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.”

You've probably heard your dentist say more than once to cut back on sweets. That's good advice not only for keeping your teeth healthy, but your whole body as well.

As a carbohydrate, a macronutrient that helps supply energy to the body's cells, sugar is prevalent naturally in many foods, particularly fruits and dairy. The form of which we're most concerned, though, is refined sugar added to candy, pastries and other processed foods.

Believe it or not, three out of four of the 600,000 food items on supermarket shelves contain refined sugar, often hiding under names like "high fructose corn syrup" or "evaporated cane syrup." So-called healthy foods with labels like "low fat" or "diet" have added sugar and chemicals to replace the taste of fat they've removed.

But perhaps the biggest sugar sources in the average U.S. diet are sodas, energy drinks, and sports drinks. With the added volume of sugar in processed foods, the growing consumption of sweetened beverages has pushed the average American's sugar intake to nearly 20 teaspoons a day—more than three times the recommended daily allowance.

And right along with the increased consumption of sugar, cases of Type 2 diabetes, heart disease and other systemic diseases have likewise risen. And, yes, preventable tooth decay continues to be a problem, especially in children, with sugar a major contributing factor in the prevalence of cavities.

So, what can you do to keep your daily sugar intake within healthy bounds?

• Check ingredient labels on packaged food for added sugar, chemicals or preservatives. If it contains sugar or "scientific"-sounding ingredients, leave it on the shelf.
• Be wary of health claims on food packaging. "Low fat," for example, is usually an indicator of added sugar.
• Drink water or unsweetened beverages instead of sodas, sports drinks or even juices. Doing so will vastly lower your daily intake of sugar.

A healthy diet with much less sugar and regular exercise will help you stay healthy. And with a lower risk for tooth decay, your teeth will also reap the benefits.

If you would like more information on the effects of sugar on your oral and general 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 “The Bitter Truth About Sugar.”

You're more apt to lose teeth because of periodontal (gum) disease and tooth decay than any other cause. But neither of these bacterial diseases have to happen: You can prevent them through daily brushing and flossing and twice-a-year dental cleanings.

But that's not all: You can also boost your dental care practices by eating foods that strengthen and protect teeth. On the other hand, a poor diet could reduce the effectiveness of your oral hygiene practices in preventing tooth decay or gum disease.

A diet that might lead to the latter is often high in refined sugar (sucrose), often added to processed foods and snacks to improve taste. But sucrose is also a top food source for oral bacteria, increasing their numbers when it's readily available. A higher bacterial population greatly increases your risk for tooth decay or gum disease.

On the other hand, certain foods benefit your overall dental health. Fresh fruits and vegetables, for example, are filled with nutrients and minerals like vitamin D or calcium that strengthen teeth against disease. And although they can also contain natural sugars, these don't pose the same problems as added sucrose due to the plant fiber you consume with them.

Dairy foods can also help you maintain healthy teeth and gums. Milk and cheese contain minerals like calcium and phosphorus, and a protein called casein, all of which strengthen teeth against decay. The enzymes in cheese stimulate saliva, which in turn neutralizes mouth acid and prevent it from harming enamel.

Some foods are also natural sources of fluoride, a mineral that strengthens tooth enamel. One example is black tea, which also, along with green tea, contains antioxidants that protect against cancer.

The best strategy for “tooth-friendly” nutrition is to pursue a diet that's high in fiber-rich natural foods and low in sugar-added processed foods. In practice, you'll want most of your diet to consist of fresh fruits and vegetables and low-fat dairy food, while minimizing foods with added sugar.

Following this kind of diet will certainly benefit your overall health. But it will also make it easier for you to prevent dental disease and keep your teeth and gums healthy.

If you would like more information on how nutrition can boost your dental 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 “Nutrition & Oral Health.”

Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.

Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).

Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.

It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.

A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.

For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.

The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.

An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.

If you would like more information on eating disorders and dental care, 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 “Bulimia, Anorexia & Oral Health.”

Knowing what to do—and what not to do—when your child is sick can greatly affect their health and well-being. That's especially true with dental problems.

Here then are some Dos and Don'ts for 3 common problems children experience with their teeth and gums.

Teething. An infant's first teeth breaking through the gums is a normal but often unpleasant experience. Fortunately, teething episodes only last a few days. And, there's usually no need to see the dentist unless they have a fever or diarrhea while teething. In the meantime:

• Do: provide them chilled (not frozen) cloth or plastic items to bite and gnaw, and massage their gums to relieve painful pressure. You can also give them an age-appropriate dose of a mild pain reliever.
• Don't: rub any medication on their gums, which can irritate them and other soft tissues. Never use alcohol or aspirin to alleviate teething discomfort. And avoid using anything with benzocaine, a numbing agent which can be hazardous to young children.

Toothache. Whether a momentary sensitivity to hot or cold or a sharp, throbbing pain, a child's toothache often signals tooth decay, a bacterial disease which could eventually lead to tooth loss.

• Do: make a dental appointment at your child's first complaint of a toothache. Ease the pain with a warm-water rinse, a cold compress to the outside of the jaw, or a mild pain reliever.
• Don't: rub medication on the teeth or gums (for similar reasons as with teething). Don't apply ice or heat directly to the affected tooth or gums, which can burn them.

Bleeding gums. Gum bleeding from normal brushing or flossing, along with red or swollen gums, may indicate periodontal (gum) disease. Although rare in children, it can still happen—and it can put an affected tooth in danger.

• Do: see your dentist if bleeding continues for a few days. Continue to brush gently with a soft-bristled toothbrush around the gums to remove plaque, a thin-biofilm most responsible for gum infection.
• Don't: brush aggressively or more than twice a day, which could unnecessarily irritate and damage the gums. And don't stop brushing—it's important to remove plaque buildup daily to lessen the gum infection.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation.