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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.

Halitosis is the medical term for chronic bad breath. Having halitosis is far different than having bad breath from eating too much garlic. Halitosis is a lingering bad breath and could be an indicator of something more serious going on with your health.

What Causes Halitosis?

What We Eat. What we consume at meals and snack time can definitely cause halitosis as mentioned previously. As we eat, the foods are absorbed into our blood stream and eventually out thru the lungs. These foods just need to be removed from the body for the halitosis to disappear. Brushing and flossing will only mask the odor for a short time before it returns. The most common foods of this type are:

Halitosis Marielaina Perrone DDS-Onions

-Garlic

-Cheese

-Pastrami

-Certain spices

-Orange juice or soda

-Alcohol

Many popular diets run into a problem with halitosis for these reasons. The large amounts of certain foods they choose to eat will linger in the body and cause chronic halitosis until they are removed.

-Xerostomia or Dry Mouth. Refers to a condition in which the salivary glands in your mouth do not produce enough saliva to keep your mouth wet. Our saliva acts as a helper to our dental health and this includes warding off halitosis as well. Our saliva has the ability to rinse our mouths when eating, help break down foods, and keep bacteria at bay to fight tooth decay. A lack of saliva would definitely lead to chronic halitosis. Saliva also enhances your ability to taste and makes it easier to chew and swallow. Dry mouth can be caused by many factors. These include:

Prescription And Over The Counter Medications. Countless medications produce dry mouth as a side effect. The most common dry mouth cuplrits include antihistamines, decongestants, and pain medications.

Medical Conditions. These include diabetes, stroke, yeast infection (also called thrush) in your mouth, Alzheimer’s disease, or autoimmune diseases (including AIDS/HIV).

Mouth Breathing And Snoring. These two acts while often inter related can also cause dry mouth.

Cancer Treatment. Chemotherapy drugs can alter your saliva and the amount your salivary glands produce. This could be a temporary situation, with normal salivary flow returning after cancer treatment is completed. Radiation treatments in the head and neck area can also lead to damage of salivary glands. This damage could cause a marked decrease in saliva production. This could be temporary or permanent.

Tobacco And Alcohol Use. Both are known to increase dry mouth symptoms.

Excessive Caffeine Consumption. Another known cause of dry mouth.

-Mouth, Nose and Throat Infections. Postnasal drip, due to head and neck infections may also contribute to bad breath. Bacteria feeds on mucus your body produces when it is battling something like a sinus infection.

Dental Health IssuesTooth decay and periodontal disease can lead to long term chronic halitosis if left untreated. The bacteria in the mouth will be out of control and difficult to bring under control unless seen by a dentist.

Preventing Halitosis

The following are simple dental health tips to ward off halitosis:

Watch What You Eat And Drink. Avoid foods and drinks that are known to cause bad breath. Choose more fruits and vegetables and drink more water to stay hydrated.

Choose Sugar Free Mints And Gum. Both of these will stimulate salivary production to help cleanse the mouth and help ward off tooth decay. They will also give you a temporary fresh smelling breath.

Avoid Tobacco Products.

Floss Daily. It is recommended to floss after every meal but 1x per day should keep breath smelling fresh.

Brush after every meal. Use an ADA approved fluoride toothpaste and brush at minimum 2x per day.

Use An Antiseptic Mouthwash. Listerine is a good example.

Be extra vigilant if you have orthodontic braces. Food and plaque can build up around brackets very easily.

What Is Halitosis? Conclusion

Halitosis is an embarassing problem to have but it can also be a sign that something more serious is happening in your body. If you have persistent halitosis, you should see your dentist and rule out the obvious causes. Your dentist will be able to diagnose the issue and get you back on track to fresher breath. With a professional cleaning and dental examination, your dentist can help rule out any dental health problems and educate you on at home dental hygiene. This will include what types of dental products to use or refer you to a physician for follow up.



Tooth sensitivity is generally the result of worn tooth enamel or exposed tooth roots due to gingival recession. Other causes of tooth sensitivity include tooth decay, a cracked or chipped tooth, a worn filling, or periodontal disease. Tooth sensitivity is a very common problem affecting more than 1 in 8 Americans. For some they are aware and neglecting the problem and for others they think it is normal and try to mask it by avoiding those teeth when it comes to certain food items. When tooth sensitivity is present it becomes difficult at times to enjoy our favorite food and drink or even brush our teeth properly.

What Causes Tooth Sensitivity?

The pain or discomfort you feel when a tooth is exposed to hot or cold temperatures or even an acidic food or drink. This is the hallmark sign of tooth sensitivity. There are 3 layers of a tooth. These are called enamel, dentin, and pulp. The enamel is the harder outer shell that covers your teeth. Tooth enamel is considered the hardest mineral substance in the body. Even stronger than bone. There is one other piece to the puzzle and that is cementum. Cementum covers and protects the root surface where the enamel does not cover. When something happens to the enamel or cementum you end up with tooth sensitivity. The enamel could be damaged thru tooth decay or trauma while the cementum can be lost due to periodontal disease.

Worn Down Enamel. Enamel can be damaged in a variety of ways. These can include overly aggressive brushing, tooth trauma, tooth enamel erosion from acidic drinks, and even teeth whitening products if not used as directed. In areas where the enamel breaks down it will expose the soft underlayer, the dentin. The dentin has tubules that connect to the inner layer the pulp. The pulp is where all the nerves and blood is. This will cause you tooth sensitivity to begin to develop.

Periodontal Disease. This is a progressive disease that triggers an inflammatory response in the mouth. If left untreated it can progress from gingivitis (reversible) to periodontitis (non reversible). Periodontitis will lead to destruction of cementum, gingival tissues, and bone surrounding your teeth. Once the roots of your teeth are exposed, you will develop tooth sensitivity.

Bruxism. Also referred to as teeth grinding. When we grind our teeth we put extreme forces on our teeth. This force can lead to cracks in the enamel on your teeth. Once those cracks form, it exposes the soft dentin beneath leading to tooth sensitivity.

Tips If You Have Tooth Sensitivity

-Softer Toothbrushing. Brushing technique should include use of a soft-bristled brush and use at a 45 degree angle to your gum. this will help prevent damage to your enamel and gum tissues.

-NO! acidic foods and drinks. These will only cause you pain and discomfort if you already suffer from tooth sensitivity. But if you do choose to consume these wait about 30 minutes after bruhing to give you a chance not to feel so much pain or discomfort.

-Slow Down On Teeth Whitening. Teeth whitening can cause temporary tooth sensitivity. If you do develop tooth sensitivity while undergoing teeth whitening treatment speak to your dentist immediately.

How Is Tooth Sensitivity Treated?

Dentistry is highly personalized care. Tooth sensitivity is no different. The treatment for tooth sensitivity will depend on the cause. A proper diagnosis is necessary to develop a proper treatment plan for your tooth sensitivity. Tooth sensitivity treatment can include:

-Use Of Desensitizing Toothpaste. A common over the counter toothpaste is called Sensodyne. This toothpaste acts to seal those tubules present in the dentin. By sealing those tubules, it will remove or diminish the tooth sensitivity you may be feeling. Sensodyne contains, calcium, phosphate, as well as fluoride.

-Fluroide Treatment. This can be done at home or in office. In office, the fluoride will be applied using a tray and applied to your teeth giving adequate coverage. There are also take prescription home rinses that can be used by the patient as needed.

-Custom Fabricated Mouth Guards. This would be used to ward off damage from teeth grinding that can cause tooth sensitivity.

-Restore Broken, Chipped, or Fractured teeth. This can include dental bonding or dental crowns to restore your teeth to a healthier state and prevent tooth sensitivity.

-Periodontal Disease Treatment. This can include bone grafting as well as gum grafts to cover the root surfaces of your teeth that have been exposed.

Root Canal Therapy (RCT). In some cases tooth sensitivity is caused by a dental infection present inside a tooth.

What Causes Tooth Sensitivity? Conclusion

Now you know the causes of tooth sensitivity it is important to address these issues if you have them with your dentist. Be proactive and treat tooth sensitivity before it gets out of control.

Comprehensive dental care is when a dentist provides a full range of dental health services for diagnosis, treatment, follow-up, and rehabilitation of a patients smile. This will include thinking about not only a person’s smile as a singular item. It will include a person’s functional health as well as facial esthetics.

“We believe in a comprehensive dental care approach to restorative and cosmetic dentistry, that fully integrates health, comfort, and beauty.” – Marielaina Perrone DDS

The human body acts as a complex group of systems and never acts in isolation. In comprehensive dental care, it is very similar in how we look at the patient and their smile. The teeth may be the focus of our smiles but they do not work in isolation either. In comprehensive dental care, we look at the soft tissues as well as the hard tissues to create a treatment plan that is personalized for you. This can and will include the TMJ joint, the muscles of the face, and how the teeth fit together (also called occlusion). Often times, a deeper dental examination Comprehensive Dental Care Las Vegas Marielaina Perrone DDSwill reveal issues with the occlusion or over active muscles. This can show as uneven wear of the teeth which can be due to genetic issues or stress. A comprehensive dental care examination will reveal these deeper functional flaws that can affect the cosmetics of your smile.

Comprehensive Dental Care Personalized

A well trained dentist with comprehensive dental care experience will know to look beyond the issue at hand and ask why did that happen? If we examine the smile in a comprehensive dental care way of looking at things, we realize a tooth extraction is not a singular event. Once that tooth is removed, there will be changes to our occlusion as well as our esthetics. This can have long term implications to a person’s overall dental health. Treating “just one tooth” is often not the best interest for your long term dental health. Below are some dental procedures that are included in comprehensive dental care to treat function and cosmetics as one:

Porcelain Crowns. This type of dental crown combines strength and beauty into one package. Porcelain crowns have the esthetics patients desire for their smile but the strength demanded by patients and dentists for function. When porcelain crowns are used properly, a patient will begin to see an immediate improvement in their occlusion and in the cosmetic appearance in the skin around the face as wrinkles will lessen. The wrinkles will lessen because the occlusion will be “raised” forcing the skin around the mouth to stretch slightly. Using dental crowns for this purpose is called bite reclamation.

Porcelain Veneers. Known as part of the Hollywood smile. Porcelain veneers are sometimes referred to as “instant orthodontics” because they have the ability to realign teeth vs wearing orthodontic braces. Porcelain veneers are more conservative than porcelain crowns and are purely cosmetic in nature and cannot be used to reclaim lost occlusion height.

Dental Implants. Dental implants are highly successful for replacing one or more teeth. These would be an integral part of comprehensive dental care especially for larger scale smile restorations.

Orthodontic Braces Or Invisalign. Many people see orthodontics or invisalign as a purely cosmetic treatment for adults. However, in comprehensive dental care your dentist will see that re aligning the bite will result in straighter teeth but it will also bring those teeth into harmony with one another. This will place less stress on the teeth thru their daily functions as well.

Tooth Bonding. can be used to repair a tooth damaged by trauma or tooth decay. These tooth colored restorations can make an immediate improvement to your smile.

Facial Asymmetry. In comprehensive dental care, your well trained dentist will evaluate not just the smile but also the entire face. By looking beyond the smile, they may be able to see certain asymmetry’s in the alignment of your face. The use of botox can be used to balance the facial muscles and bring them into harmony with your smile. An eyebrow lift or aComprehensive Dental Care Marielaina Perrone DDS depression of the brow can also be enhanced using botox applications.

Gummy SmileThis occurs when too much gum tissue is exposed upon smiling. This usually is the result of the lip rising too high when smiling. Injecting Botox into the upper lip weakens the retractor muscles of the upper lip so that it won’t raise as high and your smile will appear better balanced. In comprehensive dental care, your dentist will see this immediately and factor this into your treatment plan.

Crown Lengthening. This is a comprehensive dental care surgical process whereby your dentist will remove bone around a tooth to expose more of the tooth into the mouth. This is often needed in patients with a severe grinding issues to reclaim lost occlusal height.

Gum and Bone Grafting and Recontouring. Both gum tissues and bone tissues can be grafted in to replace lost tissues in comprehensive dental care. These have both functional and esthetic concerns. Functionally, adding more bone will aid in support of teeth and adding gingival tissues can cover exposed roots alleviating tooth sensitivity and stop tooth decay from forming on the roots of your teeth. Cosmetically, these grafts can restore your smile to its youthful glory.

Teeth Whitening. Many of our worn teeth are also dark and discolored. The color you desire to reach may require a dental whitening process, or simply a whiter color bonding restoration or a whiter colored porcelain restoration. Teeth whitening is included in comprehensive dental care because it will be usually a priority for most patients when trying to rejuvenate their smiles.

Juvederm Dermal Fillers. These fillers can be used to turn back the clock and fill in areas that time has changed. Again bringing about a balance between function and smile is a hallmark of comprehensive dental care.

Comprehensive Dental Care Conclusion

A dentist who is well trained in comprehensive dental care will be able to spot problem areas quite easily. Some areas are hidden but a deeper look during a dental examination and they will be revealed. Some issues will not have longer term implications while others may. It is important to recognize the difference between the two so the proper recommendations can be made to the patient.