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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.

4WaystoEnjoyHolidaySnackingandStillKeepYourTeethHealthy

‘Tis the season to be merry—and with plenty of edible goodies! During the holidays, families fill their homes with all sorts of delectable treats for friends and loved ones. But there can be unintended consequences with all this joyous feasting, and not just added pounds come January: eating more sugar could increase your risk for dental disease.

We’re not here to throw a wet blanket on your holiday fun. Instead, we have 4 commonsense tips to help you keep your holiday snacking from ultimately causing tooth and gum woes.

Blend in healthier choices. The problem with sugar is that it’s a prime food source of disease-causing oral bacteria. The more sugar available in the mouth, the more these bacteria multiply and increase the disease threat to your teeth and gums. So, try reducing sugar by adding savory treats like nuts or flavored popcorn to your sweeter offerings. And don’t forget cheese and other dairy—eating dairy products along with sweets can help blunt some of sugar’s effect on bacteria.

Avoid “grazing.” While it’s tempting to do so during the holidays, continuous snacking increases the mouth’s acidity, which is like Superman’s kryptonite to your tooth enamel. The longer acid directly contacts your enamel, the more it can soften it and open the door to tooth decay. Saliva neutralizes after-meal acid; but if you’re constantly snacking, you could prevent saliva from completely buffering the acid present. So, limit your snacking time—or better yet, reserve your sweet treats for mealtime.

Don’t neglect your hygiene. The hectic pace of the holidays can interfere with people’s normal routines. Don’t let that happen to your daily practice of brushing and flossing. These essential hygiene tasks clean your teeth of a disease-causing biofilm called dental plaque. Miss a few days and the accumulated plaque could trigger an infection that could damage your gums and ultimately your teeth. You can help avoid this by brushing and flossing every day.

Don’t brush right after eating. The mouth’s acidity naturally increases during and just after eating. As we alluded to earlier, saliva’s on the job getting the mouth back to a more neutral state and reducing the effect of acid on enamel. That takes about an hour, though, and in the meantime your enamel may be in a slightly softened state. If you brush right after eating, you might inadvertently brush tiny bits of enamel. So, wait an hour or so after eating before you brush.

The holidays are all about enjoying friends and family and ringing in the new year. Follow these tips to ensure it’s a healthy and happy one for your teeth and gums.

If you would like more information about dental care during the holidays, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”

WhyAlfonsoRibeiroIsGratefulforRootCanalTreatment

As the host of America's Funniest Home Videos on ABC TV, Alfonso Ribeiro has witnessed plenty of unintentional physical comedy…or, as he puts it in an interview with Dear Doctor–Dentistry & Oral Health magazine, "When people do stuff and you're like, 'Dude, you just hurt yourself for no reason!'" So when he had his own dental dilemma, Alfonso was determined not to let it turn onto an "epic fail."

The television personality was in his thirties when a painful tooth infection flared up. Instead of ignoring the problem, he took care of it by visiting his dentist, who recommended a root canal procedure. "It's not like you wake up and go, 'Yay, I'm going to have my root canal today!'" he joked. "But once it's done, you couldn't be happier because the pain is gone and you're just smiling because you're no longer in pain!"

Alfonso's experience echoes that of many other people. The root canal procedure is designed to save an infected tooth that otherwise would probably be lost. The infection may start when harmful bacteria from the mouth create a small hole (called a cavity) in the tooth's surface. If left untreated, the decay bacteria continue to eat away at the tooth's structure. Eventually, they can reach the soft pulp tissue, which extends through branching spaces deep inside the tooth called root canals.

Once infection gets a foothold there, it's time for root canal treatment! In this procedure, the area is first numbed; next, a small hole is made in the tooth to give access to the pulp, which contains nerves and blood vessels. The diseased tissue is then carefully removed with tiny instruments, and the canals are disinfected to prevent bacteria from spreading. Finally, the tooth is sealed up to prevent re-infection. Following treatment, a crown (cap) is usually required to restore the tooth's full function and appearance.

Root canal treatment sometimes gets a bad rap from people who are unfamiliar with it, or have come across misinformation on the internet. The truth is, a root canal doesn't cause pain: It relieves pain! The alternatives—having the tooth pulled or leaving the infection untreated—are often much worse.

Having a tooth extracted and replaced can be costly and time consuming…yet a missing tooth that isn't replaced can cause problems for your oral health, nutrition and self-esteem. And an untreated infection doesn't just go away on its own—it continues to smolder in your body, potentially causing serious problems. So if you need a root canal, don't delay!

If you would like additional information on root canal treatment, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”

DontIgnoreToothPain-YouMayNeedaRootCanal

Tooth decay is one of the most common diseases in the world, nearly as prevalent as the common cold. It’s also one of the two major dental diseases—the other being periodontal (gum) disease—most responsible for tooth and bone loss.

Tooth decay begins with high levels of acid, the byproduct of oral bacteria feeding on food remnants like sugar. Acid can erode tooth enamel, leading to a cavity that will require removal of decayed material around it and then a filling.

Sometimes, though, decay can spread deeper into the tooth reaching all the way to its core: the pulp with its bundle of nerves and blood vessels. From there it can travel through the root canals to the bone. The continuing damage could eventually lead to the loss of the infected tooth.

If decay reaches the tooth interior, the best course of action is usually a root canal treatment. In this procedure we access the pulp through the crown, the visible part of the tooth, to remove all of the diseased and dead tissue in the pulp chamber.

We then reshape it and the root canals to receive a filling. The filling is normally a substance called gutta percha that’s easily manipulated to conform to the shape of the root canals and pulp chamber. After filling we seal the access hole and later cap the tooth with a crown to protect it from re-infection.

Root canal treatments have literally saved millions of teeth. Unfortunately, they’ve gained an undeserved reputation for pain. But root canals don’t cause pain—they relieve the pain caused by tooth decay. More importantly, your tooth can gain a new lease on life.

But we’ll need to act promptly. If you experience any kind of tooth pain (even if it goes away) you should see us as soon as possible for an examination. Depending on the level of decay and the type of tooth involved, we may be able to perform the procedure in our office. Some cases, though, may have complications that require the skills, procedures and equipment of an endodontist, a specialist in root canal treatment.

So, don’t delay and allow tooth decay to go too far. Your tooth’s survival could hang in the balance.

If you would like more information on tooth decay treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Root Canal Treatment: What You Need to Know.”

MoreThanIndigestionHowAcidRefluxCouldHarmYourTeeth

Your stomach is just one big processing plant: Incoming food is broken down into individual nutrients that are then absorbed into the body. The main food "de-constructor" for this process is stomach acid, a powerful fluid comparable in strength to battery acid. All's well as long as it remains in the stomach—but should it escape, it can wreak havoc on other parts of the body, including teeth.

That's the reality for 1 in 5 Americans with gastroesophageal reflux disease (GERD). Also known as acid reflux, GERD occurs when the ring of muscle at the base of the esophagus—which ordinarily keeps stomach acid contained—weakens to allow it into the esophagus. It can then irritate the esophageal lining, giving rise to the burning sensation of indigestion.

The scenario changes, however, if acid continues up into the mouth. This puts tooth enamel at risk for erosion. The resulting high acidity is enough to dissolve the mineral content of enamel, which could jeopardize the survival of affected teeth.

If you've been diagnosed with GERD, your teeth could be in harm's way. In recognition of GERD Awareness Week (November 17-23), here's what you can do to protect them from this potentially damaging disease.

Manage your GERD symptoms. There are effective ways to control GERD and reduce the likelihood of acid in the mouth with antacids or medication. You can also lessen reflux symptoms by quitting smoking and avoiding alcohol, caffeine or acidic foods and beverages. Finishing meals at least three hours before bed or avoiding lying down right after eating can also lessen reflux episodes.

Boost saliva to neutralize acid. Saliva neutralizes acid and helps restore minerals to enamel. You can boost its production by drinking more water, using a saliva-boosting product or chewing xylitol-sweetened gum. You can also decrease mouth acidity by chewing an antacid tablet or rinsing your mouth after eating or after a reflux episode with water mixed with a little baking soda.

Use fluoride oral hygiene products. You can further protect your teeth from acid by using oral hygiene products with fluoride, a chemical compound proven to strengthen enamel. If needed, we can also apply stronger fluoride solutions directly to the teeth or prescribe special mouthrinses with extra fluoride.

If you've been dealing with GERD symptoms, visit us for an exam to check for any adverse dental effects. The sooner we treat GERD-related enamel erosion, the better the outcome for your teeth.

If you would like more information on protecting your dental health from acid reflux, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “GERD and Oral Health.”





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