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Posts for: March, 2020

By Edward C. Smith, DMD, MPH, LLC
March 24, 2020
Category: Oral Health
Tags: oral health   cracked mouth  
PutanEndtoUncomfortableandEmbarrassingCrackedMouthCorners

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.”


By Edward C. Smith, DMD, MPH, LLC
March 14, 2020
Category: Oral Health
Tags: tooth decay  
ManageTheseRiskFactorstoReduceYourRiskofToothDecay

Tooth decay doesn't occur out of thin air, but is the end result of bacteria feeding on sugar, multiplying and producing acid. High acidity erodes tooth enamel and creates an environment for cavity development.

Modern dentistry can effectively treat cavities and often save the tooth from further damage. But you don't have to wait: You can reduce your chances of cavities by managing risk factors that contribute to decay.

Here are 4 top risk factors for tooth decay and what you can do about them.

Poor saliva flow. Saliva neutralizes acid and helps restore minerals to enamel after acid contact. But your enamel may not have full protection against acid if you have diminished saliva flow, often due to certain medications. You can help increase your saliva by consulting with your doctor about drug alternatives, drinking more water or using a saliva boosting product. Smoking can also inhibit saliva, so consider quitting if you smoke.

Eating habits. High sugar content in your diet can increase bacterial growth and acid production. Reducing your overall sugar consumption, therefore, can reduce your risk of decay. Continuous snacking can also increase your decay risk, preventing saliva from bringing your mouth back to its normal neutral pH. Instead, limit your snack periods to just a few times a day, or reserve all your eating for mealtimes.

Dental plaque. Daily eating creates a filmy buildup on the teeth called dental plaque. If not removed, plaque can then harden into a calcified form called calculus, an ideal haven for bacteria. You can help curtail this accumulation by thoroughly brushing and flossing daily, followed by dental cleanings at least every six months. These combined hygiene practices can drastically reduce your cavity risk.

Your genetics. Researchers have identified up to 50 specific genes that can influence the risk for cavities. As a result, individuals with similar dietary and hygiene practices can have vastly different experiences with tooth decay. Besides continuing good lifestyle habits, the best way to manage a genetic disposition for dental disease is not to neglect ongoing professional dental care.

If you would like more information on managing your tooth decay risk factors, 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 “What Everyone Should Know About Tooth Decay.”


By Edward C. Smith, DMD, MPH, LLC
March 04, 2020
Category: Dental Procedures
HowShawnMendesandMileyCyrusGotTheirStellarSmiles

The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.

"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")

Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)

Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).

Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.

Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.

What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”