My Blog

Posts for category: Oral Health

By Donald K. Ruddell, DDS
February 15, 2019
Category: Oral Health
Tags: oral health  
CrackedMouthCornerscanbeIrritating-HeresHowtoTreatThem

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.”

By Donald K. Ruddell, DDS
February 05, 2019
Category: Oral Health
Tags: canker sores  
YouMayNeedYourDentistsHelpEasingthePainofSevereCankerSores

Canker sores, known medically as aphthous ulcers, are fairly common among people. Lasting for about a week or so, these mouth sores are usually more irritating than painful. But about a quarter of the population, especially women, frequently suffer from an acute form that doesn't often respond well to over-the-counter remedies.

A typical canker sore is usually round with a yellow-gray center ringed by a reddened "halo." They can be preceded by tingling or painful sensations at the site a few hours or so before breaking out. Recurrent aphthous stomatitis (RAS) is the more severe form of canker sore, often with outbreaks of multiple painful sores. While the more common sore is usually less than a centimeter in diameter, RAS sores are often much larger.

Canker sores often arise during periods of stress or anxiety, and seem to be connected with eating certain acidic foods like tomato sauce, citrus fruits or spicy dishes. RAS also seems to be related to underlying systemic conditions like vitamin deficiencies, anemia or digestive disorders. Besides managing diet and stress, people with regular canker sores and milder cases of RAS can often find relief with non-prescription numbing agents often found in stores and pharmacies.

For more severe RAS, though, you may need the help of your dentist or physician with treatments like prescription steroids or other medications that come in gel or rinse form or through injections. The goal of any treatment approach is to decrease pain severity and shorten healing times after an outbreak.

While most mouth sores, including RAS, aren't dangerous to your health, you should still take any sore seriously. You should especially seek medical evaluation if a sore doesn't heal after a couple of weeks, if they seem to come more frequently and are more severe, or if you don't seem to ever be without a sore in your mouth. These could indicate a serious underlying problem that needs to be addressed.

One thing's for sure: there are ways to ease your suffering if you have frequent bouts with regular canker sores or even RAS. Talk to your dentist about ways to minimize your discomfort from these irritating mouth sores.

If you would like more information on aphthous ulcers or canker 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 “Mouth Sores.”

By Donald K. Ruddell, DDS
January 26, 2019
Category: Oral Health
ActressEmmaStoneRevealsHowThumbSuckingAffectedHerTeeth

It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.

“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”

While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)

When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.

Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.

But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.

Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

By Donald K. Ruddell, DDS
December 27, 2018
Category: Oral Health
Tags: oral health   nutrition  
DontLetSportsorEnergyDrinksRobyouofYourTeethsEnamel

In the sports world, athletes are always looking for an edge. And it’s not just college or professional sports—even Little Leaguers are focused on enhancing their performance.

That’s why sports and energy drinks have rocketed in popularity. With marketing pitches promising to increase stamina or replace lost nutrients from strenuous workouts, it’s not unusual to find these beverages in sports bags or the team water cooler.

But there’s a downside to them regarding your dental health—they’re often high in sugar and acidity. Both drink types could increase your risk of tooth decay or periodontal (gum) disease over time.

Sugar is a primary food source for the bacteria that can trigger a gum infection. They also produce acid, which at high levels can erode tooth enamel and lead to tooth decay. The risk for enamel erosion also increases with the drink’s acidity.

You can lessen your risk of these unpleasant outcomes by restricting your consumption of these beverages. In fact, unless your sports activity is highly strenuous for long periods, your best hydration choice is usually water.

But if you do drink a sports or energy drink for an extra lift, be sure to take these precautions for the sake of your teeth:

Try to drink them only at mealtimes. Continually sipping on these drinks between meals never gives your saliva a chance to neutralize mouth acid. Reserving acidic foods and beverages for mealtimes will allow saliva to catch up until the next meal.

Rinse with water after your drink. Water usually has a neutral pH. This can help dilute mouth acid and reduce the mouth’s overall acidity.

Don’t brush right after drinking or eating. Increased acid that can occur right after drinking or eating can immediately soften tooth enamel, but saliva can neutralize and help restore minerals to tooth enamel within an hour. Brushing during this period could remove tiny bits of the enamel’s minerals.

Taking these precautions will help keep sports or energy drinks from eroding your tooth enamel. Once it’s gone, you won’t be able to get it back.

If you would like more information on protecting your tooth enamel, 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 “Think Before You Drink: Sports and Energy Beverages Bathe Teeth in Erosive Acids.”

By Donald K. Ruddell, DDS
December 07, 2018
Category: Oral Health
Tags: teeth grinding  
AddressYourTeethGrindingHabitEarlytoAvoidPotentialToothLoss

Teeth grinding and other biting habits are more than a nuisance — they can generate twenty to thirty times the forces of normal biting. Over the long term, this can cause significant damage to teeth and supporting gums and bone.

This particular kind of damage is known as occlusal trauma (meaning injury from the bite). In its primary form, the habit itself over time can injure and inflame the jaw joints leading to soreness, swelling and dysfunction. The teeth themselves can wear down at a much faster rate than what normally occurs with aging. And although less common but even more serious, the periodontal ligaments holding teeth in place to the bone can stretch and weaken, causing the teeth to become loose and increasing the potential for tooth loss.

There are a number of techniques and approaches for treating excessive biting habits, but they all have a common aim — to reduce the amount of force generated by the habit and the associated problems that result. A custom occlusal guard, often worn while sleeping, helps lessen the force by keeping the teeth from making solid contact with each other. Tissue soreness and swelling can be relieved with anti-inflammatory drugs like aspirin or ibuprofen, muscle relaxants or physical therapy. In cases where stress is a main driver, behavioral therapy and counseling may also be helpful.

Biting forces are also an issue for patients with periodontal (gum) disease. In this case even biting forces within normal ranges can cause damage because the diseased gums and bone have already been weakened. If gum disease is a factor, the first priority is to treat the disease by removing built up plaque. Plaque is the thin film of bacteria and food remnant that’s both the cause and continuing growth of the infection, as well as tartar (calculus) from all tooth and gum surfaces.

A thorough dental exam will reveal whether a tooth grinding habit is playing a role in your teeth and gum problems or if it’s magnifying the damage of gum disease. In either case, there are appropriate steps to stop the damage before it leads to tooth loss.

If you would like more information on teeth grinding or other biting habits, 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 “Loose Teeth.”