What are the treatments for dental issues affecting the buccal area?

Management of Dental Issues Affecting the Buccal Area

Initial Assessment and Identification of Causative Factors

The dental team should first evaluate for sources of mechanical trauma, including ill-fitting dental prostheses, fractured teeth, or sharp dental restorations that may be causing buccal mucosal irritation. 1, 2

• Perform a systematic visual inspection of the entire oral cavity to identify all affected areas and document the duration of symptoms 2
• Counsel patients to avoid conscious cheek biting or tongue thrusting against the buccal mucosa to prevent further irritation 1, 2
• If ulcers or lesions are present and persist beyond 2 weeks, obtain blood tests including complete blood count, coagulation studies, fasting blood glucose, HIV antibody, and syphilis serology before considering biopsy 2

Essential Oral Hygiene Protocol

Brush teeth twice daily with a soft toothbrush using the Bass or modified Bass method, as this reduces bleeding risk and maintains optimal oral health. 3, 1

• Use a mild, fluoride-containing, non-foaming toothpaste to minimize irritation 3, 4
• Replace the toothbrush monthly to maintain optimal softness and hygiene 3, 4
• Rinse the brush thoroughly after use with water and store with bristles facing upward 3, 4
• If standard soft brushing causes discomfort, switch to an ultrasoft toothbrush or foam swab 4

Mouth Rinsing Regimen

Rinse with alcohol-free mouthwash at least 4 times daily for approximately 1 minute with 15 ml of solution, as alcohol-containing products will exacerbate oral discomfort and impair healing. 3, 1, 2

• Alternative rinses include bland solutions (1 teaspoon salt, 1 teaspoon baking soda in 4 cups water), sterile water, normal saline, or sodium bicarbonate solutions 4, 2
• Gargle gently and spit out; avoid eating or drinking for 30 minutes after rinsing 3, 4

Avoidance of Aggravating Factors

Completely eliminate tobacco, alcohol, spicy foods, acidic foods (tomatoes, citrus fruits), hot beverages, and crusty/abrasive foods that will aggravate buccal mucosal tissues. 3, 4

• Avoid all alcohol-containing mouthwashes as they cause additional pain, irritation, and impair healing 4, 2
• Do not use dental floss or interdental brushes if not already part of your regular routine, as these can break the epithelial barrier and cause bleeding in inflamed tissues 3, 4

Supportive Measures for Symptom Relief

Drink ample fluids throughout the day to keep the oral mucosa moist and prevent dryness-related irritation. 3, 1

• Apply lip balm containing only animal or plant-based oils (beeswax, cocoa butter, lanolin) to prevent lip cracking 2
• Avoid chronic use of petroleum jelly on lips, as it promotes mucosal cell dehydration and creates an occlusive environment that increases secondary infection risk 3, 2
• For symptomatic pain relief, topical lidocaine can be applied to affected areas not more than 3 to 4 times daily 5

Treatment Escalation Criteria

If symptoms do not improve after 1-2 weeks of conservative treatment, reevaluate for correct diagnosis and consider biopsy, as many conditions can mimic benign lesions including infections, drug reactions, and malignancies. 2

• Ulcers persisting beyond 2 weeks require more aggressive workup 2
• For periodontitis affecting the buccal area, initial non-surgical therapy consists of scaling and root planing; residual active disease may require regenerative or resective surgical therapy 6

Common Clinical Pitfalls

• Do not rely solely on clinical appearance for diagnosis, as bullous diseases, infections, and malignancies can present similarly to benign conditions 2
• Petroleum-based lip products should be avoided despite their popularity, as they create conditions favoring secondary infection 3, 2
• Quality of oral hygiene is more important than frequency; efficient cleaning has demonstrated preventive effects on oral disease 7