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.
Henry Ford famously said a customer could have any color they wanted on their Model T “as long as it was black.” Those days are over—today’s cars and trucks come with a slew of options, and not just their paint color.
There’s something else with a wide array of possible options: your choice of toothbrush. Your local store’s dental care aisle has dozens of toothbrushes in a myriad of sizes, shapes and features. And many promise better hygiene outcomes because of their unique design.
It’s enough to make your head spin. But you can narrow your search for the right toothbrush— just look for these basic qualities.
Bristle texture. At this all-important juncture between brush and teeth, softer-textured bristles are better. That might sound counter-intuitive, but soft bristles are just as capable at removing bacterial plaque, that sticky tooth film most responsible for dental disease, as stiffer bristles. Stiffer bristles, on the other hand, can damage gums and cause recession. Also, look too for rounded bristles (gentler on the gums), and multi-leveled or angled ones for better access around teeth.
Size and shape. Toothbrushes come in different sizes because, well, so do mouths. Look, then, for a brush and bristle head that can comfortably reach all the teeth in your mouth. If you have problems with manual dexterity, choose a brush with larger grip handles. A brush that’s comfortable to use and easy to handle can make your brushing more effective.
ADA Seal of Acceptance. The American Dental Association tests hygiene products like toothbrushes. If they pass the association’s standards, the manufacturer includes the ADA Seal of Approval on their packaging. Not all submit their brushes for this evaluation, so the seal’s absence doesn’t necessarily mean a brush is of low quality. The seal, though, does tell you the product passes muster with dental professionals.
It often takes a little trial and error to find the right brush, but since you should change yours out every six months, it’s a small price to experiment. And, no matter how great the brush, it’s only as good at removing plaque as the hand that holds it. So, be sure you learn proper brushing techniques—that and the right brush will keep your teeth and gums healthy.
If you would like more information on choosing the right toothbrush, 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 “Sizing Up Toothbrushes.”
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.”
Your sweet, good-natured baby has seemingly gone from zero to grumpy overnight. The reason is simple: They’re teething.
Teething is a natural process in which a baby’s first teeth (primary teeth) begin to break through the gums, usually between six and nine months of age. This process continues intermittently until all twenty of the primary teeth erupt, sometime around age 3.
This uncomfortable and sometimes painful experience can cause gum swelling, biting and gnawing, chin rash and drooling. Your child may become irritable not only from this physical discomfort but also from disrupted sleep patterns and decreased appetite that often accompanies teething.
While you may have an unhappy baby while they’re teething, there’s usually no cause for concern. This is a natural process all children encounter, and the best thing you can do is make them as comfortable as possible. An exception would be accompanying diarrhea, fever or lingering crankiness—these could be symptoms of a more serious condition. If you begin to notice these, consult your doctor as soon as possible.
During teething there are a number of things you can do to reduce irritation. For one, allow your child to chew on clean, chilled (not frozen) teething rings, or a cold wet washcloth. The cold will help numb their irritated gum tissues. Massaging their gums with a clean finger can also help counteract the pressure caused by the incoming tooth.
If your doctor advises, you can also give your child over-the-counter pain relievers like acetaminophen or ibuprofen in an age-appropriate dosage. But be sure you give these medications orally and not rub them on the gums—some ingredients in them could burn the tissues. You should also not apply rubbing alcohol to the gums for the same reason. And avoid products with the numbing agent Benzocaine® in children less than two years of age unless your doctor advises otherwise.
Teething isn’t always a pleasant time for your baby or you, but it’s necessary—and temporary. In no time at all this discomfort will pass, and in its place will be their first set of teeth.
If you would like more information on teething, 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 “Teething Troubles: How to Help Keep Your Baby Comfortable.”
Osteoporosis is a major health condition affecting millions of people, mostly women over 50. The disease weakens bone strength to the point that a minor fall or even coughing can result in broken bones. And, in an effort to treat it, some patients might find themselves at higher risk of complications during invasive dental procedures.
Over the years a number of drugs have been used to slow the disease’s progression and help the bone resist fracturing. Two of the most common kinds are bisphosphonates (Fosamax) and RANKL inhibitors (Prolia). They work by eliminating certain bone cells called osteoclasts, which normally break down and eliminate older bone cells to make way for newer cells created by osteoblasts.
By reducing the osteoclast cells, older bone cells live longer, which can reduce the weakening of the bone short-term. But these older cells, which normally wouldn’t survive as long, tend to become brittle and fragile after a few years of taking these drugs.
This may even cause the bone itself to begin dying, a relatively rare condition called osteonecrosis. Besides the femur in the leg, the bone most susceptible to osteonecrosis is the jawbone. This could create complications during oral procedures like jaw surgery or tooth extractions.
For this reason, doctors recommend reevaluating the need for these types of medications after 3-5 years. Dentists further recommend, in conjunction with the physician treating osteoporosis, that a patient take a “drug holiday” from either of these two medications for several months before and after any planned oral surgery or invasive dental procedure.
If you have osteoporosis, you may also want to consider alternatives to bisphosphonates and RANKL inhibitors. New drugs like raloxifene (which may also decrease the risk of breast cancer) and teriparatide work differently than the two more common drugs and may avoid their side effects. Taking supplements of Vitamin D and calcium may also improve bone health. If your physician still recommends bisphosphonates, you might discuss newer versions of the drugs that pose less risk of osteonecrosis.
Managing osteoporosis is often a balancing act between alleviating symptoms of the disease and protecting other aspects of your health. Finding that balance may help you avoid future problems, especially to your dental health.
If you would like more information on osteoporosis and dental care, 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 “Osteoporosis Drugs & Dental Treatment.”
Because it requires jaw movement, eating can be difficult and painful if you have a temporomandibular joint disorder (TMD). During flareups you may switch to foods that are easier to eat but may be less nutritious than those you're giving up.
But there are ways to keep healthier foods in your diet while minimizing TMD discomfort. In many cases, it's a matter of preparing your food differently. Here are a variety of food groups known for their nutritional value and what you can do to prepare them for easier eating with TMD.
Fruits and Vegetables. You should peel any fruits or vegetables with hard or chewy skin like apples, peaches or cucumbers. Try chopping or pureeing fruits and vegetables you can eat raw to reduce their size and make them easier to chew. Vegetables like carrots, potatoes, broccoli or cauliflower can be cooked, then chopped or mashed.
Legumes and nuts. Pod-based vegetables like beans or peas provide a number of nutritional elements, as do nuts with their healthy fats. Your motto with these foods should be "Not too large and not too hard." Be sure then to cook, mash or puree legumes that are larger than a pea. With nuts, try nut butters for a softer serving than eating them out of the shell.
Protein and Dairy. Any meats like poultry or beef should be cut into bite-sized pieces; you can also moisten them with broths, gravies or sauces for easier chewing, or braise or stew them in liquid to tenderize them. You can also consume most milk, yogurt or cheese products you can tolerate. If you can't, try alternatives like meal replacement or whey protein beverages.
Grains. Prepare grains by cooking them until they're softened. Hot cereals like oatmeal offer a lot of nutrition and they're relatively easy to eat. Toast your bread and cut the slice into smaller pieces to minimize jaw movement.
One last tip: take your time while eating. A slower rate not only helps you enjoy your food more, it reduces the amount of work your jaws perform while eating. Less jaw work can help further ease the discomfort of TMD.
If you would like more information on how to relieve TMD pain and dysfunction, 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 “What to Eat When TMJ Pain Flares Up.”
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.