Posts for: February, 2018
Removing plaque, a bacterial film that builds up on teeth, daily is crucial in preventing dental disease, but is your brushing and flossing making enough of a difference?
Plaque forms every day in our mouths as a result of eating. The bacteria in it produce acid, which can erode tooth enamel and cause tooth decay. Certain strains can also infect the gums and cause periodontal (gum) disease. Either of these primary diseases could lead to tooth loss.
Daily plaque removal with brushing and flossing keeps bacteria growth under control, so a quick swish of your toothbrush across your teeth won't be enough. Plaque's soft, sticky consistency enables it to hide in hard to reach places below the gum line, irregular biting surfaces, or in fillings or other dental work.
Because it's virtually invisible, it's hard to tell if you've successfully removed it. That's where disclosing agents can help. These are solutions, swabs or tablets with a dye that temporarily stains plaque while not staining tooth surfaces. Dental hygienists use them to show patients where they're missing plaque when brushing and flossing, but you can also use them at home to see how you're doing between dental visits.
After brushing and flossing, use the disclosure product according to the package directions. If you're using a solution, for example, swish it around in your mouth for about thirty seconds and then spit it out. The dye reacts with leftover plaque to stain it a bright color. Some products even offer a two-tone dye that displays older plaque in a different color from newer plaque.
After noticing the dyed plaque in a mirror, brush and floss until you don't see it anymore. You may have to change your approach, which will help you perform better in the future. Although safe in the mouth, you should still avoid swallowing the agent or getting it on your clothes. Any on your lips, gums or tongue will eventually wear off in a few hours.
A disclosing agent gives you a snapshot of where you need to improve your oral hygiene. Occasional “spot checks” will help keep your brushing and flossing well tuned.
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.”
Your smile isn’t the same without healthy gums—neither are your teeth, for that matter. So, maintaining your gums by protecting them from periodontal (gum) disease is a top priority.
Gum disease is caused by bacterial plaque, a thin biofilm that collects on teeth and is not removed due to poor oral hygiene practices. Infected gums become chronically inflamed and begin to weaken, ultimately losing their firm attachment to the teeth. This can result in increasing voids called periodontal pockets that fill with infection. The gums can also shrink back (recede), exposing the tooth roots to further infection.
Although gum disease treatment techniques vary, the overall goal is the same: remove the bacterial plaque fueling the infection. This most often involves a procedure called scaling with special hand instruments to manually remove plaque and calculus (tartar). If the infection has spread below the gum line we may need to use a procedure called root planing in which we scrape or “plane” plaque and calculus from the root surfaces.
As we remove plaque, the gums become less inflamed. As the inflammation subsides we often discover more plaque and calculus, requiring more treatment sessions. Hopefully, our efforts bring the disease under control and restorative healing to the gums.
But while gum tissue can regenerate on its own, it may need some assistance if the recession was severe. This assistance can be provided through surgical procedures that graft donor tissues to the recession site. There are a number of microsurgical approaches that are all quite intricate to perform, and will usually require a periodontist (a specialist in gum structures) to achieve the most functional and attractive result.
While we have the advanced techniques and equipment to treat and repair gum disease damage, the best approach is to try to prevent the disease from occurring at all. Prevention begins with daily brushing and flossing, and continues with regular dental cleanings and checkups.
And if you do notice potential signs of gum disease like swollen, reddened or bleeding gums, call us promptly for an examination. The sooner we diagnose and begin treatment the less damage this progressive disease can do to your gums—and your smile.
If you would like more information on protecting your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Periodontal Plastic Surgery.”