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.
Your teeth face a hostile environment populated by disease-causing bacteria. But your teeth also have some “armor” against these microscopic foes: enamel. This hard outer tooth layer forms a barrier between harmful bacteria and the tooth’s more vulnerable layers of dentin and the inner pulp.
But although it’s tough stuff, enamel can erode when it comes into contact with high concentrations of mouth acid. Losing substantial amounts of enamel could leave your teeth exposed to disease.
So, here are 3 things you can do to help protect your enamel so it can keep on protecting you.
Careful on the brushing. Brushing removes dental plaque, a thin bacterial film on teeth most responsible for dental disease. But be careful not to brush too often, too hard and too quickly after eating. Brushing more than twice a day can cause gum recession and enamel wear; likewise, brushing too aggressively. You should also wait at least 30 minutes after eating to brush to give your saliva sufficient time to neutralize any acid. You could lose tiny bits of softened enamel brushing too soon.
Cut back on acidic foods and beverages. Spicy foods, sodas and, yes, sports and energy drinks all contain high amounts of acid that can increase your mouth’s acidity. It’s a good idea, then, to reduce acidic foods and beverages in your diet. Instead, eat less spicy foods and drink primarily water or milk. Also, look for foods and beverages with calcium, which helps increase your enamel’s ability to remineralize after acid contact.
Don’t eat right before bedtime. There are a lot of reasons not to eat just before you hit the hay—and one of them is for protecting your tooth enamel. Saliva normally neutralizes acid within a half hour to an hour after eating. While you’re sleeping, though, saliva production decreases significantly. This in turn slows its neutralizing effect, giving acid more contact time with enamel. So, end your eating a few hours before you turn in to avoid too much acid remaining on your teeth.
While most tooth loss stems from dental disease or injury, another major cause is a condition known as cracked tooth syndrome. What begins as a microscopic crack in an individual tooth’s enamel could ultimately grow to a fracture that endangers its survival.
Most often related to age-related brittleness, expansion and contraction of the enamel surface because of hot foods followed by cold foods and beverages, or grinding habits, cracked tooth syndrome usually occurs in three phases. The first phase is the emergence of miniscule cracks in the outer enamel known as craze lines. These can be very difficult to detect even with x-rays, and usually calls for specialized detection methods such as probing with a sharp instrument (an explorer) or fiber-optic lighting with dye staining to highlight enamel abnormalities. If you have pain symptoms, we may ask you to bite down on a bite stick or rubber pad to locate the area by replicating the sensation.
In the next phase, the craze line grows into a crack that penetrates below the enamel into the tooth’s dentin. Pain becomes more prominent and the risk of infection increases. Left untreated, the crack may enter the third phase, a full break (fracture) occurring deep within the inner layers of the tooth. The deeper the fracture occurs, the more serious the danger to the tooth, especially if the pulp is exposed.
The best treatment approach is to attempt to detect and treat a crack as early as possible. Craze lines and moderate cracks can usually be repaired with restorative materials like composite resins. A deeper crack extending into the pulp may require a root canal treatment and the tooth covered with a permanent, protective crown.
If, however, the fracture is too deep, the tooth may be beyond repair and will need to be extracted and replaced with a dental implant or permanent bridge. In any event, the sooner a cracked tooth is discovered and treated, the greater your chance of avoiding pain, discomfort, and, ultimately, tooth loss.
If you would like more information on cracked tooth syndrome, 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 Tooth Syndrome.”
Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
Getting a new smile doesn’t have to be an elaborate affair. If your teeth have minor to moderate chips, stains or tooth gaps, dental veneers could be the answer. These thin wafers of dental porcelain mask tooth imperfections and completely change your smile’s dynamic—and without a huge impact to your wallet.
To achieve that effect, though, your personal set of veneers will require the expertise of both your dentist and a dental lab technician to design and create your veneers. And while there are numerous considerations in achieving a truly life-like appearance with veneers, one of the most important is their color.
We always associate the color white with teeth. And while it is the dominant hue, actual tooth color is more complex. An individual tooth is comprised of multiple shades and tints, that range in variation from its biting edge to the gums. Likewise, tooth color in general can differ from person to person.
Your dentist must take these individual color variations into account while designing your new veneers, especially if you’ll be getting them for some but not for all your teeth. In that case, it’s important for the veneer color to blend seamlessly with the color of your natural teeth without veneers.
Your new smile expectations and desires are also important and should be considered when designing veneer coloring. For instance, do you want a more natural look—or would you prefer a smile with more “dazzle”? This could have an impact on color.
Your dentist takes all of this information (including your input) and communicates it clearly to the dental lab technician creating the veneers. That process is a combination of both science and artistry, using a variety of techniques to achieve an accurate, life-like texture and color result. For example, a technician may paint the edges of the veneers with a ceramic paste that when cured produces a life-like translucency.
This meticulous attention to color detail is necessary to create beautiful veneers that look natural. If the color is right, you’re sure to enjoy the change your veneers bring to your smile for many years to come.
If you would like more information on transforming your smile with dental veneers, 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 “Porcelain Veneers: Your Smile—Better Than Ever.”
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