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YouMayNeedSomethingOtherThanOintmenttoClearupThisFacialRash

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.

If you would like more information on peri-oral dermatitis, please contact us or schedule an appointment for a consultation.

FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”

These4HabitsCouldHelpYouAvoidGumDisease

Here’s the bad news about periodontal (gum) disease: It’s a leading cause for tooth loss. Even worse: Half of adults over 30 will have some form of it during their lifetime.

But here’s the good news: If caught early, we can often treat and stop gum disease before it can do substantial harm to your mouth. And the best news of all—you may be able to avoid a gum infection altogether by adopting a few healthy habits.

Here are 4 habits you can practice to prevent a gum infection from happening.

Practice daily brushing and flossing. Gum disease is a bacterial infection most often arising from dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Removing plaque daily with brushing and flossing will reduce your chances of a gum infection. And be sure it’s daily—missing just a few days is enough for gum inflammation to get started.

Get regular dental cleanings and checkups. Even the most diligent personal hygiene can miss plaque, which may then harden into a calcified form impossible to remove with brushing and flossing called calculus (tartar). At least twice-a-year professional dental cleanings will clear away any remnant plaque and tartar, which can greatly reduce your risk for dental disease.

Make gum-friendly lifestyle changes. Smoking more than doubles your chances of gum disease. Likewise, a sugar-heavy diet, which feeds disease-causing bacteria, also makes you more susceptible to infection. Quitting smoking, cutting back on alcohol consumption and following a dental-friendly diet could boost your teeth and gum health and avoid infection.

Watch for signs of infection. Although you can greatly reduce your risk of gum disease, you can’t always bring that risk to zero. So, be aware of the signs of gum disease: sometimes painful, swollen, reddened or bleeding gums. If you notice any of these signs, make a dental appointment—the sooner you’re diagnosed and begin treatment, the less likely gum disease will ruin your dental health.

If you would like more information on preventing gum disease, please contact us or schedule an appointment for a consultation.

EatingtheRightCarbsHelpsKeepYourGumsHealthy

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.”

ALittleOrthodonticMagicCouldHelpanImpactedToothErupt

Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.

Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.

Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).

But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.

Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.

But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.

Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.

If you would like more information on treating complex bite problems, 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 “Exposing Impacted Canines.”





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