Have you ever experienced sore, red cracks at the corners of your mouth that just won’t seem to go away? If so, you may be dealing with a condition known as angular cheilitis.
What is Angular Cheilitis?
Angular cheilitis, also referred to as perleche or angular stomatitis, is a common inflammatory condition characterized by painful cracks or fissures at the corners of the mouth. These fissures can cause discomfort, pain, and even bleeding, making simple tasks like eating or speaking a challenge.
Causes of Angular Cheilitis
Angular cheilitis can have various underlying causes, but two primary factors are often associated with its development:
Loss of Vertical Dimension: In some cases, angular cheilitis can be caused by a loss of vertical dimension, where the mouth fails to close properly due to factors such as missing teeth or ill-fitting dentures. This can create an environment conducive to moisture retention and bacterial growth, leading to inflammation and infection at the corners of the mouth.
Nutritional Deficiencies: Deficiencies in certain vitamins, particularly vitamin B2 (riboflavin), vitamin B3 (niacin), and vitamin B12, have been linked to angular cheilitis. These vitamins play essential roles in maintaining healthy skin and mucous membranes, and their deficiency can weaken the skin’s barrier function, making it more susceptible to irritation and infection.
Symptoms of Angular Cheilitis
The symptoms of angular cheilitis can vary from person to person but often include:
Pain, tenderness, or burning sensation at the corners of the mouth
Redness, swelling, or inflammation
Cracks, fissures, or splits in the skin, which may bleed or crust over
Itching or discomfort when opening the mouth or eating
Treatment and Prevention
The treatment of angular cheilitis depends on the underlying cause but may include:
Addressing Nutritional Deficiencies: If angular cheilitis is associated with vitamin deficiencies, supplementing with vitamin B complex or specific vitamins such as riboflavin, niacin, and B12 may help improve symptoms and prevent recurrence.
Maintaining Oral Hygiene: Practicing good oral hygiene, including regular brushing, flossing, and using an antifungal or antibacterial mouthwash, can help reduce the risk of infection and inflammation at the corners of the mouth.
Addressing Dental Issues: If angular cheilitis is caused by a loss of vertical dimension or ill-fitting dentures, addressing these dental issues may be necessary to alleviate symptoms and prevent recurrence.
By addressing the underlying causes and taking steps to promote oral and overall health, individuals can effectively manage and prevent angular cheilitis. If you’re experiencing persistent symptoms, it’s essential to consult with a healthcare professional for proper diagnosis and treatment.
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As a dentist with over three decades of experience as of this writing, I’ve witnessed the magic a healthy smile can bring. But recently, my journey took a turn, opening my eyes to the heartbreaking reality of oral care in senior living facilities. While many facilities provide excellent care, it’s crucial to acknowledge the challenges older adults face and the ways families can advocate for their loved ones’ well-being.
Let’s break down the landscape:
Self-care challenges: Arthritis, dexterity issues, and cognitive decline can hinder independent oral care.
Denture struggles: Difficulty cleaning, inserting, and removing dentures can lead to infections and discomfort.
Overlooked needs: Regular dental checkups are often neglected, potentially allowing problems to worsen unnoticed.
Family members can:
Provide gentle assistance: Help with brushing, flossing, and denture care.
Schedule regular checkups: Remind and accompany loved ones to dentist appointments whenever possible.
Advocate for support: Request additional assistance from facility staff for those struggling with self-care.
Lack of oral care focus: Limited staff time and resources can lead to inadequate oral hygiene routines.
Communication barriers: Understanding and responding to residents’ needs may be difficult due to cognitive decline or physical limitations.
Pain and discomfort: Untreated oral issues can cause significant pain and impact quality of life.
Family members can:
Express concerns: Speak up to facility staff about suspected oral issues and request better or more attentive care.
Educate the staff: Provide information about loved ones’ specific needs and preferences.
Seek additional support: Advocate for involvement of dentists or specialists if necessary.
A Word on Mobile Dental Services:
Many facilities are contracted with mobile dental services, which can offer some relief. However, it’s important to know that these services often have limitations:
Limited scope: They may primarily focus on extractions, denture maintenance, diagnosis, and referrals for more complex care.
Long wait times: Due to serving multiple facilities, appointments can take weeks or even months to schedule.
While mobile services can be a valuable resource, they might not always provide the full range of care needed. If you feel your loved one requires more comprehensive treatment, explore options like advocating for involvement of local dentists or specialists, even if it means seeking additional appointment slots outside the facility contract.
Remember, a healthy smile is more than just aesthetics for seniors. It’s about pain management, nutrition, and overall well-being. By shedding light on these challenges and empowering families to be advocates, we can work together to illuminate the path towards brighter smiles for our loved ones in their later years.
Many people believe that since they aren’t experiencing dental symptoms – like tooth pain or bleeding gums – then all must be well.
Unfortunately, a sizable number of dental problems, including cavities and periodontal disease (bone loss around your teeth), just don’t produce obvious symptoms in their early stages. At least not symptoms that tend to be obvious to patients.
In fact, by the time people the average person experiences pain, his dental issue is typically pretty far along. And all too often, by then, the problem can also be quite expensive to handle.
It might amaze you to discover the types of problems your average dentist encounters every week, many of which you would expect to be painful, but they just aren’t. They can still result in tooth loss though.
Pretty much anyone who has ever worked in a dental office for any length of time will tell you this is so. And they will tell you that you can inform some people that they have a problem, but unless it is “real” to them, they just won’t do anything about it.
They may come back a few years later (or maybe sooner) – usually with an emergency – desperately wanting to save the tooth that you told them about earlier. Of course, by now, it may be too late. And very often they will have forgotten it was ever discussed at all, because it was never a realistic problem for them to begin with.
Human nature can be funny that way.
So, keeping that in mind, it’s generally a good idea to get checked out by a dentist. Regularly.
The best news you can hear is that everything looks great.
But sometimes getting a confirmation that you don’t have cavities or gum disease is not the only reason to get a dental exam. Over the years, I have detected cancer (not just oral cancer) – as well as a host of other non-dental problems – that might have been overlooked had the patient not scheduled an exam. Obviously, we refer patients to an appropriate specialist for treatment when we discover medical problems outside the scope of dental practice.
Other benefits of getting a dental exam: I can recall many patients who told me that what they thought were unrelated health problems simply resolved when their oral problems were gotten under control. These have included digestive problems, low energy problems, elevated blood cell counts, hypertension, and more.
Over the years, some people have told me they don’t want to get a dental exam because they don’t want to discover they have any problems. I guess that works.
Just maybe not too well.
Your overall health is connected to your oral health. Take a look at this infographic. Then think it over. . . .
Millions of people worldwide wear full dentures. While we often associate this aging, wearing full dentures is not just limited to older adults. Illness, accidents — sometimes even pregnancy — can contribute to tooth loss and, in a number of cases, this affects younger individuals as well.
Young or old, the psychological consequences of losing teeth can be severe.
Several studies have suggested that a smile is very often thefirst thing people notice about another person. So, losing one’s teeth can be devastating in a variety of ways.
Toothlessness may affect digestion. This, in turn, can influence nutrition and health. There can be issues with self-esteem, intimacy, and a host of other areas most people wouldn’t normally take the time to consider.
This is stressful enough. But having to now replace the teeth can also become stressful for some.
Many people worry about whether they will be able to eat with their dentures. Will people notice that they are wearing them? Will they sound funny when they speak? Will it hurt to eat with the dentures? Will they be able to chew their food? How will the dentures affect the ability to taste food? Will the dentures slip when they talk? What can they afford?
These are natural concerns, but for the first-time wearer, they add up to a lot of unknowns.
The truth is that no two situations are alike. But almost all denture challenges have solutions.
Another thing to consider is that there are many ways to go about addressing total tooth loss. The solutions depend upon a person’s preferences, financial options, and — frankly — anatomy.
If a person were building a house and they decided to hire an architect, the architect would undoubtedly first gather a lot of information about the project. For example: Where is he going to be building? What does the client want: a log cabin or a mansion? What does the foundation look like? What is the client’s budget?
In some ways, restoring a person’s smile is not too dissimilar.
For the person without teeth, they may be surprised to learn that there are multiple ways to go about replacing the teeth. The length of time will vary with each approach, as well as the cost.
To help clarify the options and give some sense of the costs, I put together a free report that helps discusses different levels of care, from simple to more complex. Included is a sense of the pros and cons of each approach, and a general price range at today’s rates. Of course, this can vary widely from area to area and doctor to doctor.
It is not without purpose that dentists repeatedly herald the fact that your mouth tells us a great deal. Yes, it will communicate — and without words — whether you have been brushing or flossing. But it will also tell us a story of your overall health.
For centuries, even the physician began his examination of the patient with a look at the head, ears, eyes, nose and throat. He would ask you to “Say aah.”
Ever wonder why?
The specific reason is that the sound you make elev
ates the soft palate and allows for a clearer view of the back of the throat, but it also tests the function of the vagus and glossopharyngeal nerves. Doctors have an abbreviation they use to describe this evaluation: HEENT (head, ears, eyes, nose, throat). More recently, health professionals have been pushing for a modification to that standard evaluation, changing it to “HEENOT” instead (head, ears, eyes, nose, oral cavity, and throat).
Thus, health professionals can work together in the best interest of their patients. By performing a thorough oral exam, the dentist will often spot systemic problems and refer their patient to a physician for further evaluation. The family doctor can, in turn, evaluate oral health and alert the patient to the fact that it is time to see a dentist in order to get better.
Anyone following our blog or newsletter for any length of time has already been acquainted with the fact that what goes on in our mouths can affect the health of the rest of our bodies. Studies continue to show the links between oral and general health. By way of review – periodontal disease has been linked to complications with diabetes and pre-term labor in pregnancy. There is also a strong connection between poor oral health and rheumatoid arthritis, cardiovascular disease, strokes, and Alzheimer’s.
The fact that we perform an oral (and oral cancer) examination during your bi-annual checkups and “cleaning visits” does not excuse you from seeing your doctor for general health problems, and vice-versa. We are professionals in oral health and regular maintenance in our office helps you to stay healthy. So you want to be certain that each time your family doctor ask you to “say aah,” they then say “good job – everything looks great!”
The posting below is actually taken from our Weird Dental “Facts” section. It’s an assortment of dental trivia and facts — some true, some we’re not so sure about 😉 — but either way, we hope to entertain, as well as educate you, with our postings.
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This dental fact was prompted by a recent television program I watched that discussed three of the top life-threatening emergencies. We hope you never find yourself confronting this type of problem, so here is the Weird Dental “Fact”:
A dental infection can kill you.
But also true.
A toothache left untreated can, over time, develop an abscess. (An abscess is an infection that fills with pus and debris.)
Periodontal disease, left untreated, can also develop an abscess over time.
The trouble with many dental problems, though, is that in their early stages they are seldom painful.
In fact, sometimes, they aren’t painful even after they become more advanced. So people tend to put off treating cavities and gum disease hoping it will just go away or get better on its own. Then, when it does get worse, they will often put that off as well This is where it can get really dangerous.
One complication of a dental infection is called Ludwig’s Angina. It’s a type of infection that can travel from the roots of the teeth to the floor of the mouth and under the tongue. The infection can spread very quickly, creating a swelling that can block your airway or prevent you from swallowing. This can be life-threatening.
It can be cured with quick treatment that gets the airway open and with antibiotics, but sometimes surgical intervention is also necessary.
The better solution is to never let your oral health become so neglected as to allow the possibility of this type of infection.
We hope we will never lose a single tooth. Unfortunately, it happens sometimes. We can lose a tooth for many reasons. I won’t delve into them in this article. The purpose here is to help you to decide between a bridge and an implant, in the event that you have to make that choice.
Just so we are clear: No two situations are completely alike. I have neither seen nor evaluated your case and am simply discussing general principles. You should always consult a comp
etent and licensed professional to assess your specific circumstance before making a decision that will affect both your health and finances. Nevertheless, here you are. Either a tooth has been compromised and is lost already, or it is about to be extracted. If the idea of dental implants has crossed your mind, your dentist first has to determine whether you are a good candidate for the implants. The criteria can be broken down into three broad categories:
Do you have any medical issues that may prevent successful placement of an implant?
Do you have sufficient bone?
Will your existing bite allow it?
So let’s get into it:
1. Medical Issues. Health conditions that could prevent an implant being placed may include, but are not limited to:
Recent heart attack or stroke
Active treatment of malignancy
Intravenous bisphosphonate use
You should disclose anything you think could be a matter of concern with your dentist. The success rate with dental implants is very high, but careful case selection is the key to success.
2. Sufficient Bone. Again, this needs to be determined by the implant surgeon. Your bone needs to be high enough and wide enough to accommodate the implant. If it isn’t, you may still qualify for a dental implant, but will likely require an additional procedure called bone grafting. Your dentist or implant specialist will determine your specific needs.
3. Your Bite. What does the bite have to do with anything? There was a tooth there to begin with, right? Both implants – and natural teeth – survive longer when your teeth and jaw are in harmony. If your bite has collapsed – meaning the upper jaw and lower jaws are now too close to each other – there may not be enough room to place an implant without orthodontic (braces), or surgical, intervention.
Starting to sound a bit complicated? Don’t worry, in most cases, the dentist can tell you pretty quickly if he feels implants will work for you. Sometimes, he needs additional screening tools to make the final call but, if he does, he’ll let you know that too.
Dr. Richard Walicki is a dentist practicing general and cosmetic dentistry. While we hope you find the information contained herein interesting and useful, this blog is for informational purposes and is not intended to diagnose any oral disease. Dental conditions should be evaluated by your dental health professional or a qualified specialist.