Posts for tag: oral health
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.”
Not coincidentally, GERD Awareness Week overlaps with the Thanksgiving holiday. Many people get acid indigestion from time to time, especially during this month of major feasting, but if you suffer from more than occasional acid reflux, you may be among the 20 percent of U.S. adults with gastroesophageal reflux disease, or GERD. For many individuals, painful heartburn often accompanies acid reflux; however, for others there are few or no symptoms. In the latter situation, dentists may be the first to suspect GERD based on what we see during a regular dental exam.
With GERD, acid washes up from the stomach into the esophagus or throat, and even into the mouth. If the condition is not treated, the repeated contact with acid can lead to ulcers and cause pre-cancerous cell changes along the esophagus lining. In addition, the acids can eat away at tooth enamel and harm the soft tissues of the mouth, which may result in severely eroded teeth and chronic gum disease. Unfortunately for those who have relatively minor symptoms, GERD may go undetected until serious damage has been done. For this reason, diagnosis and treatment of GERD is very important.
You can play a big role in managing your GERD symptoms. Besides taking any over-the-counter or prescription medication your doctor recommends, you can help control acid reflux by eating smaller meals, avoiding foods and beverages that trigger heartburn, refraining from eating within three hours of bedtime, and resisting the urge to recline right after eating. Also, quitting smoking and taking off extra weight can help greatly.
Further, it is important to take steps to protect your teeth if you suffer from GERD. Here are some tips:
- Neutralize acid by chewing on an antacid tablet or rinsing your mouth with half a teaspoon of baking soda mixed into a cup of water.
- Don't brush your teeth immediately after an episode of acid reflux, as this could damage the weakened tooth enamel. Instead, rinse your mouth with water to dilute the acid and wait an hour before you brush to allow your saliva to rebuild the minerals on the surface of your teeth.
- Schedule regular dental visits to monitor the health of your teeth and gums. Depending on your specific situation, we may recommend a particular treatment to help strengthen your teeth.
Our goal is to help you preserve your teeth for life, so be sure to tell us if you have been diagnosed with GERD or any other medical condition. If you have questions, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “GERD and Oral Health” and “Tooth Decay: How to Assess Your Risk.”
Because the mouth is one of the most sensitive areas of the body, we go to great lengths to eliminate pain and discomfort associated with dental work. Anesthesia, both local and general, can achieve this during the actual procedure—but what about afterward while you’re recuperating?
While a few procedures may require prescription opioids or steroids to manage discomfort after a procedure, most patients need only a mild over-the-counter (OTC) pain reliever. There are several brands available from a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like aspirin or ibuprofen work by blocking the release of prostaglandins into the body, which cause inflammation in tissues that have been damaged or injured.
Unlike their stronger counterparts, NSAIDs have fewer side-effects, cost less and aren’t addictive. And unlike opioids NSAIDs don’t impair consciousness, meaning patients can usually resume normal activities more quickly.
But although they’re less dangerous than opioids or steroids, NSAIDs can cause problems if taken at too strong a dose for too long. Its major side effect is interference with the blood’s clotting mechanism, known as “thinning the blood.” If a NSAID is used over a period of weeks, this effect could trigger excessive external and internal bleeding, as well as damage the stomach lining leading to ulcers. Ibuprofen in particular can damage the kidneys over a period of time.
To minimize this risk, adults should take no more than 2400 milligrams of a NSAID daily (less for children) and only for a short period of time unless directed otherwise by a physician. For most patients, a single, 400 milligram dose of ibuprofen can safely and effectively relieve moderate to severe discomfort for about 5 hours.
Some patients should avoid taking a NSAID: pregnant women, those with a history of stomach or intestinal bleeding, or heart disease (especially if following a daily low dose aspirin regimen). If you have any of these conditions or similar concerns, be sure you discuss this with your dentist before your procedure for an alternative method for pain management.
If you would like more information on managing discomfort after dental procedures, 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 “Treating Pain with Ibuprofen.”
There are a lot of opportunities to have your blood pressure checked: your doctor's office, of course; your local pharmacy; health fairs; and the dentist's office. The last one might surprise you, but blood pressure monitoring before a dental examination or office visit has become quite routine.
Why all this attention to blood pressure? Because chronic high blood pressure (hypertension) is a major cause for cardiovascular disease (CVD), a family of life-threatening conditions that affects 80 million people in the United States. And, you may not even be aware you have it.
That's why avenues for blood pressure screening are on the rise, and the dental office is a prime opportunity. Since you see us regularly for cleanings and checkups (you do, don't you?), there's a good chance we might help you become aware you have a problem if we perform blood pressure readings.
One study published by the Journal of the American Dental Association, for example, followed a group of dental patients with no previous risk factors of CVD, and who had not seen a doctor in the previous twelve months. Through blood pressure screening at their dental visits, 17% discovered they had high blood pressure and at risk for a cardiovascular event.
Your blood pressure can also have an effect on your oral health, especially if you're taking medication to control it. Some medications can cause reduced saliva flow, which could drastically increase your chances of developing tooth decay or periodontal (gum) disease. We would also need to exercise care during dental procedures with certain local anesthetics: some may cause both your pulse and blood pressure to rise.
Although we're primarily focused on your dental care, we also know it's only one aspect of your overall health. By simply including blood pressure checks during your checkup, we may help you identify a problem before it causes you greater health problems in the future.
If you would like more information on blood pressure 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 “Monitoring Blood Pressure.”
You may have been surprised by a new addition to your regular dental appointment routine—we took your blood pressure at the start. While you might expect this at a medical clinic, it seems unusual at the dentist’s office.
But not anymore: blood pressure checks at dental offices are quickly becoming routine, including during regular cleanings and checkups. Here are 3 reasons why checking your blood pressure is now part of your dental visit experience.
Your blood pressure could be an issue during dental work. While we do everything possible to make you comfortable, undergoing dental work can create stressful feelings. Blood pressure normally increases when stress occurs, including before dental procedures. If you already have issues with hypertension (high blood pressure), any circumstance that might increase it could lead to health problems or even an emergency like a stroke. If your blood pressure is high, we may forgo any planned procedures and refer you to a physician for further examination.
Local anesthesia can affect blood pressure. Local anesthesia is an important part of dental work—without it we couldn’t provide maximum comfort during procedures. But many anesthetics include epinephrine, which helps prolong the numbing effect. Epinephrine also constricts blood vessels, which in turn can elevate blood pressure. We may need to adjust the anesthesia drugs and dosages we use in your case if you have high blood pressure.
It could save your health—and your life. The symptoms for hypertension can be subtle and often go unnoticed. A blood pressure screening check is often the first indication of a problem. That’s why blood pressure screenings in a variety of healthcare settings are so important. A routine blood pressure check at your dentist (who hopefully sees you at least every six months) is one more opportunity to find out. Discovering you may have high blood pressure is the first step to controlling it and hopefully avoiding more serious conditions like diabetes or cardiovascular disease.
If you would like more information on monitoring vital signs during dental visits, 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 “Monitoring Blood Pressure.”