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Canker sores (also referred to as apthous ulcers) are a common type of mouth ulcer presenting as a small and shallow ulcer. Canker sores can show on the inner surface of the cheeks and lips, soft palate, the tongue, and along the gums. Canker sores appear as a bright red area surrounding a white or yellow center. More than half the population is affected by them. They generally last about 10-14 days with no long term health issues (not cancerous). They are very different from cold sores that develop from the herpes simplex virus and are contagious unlike canker sores.

What Causes Canker Sores?

The exact cause of canker sores remains a mystery to dentists and physicians alike. The following are some of the issues linked to what causes canker sores:

Canker Sores Marielaina Perrone DDS-Emotional Stress. This seems to bring canker sores on in many people but not all.

-Trauma To Tissues. Biting lip or cheek, orthodontic braces causing trauma, or ill fitting dentures can trigger canker sores to develop.

Nutritional Deficiencies. This includes deficiencies of B-12, Zinc, iron, or folic acid.

-Impaired Immune System.

-Presence Of Gastrointestinal Disease (GI Disease). This can include celiac disease or crohn’s disease.

-Hormonal Changes. For many women, the oncoming menstrual cycle can bring on the occurrence of canker sores.

-Genetics. Canker sores seem to run in families with women being affected more often than men.

Signs And Symptoms Of Canker Sores

Signs and symptoms of include the following:

-A painful sore or sores inside your mouth. These sores can be anywhere on the tongue, on the soft palate, or inside your cheeks or lips.

-A tingling or burning sensation before the sores appear.

-Canker sores present in your mouth round in size, white or gray center, and with a bright red border.

Although canker sores will heal on their own they can be quite uncomfortable especially when speaking or eating. The following are some of the treatments recommended for canker sores:

-Non prescription anesthetic cream. This will help relieve some of the discomfort of the canker sores. Topical creams can include benzocaine (Anbesol), fluocinonide (Lidex), and hydrogen peroxide (Orajel).

-Prescription Mouth rinse. Prescription mouth rinse containing the steroid dexamethasone to reduce pain and inflammation.

-Dental Laser. Can eradicate canker sores giving almost immediately relief

-Oral Medications. Oral steroids can be given in severe cases.

-Debacterol. This is topical solution formulated to treat canker sores. Debacterol works by chemically cauterizing canker sores. Debacterol medication has the ability to reduce healing time to about a week.

-Nutritional Supplements. based on laboratory results your doctor may prescribe a nutritional supplement if you are low folic acid, vitamin B-12 or zinc.

At Home Help For Canker Sores

Below are some remedies to try at home to speed healing time of your canker sores:

-Use salt water or baking soda rinse.

-Milk of magnesia. Place a small dab on your canker sores 3-4 times a day.

-Avoid Certain Foods. Avoid abrasive, acidic or spicy foods that can cause more irritation and discomfort.

-Use Ice. Allow ice chips to slowly dissolve over the area of the canker sores for relief.

-Soft Brushing. Using a soft brush and foaming-agent-free toothpaste such as Biotene or Sensodyne ProNamel can give relief. Look for SLS (Sodium Lauryl Sulfate) Free toothpastes.

 What Causes Canker Sores? Conclusion

Canker sores are not a serious health event but are definitely uncomfortable when they occur. At first sign of a sore speak to your dentist or doctor to ensure it is not something more sinister. While unusual, they can often be overlooked as oral cancer. If they last more than 3 weeks get them checked out immediately. As always see your dentist regularly for a happy, healthy smile.



Dentistry is not a one size fits all type of medicine. Dentistry is a very personalized treatment for our dental health. This includes treatment and management of periodontal disease. DNA testing is all the craze with companies like 23andMe. But did you know you can use DNA testing for oral diseases as well? The company is called OralDNA and they have developed three separate testing methods. These include early warning and detection for periodontal disease, personalized treatment for periodontal disease, and checking if you have increased risk of developing HPV related oral cancers.

OralDNA Approach To Periodontal Disease

OralDNA Henderson NV Marielaina Perrone DDS-OralDNA MyPerioPath testing. Oral DNA MyPerioPath is a diagnostic tool for the detection of the type of oral pathogens present in your mouth that can cause periodontal disease. By using this test your dentist can create a personalized care to deal with the pathogens causing the issues in your mouth. There is also evidence that knowing what oral pathogens are present can also determine a patients increased risk of developing Diabetes, cardiovascular disease, alzheimer’s disease, possible stroke, and if pregnant, risk of birth complications. Clinical studies are increasingly linking oral bacteria with systemic disease. For example, inflammation is a major factor in both periodontal disease and heart disease. recent studies have found that a high dose of a common cholesterol medication (atorvastatin) can prevent inflammation from both periodontal inflammation as well as cardiovascular inflammation. Statin family of medicines have other side effects as well not always that good. But this adds to the education that there is a connection between periodontal disease and heart disease.

The Oral DNA MyPerioPath test can determine if the following pathogens are present and in what levels:

  • (Aa) Aggregatibacter actinomycetemcomitans
  • (Pg) Porphyromonas gingivalis
  • (Tf) Tannerella forsythia
  • (Td) Treponema denticola
  • (En) Eubacterium nodatum
  • (Fn) Fusobacterium nucleatum/periodonticum
  • (Pi) Prevotella intermedia
  • (Cr) Campylobacter rectus
  • (Pm) Peptostreptococcus (Micromonas) micros
  • (Ec) Eikenella corrodens
  • (Cs) Capnocytophaga species (gingavalis, ochracea, sputigena)

The Oral DNA MyPerioPath testing should be done on an annual basis. Once at start of periodontal disease treatment and then one at end of first year to track progress of personalized treatment and if any changes need to be made to improve periodontal disease state. Oral DNA MyPerioPath is a valuable tool that can allow you and your dentist to measure success and track progress for a more personalized periodontal disease therapy.

Oral DNA MyPerioPath combined With MyPerioID. The Oral DNA MyPerioID test assesses a persons inherited genetic risk to developing periodontal disease as well as other systemic diseases as mentioned above. Combining the 2 tests can give greater control to personalized periodontal disease care and give a fuller picture to you and your dentist. Can also help determine which patients are at increased risk for more severe periodontal disease infections due to an exaggerated immunity response.

Oral DNA OraRisk HPV Test. This test can determine if there is increased risk for HPV related oral cancer. Human papillomavirus (HPV) is one of the most common virus groups inoral DNA Periodontal Disease las vegas Marielaina Perrone DDS the world (and is linked to the HPV virus in the mouth). Specific types of oral HPV are now considered to be separate and serious risk factors for developing oral cancers. Early detection and identification of the presence or absence of oral HPV is important, as early oral HPV infections do not typically cause any clinical signs or symptoms.

-Oral DNA OraRisk HPV Complete Genotyping Test. This HPV test gives data to your dentist or doctor to establish if there is increased risk for oral cancer and have the ability to make proper referral for further treatment.  Oral DNA OraRisk HPV complete genotyping has the ability to identify a total of 51 different types of oral HPV.

Oral Pathogens Associated With Periodontal Disease

Periodontal researchers have uncovered more than 350 different species of microorganisms that are present in a normal, healthy person’s mouth. Fewer than 5% of these species are linked to periodontal disease. It has also proven that these bacteria that cause periodontal disease, can be shared with your partner or loved ones.

Generally healthy and disease causing bacteria are usually placed into two distinct bacteria categories:

Gram positive aerobic bacteria. These are harmless or helpful bacteria in the mouth.

Gram negative anaerobic bacteria. These are the bacteria known to be related to periodontal disease. When periodontal disease develops, the bacterial balance in the mouth shifts over to gram negative anaerobic bacteria. Inflammation and injury cannot develop without these bacteria flourishing in the mouth.

Common bacteria involved in periodontal disease include:

Actinobacillus actinomycetemcomitans (Ag) and Porphyromonas gingivalis (Pg). These two bacteria appear to be particularly likely to cause aggressive periodontal disease. Both P. gingivalis and A. actinomycetemcomitans, along with multiple deep pockets in the gum, show increased resistance to standard dental treatments for periodontal disease. The presence of P. gingivalis may even have 2x the risk for serious periodontal disease. P. gingivalis produces enzymes, such as one called arginine-specific cysteine proteinase, that has been linked to a disruption of the immune system and lead to subsequent periodontal connective tissue destruction.

Bacteroides forsythus is also strongly linked to periodontal disease.

Other bacteria associated with periodontal disease are Treponema denticolaT. socranskii, and P. intermedia. These bacteria, together with P. gingivalis, are frequently present at the same sites, and are associated with deep periodontal pockets.

Some bacteria are related just to gingivitis, but not development of plaque. They include various streptococcal species.

As you can see there are a variety of bacteria that are linked to periodontal disease. The MyPerioPath testing can isolate the bacteria causing the issues for you. Your dentist can use antibiotic therapy and rinses to personalize care for your particular case.

How does OralDNA testing help to individualize periodontal disease treatment?

The ability to know the bacteria that is causing the issue allows treatment to target that bacteria. Periodontal disease treatment can include the following:

Scaling And Root Planing (S&RP). Also called a “deep” cleaning. The initial goal of any periodontal disease treatment must be the removal of plaque and tartar buildup that is causing irritation and inflammation development. The scaling and root planing procedure is done with this in mind as well as to allow for healing and reattachment of gingival fibers to the tooth. This healing can hopefully reduce size of periodontal pocketing (normal about 3mm).

Antibitoics Application. This can include administering this via a pill orally or placed into local areas that need help. Arestin is an antibiotic that can be placed directly into a periodontal pocket and give local therapy. This is important as it reaches places your dentist cannot but it also does not have the side effects of a systemic pill. The use of antibiotics will help control the overgrowth of the “bad” bacteria that is flourishing due to periodontal disease.

-Dental Hygiene Instructions. This is a staple of any periodontal disease treatment. This disease will be an ongoing problem that needs maintenance to stave it off. This includes proper brushing, flossing, and rinsing. Your dentist may even prescribe a prescription oral rinse to control bacteria or even Periogen. Periogen is an oral rinse that has been shown to help dissolve tartar between visits to the dentist. By lowering amount of tartar in the mouth you are hopefully also lowering the irritatation and inflammatory response.

Periodontal Disease Treatment With Oral DNA Testing Conclusion

DNA testing has been a great tool in many facets of society. It can also be one for dentistry thanks to OralDNA. There is an increased cost for this type of testing but it comes with great benefits in controlling a disease that can be difficult to manage. Any advantage will save you time and discomfort over time during treatment as well as possible tooth loss and systemic health maintenance. Periodontal disease linked to heart disease (as well as other diseases) should be motivation enough to get this under control. See your dentist at the first signs of periodontal disease and get your health back on track.




Dentist Vs Orthodontist – Which To Choose?

There are many misconceptions between dental specialties as the lines become blurred. Many services that were only done by specialists are now routine in a family dental office. These procedure include dental implants, root canal therapy, and orthodontics. A family dentist vs orthodontist begin with same basic training in dental school and then the paths diverge following graduation from dental school. Read below for further clarification on dentist vs orthodontist.

Dentist Vs Orthodontist Education And Training

Following 4 years of dental school, a dentist has multiple paths to go forward into their future career. They can enter private practice or they can complete a dental residency for advanced training or they can go on to further schooling to specialize in a particular specialty branch of dentistry. These specialties can include oral surgery, periodontics, or orthodontics.

Those who choose to specialize will apply to graduate programs in the field of their choice. Between 6 and 8% of all dental school graduates go on to become orthodontists. Orthodontic training continues from the basics learned in dental school and narrows the focus to a branch of dentistry dealing with irregularities of the teeth (such as malocclusion) and their correction (as by braces). That definition comes directly from Merriam Webster. Both are extremely important to ensure your mouth functions properly when eating and chewing. If your teeth are crooked or your jaws are misaligned this can cause digestive problems  and dental hygiene issues, such as gingivitis (gum disease). It can also make it difficult to clean your teeth properly.The extended training takes between 2-3 years and adds about 5,000 hours of orthodontic training. Orthodontists have many techniques and dental materials at their disposal Marielaina Perrone DDS Dentist Vs Orthodontist Las Vegas NVto help them move the teeth and jaws into proper alignment, including traditional braces, lingual braces (attached on inside of teeth) and clear aligners (like Invisalign), among other orthodontic appliances. Because every patient has their own unique alignment issues, orthodontists use X-rays and pictures of the teeth to create personalized treatment plans. These plans can be simple to very extensive depending on the issues with your smile.

Family dentists treat patients’ overall oral and dental health. Through routine checkups, dentists can detect and treat cavities, periodontal disease, and oral hygiene problems, and they can also extract teeth as necessary. Dentists also can improve the function and cosmetic appearance of teeth with the following services: tooth bonding, porcelain or composite veneers or dental crowns to teeth that are broken, chipped, misshapen or have been affected severely by tooth decay. Your dentist will also evaluate the tissues inside your mouth for signs of oral diseases (such as oral cancer) and gives advice on how to maintain your oral health. If your dentist notices a problem beyond the scope of their education, they will refer you to a dental specialist or physician as they see fit. An orthodontist is one of those specialists your dentist may refer you to for further treatment.

Choosing Between Dentist Vs Orthodontist

When choosing dentist vs orthodontist there will be some overlap between dental services offered. Many family dentists will also offer some orthodontic services to their patients. Orthodontists are only able to offer services that fall under their specialty. A dentist can perform orthodontics but an orthodontist cannot treat periodontal disease or fabricate a dental crown. This is a major difference in the dentist vs orthodontist debate.

Dentist Vs Orthodontist Treatments Offered

Family dentist services can include but not limited to the following:

-Treatment and Restoration of Tooth decay

-Root Canal Therapy

-Treatment of Periodontal Disease

-Dental Crowns and Dental Bridges

-Porcelain and Composite Veneers

Teeth Whitening

Dental Implants (placement and restoration)

-Basic Orthodontics

Orthodontists provide services related to:

-Misaligned Teeth

-Crowded Teeth

-Overbite

-Underbite

Dentist Vs Orthodontist Conclusion

A dentist should be your go to for all your dental needs. An orthodontist will be necessary when your dentist decides treatment behind their scope is needed. An orthodontist is someone you will see for a fairly short time while a dentist will be someone you will see for a lifetime to maintain healthy teeth and gum tissues. The dentist vs orthodontist question is not a battle but a partnership. They work hand in hand to deliver high quality dental care to their patients.

 




The standard of care for professional dental cleanings has long been every 6 months. This still holds true today for most patients. Studies have repeatedly shown that those who goto regular dental visits are less likely to have the need for a dental restoration or to have a tooth removed.

Are Teeth Cleanings Necessary?

While for many at home care can be a breeze for many others it is a constant struggle. Our daily lives can get in the way of even the simplest tasks including our oral hygiene. Regular professional teeth cleaning removes plaque, the soft yellowish build-up, and calculus (hardened plaque) that we are just not able to get to. This soft build-up is made up of billions of different types of bacteria that live and reproduce in our mouth by feeding on the food we eat releasing acids that if left alone will damage our teeth and periodontal tissues.

Most bacteria co exist in our bodies without causing too much trouble to our health and well being. But certain bacteria in dental plaque, when they grow in numbers, can lead to tooth decay or periodontal disease.

A professional dental cleaning will reduce your chances of developing tooth decay or periodontal disease by significantly reducing the amount of plaque, calculus, and bacteria in your mouth.

How Often Is Acceptable?

As a dentist, my patients often ask me how regularly they should come in to get their teeth cleaned. My response is usually: “That depends”. For most of the population every 6 months is the right number. But there are those who just cannot maintain dental hygiene on their own or they develop calculus faster than others. So for those patients I will recommend a schedule of every 3 months. 2 extra visits a year to maintain your dental health should not feel like a lot. This will reduce chances of tooth decay and periodontal disease development in these patients over the long haul.

Factors Affecting Dental Hygiene

We know certain lifestyle choices can affect a person’s risk of developing tooth decay and periodontal disease. Following are some questions you may ask yourself to understand whether you are at an increased risk:

-Does your drinking water contain Fluoride? Is this your main source of drinking water?

-Do you frequently snack, including on sweets?

-Are you a regular flosser?

-Do you brush your teeth at least twice a day?

-Do you visit your dentist for toothaches rather than routine examinations?

-Have you had multiple teeth with tooth decay at your last few dental visits?

-Is your dentist “watching” a lot of teeth with early tooth decay?

-Do you have to wear a denture or undergoing orthodontic treatment?

-Do you develop excessive amounts of calculus quickly?

-Do you suffer from a chronic long-term health condition such as diabetes?

-Do you suffer from a xerostomia (dry mouth)?

If you were able to answer “yes” to most of the questions above, you are likely to need to see your dentist or hygienist at least every six months, if not more often based on your dentist’s recommendations. Following a professional cleaning, people prone to tooth decay can benefit from the fluoride treatment following removal of plaque and calculus. Studies have shown that professional fluoride treatment every six months can lead to about a 30% reduction in the development of tooth decay.

Dental Health = Overall Health

Some patients with chronic health issues such as cardiovascular disease or diabetes will need to see their dentists more frequently. This is because they are much more susceptible to periodontal disease.

Patients taking blood thinners and other medications, such as for osteoporosis, may need to visit the dentist more regularly as well. These medications can complicate the process of an tooth extraction or other dental work, so regular checks and cleanings are best to help detect problems before they become serious.

Financial Concerns?

The cost of seeing your dentist and dental hygienist 2-4 times per year will be far less than restoring your teeth over the long run. Routine dental health maintenance is the best insurance you have to maintain a healthy smile.

Protecting your smile

Parents often wish to set a good example for their children by making regular check and cleaning appointments for the whole family. In the end, only you can choose what you feel is right for you. Maintaining a healthy smile that will last a lifetime is important to most people.