Your oral health is not limited to your teeth. Sores or irritations can develop in and around the mouth. Fortunately, they usually heal on their own within a week or two. Anything that does not heal or go away in 2 weeks should be checked by us. Textbooks are written on the subject of oral lesions. Only a few more common ones are listed here. Do not be hesitant to ask us about anything unusual.
- Burning Mouth Syndrome (BMS)
- Canker Sores
- Cold Sores
- Dry Mouth (Xerostomia)
- Erosive Licken Planus (ELP)
- Sensitive Teeth
- Smoking Stomatitis/Snuff Pockets
- Thrush or Monillosis
Burning Mouth Syndrome (BMS)
BMS can be classified as primary with no clinical or laboratory findings to account for the problem to secondary BMS which is a result of clinical abnormalities such as oral lesions, systemic disease, psychological conditions and the effects of certain medications. Differentiating the two can be very difficult and time consuming but is required for the correct treatment. We will be happy to help you with this perplexing problem. Please call.
Canker sores develop inside the mouth as small white or gray sores that have a red border. They are not contagious. They may occur as one sore or several. In some cases, the cause is unknown, but trauma to oral soft tissues is a common cause of canker sores. Canker sores usually heal on their own after one or two weeks. They are painful; over-the-counter topical anesthetics and antimicrobial mouth rinses may provide temporary relief. Spicy, salty or acidic foods, such as citrus fruits or juices, can irritate the sore.
Cold sores (also called “fever blisters”) appear as clusters of red, raised blisters outside the mouth, typically around the lips, although they can develop under the nose or around the chin. The blisters are filled with fluid and can break open, allowing the fluid to lead out. They then can scab over until they heal. Cold sores are caused by the herpes simplex virus and are highly contagious. The initial infection with the herpes virus can be accompanied by cold or flu-like symptoms and can cause painful oral lesions. There is no cure for the herpes virus; once you are infected, the virus stays in the body and causes occasional flare-ups associated with the cold sores. Cold sore blisters usually heal by themselves in about one week. Over-the-counter topical anesthetics can provide some pain relief. Zovirex is a compound we dispense to reduce the healing time for these sores.
Diabetes affects your gum tissues and your gums affect your diabetes. We now know that gum disease makes sugar control more difficult and the lack of sugar control makes gum disease worse and more difficult to treat. Diabetics need to practice excellent oral hygiene and never miss your regular cleaning appointments which may need to be increased to every three or four months depending on your control. We will work with your physicians to help you control this insidious disease.
Dry Mouth (Xerostomia)
With so many people taking so many medications, dry mouth is becoming a larger problem. The lack of saliva causes a significant increase in tooth decay and, therefore, needs attention. Commercial saliva substitutes help and so does drinking lots of water. We also increase daily use of fluoride in custom trays and the use of Prevident toothpaste which is five times stronger than regular toothpaste. We also encourage the use of Xylitol chewing gum which stimulates saliva and kills the cavity forming bacterial. Regular check-ups and excellent oral hygiene are very important for people with this problem.
Erosive Licken Planus (ELP)
ELP is a disease that affects the skin, tongue and mucous membranes of the mouth with pustules and uncomfortable rashes. The cause is unknown. Treatment consists of steroid mouth washes and a number of additional drugs are tried to attenuate but not cure this disease. This is not a quick fix and may last for years. We have had experience with this disease and would be happy to share our knowledge.
Leukoplakia is an overgrowth of cells that results in a rough patch of whitish tissue. It can develop anywhere in your mouth. These patches typically are not painful and are not contagious. They can result from irritations such as ill-fitting dentures or the habit of chewing on the inside of the cheek. Leukoplakia also occurs among tobacco users. Treatment begins with the identifying the source of the irritation. Once the irritant is removed—which may mean giving up tobacco—the patches should disappear. Sometimes, leukoplakia is associated with oral cancer, so it’s important to maintain regular check-ups if you notice any of these patches developing. We may recommend a biopsy if the patch appears suspicious.
Congratulations on this exciting and busy time of your life! You have so much to think about during pregnancy but don’t forget about your teeth and gums. It may be easy to overlook your mouth, but all the changing hormone levels that occur with pregnancy can actually make some dental problems worse. Brushing and flossing contributes to your overall health, too, and if your mouth is healthy, it’s more likely that your baby’s mouth will be healthy. If you have morning sickness and vomit, rinse your mouth with water ASAP. Also rinse with a fluoride mouthwash and place a dab of toothpaste on your finger and coat your teeth with it. Do not brush for at least an hour. Furthermore, Xylitol chewing gum can reduce your child’s cavities by 70%. Ask us how. We’re here to help you and your baby have great dental health. Look for more information under Children’s Dentistry and Prevention. So keep your dental check-ups! It’s important to continue to see Dr. Regan and our hygienist during pregnancy for oral examinations and professional teeth cleanings. Make sure to tell us that you are pregnant and about any changes you have noticed in your oral health. Good daily care is vital. That means always brushing your teeth four times a day with fluoride toothpaste, cleaning between your teeth once a day with floss, eating a balanced diet and limiting between meal snacks.
We see patients daily complaining about sensitive teeth caused by a wide range of problems. Aside from actual toothaches, one of the most frequent causes is clenching and grinding. Cracks in teeth can also create this problem and can be very perplexing to diagnose. There are little “tunnels”—actually tubules—running from the inside of the tooth nerve in the pulp chamber to the outside of the tooth root. The top of the tooth is covered with enamel to cover these “tunnels” carrying nerves but they are exposed on the root of the tooth. We know that potassium nitrate, fluoride and calcium carbonate will block these tunnels. Potassium nitrate is the ingredient in Sensodyne toothpaste and that’s why it works to reduce sensitivity in the root. Sometimes we apply special bonding agents to the root also to cover these “tunnels.”
Orthotics or specially designed mouth guards are made for clenching and grinding. Cracks in teeth can sometimes be resolved by onlays or crowns or even root canal treatment. In any case, we need to see the problem to determine the cause. Call today to get rid of sensitive teeth.
Smoking Stomatitis/Snuff Pockets
Smoking is a terrible health hazard even in the mouth. Besides causing oral cancer, it is very difficult for a smoker to control gum disease. Smoker’s stomatitis is a chronic irritation of the soft tissues and especially of the palate and especially of upper denture wearers. Brushing this area does help somewhat.
Snuff creates a special set of problems. First, the tissues where the snuff is held—the snuff pocket—are usually leukoplakic-a precancerous condition-and highly distorted. The gum tissue around the area can show advanced recession stripping the bone from the teeth. Snuff usually contains sugar and pumice. The sugar causes cavities and the pumice wears away the teeth like rubbing them with sandpaper.
It’s easy to say stop using these products but most of the time we find patients so “hooked” on their habit that more help is needed. A stop smoking program is most effective but substituting another substance such as Xylitol gum has been effective for some. Tell us you want to change and we can offer additional help.
Thrush or Monillosis
Thrush is caused by a fungus, Candida Albicans, characterized by soft, white elevated patches on the cheeks, tongue, palate and gums which can be stripped off leaving a bleeding surface. The fungus appears with the use of antibiotics or debilitated persons. Because it is common among denture wearers, a thorough daily cleaning of one’s denture is important. Removing the dentures at night also allows the tissue to regenerate.