Oral and facial clefts are among the most common and heartbreaking of birth defects. Clefts make feeding or even breathing difficult and can affect speech development.
But there's one other profound effect: an “abnormal” face caused by a cleft can have devastating consequences for a person's self-image and social relationships.
About 1 in 700 U.S. babies are born with some type of visible gap or “cleft.” It can occur in their upper lip, soft and hard palate, nose or occasionally extending to the cheek or eye region. We typically classify clefts as “unilateral” (affecting only one side of the face) or “bilateral” (affecting both sides).Â We're not completely sure on the root causes, but research so far has uncovered links with the mother's possible exposure to toxic substances, nutrient or vitamin deficiencies, or infections during fetal development.
Taking steps during pregnancy to minimize these exposures is certainly helpful. But what can be done for children born with a cleft?
A great deal, thanks to the development of surgical repair techniques over the last century. The surgical approach relies on the fact that the tissues required to repair the cleft already exist. They're simply distorted by the cleft break.
Even so, the road to restoration is a long and arduous one. Lip repairs usually take place at 3-6 months of age; palate (roof of the mouth) clefts are undertaken at 6-12 months. As the child's jaw and mouth structure develops, further surgeries may be needed to match earlier repairs with development.
Cleft repairs also require a team of specialists including a maxillofacial (oral) surgeon, orthodontist and general dentist. The latter plays an important role during the process, ensuring the child maintains good dental health through prevention and treatment of disease and dental work for at risk teeth.
The road to a normal life is difficult — but well worth it. A repaired cleft vastly improves a child's health and well-being. Moreover, it restores to them something the rest of us might take for granted — a normal face and smile.
A "toothy grin" might be endearing, but not necessarily healthy. More of the teeth showing may mean your gums have pulled back or receded from the teeth. If so, it's not just your smile that suffers—the parts of teeth protected by the gums could become more susceptible to disease.
There are a number of causes for gum recession. Some people are more likely to experience it because of genetically thinner gum tissues. Over-aggressive brushing could also contribute to recession. But the most common cause by far is periodontal (gum) disease, a bacterial infection triggered by dental plaque accumulating on teeth mainly as a result of inadequate hygiene.
There are some things we can do to help heal and restore recessed gums, most importantly treating gum disease. The number one goal of treatment is to uncover and remove all dental plaque from tooth and gum surfaces, which can take several sessions and sometimes minor surgery if the infection has reached the tooth roots. But removing plaque and tartar (calcified plaque) is necessary to stop the infection and allow the gums to heal.
For mild recession, this may be enough for the gums to regain normal coverage. But in more severe cases we may need to help rejuvenate new tissue with grafting surgery. In these highly meticulous procedures a surgeon uses microscopic techniques to position and attach donated tissue to the recession site. The graft serves as a scaffold on which new tissue growth can occur.
While these treatments can be effective for reversing gum recession, they often require time, skill and expense. It's much better to try to prevent gum recession—and gum disease—in the first place. Prevention begins with daily brushing and flossing to prevent plaque buildup, as well as regular dental visits for more thorough cleanings. Be on the lookout too for any signs of a beginning gum infection like swollen, reddened or bleeding gums and see your dentist as soon as possible to minimize any damage to your gums.
Caring for your gums is equally as important as caring for your teeth. Healthy gums equal a healthy mouth—and an attractive smile.
If you would like more information on preventing gum recession, 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 “Gum Recession.”
Surgical tooth extraction is a fairly routine procedure with few complications. But one rare complication called dry socket does affect a small number of patients. Dry socket, which derives its name from its appearance, can be quite painful. Fortunately, though, it doesn't pose a danger to oral health.
Normally after a surgical extraction, a blood clot forms in the empty socket. This is nature's way of protecting the underlying bone and nerves from various stimuli in the mouth as well as protecting the area. Sometimes, though, the clot fails to form or only forms partially (almost exclusively in lower wisdom teeth), exposing the sensitive tissues beneath the socket.
Patients begin to notice the painful effects from a dry socket about three or four days after surgery, which then can persist for one to three more days. Besides dull or throbbing pain, people may also experience a foul odor or taste in their mouth.
People who smoke, women taking oral contraceptives or those performing any activity that puts pressure on the surgical site are more likely to develop dry socket. Of the latter, one of the most common ways to develop dry socket is vigorous brushing of the site too soon after surgery, which can damage a forming blood clot.
Surgeons do take steps to reduce the likelihood of a dry socket by minimizing trauma to the site during surgery, avoiding bacterial contamination and suturing the area. You can also decrease your chances of developing a dry socket by avoiding the following for the first day or so after surgery:
- brushing the surgical area (if advised by your surgeon);
- rinsing too aggressively;
- drinking through a straw or consuming hot liquid;
If a dry socket does develop, see your dentist as soon as possible. Dentists can treat the site with a medicated dressing and relieve the pain substantially. The dressing will need to be changed every few days until the pain has decreased significantly, and then left in place to facilitate faster healing.
While dry sockets do heal and won't permanently damage the area, it can be quite uncomfortable while it lasts. Taking precautions can prevent it—and seeing a dentist promptly if it occurs can greatly reduce your discomfort.
If you would like more information on oral surgery, 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 “Dry Socket: A Painful but Not Dangerous Complication of Oral Surgery.”
Multi-platinum recording artist Janet Jackson has long been known for her dazzling smile. And yet, Jackson admitted to InStyle Magazine that her trademark smile was once a major source of insecurity. The entertainer said, “To me, I looked like the Joker!” It was only after age 30 that the pop icon came to accept her unique look.
Jackson is not alone. A study commissioned by the American Association of Orthodontists found that more than one third of U.S. adults are dissatisfied with their smile. But there’s good news—modern dentistry can correct many flaws that can keep you from loving your smile, whether you’re unhappy with the color, size, or shape of your teeth. Here are some popular treatments:
Professional teeth whitening: Sometimes a professional teeth whitening will give you the boost you need. In-office whitening can dramatically brighten your smile in just one visit.
Tooth-colored fillings: If you have silver-colored fillings on teeth that show when you smile, consider replacing them with unnoticeable tooth-colored fillings.
Dental bonding: If you have chipped, cracked, or misshapen teeth, cosmetic bonding may be the fix you’re looking for. In this procedure, tooth colored material is applied to the tooth’s surface, sculpted into the desired shape, hardened with a special light, and polished for a smooth finish.
Porcelain veneers: Dental veneers provide a natural-looking, long-lasting solution to many dental problems. These very thin shells fit over your teeth, essentially replacing your tooth enamel to give you the smile you desire.
Replacement teeth: Is a missing tooth affecting your self-confidence? There are several options for replacing missing teeth, from a removable partial denture to a traditional fixed bridge to a state-of-the-art implant-supported replacement tooth. Removable partial dentures are an inexpensive way to replace one or more missing teeth, but they are less stable than non-removable options. Dental bridges, as the name implies, span the gap where a tooth is missing by attaching an artificial tooth to the teeth on either side of the space. In this procedure, the teeth on both sides of the gap must be filed down in order to support the bridgework. Dental implants, considered the gold standard in tooth replacement technology, anchor long-lasting, lifelike replacements that function like natural teeth.
After coming to embrace her smile, Jackson asserted, “Beautiful comes in all shapes, sizes, and colors." If you don’t feel that your smile expresses the beauty you have inside, call our office to schedule a consultation. It’s possible to love your smile. We can help.
For more information, read Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”
While a relatively minor health issue, cracked mouth corners (medically known as angular cheilitis) can certainly be irritating. Fortunately, you don't have to live with it—we can help reduce the discomfort and even make it less likely to happen in the future.
Angular cheilitis is most characterized by redness and fissures (or cracks) in the skin at the corners of the lips. It commonly happens in younger ages (children to younger adults) because of drooling or complications from wearing braces. Older adults can also develop cracked mouth corners due to wrinkling around the mouth. The immediate causes are usually localized to the mouth and lip region, but it can sometimes arise from systemic conditions.
A case of angular cheilitis can also become infected, usually with a strain of yeast known as “candida albicans,” which then intensifies inflammation and discomfort. This is usually due to interaction between saliva and the open fissures, helped along by people's tendency to habitually lick these cracks (hence the other name for cracked mouth corners, perleche, from the French “to lick”).
The best way to treat angular cheilitis is with a series of applications of oral or topical antifungal medication. These may also be combined with steroid ointments that help retard redness and inflammation. If the infection involves the inside of the mouth, you may also need to use an antibacterial rinse until it clears up.
There are also things you can do to minimize future occurrences. Be sure to have missing teeth replaced or loose dentures refitted, and stay vigilant with daily brushing and flossing. You might also consult with a dermatologist about ways to treat wrinkling around the mouth. And easing those wrinkles could not only minimize your chances of developing angular cheilitis, but also give you a more youthful appearance.
Cracked mouth corners can be unnerving. But with a few simple steps we can help relieve any current discomfort and help you reduce the chances of another occurrence.
If you would like more information on cracked mouth corners and other oral irritations, 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.”
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