It may begin as an itching or burning feeling on your skin, followed by numbness or sensitivity to touch. But then you develop a painful red rash that forms crusty lesions. Fever and fatigue may follow.
These are the common symptoms for a form of chicken pox called shingles, a contagious disease from the human herpes group of viruses. While anyone can contract the shingles virus, it most often lies dormant in a person’s nervous system for decades after an earlier bout of chicken pox. It then breaks out (sometimes repeatedly), usually in patients over fifty.
A shingles outbreak can be miserable. It could also affect your dental care, especially if you have a rash on your face and neck. Here are 3 things you should do if you have shingles in regard to your dental care and overall health.
Tell your dentist you have shingles. A shingles outbreak is highly contagious in its early stages and can spread from direct contact with blisters or through airborne secretions from the infected person’s respiratory system. Even a simple teeth cleaning (especially with an ultrasonic device) at this stage could spread the virus to staff and other patients. So inform your dentist if your appointment coincides with an outbreak—it may be necessary to re-schedule your visit.
Start antiviral treatment as soon as possible. If you’re diagnosed with shingles, more than likely your doctor or dentist will recommend immediate antiviral treatment (typically acyclovir or famciclovir) within 3 days of symptom onset. This can help speed up healing, alleviate pain and possibly prevent more serious complications.
Get the shingles vaccine. Of course, you don’t have to wait for shingles to occur—there is an effective vaccine that could help prevent an outbreak. If you’ve had chicken pox (over 90% of American adults have) or you’re over sixty with or without previous chicken pox, the U.S. Centers for Disease Control recommends you get vaccinated.
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
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.”
Twenty-six percent of American adults between 65 and 74 have lost all their teeth to dental disease. This isn’t an appearance problem only—lack of teeth can also harm nutrition and physical well-being.
Fortunately, we have advanced restorative options that can effectively replace missing teeth. Of these, there’s a tried and true one that’s both affordable and effective: removable dentures.
Dentures are simple in design: a plastic or resin base, colored with a pinkish-red hue to resemble gums to which we attach prosthetic (false) teeth. But while the design concept isn’t complicated, the process for creating and fitting them can be quite involved: they must conform to an individual patient’s jaws and facial structure if they’re going to appear natural.
If you’re considering dentures, here’s some of what it will take to achieve a successful outcome.
Positioning the teeth. The position of the prosthetic teeth on the base greatly determines how natural they’ll appear and how well they’ll function. So, we’ll need to plan tooth placement beforehand based on your facial and jaw structures, as well as photos taken of you before tooth loss. We’ll also consider how large the teeth should be, how far to place them forward or back from the lips, and whether to include “imperfections” from your old look that you see as part of your appearance.
Simulating the gums. While the teeth are your smile’s stars, the gums are the supporting cast. It’s important that we create a denture base that attractively frames the teeth by determining how much of the gums show when you smile, or adding color and even textures to better resemble gum tissue. We can also add ridges behind the upper teeth to support speech.
Balancing the bite. Upper and lower dentures don’t operate in and of themselves—they must work cooperatively and efficiently with each other during eating or speaking. So while appearance matters, the bite’s bite adjustment or balance might matter more. That’s why we place a lot of attention into balancing and adjusting the bite after you receive your dentures to make sure you’re comfortable.
This is a detailed process that we may need to revisit from time to time to make sure your dentures’ fit remains tight and comfortable. Even so, modern advances in this traditional restoration continue to make them a solid choice for total tooth loss.
If you would like more information on denture restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Removable Dentures.”
If your child has a toothache, there’s good news — and not so good news. The good news is the pain rarely indicates an emergency. On the downside, though, it may definitely be something that needs our attention.
Here, then, are 4 things you should do as a parent when your child tells you their tooth hurts.
Try to find out exactly where the pain is and how long it has hurt. Ask your child which tooth or part of the mouth hurts. You should also find out, as best you can, when the pain started and if it’s constant or intermittent. Anything you learn will be useful information if you bring them to the office for an examination. And, any tooth pain that keeps your child up at night or lasts more than a day should be examined.
Look for signs of recent injury. Your child may have suffered a blow to the mouth that has damaged the teeth and gums. Besides asking if they remember getting hurt in the mouth, be sure to look for chipped teeth, cracks or other signs of trauma. Even if there aren’t any outward signs of injury, the tooth’s interior pulp may have been damaged and should be checked out.
Look for signs of dental disease. Take a close look at the tooth your child’s complaining about: do you see brown spots or obvious cavities? You should also look for swollen gums or sores on the inside of the mouth. If there’s been no apparent injury, these could be signs of infection related to tooth decay.
Try to relieve pain symptoms. If you don’t see anything unusual, there may be a piece of candy or other hard food debris between the teeth causing the pain — gently floss around the tooth to dislodge it. If the pain persists give appropriate doses of ibuprofen or acetaminophen (not aspirin). If there’s swelling, you can also apply an icepack on the outside of the jaw. In any case, you should definitely schedule a visit with us for an examination.
If you would like more information on dental care for your child, 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 “A Child’s Toothache.”
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