Exfoliative cheilitis and lip damage: A clinical overview for dental hygienists

In an appearance-conscious world, patients today are increasingly concerned about their outward appearance. Various media have heightened public awareness of appearance, making patients very aware of any variations in what is deemed “normal.” The mouth and lips are so prominent that when there are abnormalities, patients want our help—both to fix their appearance and address concerns about cancer and other abnormal disease states. That is why chronic lip peeling, lip scaling, and ulcerative lesions of the lip will bring patients into a dental practice searching for answers.

Lip abnormalities

Abnormalities of the lips and their various causes include the following:

• lip injuries

• exfoliative cheilitis

• basal cell and squamous cell carcinoma

• angular cheilitis

• cheilocandidiasis

• parafunctional causes, such as lip smacking, lip biting, and chronic lip licking

• circumoral dermatitis

• chronic chapped lips

• mouth breathing resulting in lip fissures

• allergy-type reactions from lip products, toothpaste, and dental products

• metal allergy reactions

• food sensitivity

• damage from sun exposure

• contact dermatitis and skin diseases such as lichen planus, scleroderma, and pemphigus/pemphigoid

An abnormal outward appearance of the lips usually demands an etiology for the patient. Hygienists can begin by asking questions to narrow the prospect of the offending product or disease state.