My Blog

By Kyle Bouhana, D.D.S.
September 20, 2020
Category: Oral Health
Tags: oral health  
UnpleasantCrackedMouthCornersCanBeTreatedandPrevented

Ever have a paper cut or an irritated hangnail? They're not considered major health problems, but, boy, can they sting!

Something similar can occur in the corners of your mouth called angular cheilitis. It's also known as perleche, from the French word “to lick” (a common habit with this type of sore). It can occur at any age, with children or young adults developing it from drooling during sleep or orthodontic treatment.

Older adults, though, are more prone than younger people for a variety of reasons. Age-related wrinkling is a major factor, especially “marionette lines” that run from the mouth to the chin. Dried or thinned out skin due to exposure from cold, windy weather may also contribute to perleche.

Perleche can also develop from within the mouth, particularly if a person is experiencing restricted salivary flow leading to reduced lubrication around the lips. Poorly cleaned dentures, weakened facial supporting structure due to missing teeth, vitamin deficiencies and some systemic diseases can all lead to perleche. And if an oral yeast infection occurs around the cracked mouth corners, the irritation can worsen and prolong the healing process.

To clear up a case of cracked mouth corners, you should promptly see your dentist for treatment. Treatment will typically include some form of antifungal ointment or lozenge applied over a few days to clear up the sores and prevent or stop any infection. You might also need to apply a steroid ointment for inflammation and other ointments to facilitate healing.

To prevent future episodes, your dentist may ask you to use a chlorhexidine mouthrinse to curb yeast growth. If you wear dentures, you'll need to adopt a regular cleaning routine (as well as leaving them out at night). You might also wish to consider updated dental restorations or orthodontics to improve dental support, and help from a dermatologist if wrinkling might be a potential cause.

Cracked mouth corners won't harm you, but they can make for a miserable experience. Take steps to relieve the irritation and any future occurrence.

If you would like more information on angular cheilitis or similar oral conditions, 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 Kyle Bouhana, D.D.S.
September 10, 2020
Category: Oral Health
Tags: dry socket  
HowtoAvoidThisPainfulConditionAfterToothExtraction

Dentists and oral surgeons remove millions of teeth every year, most without any adverse aftereffects. But about 2% of patients experience a dry socket, a condition that, although not dangerous to health, can be quite painful.

Also known as alveolar osteitis, a dry socket occurs when the blood clot that normally forms right after extraction doesn't form or becomes lost later. The clot serves as a barrier for the underlying bone and nerves during the healing process; without it these tissues can become irritated from contact with air, food or fluids.

Dry sockets (which usually occur in the back, lower molars) are fortunately rare, mainly in patients over 25, smokers or women using oral contraceptives. Patients also have a higher risk of developing a dry socket if they attempt certain activities too soon after tooth extraction like vigorous chewing or brushing that may dislodge the protective clot.

You can reduce your chances of a dry socket after a tooth extraction with a few simple guidelines. Unless advised otherwise by your dentist, avoid brushing the day after extraction and gently rinse the mouth instead. It also helps to avoid hot liquids and eat softer foods for a few days. If you smoke, you should avoid smoking during this time and use a nicotine patch if necessary.

Over the next few days, you should remain alert for any signs of a dry socket, often a dull, throbbing pain that radiates outward toward the ears, and a bad taste or mouth odor. A prompt visit to the dentist will help alleviate these symptoms, often in just a few minutes.

To treat it, a dentist will typically irrigate the socket and apply a medicated dressing, which you would need to change every other day for up to a week. After that, you'll leave the dressing in place for a while as you heal.

A dry socket doesn't interfere with the healing process: Your extraction site will heal whether or not you have one. But prevention and treatment for a dry socket will help ensure your healing after an extracted tooth is much less uncomfortable.

If you would like more information on dry socket after tooth extraction, 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 Socket.”

By Kyle Bouhana, D.D.S.
August 31, 2020
Category: Dental Procedures
Tags: dental implant  
ReplaceYourTeethinStagesWiththeHelpofDentalImplants

Complete tooth loss is a common condition among older adults, gradually occurring one or two teeth at a time. There often comes a point of realization, though, that all the teeth will eventually be lost.

This can create a dilemma: Do you replace teeth as they're lost, or go ahead and have all of them removed at one time?

Up until recently, the latter choice seemed the most practical and affordable. But most dentists would agree that keeping natural teeth for as long as practical is better for a person's overall oral health and to slow any potential bone loss.

The emergence of dental implants has made this less of a dilemma: We can use this technology to more affordably replace teeth in stages rather than all at once. This is because an implant is technically a root replacement: a dentist inserts a titanium metal post into the jawbone. Because of an affinity with titanium, bone cells grow and adhere to the implant surface, which creates a stronger hold. It also impedes bone loss.

We can, of course, use implants as individual tooth replacements. But the expense of this approach with multiple teeth puts it well out of reach financially for many people. But implants can also be used as connective points between the patient's jaw and other kinds of dental restorations like bridges, partial dentures, and full removable or fixed dentures.

Using this approach, we can adopt a strategy of allowing healthier teeth to remain until it's necessary to remove them. We initially place implants to support a bridge, for example; later we can use the same implants along with additional ones to support a larger restoration, even a fixed full denture.

An implant-supported restoration is typically more expensive than traditional bridges or dentures, but far less than replacing teeth with individual implants. And because the stages of restorations may occur over a long period of time, the cost can be spread out to make it more manageable.

If you're facing a future where it's likely you'll lose all your teeth, you don't have to lose them all at once. Staged restorations with implants could help you hold on to your natural teeth for as long as possible, slow bone loss and make for a healthier mouth.

If you would like more information on the wide array of dental restoration options, 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 “Replacing All Teeth But Not All at Once.”

WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

By Kyle Bouhana, D.D.S.
August 11, 2020
Category: Oral Health
Tags: oral hygiene  
AWordtoYoungAdultsBrushingandFlossingareKeytoaHealthyMouth

Keeping your teeth and gums healthy doesn't require an elaborate plan. It's simple: Besides twice-a-year dental visits, the most important thing you can do is brush and floss every day to remove accumulated dental plaque.

The bacteria that live and breed in this thin biofilm is the main catalyst for both tooth decay and gum disease, the top two diseases that endanger teeth. Brushing and flossing removes this buildup and thus reduces the long-term risk for either disease.

Unfortunately, the message on these important hygiene tasks hasn't resonated with “Millennials,” the first generation to reach adulthood in the 21st Century and new millennium. One recent survey of 2,000 members of this age group found only about 30% brushed their teeth at least once a day, with many skipping the task for two days at a time.

If brushing has taken a beating among millennials, you can well imagine the state of flossing. Unfortunately, the news media has helped this along: Just a few years ago, the Associated Press reported a study that concluded flossing's role as a dental disease deterrent hadn't been proven. A follow-up study a year or two later by the University of North Carolina pushed back on the original AP story with findings of lower risk of tooth loss among flossers than non-flossers.

This decline in oral hygiene practices among millennials has had an unsurprisingly negative effect. Recent statistics indicate that one in three people between the ages of 18 and 34 have some form of untreated tooth decay. As this generation ages this may inevitably result in more extensive dental treatment and higher rates of tooth loss unless the trend toward hit and miss dental care makes a complete U-turn.

The good news is that it may not be too late for many of those slacking on daily care. All that's needed is to heed the same dental advice their grandparents and parents were given: Brush twice and floss once every day.

No matter what your age, consistent daily brushing and flossing still remains essential to keeping potential dental disease at bay. These twin hygiene tasks remain the solution to good dental health throughout your life.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation.





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