During your latest dental cleaning and checkup, your dentist notices a skin rash around your mouth. You sigh—it’s been going on for some time. And every ointment you’ve tried doesn’t help.
You may have peri-oral dermatitis, a type of skin rash dentists sometime notice during dental treatment. It doesn’t occur often—usually in only 1% of the population—but when it does, it can be resistant to common over-the-counter ointments.
That’s because peri-oral dermatitis is somewhat different from other facial rashes. Often mistaken as acne, the rash can appear as small red bumps, blisters or pus-filled pimples most often around the mouth (but not on the lips), nostrils or even the eyes. Sometimes the rash can sting, itch or burn.
People with peri-oral dermatitis often try medicated ointments to treat it. Many of these contain steroids that work well on other skin conditions; however, they can have an opposite effect on peri-oral dermatitis.
Because the steroids cause a constriction in the tiny blood vessels of the skin, the rash may first appear to be fading. This is short-lived, though, as the rash soon returns with a vengeance. Prolonged steroid applications can also thin the affected skin, making it more susceptible to infection and resistant to healing.
Peri-oral dermatitis requires a different treatment approach. The first step is to stop using any kind of steroidal cream, as well as moisturizers, ointments and both prescription and non-prescription medications. Instead, you should only use a mild soap to wash your face.
You may find the rash looking worse for a few days but be patient and continue to avoid ointments or creams. Your healthcare provider may also prescribe oral antibiotics, usually of the tetracycline family. It may take several weeks of antibiotic treatment until the skin noticeably clears up.
For most people, this approach puts their rash into permanent remission. Some, though, may see a reoccurrence, in which case it’s usually best to repeat treatment. With a little patience and care, though, you’ll finally see this persistent rash fade away.
Miley Cyrus's rise to fame began when she was cast in the Disney series Hannah Montana. She played the title character, Hannah Montana, a famous singing star hiding her true identity, ordinary girl, Miley Stewart. In her real life at the time, Miley Cyrus had her own little secret—she was undergoing orthodontic treatment to straighten her smile.
Like many teenagers (as well as many adults), Cyrus's dental bite wasn't in proper alignment. She could have gone the traditional way by straightening her smile with braces fixed to the front of her teeth. It's an effective treatment, but the metallic hardware can overwhelm a person's appearance.
With her various roles in the public spotlight, Cyrus and her family wanted an effective but out-of-sight method for moving her teeth. They chose a relatively new one called lingual braces. Unlike traditional braces, the hardware for lingual braces is fixed on the back of the teeth (or the tongue side, hence the term “lingual”).
Lingual braces can correct any bite problem labial (“lip”) braces can, just through different mechanics of movement. Its main appeal is that the hardware is hidden behind the teeth, so only you and your orthodontist need know you're wearing braces.
There is also less risk of damage to the mouth or the braces themselves if you're in a sport or profession where you're at high risk for facial blows. And unlike patients with traditional braces, you'll have an unobstructed view of your progress over the course of treatment.
Lingual braces do tend to cost more than traditional braces. Some patients also have difficulty at first with speaking and tongue comfort, though most grow accustomed to the braces within a couple of weeks. Because lingual braces are relatively new, there's been a limited number of orthodontists offering it.
But lingual braces are just one of the ways to straighten teeth. Modern dentistry offers several ways to give you your dream smile. If you have dental problems or would like to improve the look of your smile, please contact us or schedule a consultation, and we can discuss your options. To learn more, read the Dear Doctor magazine articles “Lingual Braces” and “The Magic of Orthodontics.”
Repairing a decayed tooth may be as simple as removing the damaged tooth material and filling the void. Many filling materials can now match the color of a tooth, so the dental work is hardly noticeable.
Sometimes, though, the decay is too extensive or we've treated the tooth several times and it won't support another filling. If the tooth is still viable, we may be able to cover it with a custom crown.
Also known as a cap, a crown fits over and is securely affixed to the tooth with bonding material or cement. Crowns have been used for decades to restore teeth, but the materials they're made of have changed with time.
The original crowns were made of metal, usually gold or silver. They were strong and could hold up well to the daily forces produced by chewing or biting. They did, however, visually stand out and came to be regarded as unattractive. There were porcelain materials available that could closely mimic the life-likeness of teeth, but they could be weak and brittle.
Dentists came up with a hybrid crown that could supply strength as well as an attractive appearance. These were composed of two parts: an inner metal frame for strength overlaid with porcelain for appearance. These fused crowns were the most popular until the mid-2000s.
About that time, newer forms of porcelain came on the market that were not only attractive, but also durable. Although caution should still be taken when biting something hard, they've proven to stand up well to biting forces. Fused porcelain to metal is still in use, but usually for back teeth where biting forces are higher and the crown won't be as noticeable as on front teeth.
Crowns can also address cosmetic issues with chipped, fractured or excessively worn teeth. But with any crown you should be aware that much of the original tooth material must be removed to accommodate the fit. The altered tooth will require a crown or other restoration from then on. Crowns must also be custom-made by a dental technician in a process that can take weeks.
Still, the process can be well worth it. With proper care and maintenance, a crown could serve you and your smile well for many years to come.
If you would like more information on crowns and other restoration options, 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 “Crowns & Bridgework.”
Bonjour! Hola! Shalom! December is National Learn a Foreign Language Month, and learning to say “Hello” in different tongues is a good place to start. You could then move on to another set of wonderful words like sonrisa, lächeln and sourire, the Spanish, German and French words for “smile.”
But then again, smiling itself doesn’t need a translation—it’s common to every culture on earth. It’s one of our best assets for interacting with people, both at home and abroad. So, make sure your smile is the best it can be by taking care of the “stars of the show”: your teeth and gums.
Here are a few tips for keeping your teeth and gums healthy and your “international” smile attractive.
Brush and floss daily. It takes just 5 minutes a day to perform one of the most important things you can do for your long-term oral health. Brushing and flossing clean away dental plaque, a sticky bacterial film that causes tooth decay and gum disease. A daily oral hygiene practice helps keep your teeth shiny and clean and your gums a healthy shade of pink.
Get regular dental cleanings. Even the most diligent hygiene habit may not clear away all plaque deposits, which can then harden into a calcified form called calculus. Also known as tartar, calculus is an ideal haven for disease-causing bacteria—and it can’t be removed by brushing and flossing alone. Dental cleanings at least twice a year remove stubborn plaque and calculus, further reducing your disease risk.
Don’t ignore dental problems. While your dentist will check your mouth for disease during your regular cleanings, you should also be on the lookout for signs of problems between visits. Watch for odd spots on the teeth and swollen, reddened or bleeding gums. If you see any abnormalities like these, don’t ignore it; make an exam appointment as soon as possible. The sooner we identify and begin treating a potential dental issue, the less your oral health—and your smile—will suffer.
Consider cosmetic improvements. Keeping teeth clean and healthy is one thing, but what can you do about existing dental blemishes that detract from your smile? Fortunately, there are numerous ways to cosmetically enhance teeth and gums, and many are quite affordable. Teeth whitening can brighten up yellow, dingy teeth; bonding can repair minor chips and other tooth defects; and veneers and other restorations can mask tooth chips, stains or misalignments.
Like the ability to speak another language, a confident, joyful smile can open doors to new cultures, places and friends. Let us partner with you to make your smile as attractive as possible.
If you would like more information about improving and maintaining your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “10 Tips for Daily Oral Care at Home.”
As with most Western countries, we in the U.S. love our carbs. While fats and proteins make an appearance in our diets, many of us go full-tilt on sugars, starches and fibers.
Regardless of what some diet gurus say, we do need these organic compounds to generate energy for our cells. But carbs can also fuel inflammation: This is a mechanism in the body that isolates and protects healthy tissues from damaged tissues or toxins. Chronic inflammation, though, contributes to systemic conditions like diabetes, heart disease and, yes, gum disease.
And it's not just a matter of too many carbs in your diet. Not all carbs are equal: Some can actually stimulate inflammation, making conditions like gum disease worse. Others, though, might actually help decrease inflammation.
So, in terms of your gum health in particular, how do you know which carbs are better for you and which are worse?
It depends on their ranking on the glycemic index, a measure of how fast the body digests a particular carbohydrate to form glucose, the blood sugar that fuels our cells. The faster the digestion (higher on the glycemic index), the more likely they'll overload the bloodstream with glucose, requiring the release of the hormone insulin to bring the levels back to normal. Continuous insulin increases ultimately lead to higher inflammation.
High glycemic foods include those with added sugar, bakery items made with white flour, white rice or mashed potatoes. But there are also carb foods low on the glycemic scale—most vegetables, greens, beans, nuts and whole grains—whose slower digestive rates avoid the big blood sugar spikes and excessive insulin—and actually hinder inflammation.
So, if you want to control inflammation, reduce your consumption of high glycemic foods like chips, French fries, cookies and similar items. Instead, eat low glycemic foods like apples, bulgur wheat products, oatmeal, and other fruits, vegetables, legumes and nuts.
In short: steer clear of processed foods with added sugar, and indulge yourself in fresh “real” food. These also have the added bonuses of minerals, vitamins and antioxidants that keep your body functioning normally. And that can also make a big difference toward keeping your gums healthy and disease-free.
If you would like more information on diet and dental health, 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 “Carbohydrates Linked to Gum Disease.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.