Posts for: April, 2016
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.”
One of the most important aspects of social interaction is smiling, showing others we’re confident and outgoing. Â Many people, though, are hesitant to use this important social skill because their teeth are unattractive.
But even the most unattractive teeth can be dramatically transformed through cosmetic dentistry. Here are 5 prominent ways we can restore beauty to your problem teeth.
Enamel shaping. Sometimes teeth can have an irregular shape that makes them stand out like a sore thumb. With this “sculpting” technique, we remove very small amounts of enamel, the outer protective layer of a tooth, which improves the tooth’s overall shape without harming it.
Bonding. Recent developments in acrylics now make it easier to repair chipped, broken or decayed teeth with minimal preparation. The acrylic material can be molded to resemble a natural tooth and colored to precisely match its shade and that of neighboring teeth. It’s then bonded to the tooth with a durability that can last through years of daily biting and chewing.
Veneers. These thin layers of dental porcelain are bonded to teeth to cover minor defects. Otherwise healthy teeth that are slightly chipped, stained or a bit out of alignment can get a more attractive “face” that’s durable and lasting.
Crowns and Bridgework. Sometimes teeth are too heavily decayed or lost altogether to use bonding or veneers. With porcelain dental restorations that have a strong inner core and an outer life-like appearance, we can completely cover an individual damaged tooth with a custom-made crown or replace one or more missing teeth with fixed bridgework.
Dental Implants. Introduced over thirty years ago, implants are a popular tooth replacement choice. Â Its inner titanium post is surgically inserted into the jaw where bone cells grow and adhere to it to form a strong, lasting bond. Implants can be used for single teeth or as supports for fixed bridgework or removable dentures.
Regardless of your teeth’s appearance problems, cosmetic dentistry has a solution. The first step is a comprehensive examination — from there we can advise you on the best options for turning your embarrassing smile into a more beautiful and confident one.
If you would like more information on the various techniques for smile transformation, 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 “Beautiful Smiles by Design.”
Dental implants are known for their durability as well as life-like beauty. Thanks to their unique construction and ability to integrate with bone, they have a very high success rate and can last for decades.
But while they’re less problematic than other restorations, we still can’t “set them and forget them.” While the implants themselves aren’t susceptible to disease, the supporting gums, bone and adjacent teeth are. If you want them to last as long as possible, you’ll need to care for them and the rest of your mouth through daily oral hygiene and semi-annual office cleanings.
With that said, there are a few differences in how we perform hygiene tasks with implants. This is due to the way in which they attach to the jaw, as the titanium post is inserted directly into the bone. Natural teeth, on the other hand, are held in place by the periodontal ligament, a strong connective tissue that lies between the teeth and bone. The ligament holds the teeth firmly in place while also allowing minute tooth movement in response to changes in the mouth.
The ligament also has an ample blood supply that assists with fighting infection that may arise in the tooth and its supporting gums. Without this extra source of defense, infections that arise around an implant can grow quickly into a condition known as peri-implantitis and lead to rapid bone loss that could cause the implant to fail.
That’s why you and your hygienist must be ever vigilant to the buildup of plaque, the bacterial film that gives rise to dental disease, around implants and adjacent teeth. This includes removing plaque buildup from implant surfaces, although your hygienist will use tools (scalers or curettes) made of plastic or resin rather than traditional metal to avoid scratching the implant’s dental material. They’ll likewise use nylon or plastic tips with ultrasonic equipment (which uses high vibration to loosen plaque) and lower power settings with water irrigation devices.
Keeping infection at bay with effective hygiene is the number one maintenance goal with dental implants. Doing your part along with your hygienist will help you get the most of this investment in your smile.
If you would like more information on oral hygiene with 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 Implant Maintenance.”