Most of what goes on inside our mouths—good or bad—is fairly predictable. But every now and then, people encounter something out of the ordinary. A good example is lichen planus.
Lichen planus are rare skin lesions that can occur on various parts of the skin, including inside the mouth. The name comes from their lacy appearance, which resembles a fungus that grows on rocks or trees called lichen.
Being similar in appearance, though, is all that lichen planus has in common with its fungal namesake. It's believed that the sores are caused by a reaction of the immune system mistaking some of the body's cells as foreign.
But don't let the exotic sounding name alarm you—true lichen planus is considered a benign mouth sore. You may not even realize you have it until your dentist notices and points it out. But the lesions can sometimes cause mild pain or burning, especially if they occur near the gums or if you indulge in spicy or acidic foods.
As we said, these lesions aren't considered dangerous. But in a small number of cases, oral cancer was found to develop later. It's unclear whether the lesions were related to the cancer, or if what were diagnosed as lichen planus lesions were actually pre-cancerous cells mimicking the appearance of the benign sore.
In any event, your dentist will probably continue to monitor the lesions and possibly conduct regular oral cancer screenings to be on the safe side. You may also want to stop using tobacco or alcohol products to further decrease your risk of oral cancer.
As to managing lichen planus, it starts with a daily habit of brushing and flossing. You'll also want to avoid spicy or acidic foods like citrus fruits, tomatoes, peppers or caffeinated drinks, especially during flareups. If the lesions are causing discomfort, your dentist may also prescribe a topical steroid to apply to them.
Since it's quite possible you won't know if you have lichen planus (as well as other types of mouth sores) unless your dentist observes them, you should keep up regular dental visits. Having your dentist check your entire mouth, not just your teeth and gums, will help both of you stay on top of your oral health.
If you would like more information on 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.”
During the COVID-19 quarantines, stir-crazy celebrities have been creating some “unique” home videos—like Madonna singing about fried fish to the tune of “Vogue” in her bathroom or Cardi B busting through a human-sized Jenga tower. But an entertaining Instagram video from Kevin Bacon also came with a handy culinary tip: The just-awakened film and TV actor showed fans his morning technique for cutting a mango to avoid the stringy pulp that gets between your teeth. After cutting a mango in half, he scored it lengthwise and crosswise to create squares and then turned the mango inside out for easy eating.
With his mango-slicing video garnering over a quarter-million views, the City on a Hill star may have touched a nerve—the near universal annoyance we all have with food stuck between our teeth. Trapped food particles aren't only annoying, they can also contribute to a bacterial film called dental plaque that's the top cause for tooth decay and gum disease.
Unfortunately, it's nearly impossible to avoid stuck food if you love things like popcorn, poppy-seed muffins or barbecue ribs. It's helpful then to have a few go-to ways for removing food caught between teeth. First, though, let's talk about what NOT to use to loosen a piece of stuck food.
A recent survey of more than 1,000 adults found that when removing something caught between our teeth, we humans are a creative lot. The makeshift tools that survey respondents said they've used in a pinch included twigs, safety pins, screwdrivers and nails (both the hammer and finger/toe variety). Although clever, many such items are both unsanitary and harmful to your gums and tooth enamel, especially if they're metallic or abrasive.
If you want a safe way to remove unwanted food debris, try these methods instead:
Brush your teeth: The gentle abrasives in toothpaste plus the mechanical action of brushing can help dislodge trapped food.
Use dental floss: A little bit of dental floss usually does the trick to remove wedged-in food—and it's easy to carry a small floss container or a floss pick on you for emergencies.
Try a toothpick. A toothpick is also an appropriate food-removing tool, according the American Dental Association, as long as it is rounded and made of wood.
See your dentist. We have the tools to safely and effectively remove trapped food debris that you haven't been able to dislodge by other means—so before you get desperate, give us a call.
You can also minimize plaque buildup from food particles between teeth by both brushing and flossing every day. And for optimally clean teeth, be sure you have regular dental office cleanings at least twice a year.
Thanks to Kevin Bacon's little trick, you can have your “non-stringy” mango and eat it too. Still, you can't always avoid food getting wedged between your teeth, so be prepared.
Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.
But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.
A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.
Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.
Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.
The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.
These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.
If you would like more information on TMD management and 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 “Chronic Jaw Pain and Associated Conditions.”
The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.
Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).
Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.
A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.
CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.
But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.
And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.
If you would like more information on advanced dental diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”
If you think your smile is beyond hope, you might be in for a happy surprise: Today's dental cosmetics can improve even the most forlorn dental situation. It could be a one-visit tooth whitening—or a total “smile makeover.”
If it's the latter, your transformation journey could take months or even years—so you need some idea of where this journey will take you. That will come through initial discussions with your dentist about your dreams and desires for a new smile.
But you'll also need to consider what your dental condition will practically allow: Although your goal is a more attractive appearance, the higher priority is your long-term dental health. There's also cost—dental enhancements can be expensive, so you may have to adjust your dream smile to match the reality of your finances.
With the big picture in focus, the next step is to refine the details of your makeover plan. Nothing does this better—for you and your dentist—than to “see” your proposed smile ahead of time. This is possible with computer technology: Your dentist can modify a digitized photo of your face and smile to show the proposed changes to your teeth and give you a reasonable view of your future smile.
Another way is to create a “trial smile.” Using composite dental material, your dentist fashions a temporary restoration that fits over your teeth. Unlike the digitally enhanced still photo, a trial smile let's you see what your new appearance will look like while moving, talking or smiling. Although it's removed before you leave the office, you can have photos taken to show friends and family.
You and your dentist can use these methods to make adjustments to your makeover plan before applying the real enhancements. It also eliminates any unpleasant surprises after all the work is done—you'll already know what your future smile will look like.
These initial steps are just as important as the actual procedures you'll undergo. Through careful planning, you'll gain a new smile that can improve your life.
If you would like more information on smile transformations, 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.”
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