You've been treating a persistent rash around your mouth with medicated ointments, but it's not going away. The problem may be the ointment — it could actually be sustaining the particular rash you have.
Peri-oral dermatitis is a scaly rash with small bumps (some filled with pus) around the mouth, eyes or nose. It's especially common among women ages 20-45, possibly due to hormonal factors or cosmetic use. Other than its unattractiveness you might not otherwise notice it, although it can cause stinging, itching or burning. There are ways to treat it effectively, though not necessarily the way you might think.
Many skin conditions respond well to topical steroids, like ointments or lotions containing hydrocortisone. But prolonged use of a steroid for skin irritations might actually increase risks for peri-oral dermatitis. Applying it to an existing rash may also deceive you — the steroid constricts some of the skin's tinier blood vessels, which will make the rash appear as if it's fading. The effect, though, usually doesn't last more than an hour. If you continue to use the steroid, the rash won't get better.
The key to alleviating peri-oral dermatitis requires treatment from a physician, dermatologist or dentist, who will also be able to accurately diagnose the specific skin condition you have. If it is peri-oral dermatitis, the first step is to stop using any topical steroids and only wash with mild soap or similar substitute. You'll have to be patient because the rash may at first appear to flare up and worsen before getting better.
Instead of steroids, we may prescribe antibiotics to help clear the rash, typically tetracycline. It may take several weeks of use before the rash begins to clear; as it does clear, you would either stop the antibiotic treatment or taper off over a four-to-five week period.
While some cases of peri-oral dermatitis will clear up and remain that way, some people may experience chronic reoccurrences. Even so, by using the same treatment approach we can still effectively manage the condition for the long-term.
Dental implants are widely considered the most durable tooth replacement option, thanks in part to how they attach to the jaw. But durable doesn't mean indestructible — you must take care of them.
Implants have a unique relationship to the jawbone compared to other restorations. We imbed a slender titanium post into the bone as a substitute for a natural tooth root. Because bone has a special affinity with the metal, it grows to and adheres to the implant to create a secure anchor. This unique attachment gives implants quite an advantage over other restorations.
It isn't superior, however, to the natural attachment of real teeth, especially in one respect: it can't match a natural attachment's infection-fighting ability. A connective tissue attachment made up of collagen fibers are attached to the tooth root protecting the underlying bone. An elastic gum tissue called the periodontal ligament lies between the tooth root and the bone and attaches to both with tiny collagen fibers. These attachments create a network of blood vessels that supply nutrients and infection-fighting agents to the bone and surrounding gum tissue.
Implants don't have this connective tissue or ligament attachment or its benefits. Of course, the implants are made of inorganic material that can't be damaged by bacterial infection. However, the gums and bone that surround them are: and because these natural tissues don't have these same biologic barriers to infection and perhaps access to the same degree of antibodies as those around natural teeth, an infection known as peri-implantitis specific to implants can develop and progress.
It's therefore just as important for you to continue brushing and flossing to remove bacterial plaque that causes infection to protect the gums and bone around your implants. You should also keep up regular office cleanings and checkups. In fact, we take special care with implants when cleaning them by using instruments that won't scratch their highly polished surfaces. Such a scratch, even a microscopic one, could attract and harbor bacteria.
There's no doubt dental implants are an excellent long-term solution for restoring your smile and mouth function. You can help extend that longevity by caring for them just as if they're your natural teeth.
If you would like more information on caring for dental implants, 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 “Dental Implant Maintenance.”
If you’re the kind of person who can’t do without a smart phone, you’ve probably heard the expression “There’s an app for that!” These nifty little programs let you get directions, check the weather, watch stock prices… even optimize your sleep patterns and make high-pitched dog whistles. And shortly, you’ll be able to check how well you’ve been brushing your teeth.
News reports have mentioned a soon-to-be-available toothbrush that will interface with an app on your smart phone. The brush has sensors that record how much time you spend brushing, whether you reach all parts of your mouth, and whether you brush correctly (with up and down motions, not just side to side). It charts your oral hygiene habits, scores your brushing technique — and, if you allow it, shares information about how well (or poorly) you’re doing with your family, friends… even your dentist.
So do you need to run out and buy one of these gizmos as soon as they’re available? Of course not! However, anything that encourages you to take better care of your oral hygiene can’t hurt. A wise dentist once said: The important thing is not the brush, but the hand that holds it.
If you’re a “gadget person,” you may be intrigued by the device’s high-tech design, and the fact that it interfaces with your phone. Plus, maybe the idea of compiling (and sharing) your brushing record has a certain appeal. On the other hand, you might prefer a sleek, light electric brush that doesn’t keep track of your movements. Or maybe the simplest brush of all — a manual one, with soft bristles and a comfortable handle — works best for you.
The most important thing is that you regularly practice good oral hygiene: Brush twice a day, for two minutes each time, and floss once a day. Use whichever brush is best for you, and be sure to change it every three months, or when the bristles get stiff. Stay away from sugary snacks between meals (they contribute to decay by keeping your teeth bathed in acidic byproducts). Don’t use tobacco in any form, or chew on things that don’t belong in your mouth. And remember to come in for regular exams and professional cleanings. If an app helps you do these things — we're all for it.
If you would like to learn more about maintaining good oral hygiene, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine article “Top 10 Oral Health Tips For Children.”
Digital computer technology has made a big impact on cosmetic dentistry. We can now simulate on a monitor display of your face how your new smile will appear after dental work, thanks to a graphics program specifically designed for cosmetic dentistry.
While that's an amazing development, we can also take it a step further by creating the look of a new smile on your actual teeth during an office visit. We call it a “trial smile.”
To create a trial smile, we begin with composite resin, a tooth-colored bonding material, and fashion it into temporary veneers or crowns that we then temporarily place over your teeth. This gives us the chance to see what your new smile will look like in all three spatial dimensions (rather than the two-dimensional view on a computer monitor) and while your face is in motion as you talk and smile. This can give us a great deal more detail to help better evaluate your proposed look.
A trial smile also helps us in planning your new look. Like you, we want the best result possible: a trial smile allows us to see how your jaw movement interacts with your updated look and if everything works together as it should. It will also give us a better idea how much tooth structure we'll need to remove to accommodate your permanent veneers or crowns — the less, of course, the better.
Although you won't be able to take your trial smile with you when you leave, we can take a photograph you can review later, as well as show friends and family for their opinion. Trial smiles do add some cost to treatment, but the proportion of expense to the benefit of actually viewing your smile in this fashion is well worth it. It's one more way we can ensure your final new smile meets your expectations.
If you would like more information on “trial smiles,” 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 “Testing Your Smile Makeover.”
You may be familiar with a dental implant used to replace a single tooth — but implant technology can do much more. Implants can also support other restorations including total teeth replacement on a jaw.
The reason they're so versatile is because implants replace the tooth root as well as the visible crown. We use a metal post, usually made of titanium, which we surgically implant in the jawbone as a root substitute. Because of a special affinity with titanium, bone around the implant grows and adheres to it and creates a durable bond.
With a single tooth replacement (the implant's original purpose when they were introduced in the 1980s) we attach a life-like porcelain crown to the individual titanium post. But with their continuing development we've adapted implants for other applications, like using a few strategically-placed implants as a stable platform for removable dentures or fixed bridges.
We're now able to use implants to support a full prosthetic (false) dental arch. Though similar in appearance to a removable denture, this particular prosthesis is permanently joined to the supporting implants with retaining screws.
Of course, the application requires careful pre-planning, which includes making sure you have enough healthy bone to support the implants. We'll also need to determine how many implants you'll need (usually four to six for this application) and create a surgical guide to place them in the best location for supporting the prosthesis. A dental technician will then create the prosthesis to match your jaw ridge contours and facial structure.
Using implants this way has a benefit other types of restorations can't provide: they may help stop future bone loss. The jawbone life cycle depends on stimulation from the attached tooth as you bite and chew — stimulation that ends when you lose the tooth. Traditional dentures and other restorations can't replicate that stimulation. Implants, on the other hand, directly encourage bone growth and can stop gradual bone loss.
If you need some form of total teeth replacement, consider one supported by implants. You may find they'll provide an excellent long-term solution to both function and appearance.
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