Redness, swelling, cracks, pain, a noticeable crust and bleeding are symptomatic and it can afflict one or both sides of where the upper and lower lips meet. (Yours – not yours and someone else’s. That’s much more pleasant.) Sometimes it can extend to part of the lip, but it primarily corners itself in the corners.

Also known by the other terms of cheilosis, angular stomatitis, rhagades, and perlèche, depending on the underlying cause it can last for days or persist indefinitely. One positive is that it’s non-contagious; the simplest cause being old skin cells at the mouth corners (labial commissures) allowing saliva to create too much moisture, and then drying.

It’s this that leads to the painful fissures; the blistering can be irritation or infection. Having deep furrows that are clinically referred to as ‘marionette lines’ can be a contributor.

Yeast or bacteria can be infectant causes. In some cases it’s polymicrobial – having both as contaminants: candida, as well as the bacteria staphylococcus (staph) or streptococci (strep).

There are a number of risk factors in contracting angular cheilitis. Diabetes is one contender, as it is with other oral health conditions. Elevated blood glucose levels create a more sugary saliva and a dry mouth – creating an environment that promotes dental plaque build-up and greater susceptibility to cavities and periodontitis.

Allergy sensitivities, anaemia, and immune system vulnerabilities from chronic disease, and cancer treatments are also potential determinants. Still, the list continues and extends to nutritional issues.

It’s not uncommon for older people in particular to have iron, zinc and vitamin B deficiencies; something that bariatric patients can also suffer. Poor diet can occur across the board and can too, be responsible. Those with either celiac disease, or the chronic conditions of gastritis or pancreatitis are also highly prone to needing useful remedies to resolve, or at least alleviate the physical discomfort – and for some, the embarrassment – that comes with angular cheilitis.

The certainty in all of this, is that these are people who really don’t need something else they have to deal with. Were any of this broad group to have oral thrush and ill-fitting dentures as well, then the world really has lost sight of what’s fair and equitable.

Yes, a dentist can play a crucial role in diagnosing and treating angular cheilitis, especially when the condition is linked to oral health issues. Here’s how:

1. Identifying Oral Health Risk Factors

A dentist can assess whether oral factors, such as ill-fitting dentures, poor dental hygiene, or missing teeth, are contributing to angular cheilitis. Addressing these issues may help prevent recurrence.

2. Prescribing Antifungal or Antibiotic Medications

If a fungal or bacterial infection is detected, a dentist can prescribe antifungal ointments (such as nystatin or clotrimazole) or antibiotic creams to eliminate the infection.

3. Adjusting Dentures and Dental Appliances

For patients with dentures, a dentist can ensure that they fit properly and provide guidance on proper cleaning to prevent fungal buildup. In some cases, replacing old dentures or using dental adhesives may help reduce saliva pooling.

4. Recommending Oral Hygiene Practices

Good oral hygiene can prevent bacterial and fungal growth. A dentist can recommend specific oral care routines, including using an antiseptic mouthwash, brushing with fluoride toothpaste, and avoiding habits that may worsen the condition, such as excessive lip licking.

5. Assessing Nutritional Deficiencies

While a dentist is not a nutritionist, they may identify signs of deficiencies that could be contributing to angular cheilitis and suggest that patients see a doctor or dietitian for further evaluation.

Additional Treatment Options

In addition to dental interventions, other treatment approaches can help manage and prevent angular cheilitis:

Topical Ointments: Over-the-counter antifungal or antibacterial creams can help clear infections.

Lip Balms and Moisturisers: Keeping the lips hydrated with petroleum jelly or hypoallergenic lip balms can prevent cracking.

Nutritional Supplements: Taking vitamin B complex, iron, or zinc supplements may help if deficiencies are identified.

Medical Consultation: If angular cheilitis is persistent or severe, seeing a dermatologist or primary care doctor is recommended for further evaluation.

There are simple home remedies that can work and negate the need for medical treatment – denture issues withstanding. This of course requires the expertise of your dentist, and is likely to include a dental technician or a prosthodontist.

Icy compresses, the application of vaseline or lip balm, and avoiding the extremes of wind, cold and spicy foods are obvious basics. Toothpaste and mouthwashes can irritate. The antibacterial qualities of honey can help; as can applying the coolness of cucumber. Salt water rinses are useful. What seems so counterproductive given the weather to stay out of, is exposure to strong sunlight. It kills fungus and bacteria, so day at the beach with a few salty swims would be perfect. Dietary changes to improve the intake of folates – and depending upon your point of view in terms of the value of supplements – vitamin B, zinc and iron can aid healing.

Failing those suggestions, a zinc-oxide ointment can get results.

Further to that, a more intensive treatment is necessary. Particularly if it’s recurring. Your dentist can properly diagnose the problem and based on the severity and duration of the condition, prescribe the specific medication. That’ll finally put a smile on your face that doesn’t crack the corners.

Disclaimer: The material posted is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis or treatment. Results vary with each patient. Any dental procedure carries risks and benefits. If you have any specific questions about any dental and/or medical matter, you should consult your dentist, physician or other professional healthcare providers.

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