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Serving Las Vegas and Henderson, Nevada since 1999.

Everyone knows the basic structures of the mouth including your teeth and gums. But there is more to your mouth than just those two anatomical parts. This means

Maintain Oral Health - Marielaina Perrone DDS

Anatomical Structures of the Mouth

maintaining good oral hygiene goes beyond just your teeth and gums.  In addition to your teeth and gums, your mouth is made up oral mucosa, the upper (maxilla) and lower (mandibular) jaw, the tongue, salivary glands, the uvula, and the frenulum. All of these structures play an important role when it comes to good oral health and are regularly examined by your dentist when you receive dental care.

Anatomical Structures of the Mouth

- Oral Mucosa. When you look in your mouth everything that is not a tooth is the oral mucosa. The oral mucosa is a protective lining and includes the gum tissues. This lining is very similar to the lining in your nostrils and inner ears. The oral mucosa plays a very large and essential role in maintaining your oral health. It is also important in maintenance of your overall health by defending against germs and other irritants that come into your mouth. The oral mucosa has a tough component called keratin. Keratin (also found in fingernails and hair) helps keep the oral mucosa protected from injury.

-Gums or gingival tissue. Your gums are the pink, attached, colored tissue that envelops and supports your teeth. Also covered by oral mucosa, gums play a critical role in your oral health. Healthy gums are firm, cover the entire root of the tooth, and do not bleed when brushed, flossed, or probed. Diseased gum tissue, or Periodontal disease can ultimately progress to tooth loss. This makes it essential to take care of your gums by flossing daily and brushing regularly.

-Upper (Maxilla) and Lower (Mandible) Jaws. Your jaws are an essential structure of the mouth and face. The jaws give your face its shape and are the structures holding your teeth. They are needed for chewing and speech. The Upper jaw or Maxilla is made up of two bones fused together and then to the rest of the skull. The lower jawbone (mandible) is separate from the rest of the skull which allows it to move up and down, and side to side in your jaw joint (TMJ) when you speak and chew.

-The Tongue.  This is an extremely strong muscle covered in specialized mucosal tissue that also includes the taste buds. The tongue is unique in that it truly plays a dual role in our health. The tongue plays an integral role in the ability to speak. It does this by allowing people to shape the sounds that come from your mouth. It’s other role is being a part of the body’s digestive system. The tongue is responsible for moving food over to your teeth and following chewing, the tongue moves to the back of the throat so it can force it down to continue on its path thru swallowing. In infants the tongue and jaw work as one to allow the infant to breastfeed.

-Salivary Glands. There are three different major salivary glands in your mouth and neck. These are the parotid, sub mandibular, and the sub lingual glands. There are also smaller, or minor salivary glands in your hard palate, soft palate, and inner lip. These glands are responsible for producing saliva. Saliva is critical to maintaining good oral health. It functions in the following ways:

1) Breakdown of food. Saliva contains special enzymes that help break down food. This makes it easier for you to digest your food.

2)Lubrication. Saliva aides in swallowing food by acting as a carrier of foods out of the mouth and into the throat. Saliva also keeps gums and teeth from drying out. This constant lubrication makes it more difficult for bacteria to stick and stay, and helps keep teeth and gums clean.

3) Protection of teeth and gums. Saliva is able to offer protection of teeth and gums by rinsing away food and bacteria. It is also able to neutralize acids or acidic foods that can wear down your teeth causing tooth cavities.

-The Uvula. The uvula is the small flap of tissue which hangs down at the back of your throat. The uvula is made up of muscle fibers as well as connective and glandular tissues. The uvula is covered by oral mucosa. The uvula’s functions are not fully understood as of yet. However, it seems to play some role in speech and in keeping the mouth and throat moist.

-The Frenulum Linguae. The frenulum or frenum, is an attachment of oral mucosa that connects and pulls two areas together. There is one major frenum attachment above your two front teeth connecting your lip to the adjacent gums, another major one is under the tongue attaching it to the floor of the mouth. There can be any number of minor frenum attachments from lip to gum or cheek to gum.  Children can be born with a frenulum that is too short, or not elastic enough, keeping the tongue almost tied down. This can  affect speech as the tongue is not able to protrude as far as necessary. A short frenum can also affect swallowing and feeding in babies.

Take notice the next time you are brushing your teeth, spend a minute looking at the parts of the mouth that lie farther inside the oral cavity. Knowing what these structures do and what they look like can help you to maintain optimal oral health, and notice changes that can occur. Your self awareness can help you point changes out to your dentist, and find out why they have occurred. As always, see your dentist regularly and have an open line of communication to ensure that your mouth is it’s healthiest!


We all have habits some good and some bad. But did you know that some of these habits can affect your teeth?

The following are some habits that can damage your teeth and oral health…

1. Tobacco. This is an obvious one for most people. Smoking turns your beautiful white teeth yellow over time, but it can be much more damaging than that. Smoking or even smokeless tobacco has been shown to cause oral cancer (along with lung and throat cancer), periodontal disease, tooth decay, and eventually tooth loss.

2. Diet pills. Taking these may seem like a quick way to slim your waist line, diet pills can also be an easy way to develop gum disease and tooth decay. Most people do not realize but many over the counter medications, like diet pills, actually cause your body to decrease salivary flow. When salivary flow decreases you increase your risk for tooth decay and periodontal disease. The best prescription for losing weight is a well balanced diet along with regular exercise. Not only will you lose weight but you will protect your smile.

3. Teeth grindingTeeth grinding (also called Bruxism) has a wide range of effects on a person’s smile. Grinding your teeth can affect your temperomandibular joint (commonly referred to as the TMJ), cause premature breakdown of teeth, cause tooth sensitivity, and even change the appearance of your face. People who have normally healthy teeth will over time destroy the outer layer of their teeth(the enamel) which causes chipping, fractures, and sensitivity. Stress is a major factor in teeth grinding so finding ways to relax prior to bedtime will be the long term goal. Your dentist can fabricate a custom night guard for you to protect your teeth and help stop the habit.

4. Choosing not to Floss. Brushing and flossing are equally important. Many people use the excuse that they are really good brushers so they do not need to floss. But that is not the case. Flossing at least once per day is one of the best things you can do for maintenance of your teeth. Flossing helps remove plaque and food debris from around the teeth, in between the teeth and along the gum line. This will help prevent the onset of periodontal disease. Flossing will also help control bad breath by removing the bacteria and food debris causing it in most cases.

5. Brushing at the wrong time. We have always been taught to brush after every meal. But recent studies have shown that depending on what you are consuming it might no be the best idea for you. After eating or drinking foods high in acid (like soft drinks, citrus fruits, or even wine) it is best to rinse with water first to neutralize the acids and then brush about an hour or so later. Researchers have shown this is because right after exposing our teeth to the high acid environment the enamel weakens and the brushing action could cause tooth enamel erosion. So its best to rinse first to neutralize the acid and then brush later.

6. Chewing Ice. This is especially dangerous for your molars in the back of your mouth. Chewing on ice presents an advanced challenge to our teeth. The tremendous forces needed to break thru the ice can crack your teeth or existing fillings. Our molars have pointy edges called cusps and can shear off and break from chewing ice. The coldness of ice can cause the nerves connected to the teeth to get damaged as well. An alternative to crushing the ice with your teeth and let the ice cube melt in your mouth.

7. Sports drinks. These types of drinks have become extremely popular among athletes as well as the general population. But they are hazardous to your teeth. Sports drinks are highly acidic just like soft drinks. This means they can have the same effect as soft drinks in eroding away a tooth’s enamel. Also many of these drinks are high in sugar content which can lead to increased risk for tooth decay.

8. Nail Biting. This is the most commonly found bad habit in children and even adults. When thinking, during stressed times, people tend to put their nails under their teeth

teeth damaged by bad habits

Bad habits Damaging your teeth?

and bite on them continuously. This is an unhygienic habit as all the dirt from the nails will enter your mouth. When you bite on your nails this dirt enters your mouth with your saliva. Also your teeth tend to chip and break when you bite your nails often.

9. White wine. Many people enjoy a glass of wine from time to time whether just relaxing at the end of a long day or with dinner. Most know that red wine can cause staining on teeth so many of us drink white wine. White wine can be just as damaging but in a different way. White wine is extremely acidic and can cause permanent damage to your teeth thru enamel erosion. A good tip is following drinking a glass of white wine rinse out your mouth with water to neutralize and cleanse the acids away. 

 10. Skipping Regular Dental Exams and Cleanings. Even if you brush and floss as recommended, dental plaque and calculus can build up on surface tooth enamel and below the gum line. Periodic dental exams and professional cleanings every 6 months can greatly lower your risk of tooth decay, tooth loss and periodontal disease.

gummy smile fix

Fixing a Gummy Smile

What is a Gummy smile? A person’s smile can be called a gummy smile if a significant amount of gingival (gums) tissue can be seen by others when that person smiles.  A gummy smile by itself is not considered to be unhealthy or abnormal. It has been long considered by dentists a normal variation of human anatomy. Many people with a gummy smile tend to be very self conscious of how they smile, and tend to not smile as broadly.

A gummy smile tends to make the teeth look short and unhealthy. The gingival tissue should be at or just above the neck of the tooth, called the cementoenamel junction. In cases of a gummy smile, the tissue may cover 50% or more of the teeth. The gummy smile can be caused by a variety of things. These can include higher than normal bone tissue, possible incomplete eruption of the tooth, excess gum tissue, or abnormally thick gingival fibers. The presence of excess gum tissue makes maintenance of oral hygiene very difficult or at least more difficult than for patients without a gummy smile. This can lead to unhealthy tissue that can bleed easily as well as increased risk for tooth decay. The excessive tissue will allow food and bacteria to get lodged underneath, causing red, swollen gums and bleeding. This early situation is called gingivitis. Gingivitis is the earliest form of periodontal disease. If this goes untreated the gingivitis

Gummy smile before fix

Gummy Smile – Before

leads to  periodontal disease with progression toward tooth loss. Most people notice this just on the front teeth but it can also happen in the back teeth as well.

Cosmetic dentistry is a great way to fix the gummy smile problem and can be quite rewarding for patient and doctor alike. Upon final completion of a case the results are usually quite dramatic. The completed result is usually noticed by everyone around the patient increasing their self esteem almost immediately. Changing the way you smile can positively change your outlook on life. Patients tend to smile more, and feel more confidence and pride in appearance. When patients return for follow up visits they almost always report they should never have waited so long to have this treatment done. It is that dramatic.

Using cosmetic dentistry to correct a gummy smile is very straightforward. There are two separate procedures to fix a gummy smile. The type of procedure needed depends on the cause of the gummy smile. Whether it is removal of excess gum tissue or, removal of excess bone, or a combination of the two.

gummy smile after fix

After – Gummy Smile procedure

Cosmetic Dentistry Procedures to fix a Gummy Smile

1) Gingivectomy. A gingivectomy is simply the removal of excess gum tissue. By removing the excess tissue and reshaping the gums, you end up with a very cosmetic result. During this procedure a very small amount of gum tissue needs to be removed. The Dentist will generally use a laser, an electrical cautery unit, or periodontal incisions to complete the reshaping and removal of gum tissue. Although the procedure is generally quite painless, local anesthetic is necessary. The treatment requires no sutures and typically the gingival tissue heals within 1-2 weeks. A gingivectomy is usually the prescribed procedure when only a few teeth are affected by the gummy smile. Sometimes, the bone must also be remodeled to correct the problem. Which leads us to #2…

2) Crown Lengthening. During this procedure, excess gum and bone tissue is removed and reshaped to expose more of the natural tooth. This can be done to one or more teeth to expose a natural, even, wide smile. This procedure is a bit more advanced but still relatively easy to perform by a trained dentist or specialist. The gum tissue is removed in the same way as in a gingivectomy, the bone removal requires rotary instrumentation.

There is a very low risk of complications for both procedures. Any discomfort following the procedures can usually be handled by over the counter medications. Patients will see results immediately. But over the next few weeks following the procedure it will look even better. This is because the gingival and bone tissues need time to fully heal. Once fully healed they will see the full effect of a beautiful and healthy smile and can say goodbye to their old gummy smile!



It is estimated that well over 1 billion people in the world smoke. Many of these smokers have their health directly affected by their choice of habit. Research has shown time and again that smoking is a significant hazard to a person’s general well being but it has been less publicized the effect smoking has on a person’s dental health.

Logically, the mouth is the primary recipient of the tars, nicotine, and smoke from either smoking or chewing tobacco. The tissues of the oral cavity would be the first to come into contact with these harmful and toxic materials. Even though the smoke is in the mouth for only a short period of time it is more than enough time for it to cause damage.

The following are some of the effects smoking has on a person’s dental health:

1) Increased risk of developing oral cancer. Oral cancer affects almost 40,000 Americans each year. Oral Cancer kills one person per hour (totals about 8,000 deaths per year). Only a little more than 50% of those 40,000 diagnosed, will be alive in 5 years. This is a sobering statistic that has stayed steady for quite a few years. Around the globe, the problem is even greater. There are a reported 640,000 new cases of oral cancer each year.

2) Increased risk of periodontal disease. Periodontal disease is a leading cause of tooth loss. The most recent research studies have shown that tobacco use may be one of the most significant risk factors in the development and advancement of periodontal disease.  A study published in journal of periodontology highlights that smokers are 4X more likely to suffer from advanced periodontal disease. Also, the chemicals in tobacco can make oral surgery or periodontal treatments less predictable. It seems that smoking interferes with the normal function of gum tissue cells. This interference makes smokers more susceptible to infections, such as periodontal disease. Every Time you inhale, the blood vessels in the mouth constrict and impair blood flow to the gums. This decreased blood flow affects wound healing. Smokers are more likely than nonsmokers to have the following issues:

-Increased build up of plaque and tartar.

-Deep pockets between your teeth and gums

-Loss of the bone and tissue that support your teeth

smoking facts

Facts about Smoking

If the bacteria is not removed during a professional cleaning, and it remains below your gum line, the bacteria can destroy your gum tissue and cause your gums to become inflamed, swollen, and pull away from your teeth.  When this happens, periodontal pockets form and fill with disease-causing bacteria. Periodontal disease is a progressive disease and if this situation is left untreated it will only get worse. The pockets between your teeth and gums can get larger allowing more bacteria to get in to destroy and breakdown gingival tissue and supporting bone. The gums may shrink away from the teeth making them look longer. Without any further treatment to slow or stop the progression your teeth may become loose, painful, and will probably fall out.

3) Discoloration of teeth. Nicotine and tar present in cigarette smoke, form deposits on tooth surface and cause discoloration of teeth. These discolorations can range from yellow to black. Most smokers are aware of this discoloration but it is almost impossible to remove via regular home care techniques.

4) Halitosis or smoker’s breath. Every smoker at some time or another has probably been told that their breath smells bad. Most smokers become used to the bad smell and hardly notice it but the bad breath is quite obvious to non smokers. This is not something that will go away without cessation of smoking.

5) Increased risk of tooth decay.  The deposits from tar and nicotine caused by smoking add to the plaque build up in the mouth creating a environment for tooth-decay causing bacteria to flourish. Smoking will also affect dental work and will reduce success rates of procedures such as periodontal surgery and dental implants. Dental implants are quite costly and smoking can mean the difference between a successful outcome and an unsuccessful one.

6) Xerostomia or Dry Mouth. Cigarette smoking causes the condition known as dry mouth. This decrease in saliva is generally caused by the inflammation of the salivary gland ducts. This can in turn lead to a variety of problems including bad breath and cavities.

Some lesser effects from smoking include change in taste sensation, sinusitis, and delayed wound healing.

Quitting Tobacco Use

If you wish to quit smoking, your dentist can help calm your nicotine cravings with certain medications. These can include nicotine gum, nicotine patches, or puffers (an artificial cigarette with nicotine only). Most of these are over the counter medications but others need a prescription. For example, Zyban and Chantix are prescription drugs used to help patients quit smoking, and must be

quit smoking - chantix

chantix – quit smoking

monitored by your physician.

Smoking cessation classes and support groups are often used together with drug therapy. Ask your dentist for information they may have on similar smoking cessation programs.

Herbal remedies, along with hypnosis and acupuncture, are other treatments that may help patients quit smoking.

The bottom line is that the habit of smoking poses a very significant threat to your overall health and that includes your dental health. Education is the key to making current smokers aware of the pitfalls of smoking as well as the rest of the population who may take up the habit now or in the future. As always regular dental visits are recommended.