The red, scaly rash suddenly appearing on your face doesn’t cause you much physical discomfort, but it’s still embarrassing. And to make matters worse treating it as you would other skin ailments seems to make it worse.

Your ailment might be a particular skin condition known as peri-oral dermatitis. Although its overall occurrence is fairly low (1% or less of the population worldwide) it seems to be more prevalent in industrialized countries like the United States, predominantly among women ages 20-45.

Peri-oral dermatitis can appear on the skin as a rash of small red bumps, pimples or blisters. You usually don’t feel anything but some patients can have occasional stinging, itching or burning sensations. It’s often misidentified as other types of skin rashes, which can be an issue when it comes to treatment.

Steroid-based ointments that work well with other skin ailments could have the opposite effect with peri-oral dermatitis. If you’re using that kind of cream out of your medicine cabinet, your rash may look better initially because the steroid constricts the tiny blood vessels in the skin. But the reduction in redness won’t last as the steroid tends to suppress the skin’s natural healing capacity with continued use.

The best treatment for peri-oral dermatitis is to first stop using any topical steroid ointments, including other-the-counter hydrocortisone, and any other medications, lotions or creams on it. Instead, wash your skin with a mild soap. Although the rash may flare up initially, it should begin to subside after a few days.

A physician can further treat it with antibiotic lotions typically containing Clindamycin or Metronidazole, or a non-prescription, anti-itch lotion for a less severe case. For many this clears up the condition long-term, but there’s always the possibility of relapse. A repeat of this treatment is usually effective.

Tell your dentist if you have recurring bouts of a rash that match these descriptions. More than likely you’ll be referred to a dermatologist for treatment. With the right attention—and avoiding the wrong treatment ointment—you’ll be able to say goodbye to this annoying and embarrassing rash.

If you would like more information on peri-oral dermatitis, please contact us or schedule an appointment for a consultation.

Tooth decay is more prevalent than diseases like cancer, heart disease or influenza. It doesn't have to be—brushing with fluoride toothpaste, flossing, less dietary sugar and regular dental cleanings can lower the risk of this harmful disease.

Hygiene, diet and dental care work because they interrupt the disease process at various points. Daily hygiene and regular dental cleanings remove dental plaque where oral bacteria flourish. Reducing sugar eliminates one of bacteria's feeding sources. With less bacteria, there's less oral acid to erode enamel.

But as good as these methods work, we can now take the fight against tooth decay a step further. We can formulate a prevention strategy tailored to an individual patient that addresses risk factors for decay unique to them.

Poor saliva flow. One of the more important functions of this bodily fluid is to neutralize mouth acid produced by bacteria and released from food during eating. Saliva helps restore the mouth's ideal pH balance needed for optimum oral health. But if you have poor saliva flow, often because of medications, your mouth could be more acidic and thus more prone to decay.

Biofilm imbalance. The inside of your mouth is coated with an ultrathin biofilm made up of proteins, biochemicals and microorganisms. Normally, both beneficial and harmful bacteria reside together with the “good” bacteria having the edge. If the mouth becomes more acidic long-term, however, even the beneficial bacteria adapt and become more like their harmful counterparts.

Genetic factors. Researchers estimate that 40 to 50 hereditary genes can impact cavity development. Some of these genes could impact tooth formation or saliva gland anatomy, while others drive behaviors like a higher craving for sugar. A family history of tooth decay, especially when regular hygiene habits or diet don't seem to be a factor, could be an indicator that genes are influencing a person's dental health.

To determine if these or other factors could be driving a patient's higher risk for tooth decay, many dentists are now gathering more information about medications, family history or lifestyle habits. Using that information, they can introduce other measures for each patient that will lower their risk for tooth decay even more.

If you would like more information on reducing your risk of tooth decay, 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 “What Everyone Should Know About Tooth Decay.”

Brushing and flossing daily, and dental visits at least twice a year: These are the essential things you should be doing to protect your teeth and gums against dental disease. But you're also getting an automatic assist from your body through saliva, that humble fluid swishing around in your mouth, to protect your oral health.

It's more than simply “mouth water”: Without saliva and its various components, your risk for tooth decay or periodontal (gum) disease would be much higher. Here are 4 ways saliva helps you keep your teeth and gums healthy.

Cleansing. Chewing prepares your food for digestion, but in the process produces tiny particles of food debris. Settling on tooth surfaces, these bits become part of the dental plaque that forms on your teeth and develops the ideal breeding ground for disease-causing bacteria. Saliva helps rinse away much of this debris—particularly sugar, the primary food source for bacteria.

Protection. Saliva is the first line defense against disease-causing microorganisms entering the mouth. The primary source of this protection is a protein-based antibody called Immunoglobulin A (IgA), which directly fights infection-causing organisms. Another protein in saliva, lactoferrin (also found in tears), interferes with bacterial growth.

Buffering. The main enemy of tooth enamel is mouth acid, produced by oral bacteria and the foods that we eat. Saliva neutralizes acid to help the mouth maintain its normally neutral pH range. And it works fast: Saliva can buffer acid and restore balance within thirty minutes to an hour after eating.

Re-mineralization. It's normal for acid to build up after eating, and for it to quickly remove minerals from surface enamel, a process called de-mineralization that can soften and weaken the enamel. But saliva helps restore some of these lost minerals as it's neutralizing acid. This re-mineralization re-strengthens enamel against tooth decay.

Saliva is so important for maintaining a healthy mouth, it's worth your efforts to protect it. Diminished saliva production not only produces an unpleasant dry mouth, it may increase your risk for disease. If this is a constant problem, speak to your dentist about causes and remedies. You'll be doing your teeth and gums a favor.

If you would like more information on the role of saliva in maintaining oral 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 “Saliva: How it is Used to Diagnose Disease.”

Howie Mandel, one of America’s premier television personalities, rarely takes it easy. Whether performing a standup comedy gig or shooting episodes of America’s Got Talent or Deal or No Deal, Mandel gives it all he’s got. And that intense drive isn’t reserved only for his career pursuits–he also brings his A-game to boosting his dental health.

Mandel is up front about his various dental issues, including multiple root canal treatments and the crowns on his two damaged front teeth. But he’s most jazzed about keeping his teeth clean (yep, he brushes and flosses daily) and visiting his dentist regularly for cleanings and checkups.

To say Howie Mandel is keen on taking care of his teeth and gums is an understatement. And you can be, too: Just five minutes a day could keep your smile healthy and attractive for a lifetime.

You’ll be using that time—less than one percent of your 1,440 daily minutes—brushing and flossing to remove dental plaque buildup. This sticky, bacterial film is the main cause of tooth decay and gum disease. Daily hygiene drastically reduces your risk for these tooth-damaging diseases.

But just because these tasks don’t take long, that’s not saying it’s a quick once-over for your teeth: You want to be as thorough as possible. Any leftover plaque can interact with saliva and become a calcified form known as calculus (tartar). Calculus triggers infection just as much as softer plaque—and you can’t dislodge it with brushing and flossing.

When you brush, then, be sure to go over all tooth areas, including biting surfaces and the gum line. A thorough brushing should take about two minutes. And don’t forget to floss! Your toothbrush can’t adequately reach areas between teeth, but flossing can. If you find regular flossing too difficult, try using a floss threader. If that is still problematic, an oral irrigator is a device that loosens and flushes away plaque with a pressurized water stream.

To fully close the gate against plaque, see us at least every six months. Even with the most diligent efforts, you might still miss some plaque and calculus. We can remove those lingering deposits, as well as let you know how well you’re succeeding with your daily hygiene habit.

Few people could keep up with Howie Mandel and his whirlwind career schedule, but you can certainly emulate his commitment to everyday dental care—and your teeth and gums will be the healthier for it.

If you would like more information about daily dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health” and “10 Tips for Daily Oral Care at Home.”

The subject of allergies covers a wide swath in medicine. Among other things, people have allergic reactions to animal fur, various foods and plant pollen. The effects are equally wide-ranging, anything from a mild rash to anaphylaxis, a life-threatening shutdown of the body's vital systems.

Approximately 5% of people are also allergic to various metals including nickel, cobalt, chromium and gold. Reactions to metal can occur when an allergic person comes in contact with items like jewelry, clothing or even mobile phones. There's even a chance of a metal allergy reaction from certain kinds of dental work.

It's unlikely, though, that you should be concerned if you're considering dental treatment or cosmetic work to upgrade your smile. Although allergic reactions like inflammation or a rash have been known to occur with amalgam “silver” fillings, it's quite rare. It's even less of a concern since “tooth-colored” materials for fillings are now outpacing the use of amalgam fillings, which are used in out-of-sight back teeth.

Of course, metal is used for other dental treatments besides fillings, including the most popular of tooth replacement systems, dental implants. An implant is essentially a metal post, usually made of pure titanium or a titanium alloy, which is imbedded into the jawbone. Even so, there's little chance you'll develop an allergic reaction to them.

For one thing, titanium is highly prized in both medical and dental treatments because of its biocompatibility. This means titanium devices like prosthetic joints and implants won't normally disrupt or cause reactions with human tissue. Titanium is also osteophilic: Bone cells readily grow and adhere to titanium surfaces, a major reason for dental implants' long-term durability.

That's not to say titanium allergies don't exist, but their occurrence is very low. One recent study detected a titanium allergy in only 0.6% of 1,500 implant patients who participated.

At worst, you may need to consider a different type of tooth replacement restoration in the rare chance you have a titanium allergy. More than likely, though, you'll be able obtain implants and enjoy the transformation they can bring to your smile.

If you would like more information on allergic reactions and dental 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 “Metal Allergies to Dental Implants.”