There could be several reasons why one might get cracks on either corner of one’s mouth. Often this is caused by excessive saliva (most commonly seen in patients with dentures), sagging facial muscles, or habits such as habitual licking of the lips.

Other possible causes might be:

• Fungal infection or Thrush. This can be caused by yeast or Candida Albicans. This condition can be treated with anti-fungal creams and ointments, some of which are available over the counter and some by prescription. Ask your pharmacist or doctor. Additionally, to correctly diagnose this condition, your doctor might have to do a smear of the area and see under a microscope what organisms are present.
• Viral / Herpes Simplex. This is usually unilateral (on one side) and is recurrent. But don’t be fooled, it can also be on both sides. The area should be checked and a smear taken to see if viral particles are present. Many options including antiviral creams or oral anti-viral medications that can be given to treat this condition and prevent recurrence.
• If the lesions remain crusted, this could also be indicative of a bacterial infection such as staphylococcus aureus, which can be treated with antibiotic creams. We don’t want this type of bacteria to spread around the body. These lesions can also be spread between partners, sharing towels and the spread of bodily fluids.

The bottom line: Have the area around the corners of the mouth checked to see if this is a fungal, viral or bacterial infection. After a precise diagnosis is obtained, then the correct treatment can instituted rather than trying to guess randomly how to cure the cracks on the sides of the mouth.

Is chewing gum bad for you? It’s a question I hear frequently and just one example of the many myths that abound regarding oral health.

Let’s review some of the more common myths — starting with that chewing gum question:

• Chewing gum is bad for you. Although it can be (if it contains sugar, which can cause tooth decay), the movement of the upper and lower jaws during chewing is actually good exercise for the muscles of mastication. And chewing gum actually works to cleanse the mouth and stimulate salivary flow. Stick to sugar free chewing gum without artificial ingredients, if possible.
• A cleaning once a year is enough. In my experience as a periodontist, most of my patients over the last 26 years needed to have their teeth cleaned an average of 3-4 times a year. This is critically important to maintain good oral health.
• Dental X-ray exposure will cause damage and possibly cancer. In the last decade, with the introduction of digital X-rays, the risk to patients from exposure to dental X-rays is insignificant. Even the older technology (traditional X-rays with a higher exposure rate) has never been shown to have any associations to any harmful systemic diseases or illnesses. The American Dental Association has made recommendations on how often a full mouth series of X-rays should be taken. Routine X-rays are safe. However, if you are pregnant please let your dentist or periodontist know.
• Bleeding gums are normal. This couldn’t be further from the truth. Bleeding gums can be a sign of gum disease, or potentially a more serious systemic disease. We also know that gum disease is caused by “bad bacteria” or infection in the mouth. Bacteria and infection can potentially spread to other parts of the body if not controlled with better oral hygiene and treatment by a dentist or periodontist.
• Dental insurance covers everything. For those who have dental insurance, you already know that it usually covers only a portion of the total costs of care. The exception might be HMO plans. However, each plan is different and has its own rules. Check with your employer about the type of plan you have, and be prepared for the actual restrictions and benefits of your dental insurance.

There are many more oral care myths out there. Is there anything you’ve heard that’s made you wonder if it’s really true?

When most of us think of fluoride, we think of the fluoride that is present in our toothpaste or in our drinking water, although not all states fluoridate their water. In the communities around the US where the water is not fluoridated, fluoride supplementation is common.

There has been a debate raging in the dental community about the pros and cons of fluoride usage.

The pros include:

• Prevention of tooth and root decay
• Anti-bacterial action against some forms of gum disease, in conjunction with daily oral hygiene and visits to your dentist or periodontist
• Alleviating symptoms of tooth or exposed root sensitivity
• Controlling bad breath
• Easy application with toothpastes, gels, and rinses

The cons include:

• Possible concern with over dosage of fluoride (the combination of water, drops, pastes, rinses, pills, etc.)
• Some professionals believe that fluoride can be toxic (This has not been proven.)
• Concern about the levels of fluoride in community drinking water
• Possible systemic effects not yet seen in the population

In our own 26-year-old periodontal practice, we will often suggest the use of non-dietary sources of fluoride, including gels, rinses, and pastes. This has been a recommended part of all our patients’ daily oral hygiene regimens.

Does your daily oral care routine include fluoride in any form? What do you think about the current fluoride debate?

Patients often ask me if there are any connections between what happens in the mouth and the rest of the body. Many do not realize that bleeding gums, mouth infections, bad breath, plaque build-up, not brushing and flossing adequately, color changes in oral tissues, and irregular dental visits can all strongly affect your overall health.

In the last few years, scientific studies have shown connections and strong links between gum disease and the risk of heart disease or stroke. Other medical conditions that have been linked to gum disease include obesity, diabetes, kidney disease, lung disease, and other systemic illnesses. A connection that might surprise you — even premature births have been linked to untreated gum disease.

Besides gum disease, there are other oral health conditions that can affect your overall health. Tooth decay, if not treated promptly, can lead to infections in the nerves of the teeth. Neglected and infected teeth — or wisdom teeth that need to be extracted — can also cause severe infections in the mouth. These infections can then spread into the bones and the bloodstream, and potentially cause a variety of harmful medical conditions.

Your oral health can also have an effect on your partner. Dental studies have shown that the “bad bacteria” that cause gum disease can potentially be spread from one partner to another, by kissing and sharing saliva.

So be sure to keep up with your oral health routines and visit your dentist or periodontist regularly. You’re doing more than just maintaining a nice smile. You’re defending your health, by and large.

Are you surprised to hear some of the connections I mentioned? Have poor oral conditions affected your greater health in any way?

Did you know that if you look in the mirror and really examine and look closely at your teeth, cheek, gums, and lips you can tell a lot about your oral health?

Below are some common clues and what they might mean:

• Bleeding or red swollen gums is a classic sign of gum disease or possibly a manifestation of a systemic illness.
• Receding gums is another sign of gum disease and/or perhaps a result of incorrect or destructive brushing habits
• Yellow teeth can be caused by staining, poor oral hygiene, smoking, or ingestion of certain medications
• Dark marks on teeth can possibly be an indicator of dental decay, staining (eg. coffee and tea), embedded food particles, or smoking remnants.
• White spots on the tongue, cheek, lips, gums can be a sign of pathology (abnormal tissue) which could be caused by a virus, bacteria, irritation or other possible sources that need to be evaluated promptly by a dental professional.
• Swollen lips, gums can be a sign of an active infection, allergy or other systemic problem.
• Crooked teeth, can be a sign of malocclusion (bad bite), which if left uncorrected, can lead to possible periodontal (gum) trauma.
• Dry mouth can be a side effect of medications, dehydration, or possibly a systemic disease.

It’s important to keep in mind, though, that while what we see in the mirror can give us some clues, it doesn’t tell us the whole story. I recommend that people always follow up their self- exams with a visit to their Dentist or Periodontist.

What about you — anything concerning you when you see your teeth in the mirror?