My Blog

Posts for: February, 2018

By Randal Bourjaily, D.D.S. P.C.
February 19, 2018
Category: Oral Health
Tags: medicine  
WhytheOintmentYoureUsingCouldbeMakingYourFacialRashWorse

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.


By Randal Bourjaily, D.D.S. P.C.
February 11, 2018
Category: Dental Procedures
BracesTakeAdvantageofTeethsNaturalAbilitytoMove

There are many new and exciting ways now to transform an unattractive smile into one you'll be confident to display. But not all “smile makeover” techniques are new — one in particular has been around for generations: using braces to correct crooked teeth.

Braces have improved the smiles (and also dental health) for millions of people. But as commonplace this orthodontic treatment is, it wouldn't work at all if a natural mechanism for moving teeth didn't already exist. Braces “partner” with this mechanism to move teeth to better positions.

The jawbone doesn't actually hold teeth in place — that's the job of an elastic gum tissue between the teeth and bone called the periodontal ligament. Tiny fibers extending from the ligament attach to the teeth on one side and to the bone on the other. In addition to securing them, the dynamic, moldable nature of the ligament allows teeth to move incrementally in response to forces applied against them.

To us, the teeth feel quite stationary (if they don't, that's a problem!). That's because there's sufficient length of the tooth roots that are surrounded by bone, periodontal ligament and gum tissue. But when pressure is applied against the teeth, the periodontal ligament forms both osteoblasts (bone-forming cells) and osteoclasts (bone-resorbing cells) causing the bone to remodel. This allows the teeth to move to a new position.

Braces take advantage of this in a controlled manner. The orthodontist bonds brackets to the outside face of the teeth through which they pass a thin metal wire. They attach the ends of the wire to the brackets (braces), usually on the back teeth. By using the tension placed in the wire, the orthodontist can control the gradual movement of teeth to achieve proper function and aesthetics. The orthodontist continues to monitor the treatment progress, while making periodic adjustments to the tension.

It takes time, but through this marvelous interplay between nature and dental science you'll gain a more healthy and beautiful smile.

If you would like more information on improving your smile with orthodontics, 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 “Moving Teeth with Orthodontics.”