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Angular Chelitis – is inflammation of one, or more commonly both, of the corners of the mouth. The inflammation is caused by yeast development in the area. The condition may show itself as deep cracks or splits in the lips, and the inflamed area may extend onto the skin of the face. In severe cases, the splits can bleed when the mouth is opened and shallow ulcers or a crust may form. It is a fungal disease, which is difficult to treat long term, and commonly recurs.

Angular chelitis has long been a curious disorder to treat. It is difficult to know the cause of the angular chelitis from individual to individual. The usual culprits include poor diet and nutrition (specifically Zinc or Vitamin B2 deficiencies) and certain medications. Angular chelitis can also be caused by the loss of vertical dimension of the teeth. Vertical dimension refers to the height of our teeth, which over time becomes less and less as our teeth wear or our dentures break down. This in combination with the aging process can lead to loose flabby skin at the corners of the mouth. These folds cause a warm, moist, dark environment in which, yeast flourishes.

Solutions For Angular Chelitis

There have been many home remedies tried in treating angular chelitis. These include vitamin regimens, tea tree oils, fish oil, and even a combination of grapefruit and vodka. None of these angular chelitis treatments work. The best approach is to eliminate the source of the issue. Dentists have long known that the loss in vertical dimension coupled with the flabby skin at the sides of the mouth are the triggers in most cases of angular chelitis. Angular Chelitis treatments include:

-Topical Antibiotic/Antifungal Treatment – monostat topical cream is a very effective solution. It needs to be applied externally only, and throughout the day for 2-3 weeks. In many cases this is a temporary solution at best as the root cause of the problem, the mouth folds in the corners, has not been solved. As the patient loses more tooth height, the folds of skin will increase in depth causing the angular chelitis to become harder and harder to treat.

-Increase Vertical Dimension – Once the yeast has been treated and eliminated, the only way to keep it from returning is to address the corner folds. This can be done in a variety of ways but the goal is to open the bite, or increase tooth height, to remove or lessen the presence of the folds around  the mouth. This can be achieved through the fabrication of a new denture (for denture wearers) or through the use of crowns to modify the bite.

-Use of Dermal Fillers – Luckily, we have a third option which many prefer. It includes the use of dermal fillers (such as Restylane and Juvederm) to replace lost volume in the tissues of the lower face. These dermal fillers are generally used in combination with Botox to relax the muscles and subsequently smooth out the wrinkles surrounding the mouth.

Angular Chelitis Conclusion

Angular chelitis can be a long term problem if not treated correctly. It can become quite uncomfortable and unsightly. Some may only be able to utilize the topical antifungal treatment, while others may be able to remove the problem permanently by increasing dental height with the aforementioned dental treatments. Fortunately, we have options at our disposal to treat this condition. You no longer need to be frustrated or embarrassed by this infection. See your dentist to see which treatment is best for you!



Just about everyone will grind their teeth from time to time. Grinding of your teeth (bruxism is the medical term for this) on rare occasions generally does not cause any harm. But when teeth grinding and clenching occurs on a regular basis damage can occur to the teeth, surrounding tissues, and other oral health complications can present themselves.

What is Teeth Grinding?

teeth grinding

Bruxism is the term that refers to a constant grinding and clenching of the teeth and jaws, unintentionally, and at inappropriate times. Bruxers (people with bruxism) are often unaware that they have developed this terrible habit. They often do not know or realize that treatment is available until damage to the mouth and teeth has already been done. Bruxism damage can present itself in a variety of ways. Every individual may experience symptoms a little differently.

Stress and anxiety are often thought as the major culprits of grinding. But it often occurs during sleep and is just as likely to be caused by an abnormal bite alignment (occlusion) or missing or crooked teeth.

Bruxism is considered to be a habit rather than a normal reflexive chewing activity. Reflexive events are responses to various stimuli and always occur without you being able to stop them (like the little hammer on the knee which makes your leg kick). Chewing and clenching can be controlled either consciously or subconsciously by the brain. During sleep, and often during daytime awake hours when we are distracted, our subconscious can take over allowing teeth grinding to happen. Bruxism can be quite rhythmic in nature. Researchers have classified bruxism as a habitual behavior and a sleep disorder.

Signs and symptoms of bruxism or teeth grinding can include:

-Anxiety, stress, and/ or tension. This can include tense musculature of the face and jaws. Waking up with an ache in the jaws face or teeth, or a headache.

-Teeth appear worn down or loose. Wear occurs from the aggressive movement of the teeth against one another. Although all teeth may show this type wear, it is especially noticeable when a person has front teeth that appear having theteeth grinding same length, as if they were somehow filed down.

-Chipped or cracked teeth. As teeth become worn, the edges of front teeth and the cusps (or corners) of back teeth will begin to show tiny fractures or cracks. These cracks generally can not be visualized by x-rays. It takes magnified vision or use of a dental microscope to diagnose them. Teeth with these type of fractures may eventually require further extensive treatment to restore their function. This could include large fillings, crowns, or even root canal therapy. Root canal treatment would be needed if the nerve was so inflamed that it could no longer heal itself, or a fracture extended into the nerve or pulpal area of the tooth allowing bacteria to leak in.

Tooth sensitivity that is quite pronounced. Can be a constant ache, sensitive to touch or chewing,  hot, cold, or even sweet sensitivity.

Receding gums and/or teeth with notches in them at the gum line. Most people have been told or assume that receding gums occur because of age, aggressive brushing or the presence of periodontal disease. In the majority of cases this is wrong.Bruxism These are called abrasion areas. When teeth grind hard against each other over time, the teeth will flex at the gum line and the enamel (which becomes quite thin in this area) micro fractures away. You end up with an area at the gum line that you can catch your fingernail in and can get very sensitive to touch and/or cold due to exposure of the root and closeness to the nerve endings.

-Jaws falling out of normal position or locking.

-Wearing away of the tooth enamel, exposing the dentin under the enamel.

-A popping or clicking in the temporomandibular joint (TMJ).

-Damage to the inside of the cheek tissues and tongue. Sometimes a bruxer will actually bite themselves on inside of the cheeks and tongue, (especially in the back part of the molar area).

The symptoms of bruxism can resemble other conditions or medical problems.

How is Bruxism Diagnosed?Teeth grinding

During routine dental examinations, your dentist will examine the teeth for evidence of bruxism. This often noted by the damage to the teeth. If the signs are present, the dentist may ask you some follow up questions to see if you have any of the other symptoms, such as snoring.It has been found that patients who both snore and grind have a much higher chance of developing sleep apnea.

Treatment

The goals of treatment are to reduce or remove pain, prevent permanent damage to the teeth, and to decrease the actual clenching. Treatment generally includes a custom made nightguard. The night guard is made for you to hold your teeth in a better position and protect your teeth when you grind to absorb the force of biting. This guard may help to prevent future damage to the teeth and aid in changing the patient’s behavior over time.

As always maintain a regular schedule of visiting your dentist so that these issues can be diagnosed in a timely manner should they arise. Also, of note is that this can affect children as well.