There's more to your dental visit than preventing or treating teeth or gum problems. We're also on the lookout for a number of potential soft tissue problems that could occur in or around your mouth.
Here are 4 examples of such problems we can detect and help you manage.
Lumps. Whenever you accidentally bite the inside of your mouth, the wound you create forms a protective layer of hard collagen. Unfortunately, the “callous” can rise higher than the surrounding cheek surface and easily get in the way of your teeth again. With successive bites and more scar tissue you'll soon notice a prominent lump. Although not a health danger, it becomes annoying with each successive bite. We can surgically remove the lump and flatten out the mouth surface.
Canker sores. Known as aphthous ulcers, these round sores with a yellow-gray center and a red “halo” can break out on the inside cheeks, tongue or back of the throat. Unless they don't heal within a couple of weeks or seem to be increasing in frequency, they're nothing to worry about. They can, however, cause a burning or stinging sensation. We can reduce this discomfort and speed healing with over-the-counter ointments or prescription options like topical or injected steroids.
Cracked mouth corners. Also known as perleche (from the French lecher, meaning “to lick”), your mouth corners can become dry and irritated and you may begin licking them to soothe the discomfort. Accumulated saliva can trigger a yeast infection, which can spread to other parts of your mouth. We can usually prevent this by prescribing antifungal ointments, and a steroid ointment to control inflammation.
Mouth rash. Peri-oral dermatitis is a red, scaly rash that appears around the outside of the mouth. Because it's often mistaken for acne or other conditions, it's often treated with topical steroids. This actually suppresses the skin's normal healing effects and can actually make the rash worse. The best way to treat it is to stop using any kind of ointment or cream and use only mild soap to wash the area. We can also prescribe antibiotics to help speed the healing process.
If you would like more information on these and other soft tissue problems, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Lumps and Bumps in the Mouth,” “Mouth Sores,” and “Cracked Corners of the Mouth.”
A third of people treated for cancer develop adverse side effects within their mouth. But while these effects can be devastating to teeth and gums, there are ways to minimize the damage.
Treatments like chemotherapy and radiation work by destroying cancer cells. Unfortunately, they may also destroy normal cells. The accumulation of this “collateral damage” ultimately affects uninvolved areas and organ systems of the body. Chemotherapy, for example, can interrupt bone marrow blood cell formation and decrease the body's ability to fight infection.
These ripple effects can eventually reach the mouth. It's not uncommon for cancer patients to develop mouth sores or see an increase in tooth decay or periodontal (gum) disease. The treatments may also inhibit saliva flow: because saliva neutralizes acid and provides other benefits that lower disease risk, dental disease is more likely to develop when the salivary flow is reduced.
The first step to minimizing these effects is to improve oral health before cancer treatment begins. An unhealthy mouth vastly increases the chances for problems during treatment. Cooperating with your cancer physicians, we should attempt to treat any diseases present as soon as possible.
During cancer treatment we should also monitor your oral health and intervene when appropriate. If at all possible, you should continue regular dental visits for cleaning and checkups, and more so if conditions warrant. We can also protect your teeth and gums with protective measures like antibacterial mouth rinses, saliva stimulation or high-potency fluoride applications for your enamel.
What's most important, though, is what you can do for yourself to care for your mouth during the treatment period. Be sure to brush daily with a soft-bristle brush and fluoride toothpaste. You can use a weak solution of one-quarter teaspoon each of salt and baking soda to a quart of warm water to rinse your mouth and soothe any sores. And be sure to drink plenty of water to reduce dry mouth.
While you're waging your battle against cancer, stay vigilant about your teeth and gums. Taking care of them will ensure that after you've won your war against this malignant foe your mouth will be healthy too.
If you would like more information on taking care of your teeth and gums during cancer treatment, 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 “Oral Health During Cancer Treatment.”
If you're one of the more than 26 million people in the U.S. with diabetes, you know first hand how the disease impacts your life. That includes your dental health — and whether or not implants are a good tooth replacement option for you.
Diabetes is actually the name for a group of diseases affecting how your body processes glucose, a simple sugar that provides energy for the body's cells. The level of glucose in the blood is regulated by insulin, a hormone produced in the pancreas. Diabetes causes the pancreas to either stop producing insulin (Type 1) or not produce enough (Type 2). Also in Type 2, the body can become unresponsive to the insulin produced.
The implications for either type are serious and can be life-threatening. If glucose levels are chronically too low or high the patient could eventually go blind, suffer nerve damage, or develop kidney disease. Diabetes also interferes with wound healing and creates a greater susceptibility for gangrene: diabetics thus have a higher risk for losing fingers, toes and limbs, and can even succumb to coma or death.
Type 2 is the most common form of diabetes. Fortunately, most people with this type can effectively manage it through diet, exercise and regular glucose monitoring; if need be, prescription medication can help regulate their levels. Even so, diabetics with their disease under control must still be alert to slower wound healing and a higher risk of infection.
Because implant placement is a minor surgical procedure, the aspects of diabetes related to healing, infection and inflammation could have an adverse impact on the ultimate success of the placement. Implant surgery creates a wound in the surrounding gum tissues and bone that will need to heal; the body's immune response in a diabetic can interfere with that process. And if infection sets in, the risks of implant failure increase.
But research has shown that diabetics with good glucose management have as high a success rate (over 95% after ten years) as non-diabetic patients. That means the implant option is a viable one for you as a diabetic — but only if you have your disease under control.
In February, the American Dental Association sponsors Children’s Dental Health Month to raise awareness about the importance of good oral health for kids of all ages. It’s a great time to focus on concerns unique to children—teething, for example. This stage of development can be stressful for children and parents alike. Just ask tennis legend (and new mom) Serena Williams. When her baby daughter recently began teething, the Olympic gold medalist and multi-Grand-Slam champion asked her instagram followers for help:
“Teething… is so hard. Poor Alexis Olympia has been so uncomfortable. She cried so much… I almost need my mom to come and hold me to sleep cause I’m so stressed. Help? Anyone?”
We certainly sympathize with Serena’s plight. The process of teething—where a child’s primary teeth start to emerge (erupt) from below the gum line—can make both baby and parents irritable in the daytime and sleepless at night. While a few infants are born with tiny teeth already showing, most kids’ teeth begin emerging at age 4-7 months.
Teething is an important milestone in baby’s growth…but it’s one that’s not always cause for celebration. It can lead to pain, drooling, gnawing, and biting; ear rubbing and gum swelling; decreased appetite and disrupted sleeping patterns. And did we mention that irritability and stress are common as well? But if you notice fever, diarrhea, or widespread rash, it may be wise to consult your dentist or pediatrician.
What can you do to ease the discomfort of teething? The American Dental Association (ADA) has a few recommendations: Try soothing the gums by rubbing them gently with a clean finger or a cool, moist towel or washcloth; or let your baby chew on a cold (but not frozen) teething ring or pacifier.
If your pediatrician recommends it, over-the-counter medications like acetaminophen or ibuprofen can be used for persistent teething pain—but make sure to use the correct dosage and wait the proper amount of time between doses.
There are also a few things you should NEVER do. Don’t give alcohol to a baby in any form, and don’t rub any medications on baby’s gums. Don’t give a baby anything to chew on that’s unsafe (bones, breakable items, etc). And don’t use teething gels containing benzociane, lidocaine or certain homeopathic ingredients: According to a recent FDA warning, they may pose a danger to infants, including risks of rare but serious medical conditions. Feel free to check with us if you are not sure whether a particular remedy is safe for your baby.
There’s no doubt that teething can be stressful. But it’s a sign of normal development—and in time it will pass…like babyhood itself. If you’re concerned about your child’s teething or would like more information, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine article “Teething Troubles.”
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