By Mario A. Vilardi, DMD
February 27, 2019
Category: Oral Health
Tags: canker sores  
YouMayNeedYourDentistsHelpEasingthePainofSevereCankerSores

Canker sores, known medically as aphthous ulcers, are fairly common among people. Lasting for about a week or so, these mouth sores are usually more irritating than painful. But about a quarter of the population, especially women, frequently suffer from an acute form that doesn't often respond well to over-the-counter remedies.

A typical canker sore is usually round with a yellow-gray center ringed by a reddened "halo." They can be preceded by tingling or painful sensations at the site a few hours or so before breaking out. Recurrent aphthous stomatitis (RAS) is the more severe form of canker sore, often with outbreaks of multiple painful sores. While the more common sore is usually less than a centimeter in diameter, RAS sores are often much larger.

Canker sores often arise during periods of stress or anxiety, and seem to be connected with eating certain acidic foods like tomato sauce, citrus fruits or spicy dishes. RAS also seems to be related to underlying systemic conditions like vitamin deficiencies, anemia or digestive disorders. Besides managing diet and stress, people with regular canker sores and milder cases of RAS can often find relief with non-prescription numbing agents often found in stores and pharmacies.

For more severe RAS, though, you may need the help of your dentist or physician with treatments like prescription steroids or other medications that come in gel or rinse form or through injections. The goal of any treatment approach is to decrease pain severity and shorten healing times after an outbreak.

While most mouth sores, including RAS, aren't dangerous to your health, you should still take any sore seriously. You should especially seek medical evaluation if a sore doesn't heal after a couple of weeks, if they seem to come more frequently and are more severe, or if you don't seem to ever be without a sore in your mouth. These could indicate a serious underlying problem that needs to be addressed.

One thing's for sure: there are ways to ease your suffering if you have frequent bouts with regular canker sores or even RAS. Talk to your dentist about ways to minimize your discomfort from these irritating mouth sores.

If you would like more information on aphthous ulcers or canker sores, 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 “Mouth Sores.”

By Mario A. Vilardi, DMD
February 17, 2019
Category: Oral Health
Tags: gum disease   nutrition  
WatchWhatCarbsYouEattoReduceYourRiskofFurtherGumDisease

If you’ve had issues with periodontal (gum) disease, no doubt a few things have changed for you. You may be seeing us for dental cleanings and checkups more frequently and you have to be extra diligent about your daily brushing and flossing.

There’s one other thing you may need to do: change your diet. Some of the foods you may be eating could work against you in your fight against gum disease. At the same time, increasing your intake of certain foods could boost your overall oral health.

The biggest culprits in the first category are carbohydrates, which make up almost half the average diet in the Western world, mainly as added sugar. Although carbohydrates help fuel the body, too much can increase inflammation—which also happens to be a primary cause of tissue damage related to gum disease.

Of course, we can’t paint too broad a brush because not all carbohydrates have the same effect on the body. Carbohydrates like sugar or processed items like bakery goods, white rice or mashed potatoes quickly convert to glucose (the actual sugar used by the body for energy) in the bloodstream and increase insulin levels, which can then lead to chronic inflammation. Complex or unprocessed carbohydrates like vegetables, nuts or whole grains take longer to digest and so convert to glucose slowly—a process which can actually hinder inflammation.  

Eating less of the higher glycemic (the rate of glucose conversion entering the bloodstream) carbohydrates and more low glycemic foods will help reduce inflammation. And that’s good news for your gums. You should also add foods rich in vitamins C and D (cheese and other dairy products, for instance) and antioxidants to further protect your oral health.

Studies have shown that changing to a low-carbohydrate, anti-inflammatory diet can significantly reduce chronic inflammation in the body and improve gum health. Coupled with your other efforts at prevention, a better diet can go a long way in keeping gum disease at bay.

If you would like more information on the role of diet in dental health, 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 “Carbohydrates Linked to Gum Disease.”

By Mario A. Vilardi, DMD
February 07, 2019
Category: Dental Procedures
Tags: gum recession  
YouMayNeedSurgerytoRepairtheDamageofGumRecession

Gum recession is an all too common problem for millions of people that if left untreated could lead to tooth and bone loss. But the good news is not only can the process be stopped, much of the damage can also be repaired through periodontal plastic surgery.

Gum recession occurs when the gum tissue protecting the teeth detaches and draws back to expose the root surface. This exposure may result in a range of effects, from minor tooth sensitivity to eventual tooth loss. There are a number of causes for gum recession, including overaggressive brushing or flossing, biting habits or badly fitting dentures or appliances.

The most prominent cause, though, is periodontal (gum) disease, a bacterial infection triggered by plaque buildup on tooth surfaces due to poor oral hygiene. Fortunately, early gum disease is highly treatable by thoroughly cleaning tooth, root and gum surfaces of plaque and calculus (hardened plaque deposits), along with possible antibiotic therapy, to reduce the infection and promote tissue healing.

Unfortunately, advanced cases of gum recession may have already resulted in extensive damage to the tissues themselves. While disease treatment can stimulate some re-growth, some cases may require reconstructive surgery to repair and further rebuild the tissues.

There are several techniques periodontists (specialists in gums, bone and other dental support structures) or dentists with advanced training can perform to “re-model” recessed gum tissues. One of the major areas is placing tissue grafts (either from the patient or a human donor) at the site to encourage further tissue growth. Properly affixing a graft requires a great deal of training, skill and experience, especially in cases where the graft may need to be connected with adjoining tissues to establish a viable blood supply for the graft.

In skilled hands, a periodontal surgical procedure is fairly predictable with minimal discomfort afterward. And the lasting effects are well-worth it — not only will your health benefit from restored gum tissue and greater protection for your teeth, you’ll also enjoy a more attractive smile.

If you would like more information the treatment of gum recession, 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 Plastic Surgery.”

By Mario A. Vilardi, DMD
January 28, 2019
Category: Oral Health
InTodaysNFLOralHygieneTakesCenterStage

Everyone knows that in the game of football, quarterbacks are looked up to as team leaders. That's why we're so pleased to see some NFL QB's setting great examples of… wait for it… excellent oral hygiene.

First, at the 2016 season opener against the Broncos, Cam Newton of the Carolina Panthers was spotted on the bench; in his hands was a strand of dental floss. In between plays, the 2105 MVP was observed giving his hard-to-reach tooth surfaces a good cleaning with the floss.

Later, Buffalo Bills QB Tyrod Taylor was seen on the sideline of a game against the 49ers — with a bottle of mouthwash. Taylor took a swig, swished it around his mouth for a minute, and spit it out. Was he trying to make his breath fresher in the huddle when he called out plays?

Maybe… but in fact, a good mouthrinse can be much more than a short-lived breath freshener.

Cosmetic rinses can leave your breath with a minty taste or pleasant smell — but the sensation is only temporary. And while there's nothing wrong with having good-smelling breath, using a cosmetic mouthwash doesn't improve your oral hygiene — in fact, it can actually mask odors that may indicate a problem, such as tooth decay or gum disease.

Using a therapeutic mouthrinse, however, can actually enhance your oral health. Many commonly available therapeutic rinses contain anti-cariogenic (cavity-fighting) ingredients, such as fluoride; these can help prevent tooth decay and cavity formation by strengthening tooth enamel. Others contain antibacterial ingredients; these can help control the harmful oral bacteria found in plaque — the sticky film that can build up on your teeth in between cleanings. Some antibacterial mouthrinses are available over-the-counter, while others are prescription-only. When used along with brushing and flossing, they can reduce gum disease (gingivitis) and promote good oral health.

So why did Taylor rinse? His coach Rex Ryan later explained that he was cleaning out his mouth after a hard hit, which may have caused some bleeding. Ryan also noted, “He [Taylor] does have the best smelling breath in the league for any quarterback.” The coach didn't explain how he knows that — but never mind. The takeaway is that a cosmetic rinse may be OK for a quick fix — but when it comes to good oral hygiene, using a therapeutic mouthrinse as a part of your daily routine (along with flossing and brushing) can really step up your game.

If you would like more information about mouthrinses and oral hygiene, contact us or schedule a consultation.

By Mario A. Vilardi, DMD
January 18, 2019
Category: Oral Health
Tags: gummy smile  
FindingtheRightSolutionforYourGummySmile

Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.

There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.

The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.

There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.

Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of  the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.

A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.

Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.

As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.

If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”





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