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    Angular Cheilitis (cracks on both corners of mouth) - how/why/STD?
    Anon_23520 posted:
    It appears from the reading I have done that I have Angular Cheilitis - both corners of my mouth are crusty, they hurt a bit when I open my mouth too wide, and feel/look as if they could bleed, but have not.

    My first question is this: can this be from oral sex? More specifically, my partner giving me oral sex and then kissing me and/or sharing with me my vaginal fluids after an orgasm? And if I have this issue and this IS the cause, is it likely that he has the same condition? This activity was about 1 week before I noticed the cracking on the corners of my mouth.

    My second question: can this be spread this to him or another partner - kissing, oral sex, any way at all?

    I have to say, this is NOT something I envisioned with a safe partner, and I am hoping beyond hope that it is a vitamin deficiency and not a bacterial or staph infection. That might lead me to giving up sex entirely!! I've never read about this when reading about STD's so I'm quite confused. And just having entered back into the world of, well, dating and sex, it could be that I'm jumping to all kinds of conclusions.

    Many thanks for your answers. I'm planning on going to my local express medical care office after work, now that I have read about angular cheilitis, but I'd like to be "armed" when I go.

    Gwen Cohen Brown, DDS, FAAOMP responded:
    Hi Anon_23520,

    Angular Cheilitis is NOT a sexually transmitted disease. (I will get back to this later in my response).

    Although I cannot diagnose you online what you have described does seem to fit into the clinical diagnosis of angular cheilitis.

    Before I respond to your question you should be aware that candida is a normal part of your oral flora and is supposed to be in your mouth. It helps keep the bacteria and microorganisms that also live in your mouth in check. Therefore testing to see if you can grow candida on an agar plate is a waste of time and money, of course a culture will show growth of candida, as it is supposed to live in your mouth.

    A very very (very) long time ago Angular Cheilitis was thought to be a vitamin deficiency specifically a vitamin b deficiency. However, unless you have a GI disease like Irritable bowel syndrome or an intrinsic factor disorder where you are not absorbing nutrients through your gut, it is virtually impossible to have a vitamin b deficiency in this country as everything is vitamin fortified or enriched.

    Oral candidiasis, colloquially referred to as "thrush', is a common fungal infection that may present in both immunocompetent and immuno- compromised patients.

    Oral candidiasis may result in pain on swallowing, oral discomfort, localized swelling, bitter or sour taste and loss of function in addition to angular cheilitis.

    It is associated with numerous local and systemic conditions including decreased vertical dimension, dry mouth, braces, drooling during sleep, immunosuppression, HIV infection, chemotherapy, poorly controlled diabetes, xerostomia, and denture stomatitis. To name a few.

    Chronic Angular Cheilitis: Presents as perioral erythema and/or cracking, fissuring and superficial ulceration at the corners/commissures of the mouth. It can be quite painful if left untreated.

    What I can tell you is that regardless of why you have angular cheilitis, the clinical presentation of angular cheilitis is always due to a yeast infection.

    Can you get it or give it to a partner during sex. Yes but the much more likely explanation is that you have an over growth of the fungal organisms that are supposed to live in your mouth.

    My recommendation is to figure out first if you have an intra oral yeast infection. If you do, treat it with an OTC or prescription anti fungal preparation and most likely the corners of your mouth will improve.

    The WORST possible thing to do is apply petroleum jelly to the affected area. Petroleum jelly is hydrophilic it will suck the moisture out of the thin skin of the lips and make the problem much worse and last longer. Vaseline is great for elbows but not the delicate skin of the lips.

    So angular cheilitis is a chronic yeast infection. It will go away however dry mouth, dentures, medication, air conditioning, may all affect how quickly you will feel better.

    If it continues to bother you I recommend seeing your dentist or physician for a prescription or checking with the pharmacist for an OTC remedy.

    I hope this helps!

    Dr. Gwen Cohen Brown
    lmsc1957 replied to Gwen Cohen Brown, DDS, FAAOMP's response:
    OMGosh, Dr. Brown, you've been so much help! I still have these cracks. They seem to come and go. I'm trying not to put any lip gloss on that part of my lips but I'm sure it is spreading there. It is darn hard to go without at work -- a little lip gloss goes a long way to keep a fresh face.

    Anyway, you've been so much help. I'll stop at the drug store today and see what my pharmacist recommends. You don't say how to find out if I have that intra oral yeast infection, and I don't see anything online. If you happen back this way in the near future, would you let me know?

    I read about thrush. Hmm. I have in this time period had a canker sore or two, (so, yes,"pain" in my mouth, and one day I had something on my tongue but it went away...just a nagging feeling like a cancer soar was on its way) unlike me unless I've bitten my cheek or tongue. I do wear a bite guard at night as I clench and grind my teeth. I would like to think I practice good oral hygiene but I could do better, and I read that for new babies who have thrush, to rinse their pacifiers in equal parts vinegar and water, so I will start doing that with my bite guard.

    Interestingly, about 2 months ago my (new) dentist told me to start using a mouthwash with alcohol in it (yuck yuck) and I started but stopped because I couldn't stand it. I read that mouthwash can be bad for the good germs in your mouth.

    Thanks again for your help. This has put me at ease, for certain. And my nutrition has been lacking, so I'm improving that, for all good reasons. And, I'm going to get some unsweetened yogurt - my digestive system isn't all that happy with it (gas!!) but I'll deal with that!

    Gwen Cohen Brown, DDS, FAAOMP replied to lmsc1957's response:
    Hi Imsc1957,
    You are welcome!
    Dr. Gwen Cohen Brown
    lmsc1957 replied to Gwen Cohen Brown, DDS, FAAOMP's response:
    By the way, for anyone who reads this, the anti-fungal cream didn't do anything for me, for 3 weeks.

    With the help of my very-knowledgeable-about-vitamins chiropractor, I started on a really good quality vitamin B supplement (a couple of B's) and one side of my mouth has cleared up, the other is getting better.
    I knew I had been eating poorly, busy schedule and eating a meal replacement bar instead of a meal, so I wasn't surprised I had a deficiency.

    So the "old wives tale" that this is not a vitamin deficiency is not so old, nor a tale!!!
    hail78 responded:
    I am not a doctor but I had this angular cheilitis for 3 months and found out It was a staph infection and the only thing that got rid of it was a prescription antibiotic ointment called mupirocin...2%. I was wrongly Diagnosed....
    Kcida responded:
    The tongue scraper on your toothbrush is the main cause of angular chilitis. So get a new toothbrush if it has a tongue scraper and don't run the bristles over the corners of your mouth either trying to get the toothpaste off at the end of brushing your teeth. Don't use any creams or anything just be careful on the corners of your mouth. Because it's a wound on the corner of your mouth and the fungus and bacteria inside your mouth infects the wound and you get discoloration and breakouts beyond the corner of your mouth.

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