have a connection with chronic snoring.
Certain medications seem to contribute to teeth grinding, particularly psychoactive drugs like amphetamines. Nicotine falls in this category, which could be why tobacco users report twice the incidence of the habit compared to non-users. Teeth grinding is also connected to another fact of modern life: stress. People who grind their teeth tend to have higher levels of anxiety, hostility or depression.
Because there are multiple triggers, there are many treatment approaches. Whatever course we take, our aim is to eliminate or minimize those factors that contribute to your habit. For example, we can create a custom mouth guard for night wear to prevent the teeth from making solid contact and thus reduce the biting pressure.
Perhaps the most important thing is to control or reduce stress. This is particularly helpful at night to prepare you for restful sleep by changing some of your behaviors. We also encourage investigating other stress therapies like biofeedback, meditation or group therapy.
Whatever the means, bringing teeth grinding under control not only reduces problems now, but could also help prevent abnormal teeth wearing and future health issues down the road.
If you would like more information on causes and treatments for teeth grinding, 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 “Stress & Tooth Habits.”
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