Posts for: January, 2017
When you visit us for your regular checkup we're examining more than your teeth and gums. We're also checking to see if you're having problems with soft tissues in and around your mouth.
Besides canker sores, rashes or other types of abnormalities, our exam may uncover strange looking lesions known as lichen planus on the inside of the mouth. These purple-tinted bumps or rash-like discolorations are named for their similarity in appearance to lichen fungi found on trees or rocks. Although these mouth sores may look odd, they're fairly rare and usually do not cause concern.
Most people don't even know they have lichen planus until it's discovered during a dental exam. If there are any symptoms, it's usually a feeling of roughness, tenderness or itching. They may increase your sensitivity to spicy or acidic foods, but rarely cause extreme pain. If they're located around the gums, you may also notice a little soreness after brushing or eating.
To confirm it is lichen planus, we need to perform a biopsy. During this procedure, we remove a tiny amount of the affected tissue and have it examined microscopically. We do this not only to determine the correct diagnosis, but also to rule out more serious problems like pre-cancerous lesions or oral cancer.
Thankfully, though, this worst case scenario is quite rare, and although the condition can't be cured, there are some things you can do to keep any discomfort to a minimum. If the lesions are irritating, we recommend using a soft toothbrush with gentle brushing action. You may also want to limit or avoid spicy or acidic foods like citrus, tomatoes, hot peppers and caffeinated drinks. Managing stress can also help. For some extreme conditions, we can prescribe a topical steroid to help relieve discomfort.
If you notice any of the above symptoms, be sure to contact us or point it out at your next appointment. Once we know what we're dealing with, we can take steps to treat you.
If you would like more information on different types of mouth sores, 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 “Lichen Planus.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
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.”