Posts for: February, 2019

By R. Tracy Durrett, D.D.S.
February 27, 2019
Category: Dental Procedures
Tags: toothache  
YourToothacheisTellingyouSomethingsWronginYourMouth

A toothache might mean you have tooth decay—or maybe not. It could also be a sign of other problems that will take a dental exam to uncover. But we can get some initial clues about the underlying cause from how much it hurts, when and for how long it hurts and where you feel the pain most.

Let's say, for instance, you have a sharp pain while consuming something cold or hot, but only for a second or two. This could indicate isolated tooth decay or a loose filling. But it could also mean your gums have receded and exposed some of the tooth's hypersensitive root surface.

While over-aggressive brushing can be the culprit, gum recession is most often caused by periodontal (gum) disease. Untreated, this bacterial infection triggered by accumulated dental plaque could eventually cause tooth and bone loss, so the sooner it's attended to the better.

On the other hand, if the pain seems to linger after encountering hot or cold foods and liquids, or you have a continuous throbbing pain, you could have advanced tooth decay that's entered the inner pulp where infected tooth nerves are reacting painfully. If so, you may need a root canal treatment to remove the diseased pulp tissue and fill the empty pulp and root canals to prevent further infection.

If you have this kind of pain, see a dentist as soon as possible, even if the pain stops. Cessation of pain may only mean the nerves have died and can no longer transmit pain; the infection, on the other hand, is still active and will continue to advance to the roots and bone.

Tooth pain could also indicate other situations: a cracked tooth, an abscess or even a sinus problem where you're feeling the pain radiating through the teeth. So whatever kind of pain you're feeling, it's your body's alarm signal that something's wrong. Promptly seeing your dentist is the best course of action for preserving your health.

If you would like more information on treating tooth pain, 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 “Tooth Pain? Don't Wait!


By R. Tracy Durrett, D.D.S.
February 17, 2019
Category: Oral Health
WhileUsuallyBenignLichenPlanusLesionsShouldStillbeExamined

If you’ve noticed a small sore in your mouth, it’s possible you have a non-contagious disease known as lichen planus. Although usually benign, it’s still a good idea to have it examined and monitored.

The condition is so named because its lesions are similar in appearance to lichen, the algae and fungi organism often found on rocks and trees. It’s believed to be a type of autoimmune disease, in which the body treats some of its own cells as foreign and reacts adversely to them. Certain medications and substances may also cause a lichenoid reaction. Besides the inner cheeks, gums or tongue, lichen planus may also appear on other skin or mucous surfaces on the wrists, legs or fingernails.

When it appears inside the mouth it usually resembles a lacy pattern of white lines or ulceration. Gum tissues may become red and inflamed, with some soreness after brushing or eating. Although there’s no known cure for lichen planus, it rarely causes serious problems — in fact, you may not even be aware you have the condition unless pointed out during a dental exam. It may, in time, fade away.

If the lesions do become bothersome (painful, itchy or overly-sensitive), there are some ways to ease discomfort: brushing with a soft toothbrush (to minimize irritation), flossing, and avoiding acidic or spicy foods and beverages which have been known to cause flare-ups. Managing stress is also helpful, and a topical steroid may be prescribed for more severe outbreaks.

Perhaps the greatest concern with lichen planus, though, is it may resemble more serious conditions, particularly oral cancer. The only way to be certain that it is a benign condition is to perform a biopsy on some of the affected tissue. If you notice a problem, be sure to visit us for a complete examination. And regardless of whether you have the condition or not, regular oral cancer screenings, as well as limits on alcohol consumption and stopping use of tobacco, will also reduce your risk of oral cancer.

Odds are if you have a case of lichen planus it isn’t causing you any problems. If it does cause you discomfort, though, you can take steps to ease your symptoms.

If you would like more information on lichen planus and similar oral conditions, please contact us or schedule an appointment for a consultation.


By R. Tracy Durrett, D.D.S.
February 07, 2019
Category: Oral Health
Tags: mouth rash  
CertainMouthRashesDontRespondtoTopicalSteroidTreatments

You've been treating a persistent rash around your mouth with medicated ointments, but it's not going away. The problem may be the ointment — it could actually be sustaining the particular rash you have.

Peri-oral dermatitis is a scaly rash with small bumps (some filled with pus) around the mouth, eyes or nose. It's especially common among women ages 20-45, possibly due to hormonal factors or cosmetic use. Other than its unattractiveness you might not otherwise notice it, although it can cause stinging, itching or burning. There are ways to treat it effectively, though not necessarily the way you might think.

Many skin conditions respond well to topical steroids, like ointments or lotions containing hydrocortisone. But prolonged use of a steroid for skin irritations might actually increase risks for peri-oral dermatitis. Applying it to an existing rash may also deceive you — the steroid constricts some of the skin's tinier blood vessels, which will make the rash appear as if it's fading. The effect, though, usually doesn't last more than an hour. If you continue to use the steroid, the rash won't get better.

The key to alleviating peri-oral dermatitis requires treatment from a physician, dermatologist or dentist, who will also be able to accurately diagnose the specific skin condition you have. If it is peri-oral dermatitis, the first step is to stop using any topical steroids and only wash with mild soap or similar substitute. You'll have to be patient because the rash may at first appear to flare up and worsen before getting better.

Instead of steroids, we may prescribe antibiotics to help clear the rash, typically tetracycline. It may take several weeks of use before the rash begins to clear; as it does clear, you would either stop the antibiotic treatment or taper off over a four-to-five week period.

While some cases of peri-oral dermatitis will clear up and remain that way, some people may experience chronic reoccurrences. Even so, by using the same treatment approach we can still effectively manage the condition for the long-term.

If you would like more information on peri-oral dermatitis and similar rashes, please contact us or schedule an appointment for a consultation.