Soft tissue changes in the oral cavity can be a source of discomfort and may discourage full compliance with a daily hygiene regimen.
Angular cheilitis appears as a horizontal fissuring at the commissure of the lips. It can be caused by candida, other organisms, or by a nutritional deficiency. Angular cheilitis may also be a result of a decrease in vertical dimension of occlusion. While angular cheilitis is not an age-related change, it is often noted in elderly patients and usually makes it uncomfortable for the patient to open their mouth fully and for extended periods of time. Dentists may prescribe or recommend application of anti-fungal ointment to treat angular cheilitis; however, due to normal aging of skin and changes in the immune system, topical medications will take up to twice as long to be effective.
Loss of elasticity can be noted around the mouth opening. Dehydration can also result in dry lips and a "purse-string" appearance. Retraction during exam and treatment procedures may be more difficult and may produce patient discomfort. Gentleness during retraction, a lubricant applied to the lips, and encouraging the patient to stop opening short of the maximum all may be helpful.