By Mario A. Vilardi, DMD
March 14, 2018
Category: Oral Health
Tags: oral health   fluoride  

Like many other families, you may use formula instead of breast milk as a safe and healthy alternative to feed your infant. But, if you use a powdered form that you mix with water your child may be taking in more fluoride than they require.

Fluoride is a natural chemical that can strengthen tooth enamel and help prevent decay. After decades of study it's also been shown to pose no serious health risks. Because of fluoride's benefits and safety, many water utilities add tiny amounts to their drinking water supply.

But it can have one side effect called enamel fluorosis. If a child ingests too much fluoride during early development it can cause discoloring mottled spots or streaking in permanent teeth. Although it doesn't affect their health, the teeth can be unattractive and require cosmetic attention.

That's why it's best to keep fluoride consumption to a healthy minimum for children. That, however, is often easier said than done, since we can encounter hidden fluoride in a variety of places. Besides hygiene products and fluoridated drinking water, you may find fluoride in prepared juices and other beverages, bottled water or in foods processed with fluoridated water. There are no labeling requirements for fluoride, so you'll have to research to find out if a product contains fluoride.

There are, however, some things you can do to control your child's fluoride intake. First, know as much as you can about known sources your child may encounter like your water supply. You can find out if your utility adds fluoride and by how much by contacting them or visiting My Water's Fluoride online at

If you use fluoride toothpaste apply only a “smear” on the end of the brush for children under two and a pea-sized amount for older children. If you have fluoridated drinking water, consider breastfeeding your infant, use ready-to-feed formula or mix powdered formula with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”

And, do feel free to discuss your concerns with us during your child's regular checkup. We'll help you adjust their diet, water intake and hygiene habits to be sure they're receiving the right amount they need for developing strong teeth — and no more.

If you would like more information on appropriate fluoride levels for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Development and Infant Formula.”

By Mario A. Vilardi, DMD
February 27, 2018
Category: Dental Procedures

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”

How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.

The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.

If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.

If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.

If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Mario A. Vilardi, DMD
February 12, 2018
Category: Dental Procedures

Periodontal (gum) disease is potentially devastating to your teeth, gums and bone. To fight it we have to remove the substance that causes and sustains the disease from all oral surfaces — a thin layer of bacteria and food particles known as plaque.

To accomplish this task, we use a variety of hand instruments called scalers to mechanically remove plaque and calculus (hardened plaque deposits), as well as ultrasonic equipment to vibrate plaque loose and flush it away with water. If we detect plaque deposits well below the gum line and around the tooth roots, we may need to use other techniques like root planing or surgery to access these deeper areas.

 While gum disease is persistent and aggressive, these traditional techniques have proven quite effective in controlling the infection and restoring health to diseased gums. Yet like other aspects of medicine and dentistry, technological advances have created a new option for gum disease treatment: the Nd:YAG laser.

The Nd:YAG laser is named for the crystal it uses to produce a narrow and intense beam of light on a specific frequency. In recent years it's become an important surgical tool because it can distinguish between diseased and healthy tissue, destroying the former while not affecting the latter. It's being used now on a limited basis for treating gum disease, especially for removing infected tissue in deep pockets that can form below the gum line, and for removing plaque and calculus from root surfaces.

 Because of its precision, early evidence of effectiveness is encouraging: minimal tissue damage and swelling, less bleeding and reduced patient discomfort after treatment. The heat from the laser has also been shown to kill bacteria and essentially sterilize the area.

Still, the findings aren't conclusive enough as to whether lasers are superior in most circumstances to traditional scaling methods. For the time being, we'll continue to use the tried and true methods for removing plaque and calculus. But as laser technology advances, the time may come when this new approach to gum disease treatment will become a more prominent and beneficial option for patients.

If you would like more information on your treatment options for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Lasers Versus Traditional Cleanings for Treating Gum Disease.”

By Mario A. Vilardi, DMD
February 04, 2018
Category: Oral Health
Tags: gum disease  

It’s bad enough the diseases caused by poor dental hygiene or lack of dental checkups could be leaving your teeth and gums more at risk. But current scientific research seems to indicate those same dental diseases may also cause you problems in other parts of your body.

The connection is especially pronounced with periodontal (gum) disease, a family of disorders that can eventually lead to tooth loss. Gum disease is caused by plaque, a thin film of bacteria and food particles that builds up on tooth surfaces due to a lack of daily brushing and flossing. Even skipping one day of hygiene increases the level of oral bacteria that cause these infections.

As it spreads, the infection causes the gum tissues to become inflamed and ulcerated. The gums weaken to the point where they easily bleed even when mildly brushed. This allows access for bacteria and other toxins to enter the bloodstream where they may eventually affect other organ systems. We’re now finding that conditions as varied as cardiovascular disease, osteoporosis, diabetes or rheumatoid arthritis (which all share a common thread with inflammation) may be affected by gum disease — and vice-versa.

If you have any of these or similar conditions, it’s important for you to stay vigilant in maintaining healthy teeth and gums. It's necessary to brush and floss daily to remove plaque buildup as well as dental checkups at least twice a year. You should also keep a close eye out for early signs of gum disease, like bleeding, swollen or reddened gums. If so, call us for an appointment as soon as possible.

Keeping your teeth and gums disease-free and healthy could have a positive impact on your treatment for other health conditions. You’ll be doing your mouth and the rest of your health a favor.

If you would like more information on how periodontal (gum) disease affects the body, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”

By Mario A. Vilardi, DMD
January 20, 2018
Category: Oral Health
Tags: gum disease   oral health  

Is there a link between periodontal (gum) disease and cardiovascular disease? Medical researchers are endeavoring to answer this intriguing question, but early findings seem to say yes. If it bears true, the findings could advance treatment for both diseases.

There is one thing that can be said for certain: inflammation is a factor in both diseases’ progression. Gum disease begins as an infection caused by bacteria growing in plaque, which is made up of bacteria and a thin film of food remnant that adheres to tooth surfaces. The body responds to this infection through tissue inflammation, an attempt to prevent the infection from spreading. Likewise, inflammation appears to be a similar response to changes in blood vessels afflicted by cardiovascular disease.

While inflammation is part of the body’s mechanism to heal traumatized tissue, if it becomes chronic it can actually have a damaging effect on the tissues intended to benefit. For patients with gum disease, chronic inflammation causes connective tissues to detach from teeth, leading eventually to tooth and bone loss. Similarly, inflammation damages the linings of blood vessels in cardiovascular disease patients.

Researchers want to know what role bacteria may also play in the progression of cardiovascular disease. Initial studies seem to indicate that proactively treating the gum disease by removing all plaque from oral surfaces in patients with both conditions does appear to improve the health of diseased blood vessel linings. Whether this could ultimately reduce the occurrence of heart attack or stroke still needs to be ascertained.

As we learn more about the possible connections between these two diseases, there’s hope it will lead to new advancements that could improve health outcomes for both. It may prove to be the case, then, that maintaining a healthy mouth promotes a healthy heart, and vice-versa.

If you would like more information on the connection between gum disease and heart disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Inflammation and Heart Disease.”

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