As dentists, we often see other mouth problems besides those with teeth and gums. One of the most common is cracking around the corners of the mouth. Although usually not serious, it can be irritating and uncomfortable.
Medically known as angular cheilitis (literally “an inflammation of the angles of the lip”), it’s also called perleche, derived from the French lecher, “to lick.” The latter moniker aptly describes the tendency of sufferers to compulsively lick the sores to relieve irritation, which actually can make things worse.
Perleche has a number of possible causes, mostly from in or around the mouth (although systemic diseases or medications can cause it on rare occasions). It’s often found among younger people who drool during sleep or older people with deep wrinkles along the sides of the mouth that increase the chances of dryness and cracking. Long-term wind or cold exposure, ill-fitting dentures or a lack of back teeth (which help support facial structure) may also contribute to the condition.
Patients with perleche can also develop yeast infections from a strain called candida albicans. The infection can spread through the whole mouth, significantly increasing the chances of physical discomfort.
Treating perleche often involves topical ointments with inflammation-reducing steroids and zinc oxide, which has antifungal properties, to provide an environmental barrier during the healing process. If a yeast infection occurs, we may treat it with oral or topical antifungal medication like Nystatin for the whole mouth and chlorhexidine rinses, which has antibacterial properties.
It also helps to adopt a few preventive measures that can minimize the occurrence of perleche. If you wear dentures, for example, cleaning them often (including, if necessary, with chlorhexidine) and leaving them out at night reduces bacterial and fungal growth. We can also see if your dentures are fitting properly. Replacing missing teeth provides better facial support and could minimize wrinkling around the mouth. And, of course, keeping up daily brushing and flossing helps ensure a healthy and disease-free mouth.
If you’re experiencing cracked mouth corners, let us know at your next appointment. With our help and of other medical professionals we may be able to give you relief from this irritating condition.
If you would like more information on gaining relief from 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 article “Cracked Corners of the Mouth.”
For generations, dentures have helped people avoid the dire consequences of total teeth loss. Now, implant technology is making them even better.
Composed of life-like prosthetic teeth fixed within a plastic or resin gum-colored base, dentures are manufactured to fit an individual patient’s mouth for maximum fit, comfort and performance. But dentures also have a critical drawback—they can’t stop bone loss in the jaw.
Bone is constantly regenerating as older cells dissolve and then are replaced by newer cells. In the jawbone, the forces generated when we chew travel through the teeth to the bone and help stimulate this new cell growth. When teeth are missing, though, the bone doesn’t receive this stimulus and may not regenerate at a healthy rate, resulting in gradual bone loss.
Dentures can’t transmit this chewing stimulus to the bone. In fact, the pressure they produce as they rest on top of the gums may actually accelerate bone loss. Over time then, a denture’s once secure and comfortable fit becomes loose.
In the past, most patients with loose dentures have had them relined with new dental material to improve fit, or have new dentures created to conform to the changed contours of the jaws. But implant technology now offers another alternative.
Implants are in essence a tooth root replacement. Dentists surgically implant a titanium metal post directly into the jawbone that naturally attracts bone cells to grow and adhere to it over time (a process called osseointegration). This not only creates a secure and lasting hold, it can also stop or even reverse bone loss.
Most people know implants as single tooth replacements with a porcelain crown attached to the titanium post. But a few strategically placed implants can also support either removable or fixed dentures. Removable dentures (also called overdentures) usually need only 3 or 4 implants on the top jaw and 2 on the bottom jaw for support through built-in connectors in the dentures that attach to the implants. A fixed bridge may require 4-6 implants to which they are permanently attached.
There are pros and cons for each of these options and they’re both more expensive than traditional dentures. In the long run, though, implant-supported dentures could be more beneficial for your bone health and hold their fit longer.
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
If there’s one essential tool for dental health, it’s the toothbrush. But though simple in basic design, manufacturers have nonetheless created a dizzying array of choices that often muddy the decision waters for consumers.
It doesn’t need to be that way—you can choose the right toothbrush like a boss. First, though, you need to know a toothbrush’s purpose expressed as two basic tasks: removing dental plaque, the thin biofilm that causes most dental disease; and stimulating the gums to maintain good health.
So what should you look for in a toothbrush to effectively perform these tasks? Here are 3 important factors to consider when buying this essential dental care tool.
Bristle quality. First, it’s a myth that bristles should be hard and stiff to be effective—in fact harder bristles can damage the gums. Opt instead for “soft” bristles that are also rounded on the ends. And look for bristling with different levels of length—shorter length sections work better around the gum line; longer sections help clean back teeth more effectively.
A “Just right” size. Toothbrushes aren’t uniform—you’ll need to choose a size and shape that works well for you personally. You might find an angled neck or a tapered head easier for getting into your mouth’s hard to reach places. If you have problems with dexterity, look for a brush with large handles. And be sure to ask us at the dental office for recommendations on brush dimensions that are right for you.
ADA Seal of Acceptance. Just like toothpaste brands, the American Dental Association assigns its seal of approval to toothbrushes they’ve evaluated and found to meet certain standards. Although you can find high quality toothbrushes that haven’t sought this evaluation, an ADA seal means it’s been independently tested and found safe and effective for use.
Of course, no matter how high quality the toothbrush you buy, it’ll only be as effective as your brushing technique. So, be sure to use gentle circular or oval motions along all your teeth and gumline surfaces—it should take you about two minutes. We’ll be happy to show you the proper technique in more detail, so you’ll be able to get the most out of your chosen toothbrush.
Dental implants are among the most popular tooth replacements with their high success rate, durability and life-like beauty. But obtaining them is a process that requires commitment, planning, and coordination — it takes a team.
Your general dentist is often the first team member you’ll encounter: because they’re most familiar with your mouth’s condition the implant discussion naturally begins here. They can help you determine if you’re a good candidate for implants, such as if you have sufficient bone mass at the intended site or if you have dental disease that must be treated first. They’ll also continue monitoring your general dental health throughout the process.
Your general dentist may also have the special training for surgically placing implants. If not, he or she may refer you to your next team member: an oral surgeon or periodontist skilled in implantation procedures. This step first requires careful planning, including developing a surgical guide for precise placement of the implant. These specialists may also contribute to other aspects of the implant process such as tooth extraction or bone grafting.
A few weeks after surgery bone will have grown and adhered to the implant to form a solid bond. It’s time for you to go back to your dentist who will work in conjunction with another member of your team, a dental lab technician. Together, your dentist and laboratory technician will guide the development, manufacture and placement of the implant’s life-like porcelain crown. The technician will take their specifications from the surgeon and your general dentist and, with his or her skill and artistry, form a crown that will blend well in color and shape with the rest of your teeth.
We also can’t forget another important team member: you. Without your input, especially in the early planning stages, your expectations for a more attractive smile might not be met. The rest of your implant team depends on you communicating your desires and wishes to balance with the technical requirements they must achieve.
The process for dental implants can take months. But with the coordinated efforts of your implant team you’ll be able to enjoy results — renewed function and a more attractive smile — that could last for decades.
If you would like more information on dental implants, 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 Implants.”
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