By Dr. T. Kirk Crane
December 31, 2018
Category: Oral Health
Tags: oral health  
GetRelieffromCrackedCornersoftheMouth

If you’ve noticed redness or small skin cracks at the corners of your mouth, you may have a common infection known as perleche or angular cheilitis. Depending on its cause, there are ways to treat the redness and skin cracking to lessen your discomfort.

The term perleche comes from the French word “lecher,” meaning to lick. This is derived from the tendency of perleche patients to constantly lick the area to ease irritation; unfortunately, this also helps perpetuate the inflammation. Once the skin is broken the area is commonly infected by yeast called candida albicans.

Initially, perleche may arise from a variety of sources, most of them locally from either inside or around the mouth, although it can be triggered by a general body infection or disease like diabetes or cancer, or vitamin or iron deficiencies. Inside the mouth reduced saliva flow, tissue inflammation under a rarely cleaned denture (denture stomatitis), pressure on the mouth corners caused by a collapsed bite due to missing teeth and similar conditions can elevate the risks for infection. Around the mouth wrinkling or “marionette lines,” deep lines that extend from the mouth to the chin due to aging or environmental exposure, can contribute to crack formation. Drooling during sleep or as a result of orthodontic treatment is also a contributing cause.

The main focus of treatment for perleche is to bring any infection under control. This can be accomplished with a course of oral or topical antifungal (yeast-attacking) medication. If the infection has spread into the mouth or throat we might then prescribe a troche, a small lozenge designed to dissolve, which you would rinse with and then swallow to affect other portions of the mouth. Steroid or zinc oxide ointments applied directly to the skin can control inflammation and serve as a barrier agent with antifungal properties to promote healing.

If the cause is more related to dental problems (ill-fitting dentures or missing teeth), then it’s important to have these addressed and treated. You may also consult a dermatologist for treatments to lessen wrinkling around the mouth that might also contribute to chronic cases of perleche.

If you would like more information on cracked mouth corners, 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 “Cracked Corners of the Mouth.”

By Dr. T. Kirk Crane
December 21, 2018
Category: Dental Procedures
CrazyLittleThingCalledHyperdontia

The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.

The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.

Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces).¬†Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.

Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.

After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.

Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.

If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”

PracticeDailyOralHygienetoPreventCalcifiedPlaqueFormation

If you’ve ever heard your dentist or hygienist talk about “calculus,” they’re not referring to a higher branch of mathematics. The calculus on your teeth is something altogether different.

Calculus, also called tartar, is dental plaque that’s become hardened or “calcified” on tooth surfaces. Plaque begins as soft food particles and bacteria that accumulate on the teeth, and more so if you don’t properly clean your teeth every day. This built-up plaque becomes both home and food source for bacteria that can cause tooth decay or periodontal (gum) disease.

Because of this direct link between plaque and/or calculus and dental disease, we encourage everyone to perform two important oral hygiene tasks every day. The first is to floss between your teeth to remove plaque as you are unable to effectively reach those areas with a toothbrush.  Once you loosen all the plaque, the other really important task is a thorough brushing of all of the tooth surfaces to remove any plaque that may have accumulated since the last brushing. Doing so every day will catch most of the softer plaque before it becomes calcified.

Once it forms, calculus is impossible to remove by brushing and flossing alone. That’s why you should have regular cleanings performed by a dental professional. Dentists and hygienists have special tools called scalers that allow them to manually remove plaque and calculus, as well as ultrasonic equipment that can vibrate it loose to be flushed away with water.

In fact, you should undergo dental cleanings at least twice a year (or as often as your dentist recommends) even if you religiously brush and floss daily. Calculus forms so easily that it’s nearly inevitable you’ll accumulate some even if you have an effective hygiene regimen. Your dental team can remove hardened deposits of calculus that may have gotten past your own hygiene efforts.

If you haven’t been consistently practicing this kind of daily hygiene, see your dentist to get a fresh start. Not only will they be able to check for any emerging problems, they can clean your teeth of any plaque and calculus buildup so that you’ll be able to start with a “clean” slate.

Calculus can be tenacious, but it not impossible to remove. Don’t let it set you up for an unhealthy experience with your teeth and gums.

If you would like more information on reducing plaque buildup, please contact us or schedule an appointment for a consultation.

HereisHowYoucanImproveYourWeddingDaySmile

Congratulations—you’re engaged! It’s a stupendous (and hectic) time in your life as you plan your upcoming wedding.

You want to look your best for the big day—which means you may be dieting, exercising or making changes to your hairstyle and makeup. Be sure, though, to consider another important part of your appearance—your teeth and gums. Here are a few options that could help your wedding day smile shine even more.

Cleanings and whitening. While dental cleanings are primarily about removing disease-causing plaque and tartar they can also give your teeth that clean and polished look. And if you want an extra boost in brightness, consider whitening—we may be able to lighten up your teeth’s stain-induced dullness.

Bonding. If your teeth have slight imperfections—chipping, slight gaps or staining that doesn’t respond well to whitening, consider bonding techniques to repair or cover these defects. Composite resin is a dental material that can be shaped and bonded to teeth to reform a deformed tooth—and with color matching as well. For more extensive defects you can cover the front of imperfect teeth with bonded porcelain veneers or completely cap a tooth with a custom crown.

Tooth restorations. If you have missing teeth marring your smile, you have several options. The top choice: dental implants, which replaces the root of the tooth and will be able to have a crown attached to it. An implant can thus restore both better function and appearance. For more affordable options, you can also turn to fixed bridges or removable dentures. The latter can be custom designed to replace all the teeth on a jaw arch or just a few in different locations.

Gum enhancements. Teeth aren’t the only part of your smile that might need a helpful touch—your gums’ appearance might also be a problem. There are cosmetic procedures including plastic surgery and tissue grafting that can help correct overly prominent “gummy” smiles or, at the other end of the spectrum, longer appearing teeth because of gum recession.

Orthodontics. If you have extended time before the wedding date, we may be able to correct crooked teeth or a poor bite (malocclusion) that’s adversely impacting your smile. In some cases, you may be able to choose clear aligners, removable plastic trays that are hardly noticeable to others, over more visible braces to correct your bite.

If you would like more information on cosmetic dentistry for lifetime events, please contact us or schedule an appointment for a consultation.

By Dr. T. Kirk Crane
November 21, 2018
Category: Oral Health
Tags: dry mouth  
GetControlofDryMouthtoProtectYourDentalHealth

As your mother used to say, “A moist mouth is a healthy mouth.” Well, maybe she didn't — but it's still true. Without the constant flow of saliva, your teeth and gums would be less healthy.

That's because among its many functions, saliva helps keep the mouth from becoming too acidic. Just after eating, your mouth's neutral pH level tips to the acidic side of the scale. Acid is enamel's number one enemy, and it takes little time for it to begin dissolving mineral content. But in thirty minutes to an hour, saliva neutralizes the acid; it also helps restore some of the enamel's minerals.

Without adequate saliva flow, acid quickly gets the upper hand. In time, this can greatly increase your risk for dental disease. And for many people, inadequate saliva — dry mouth — is a chronic problem.

There are a number of reasons why. Salivary glands may not produce as much in our later years. In addition, as we age, we may begin taking more medications, some of which can cause dry mouth. Treatments for certain kinds of systemic diseases, particularly cancer, can also inhibit saliva or even damage salivary glands.

If you feel your mouth is continuously dry, make an appointment to find out the cause, which will determine the best course of action to alleviate it. If it's related to your medication, we'll see if there's an alternative. If not, you may need to drink more water when you take your medication and more throughout the day.

There are other things you can do as well. Reduce your intake of acidic foods or caffeinated beverages. Run a cool-air humidifier at night to keep your mouth and nose membranes moist. And you can also try saliva stimulants available by prescription or even over the counter. Chewing gum with xylitol (an alcohol-based sugar) has also been shown to stimulate saliva flow.

Above all, be diligent about daily brushing and flossing and regular dental cleanings and checkups. Keeping a watchful eye will help ensure dental disease doesn't take advantage of your dry mouth.

If you would like more information on managing dry mouth, 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 “Dry Mouth.”





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