Most of what goes on inside our mouths—good or bad—is fairly predictable. But every now and then, people encounter something out of the ordinary. A good example is lichen planus.

Lichen planus are rare skin lesions that can occur on various parts of the skin, including inside the mouth. The name comes from their lacy appearance, which resembles a fungus that grows on rocks or trees called lichen.

Being similar in appearance, though, is all that lichen planus has in common with its fungal namesake. It's believed that the sores are caused by a reaction of the immune system mistaking some of the body's cells as foreign.

But don't let the exotic sounding name alarm you—true lichen planus is considered a benign mouth sore. You may not even realize you have it until your dentist notices and points it out. But the lesions can sometimes cause mild pain or burning, especially if they occur near the gums or if you indulge in spicy or acidic foods.

As we said, these lesions aren't considered dangerous. But in a small number of cases, oral cancer was found to develop later. It's unclear whether the lesions were related to the cancer, or if what were diagnosed as lichen planus lesions were actually pre-cancerous cells mimicking the appearance of the benign sore.

In any event, your dentist will probably continue to monitor the lesions and possibly conduct regular oral cancer screenings to be on the safe side. You may also want to stop using tobacco or alcohol products to further decrease your risk of oral cancer.

As to managing lichen planus, it starts with a daily habit of brushing and flossing. You'll also want to avoid spicy or acidic foods like citrus fruits, tomatoes, peppers or caffeinated drinks, especially during flareups. If the lesions are causing discomfort, your dentist may also prescribe a topical steroid to apply to them.

Since it's quite possible you won't know if you have lichen planus (as well as other types of mouth sores) unless your dentist observes them, you should keep up regular dental visits. Having your dentist check your entire mouth, not just your teeth and gums, will help both of you stay on top of your oral health.

If you would like more information on mouth sores, 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 “Lichen Planus.”

Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.

But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.

A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.

Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.

Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.

The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.

These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.

If you would like more information on TMD management and treatment, 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 “Chronic Jaw Pain and Associated Conditions.”

Each of life's moments are precious—but some are more precious than others. For one like your wedding day, you want to look your very best.

Be sure your teeth and gums are also ready for that once in a lifetime moment. Here are a few cosmetic enhancements that can transform your smile appearance.

Dental cleanings. Having your teeth cleaned professionally not only boosts your dental health, but it can also enhance your smile's brightness. A dental cleaning removes plaque and tartar that can yellow and dull teeth. With plaque out of the way, your teeth's natural translucence can shine through.

Teeth whitening. For an even brighter smile, consider teeth whitening. We apply a bleaching solution that temporarily whitens your teeth. With a little care on your part and occasional touchups, your brighter smile could last well beyond your wedding day.

Tooth repair. A chipped or cracked tooth can ruin an otherwise perfect smile. We can often repair mild flaws by bonding tooth-colored composite resins to the defective area, usually in one visit. Porcelain veneers or crowns can mask more moderate imperfections, but they must be undertaken well in advance of your big day.

Teeth replacements. We can restore those missing teeth ruining your smile with dental implants. An implant replaces the tooth root as well as the crown to create a stable and durable hold that can last for years. But similar to porcelain restorations, an implant restoration could take months—so plan ahead.

Orthodontics. Correcting a bite problem through orthodontics can have a huge impact on your smile. Straightening teeth isn't just for teenagers—you can undergo treatment at any age. And if you opt for clear aligners, no one but you and your orthodontist need know you're wearing them.

Cosmetic gum surgery. Even if your teeth look perfect, too much of your gums showing could detract from your smile. If your “gummy smile” is caused by excess gum tissue, there are a number of plastic surgical techniques that can restructure the gums so that they appear in right proportion with the teeth.

If you want a more attractive smile on your wedding day, see us as soon as possible for a full evaluation and assessment of your needs. Depending on what you need, we have the means to make your smile live up to that moment of moments.

If you would like more information on smile enhancements, 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 “Planning Your Wedding Day Smile.”

You've lost some teeth, and now you have to decide how to replace them. A fixed bridge or a partial denture are certainly good options. But the best choice today that dentistry has to offer is dental implants.

Implants have exploded in popularity among both dentists and patients, offering exceptional quality in life-likeness and durability. But they do have one drawback that might cause you to hesitate in choosing them: They're usually more expensive than other common tooth replacement systems, even more so if you're replacing each individual missing tooth with an implant.

But before you pass on them for something more affordable, take another look at dental implants. Here are 4 reasons why implants could be the wiser option for tooth replacement.

Life-like and functional. Other restorations can effectively mimic the appearance of real teeth, and they're reasonably functional. But implants score at the top in both categories because they replace more of the tooth—not just the crown, but the tooth root as well.

Bone friendly. Other restorations can't stop the gradual bone loss often caused by missing teeth, and dentures in particular can accelerate it. But implants are made of titanium, a bio-compatible metal that's also bone-friendly—bone cells readily grow and adhere to its surface. This accumulated growth around the implant site helps slow or stop bone loss.

Long-term savings. The integration of bone and implant creates a durable hold that can last for several years, possibly outlasting other restorations in the same situation. Taking into account all the costs—installation, maintenance and possible replacement—that can occur over the life of a restoration, implants could actually cost less in the long run.

Versatile. Implants can be used for more than single tooth replacements—they can be incorporated with other restorations like bridges or dentures to provide better support. Marrying implants with traditional tooth replacement systems can be less costly than implants individually while enhancing benefits like durability and bone strength.

Dental implants may not be right for everyone, particularly those who've experienced advanced bone loss. But if a thorough dental exam shows you're a good candidate, dental implants could be well worth the investment in your health and appearance.

If you would like more information on dental implant 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 “Dental Implants: Your Best Option for Replacing Teeth.”

Your gums don't just attractively frame your teeth—they protect them as well. If they shrink back (recede) from their normal covering, portions of the teeth could become exposed to bacteria and other hazards.

Unlike the visible crown, which is protected by enamel, the tooth root depends largely on the gums as a shield against bacteria and other hazards. When the gums recede, it exposes the roots and makes them more susceptible to disease or trauma. It may also cause sensitivity to hot and cold foods as the now exposed dentin gets the full brunt of temperature and pressure sensations once muffled by the gums.

There are actually a number of causes for gum recession. In rare cases, a tooth may not have erupted normally within its bony housing, which inhibits the gums from covering it fully. Thinner gum tissues, passed down genetically, are also more susceptible to recession. And a person can even damage their gums and cause them to recede if they brush too aggressively.

The most common cause, though, is advanced periodontal (gum) disease. This bacterial infection arises from dental plaque, a thin biofilm that accumulates on tooth surfaces, usually because of poor hygiene practices. As the infection and resulting inflammation in the gums worsens, they lose their attachment to teeth resulting in a number of harmful outcomes that include recession.

The first step then in treating gum recession is to treat the underlying problem as much as possible. In the case of gum disease, effective treatment could stop mild to moderate recession and sometimes reverse it. For more extensive recession, a patient may need gum grafting surgery to help regenerate lost gum tissue.

You can help prevent gum disease, and thus lower your risk for recession, with daily brushing and flossing to remove bacterial plaque. Likewise, see your dentist at least twice a year for dental cleanings to remove any residual plaque and tartar (hardened plaque).

You should also visit your dentist promptly if you notice swollen or bleeding gums, or more of your teeth surfaces showing. The earlier your dentist diagnoses and begins treatment for gum recession, the better your chances for a healthy and more attractive outcome.

If you would like more information on maintaining good gum health, 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.”