Most of what goes on inside our mouths—good or bad—is fairly predictable. But every now and then, people encounter something out of the ordinary. A good example is lichen planus.
Lichen planus are rare skin lesions that can occur on various parts of the skin, including inside the mouth. The name comes from their lacy appearance, which resembles a fungus that grows on rocks or trees called lichen.
Being similar in appearance, though, is all that lichen planus has in common with its fungal namesake. It's believed that the sores are caused by a reaction of the immune system mistaking some of the body's cells as foreign.
But don't let the exotic sounding name alarm you—true lichen planus is considered a benign mouth sore. You may not even realize you have it until your dentist notices and points it out. But the lesions can sometimes cause mild pain or burning, especially if they occur near the gums or if you indulge in spicy or acidic foods.
As we said, these lesions aren't considered dangerous. But in a small number of cases, oral cancer was found to develop later. It's unclear whether the lesions were related to the cancer, or if what were diagnosed as lichen planus lesions were actually pre-cancerous cells mimicking the appearance of the benign sore.
In any event, your dentist will probably continue to monitor the lesions and possibly conduct regular oral cancer screenings to be on the safe side. You may also want to stop using tobacco or alcohol products to further decrease your risk of oral cancer.
As to managing lichen planus, it starts with a daily habit of brushing and flossing. You'll also want to avoid spicy or acidic foods like citrus fruits, tomatoes, peppers or caffeinated drinks, especially during flareups. If the lesions are causing discomfort, your dentist may also prescribe a topical steroid to apply to them.
Since it's quite possible you won't know if you have lichen planus (as well as other types of mouth sores) unless your dentist observes them, you should keep up regular dental visits. Having your dentist check your entire mouth, not just your teeth and gums, will help both of you stay on top of your oral health.
If you would like more information on mouth sores, 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 “Lichen Planus.”
Your teeth can take decades of daily biting and chewing and not miss a beat. But they do have a nemesis, dental disease, which can easily get the upper hand. As a result, millions of people lose teeth each year to tooth decay and periodontal (gum) disease.
But while both the living tissue that makes up teeth and gums are susceptible to bacterial attack, the non-living materials in a life-like dental implant are impervious to disease. That being the case, you would think your implants wouldn't need as much hygiene as your other teeth.
But they still do. True, implants in themselves aren't affected by infection, but the bone and other tissues that support them can become diseased. This often happens with advanced cases of gum disease.
There is, in fact, a particular form of gum infection associated with implants called peri-implantitis ("peri"—around; "it is"—inflammation), which occurs in the gums around an implant. Once it starts, peri-implantitis can advance at a rapid pace.
This is because implants don't have the gum attachment of real teeth, which can fight and slow the advance of a gum infection. Because an implant doesn't have this attachment, any infection around it continues virtually unimpeded. If the bone supporting an implant becomes infected, it can weaken to the point that the implant fails.
But this dire scenario can be avoided with continuing hygiene and maintenance of the gum tissues surrounding the implant. You should brush and floss every day around implants to remove dental plaque, the bacterial film most responsible for dental disease, just as you do with natural teeth.
It's also important to keep up regular dental visits for cleanings to remove lingering plaque and tartar (hardened plaque). Your dentist may also notice and clean away any residual cement from the restoration, which can also cause gum inflammation.
And, you should promptly see your dentist if you notice any telltale signs of a gum infection, such as swelling, redness or bleeding, especially around implants. The quicker we diagnose and treat a case of gum disease, particularly peri-implantitis, the less likely it will endanger your implant.
If you like conundrums like "Which came first? The chicken or the egg?", then you may enjoy this one: "Which should you do first, brush or floss?"
Both of these oral hygiene tasks are equally important for removing dental plaque, a thin bacterial film that forms on teeth after eating. Removing plaque on a daily basis minimizes your risk for developing tooth decay or periodontal (gum) disease, the top causes for tooth loss. Brushing removes plaque from broad tooth surfaces, while flossing removes it from between teeth where brushing can't reach.
There is wide consensus that you need both brushing and flossing to thoroughly remove plaque. But there is a debate over which of these two tasks you should do first for the most effective outcome. Those debates are more or less good-natured, but there are proponents on both sides on which task should come first.
Those on the "Brush First" side say brushing initially gets the bulk of accumulated plaque out of the way. If you floss first, you may be plowing through a lot of soft plaque, which can quickly turn your floss into a gunky mess. More importantly, you may only be moving plaque around with the floss, not actually removing it. By brushing first, there's less plaque to deal with when flossing.
"Floss First" folks, though, say flossing before you brush loosens plaque stuck between teeth that can be more easily brushed away. But perhaps a more important reason is psychological: People don't really like flossing as much as brushing. Because of this, putting it off to the end may mean it doesn't happen; doing it first will help ensure it actually gets done.
In the end, though, the order you perform these tasks comes down to personal preference. You can try both ways to see which one suits you best. The important thing, however, is that you do both tasks—if you do, you can greatly lower your risk of dental disease that could rob you of your teeth.
If you would like more information on effective oral hygiene, 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 “Brushing and flossing: Which Should Be Done First?”
During the COVID-19 quarantines, stir-crazy celebrities have been creating some “unique” home videos—like Madonna singing about fried fish to the tune of “Vogue” in her bathroom or Cardi B busting through a human-sized Jenga tower. But an entertaining Instagram video from Kevin Bacon also came with a handy culinary tip: The just-awakened film and TV actor showed fans his morning technique for cutting a mango to avoid the stringy pulp that gets between your teeth. After cutting a mango in half, he scored it lengthwise and crosswise to create squares and then turned the mango inside out for easy eating.
With his mango-slicing video garnering over a quarter-million views, the City on a Hill star may have touched a nerve—the near universal annoyance we all have with food stuck between our teeth. Trapped food particles aren't only annoying, they can also contribute to a bacterial film called dental plaque that's the top cause for tooth decay and gum disease.
Unfortunately, it's nearly impossible to avoid stuck food if you love things like popcorn, poppy-seed muffins or barbecue ribs. It's helpful then to have a few go-to ways for removing food caught between teeth. First, though, let's talk about what NOT to use to loosen a piece of stuck food.
A recent survey of more than 1,000 adults found that when removing something caught between our teeth, we humans are a creative lot. The makeshift tools that survey respondents said they've used in a pinch included twigs, safety pins, screwdrivers and nails (both the hammer and finger/toe variety). Although clever, many such items are both unsanitary and harmful to your gums and tooth enamel, especially if they're metallic or abrasive.
If you want a safe way to remove unwanted food debris, try these methods instead:
Brush your teeth: The gentle abrasives in toothpaste plus the mechanical action of brushing can help dislodge trapped food.
Use dental floss: A little bit of dental floss usually does the trick to remove wedged-in food—and it's easy to carry a small floss container or a floss pick on you for emergencies.
Try a toothpick. A toothpick is also an appropriate food-removing tool, according the American Dental Association, as long as it is rounded and made of wood.
See your dentist. We have the tools to safely and effectively remove trapped food debris that you haven't been able to dislodge by other means—so before you get desperate, give us a call.
You can also minimize plaque buildup from food particles between teeth by both brushing and flossing every day. And for optimally clean teeth, be sure you have regular dental office cleanings at least twice a year.
Thanks to Kevin Bacon's little trick, you can have your “non-stringy” mango and eat it too. Still, you can't always avoid food getting wedged between your teeth, so be prepared.
Durable as well as life-like, dental implants are by far the preferred method for replacing missing teeth. But they can be costly and, although not as much, so can traditional bridgework. Is there an effective but more affordable means to replace a few missing teeth?
There is: a removable partial denture (RPD). In fact, RPDs have always been the less expensive alternative to bridgework and implants. Today's RPDs are usually made of vitallium, a strong but lightweight metal alloy. Because of the metal's characteristics, we can create an appliance that precisely matches the contours of your gums, is thin and hardly noticeable. We anchor prosthetic (false) teeth made of porcelain, resins or plastics in acrylic or nylon that resembles gum tissue.
The most important aspect of an RPD is to design it to produce the least amount of movement in your mouth as you eat or speak. A good design will minimize pressure on both the underlying bone (which can accelerate bone loss) and on the remaining teeth that support the RPD. Although a little more costly, it may be advantageous to use a dental implant to stabilize a lower partial denture when no end tooth is available for support.
To get the most out of your RPD — and to prevent dental disease — it's important for you to practice diligent daily hygiene. RPD attachments can make remaining teeth more susceptible to plaque accumulation, a thin film of bacteria and food particles that can cause tooth decay and periodontal (gum) disease. To avoid this you should remove the RPD and thoroughly brush and floss your remaining teeth. You should clean the RPD every day with recommended cleansers. You should also take it out at night while you sleep to discourage further bacterial or fungal growth.
Besides daily care for your RPD and natural teeth, be sure to visit us for cleanings and checkups at least twice a year. Taking care of both your appliance and your mouth will help ensure your RPD serves you for many years to come.
If you would like more information on removable partial dentures or other 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
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