My Blog
By George Debbaneh, DDS
November 26, 2020
Category: Oral Health
Tags: oral health  
UnpleasantCrackedMouthCornersCanBeTreatedandPrevented

Ever have a paper cut or an irritated hangnail? They're not considered major health problems, but, boy, can they sting!

Something similar can occur in the corners of your mouth called angular cheilitis. It's also known as perleche, from the French word “to lick” (a common habit with this type of sore). It can occur at any age, with children or young adults developing it from drooling during sleep or orthodontic treatment.

Older adults, though, are more prone than younger people for a variety of reasons. Age-related wrinkling is a major factor, especially “marionette lines” that run from the mouth to the chin. Dried or thinned out skin due to exposure from cold, windy weather may also contribute to perleche.

Perleche can also develop from within the mouth, particularly if a person is experiencing restricted salivary flow leading to reduced lubrication around the lips. Poorly cleaned dentures, weakened facial supporting structure due to missing teeth, vitamin deficiencies and some systemic diseases can all lead to perleche. And if an oral yeast infection occurs around the cracked mouth corners, the irritation can worsen and prolong the healing process.

To clear up a case of cracked mouth corners, you should promptly see your dentist for treatment. Treatment will typically include some form of antifungal ointment or lozenge applied over a few days to clear up the sores and prevent or stop any infection. You might also need to apply a steroid ointment for inflammation and other ointments to facilitate healing.

To prevent future episodes, your dentist may ask you to use a chlorhexidine mouthrinse to curb yeast growth. If you wear dentures, you'll need to adopt a regular cleaning routine (as well as leaving them out at night). You might also wish to consider updated dental restorations or orthodontics to improve dental support, and help from a dermatologist if wrinkling might be a potential cause.

Cracked mouth corners won't harm you, but they can make for a miserable experience. Take steps to relieve the irritation and any future occurrence.

If you would like more information on angular cheilitis or similar oral conditions, 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 “Cracked Corners of the Mouth.”

By George Debbaneh, DDS
November 16, 2020
Category: Dental Procedures
Tags: dentures  
TodaysDenturesAreMoreSecureandComfortabletoWear

Although teeth are quite durable, we can still lose them—even all of them—to disease or injury. The good news, though, is that we have effective ways to restore teeth after they're lost. One of these, the removable denture, has given people their teeth back for several generations. And with recent advances in technology, today's dentures are even better.

Although more advanced, today's dentures share the same basic structure as those from a century ago: prosthetic (false) teeth set in a plastic resin colored to resemble the gums. The traditional denture is molded to fit snugly over an individual patient's alveolar jaw ridges, which once supported the former natural teeth. The denture stays in place primarily through a suction effect between the denture and the ridges.

Modern technology, though, has greatly improved today's dentures. Digital imaging can be used to generate highly accurate impressions of the dental ridges that can lead to denture bases with better fit. Dentists using photographs of the patient, especially in earlier years, are better able to identify facial landmarks, which enables them to position the new teeth to more closely recreate the patient's former smile.

These technological aids now help dentists to create more attractive dentures with better support and comfort. But the fit that makes this possible may not last due to a particular weakness inherent in traditional dentures—continuing bone loss. When teeth are missing, the underlying jawbone can lose bone volume over time. Dentures don't stop this process and can accelerate it due to constant friction and pressure on the dental ridges.

But a new modification incorporating dental implants with dentures can help solve these problems. By placing a few strategically positioned implants in the jawbone that then connect with the denture, the appliance not only gains more stability, but also produces less pressure on the dental ridges. In addition, bone cells naturally grow and adhere to the titanium implant posts, which helps to stop or slow bone loss.

If you've experienced total tooth loss, dentures are an affordable and effective option. Thanks to modern dental advances, you can get back the smile and dental function you once lost.

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 magazine article “Removable Full Dentures.”

By George Debbaneh, DDS
November 06, 2020
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?

By George Debbaneh, DDS
October 27, 2020
Category: Dental Procedures
Tags: cosmetic dentistry  
TransformSmileZoneTeethWithCompositeResins

As far as your appearance goes, the most important teeth you have are those in the “smile zone.” These are the teeth most visible when you smile—and the ones that awkwardly stand out if they're chipped, worn or otherwise flawed. More than any other teeth, they determine how inviting your smile is to others.

You might think you'll need extensive cosmetic dental work to fix these kinds of dental defects. But that may not be necessary: We may be able to use a dental material known as composite resin to repair the defects in your “smile zone” teeth in one office visit.

Composite resins are a combination of ceramics and plastics that have been around for some time. They've only recently come into wide use, though, with the development of new techniques to bond them to tooth surfaces. They're ideal for chips, cracks, or decayed areas where front teeth make contact with one another. They may also be used occasionally to reshape irregular or misaligned teeth.

You'll first need a complete dental examination to determine if composite resin bonding is an appropriate approach for your situation. If so, we'll begin by preparing the tooth surface to better accept the resin material. We'll then apply the liquid form of the material in layers, along with other agents to increase the material's strength. Each layer is cured (hardened) before applying the next layer.

As the layers build up, we shape the material to achieve a normal tooth appearance. We'll also incorporate your individual color shadings, so that the prepared tooth blends well with surrounding natural teeth. In effect, the procedure requires as much artistry as technical skill to create a natural look.

Though not as strong as porcelain veneers or crowns, composite resins are durable if not subjected to heavy biting forces. And for a few hours in the dentist's chair with minimal tooth preparation, a composite resin treatment can create a dramatic and exciting change in your appearance.

If you would like more information on composite resin bonding, 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 “Artistic Repair of Front Teeth With Composite Resin.”

DentalImplantsCouldHelpYouAvoidThisLong-TermEffectofLosingTeeth

What happens when you lose a tooth? In the short-run, it can certainly undermine your appearance and ability to efficiently chew and digest food. But a chain of events could also be set in motion that may cause the most harm to your appearance and health—and it all has to do with bone loss.

Our bones aren't just rigid structures providing a frame for our bodies. They're living tissue with other purposes like producing blood cells and regulating the endocrine system. Bone tissue is constantly replenishing itself as older cells die and newer ones take their place.

In the jawbone, the pressure generated by the teeth while biting and chewing travels through the roots to stimulate the growth of new bone. If a tooth goes missing, however, the bone around the tooth also loses this growth stimulus.

This can cause normal bone growth to slow so that dying bone cells aren't sufficiently replaced. The bone may then diminish at an alarming rate—a decrease in width of about 25% in the first year after a tooth loss and several millimeters in height after only a few years.

This bone loss can continue to advance, especially if multiple teeth are lost, until the jaw structure as a whole loses significant height. The bite may then collapse, forcing the front teeth to push forward. In this state, a person may not be able to adequately bite or chew food. It can also damage their appearance—their smile suffers, of course, but their entire face may also appear shrunken.

You may be able to avoid this scenario if you replace missing teeth with dental implants. In addition to their life-likeness and durability, implants can also stop or slow bone loss. This is because titanium, the principle metal used in an implant, has a strong affinity with bone: Bone cells readily grow and attach to the titanium surface and foster new growth.

But don't wait: Bone loss could eventually extend beyond what an implant can accommodate—you may then need grafting to build up the bone or consider a different type of restoration. So, speak with your dentist as soon as possible about an implant restoration for a lost tooth to help avoid significant bone loss.

If you would like more information on how tooth loss can affect your life, 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 “The Hidden Consequences of Losing Teeth.”





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