Posts for: February, 2018
As dentists, we often see other mouth problems besides those with teeth and gums. One of the most common is cracking around the corners of the mouth. Although usually not serious, it can be irritating and uncomfortable.
Medically known as angular cheilitis (literally “an inflammation of the angles of the lip”), it’s also called perleche, derived from the French lecher, “to lick.” The latter moniker aptly describes the tendency of sufferers to compulsively lick the sores to relieve irritation, which actually can make things worse.
Perleche has a number of possible causes, mostly from in or around the mouth (although systemic diseases or medications can cause it on rare occasions). It’s often found among younger people who drool during sleep or older people with deep wrinkles along the sides of the mouth that increase the chances of dryness and cracking. Long-term wind or cold exposure, ill-fitting dentures or a lack of back teeth (which help support facial structure) may also contribute to the condition.
Patients with perleche can also develop yeast infections from a strain called candida albicans. The infection can spread through the whole mouth, significantly increasing the chances of physical discomfort.
Treating perleche often involves topical ointments with inflammation-reducing steroids and zinc oxide, which has antifungal properties, to provide an environmental barrier during the healing process. If a yeast infection occurs, we may treat it with oral or topical antifungal medication like Nystatin for the whole mouth and chlorhexidine rinses, which has antibacterial properties.
It also helps to adopt a few preventive measures that can minimize the occurrence of perleche. If you wear dentures, for example, cleaning them often (including, if necessary, with chlorhexidine) and leaving them out at night reduces bacterial and fungal growth. We can also see if your dentures are fitting properly. Replacing missing teeth provides better facial support and could minimize wrinkling around the mouth. And, of course, keeping up daily brushing and flossing helps ensure a healthy and disease-free mouth.
If you’re experiencing cracked mouth corners, let us know at your next appointment. With our help and of other medical professionals we may be able to give you relief from this irritating condition.
If you would like more information on gaining relief from angular cheilitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Cracked Corners of the Mouth.”
Fatigue, irritability and family complaints about snoring — all tell-tale signs you may have sleep apnea. There’s more to this condition than being grouchy the next day — the long-term effect could increase your risks for life-threatening diseases.
But how do you know if you actually have sleep apnea? And if you do, what can you do about it?
Undergo an exam by a physician trained in “sleep medicine.” Sleep apnea occurs when the airway becomes blocked while you sleep, dropping the body’s oxygen levels; your body awakens to re-open the airway. The event may only last a few seconds, but it can occur several times a night. Even so, sleep apnea is one potential cause among others for snoring or fatigue. To know for sure if you have sleep apnea you’ll need to undergo an examination by a physician trained to diagnose this condition. He or she may then refer you to a dentist to make a sleep appliance if you have mild to moderate apnea.
Determine the level of your apnea’s intensity. Not all cases of sleep apnea are equal — they can range in cause and intensity from mild to advanced, the latter a reason for concern and focused intervention. Your physician may use different methods for determining the intensity of your case: review of your medical history, examining the structures within your mouth or having your sleep observed directly at a sleep lab. Getting the full picture about your sleep apnea will make it easier to develop a treatment plan.
Match the appropriate treatment to your level of sleep apnea. If you have moderate to advanced apnea, you may benefit from continuous positive airway pressure (CPAP) therapy, an electrical pump that delivers pressurized air through a mask worn while you sleep that gently forces the airway open. It’s quite effective, but uncomfortable to wear for some people. Advanced cases may also require surgery to alter or remove soft tissue obstructions. If, you have mild to slightly moderate apnea, though, your dentist may have the solution: a custom-fitted mouth guard that moves the tongue, the most common airway obstruction, down and away from the back of the throat.
If you suspect you may have sleep apnea, see a trained physician for an examination. It’s your first step to a good night’s sleep and better overall health.
If you would like more information on sleep apnea treatments, 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 “If You Snore, You Must Read More!”