Marielaina Perrone DDS's Posts (27)

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Periodontal disease is a progressive disease of the structures (bone and gingival tissues) surrounding our teeth. It is believed that about 65 million americans have some form of periodontitis. Periodontitis is the advanced form of periodontal disease. Once the disease state reaches periodontitis it means there have been some form of permanent loss of bone or gingival tissues to the disease. In those 65 and over this number jumps to 70% of that population. These numbers are startling. Luckily, there has been extensive research into periodontal disease and new treatment modes have been developed. One such method is treating periodontal disease with Arestin.

What Is Arestin?

Arestin (minocycline hydrochloride) is an antibiotic that comes in the form of micrspheres. These microspheres are placed locally into areas of concern. Periodontal disease generally hits certain areas over others initially. This gives us a chance to localize treatment of periodontal disease with arestin.

Treating Periodontal Disease With Arestin

Periodontal disease if left untreated will develop deeper and deeper “periodontal pockets” around out teeth. The normal space between our teeth, gums and bone is approximately 3 mm. When periodontal disease begins to damage these areas these pockets can widen and deepen as bone is lost and gum tissues lose their connections to our teeth. As the periodontal disease develops and progresses it is not unheard of to have periodontal pocketing in the 6-8 mm range. That is a doubling over normal pocket size. This allows food and bacteria to penetrate these areas and create even more damage to gingival tissues and bone. Once these support structures become damage they can cause our teeth to become loose and eventually lost them.

The standard course of treatment for periodontitis is scaling and root planing (S&RP). This treatment is highly effective for treatment of periodontal disease.

-Periodontal scaling of teeth with instruments involves manually removing all the plaque, tartar, and food from on and around our teeth.

-Periodontal planing can smooth out rough areas on our teeth’s roots where bacteria and plaque can attach.

Scaling and root planing has been our #1 treatment for periodontal disease for decades. Where does treating periodontal disease with Arestin come in? Combining the use of Arestin with the traditional scaling and root planing gives dentists and periodontists a real chance to reduce the periodontal pocketing around our teeth. In routine scaling and root planing, depending on depth of pockets, it may be difficult to reach to the entire depths of those pockets. Everyone’s anatomy is different so some areas are easy to reach while others might be more difficult based on root structures and how the periodontal pockets form. None are uniform. Using microspheres of Arestin allows your dentist to reach the bottom of those pockets and destroy harmful bacteria before further destruction of tissues can occur.

Treating Periodontal Disease With Arestin Procedure

The following is what to expect if you are undergoing treatment of periodontal disease with Arestin.

Diagnosis of Periodontal Disease. In its earliest form (Gingivitis) there is no damage to bone or gingival tissues and can be reversed thru professional cleaning and increased at home dental hygiene care. In periodontitis, destruction has begun. A simple professional cleaning is no longer as effective. Diagnosis of periodontal disease is achieved thru x-rays and use of a periodontal probe. This dental instrument allows your dentist or hygienist to measure around the teeth and see what areas might be affected by periodontal disease. A normal reading of 3 mm means tissues are healthy. Anything over that raises a red flag and leads to a diagnosis of periodontal disease.

-Treatment Plan To Fight Periodontal Disease. Your dentist will explain these results to you and discuss treatment necessary. The first line of defense is always a scaling and root planing (also called a deep cleaning). Your dentist may now offer Arestin in conjunction with this type of cleaning to give you a better chance of stopping this problem from developing further and also repairing tissues around our teeth.

-Treatment With Scaling And Root Planing.

-Arestin Application Following Scaling And Root Planing. The arestin is in the form of a microsphere. This allows the arestin to release the antibiotic gradually over time to fight the bacteria in the deepest depths of those periodontal pockets. It is able to target areas scaling and root planing instruments just cannot reach.

Is Arestin Effective?

Yes! Studies have shown that is more effective in treating pocket reduction when paired with Scaling and Root Planing Vs S&RP alone. In fact clinical trials have shown significant pocket reductions in as little as 1-3 months and maintenance for at least 9 months. It has also shown significant reductions in our more difficult to treat patients. Those include the smoker’s, ones with a history of heart disease, and those over age 50. The chart below shows those statistics.

Periodontal Disease With Arestin Marielaina Perrone DDS

Is Arestin A Miracle Drug? Conclusion

Arestin is not a miracle drug. But it will help controlling a very difficult progressive disease. Periodontal disease is difficult to control because it relies on many factors. The biggest one is at home dental hygiene. Patients need to understand their dental care does not begin and end inside the walls of their dental office. Fighting periodontal disease is a daily battle. Periodontal disease treatment with Arestin can help reverse some of those issues but it will not be a cure for it.

 

 

© 2019, Marielaina Perrone DDS. All rights reserved. Botox Henderson NV

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Bone Grafts And Dental Implants

We don’t often give much regard to the importance of the bone our teeth sit in until there is a problem. The bone not only serves as the foundation for our teeth but it also plays a big part in our visual aesthetic appearance. Bone can be lost by tooth removal or periodontal disease. If a tooth is missing or removed, the bone may collapse into the empty socket and cause a sunken appearance to our cheeks or jawbone. A bone graft can restore these problems caused by dental disease or those that result from an accident. One of the main reasons for bone grafts in modern dentistry is to form a good foundation for dental implants.
 

What is a Bone Graft?

 
bone graft is the replacement or augmentation of the bone around the teeth. Bone grafting is a term used to describe a variety of procedures used to add or build bone so that dental implants can be placed.
Dental Bone Grafting
bone graft typically involves adding bone or bone like materials to the jaw. The bone graft can be your own bone (also called Autologous  bone), synthetic bone, be processed bone obtained from a cadaver (also called Allograft), or can even come from bovine/cow sources (these types are also called Xenografts). After grafting, you generally have to wait several months for the grafted material to fuse or become one with the existing bone structure.  Processed bone grafted materials either cause surrounding bone to grow into the graft or cause cells around the graft to change into bone. Autologous bone transplants bone cells or a block of bone that fuses to the jaw.

Implant Dentistry

It is often used to augment bone to allow for a more successful implant placement. A few reasons for bone grafting in implant dentistry include:
1) Augmenting bone in the sinus area to allow for implant placement.
2) Augmenting bone to enhance the fit and comfort of removable prostheses (dentures)
3) To enhance aesthetics of a missing tooth site in the smile or aesthetic zone. This zone is generally defined as the visible area seen upon full smile, including the teeth, gingiva, and lips.
 
For a dental implants to be a success, the patient must have sufficient bone in the jaw to place the implant into.
Assumptions were once made that if a patient did not have sufficient quality or quantity of bone in their jaw they would not be suitable candidates for dental implants. Today, thanks to the exponential advances in dental techniques, materials, and technology, patients with insufficient bone in their jaws can have the bone rebuilt using bone grafting.

Bone Grafting Procedure

The actual bone grafting procedure is quite straightforward. A dentist will assess the quantity and quality of your bone during the treatment planning stages. It will be at this time that he/she will determine if there is a need for bone grafting. Then your dentist will review the different types of bone grafts with you and decide which will be the most suitable for your individual case.

Once this has been decided the bone graft procedure can be performed. The actual procedure requires the dentist to place bone under the gum tissue at the site where the bone graft is needed. The dentist will then be able to place the bone to be grafted onto the site and then cover it with a membrane for protection. Membranes are often used to help stabilize the bone graft as well as keep the gum tissue from invading the healing bone graft. The gum tissue will grow at a much faster rate than bone, therefore, membranes are used to prevent gum tissue from growing in and displacing the bone graft before it fully matures.This membrane is also used to protect the boneDental Bone Graftingfrom any germs found in the oral cavity and ensure that the area is perfectly clean to allow the healing process to take place. Finally, the area is closed and the tissue is stitched into place. Bone graft healing time is usually right around 4-6 months. But this can vary from patient to patient. Patients are given a prescription for antibiotics to take following their bone graft. Antibiotic mouthwashes can also be prescribed to preserve the health of the gum covering the bone graft.

On follow up visits the dentist will check on the success of the bone graft by taking x-rays to determine the height and width of the new bone. Once this has been verified as satisfactory, and the site of the bone graft is completely healed, the next stage of the dental implant process can begin.

Dental bone grafts for the purpose of dental implants has a very high success rate. But there is always a possibility that the bone graft will not work as planned, even if your own bone was used. Bone grafts are not rejected by the body like organ transplants. There is still some mystery as to why some bone grafts fail. We do know that certain people (for example, smokers, diabetics, patients with poor dental hygiene) have higher risks of graft failure.

A failed graft will need to be removed. Once healed properly, you and your dentist may choose to place a second graft.

A bone graft gives the implant dentist and patient one more tool to achieve a successful outcome to just about any implant treatment.

Dental Bone Graft

© 2012 – 2019, Marielaina Perrone DDS. All rights reserved. Dental Implants Las Vegas

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Dental Implants Vs Dental Bridge

Dental implants vs bridge is a question many patients are faced with when attempting to replace a lost tooth or multiple teeth. The traditional dental bridge was the main dental procedure used by dentists for a very long time to replace missing teeth. As dental implants have become popular due to long term success rates the traditional dental bridge has become in many people’s mind the lessor alternative. Dental implants vs bridge is an interesting scenario as they both achieve the same thing but in different ways. The dental implants vs bridge debate is one that many of us will face in our lives. Below are some facts about both to help with your decision.

Dental Implants Vs Bridge Procedure

Steps For A Dental Bridge

During the first visit to your dentist for the fabrication of a dental bridge, the teeth surrounding the missing tooth are prepared to accept a dental crown. The preparation involves removing the outer layer of teeth to allow for a dental crown to be placed over top them. Next, dental impressions of the teeth are taken, which give the dental lab technician a precise dental model from which the dental bridge, pontic (fake tooth between the dental crowns), and dental crowns will be fabricated. Your dentist will create a temporary dental bridge for you to wear to protect the exposed teeth and gums while the dental bridge is being made. This generally takes about 2 weeks.

At the second visit, your temporary bridge will be removed, the temporary cement will be cleaned off the teeth, and the new porcelain or metal bridge will be checked and adjusted, as necessary, to achieve an ideal fit. Depending on how extensive the dental bridge is multiple visits may be needed to check the fit of the metal framework and ensure the bite is correct. This is dependent on each individual’s case as metal can distort as well as teeth moving ever so slightly during time in between visits. If the fit is acceptable to the dentist, the dental bridge will then be cemented permanently in place. In the discussion of dental implants vs bridge, a traditional bridge is placed in only one way (cemented) while a dental implant can be placed in 2 different ways (screw retained or cemented).

Steps For A Dental Implant

-Initial Consultation. At this initial appointment, your dentist will complete a thorough dental examination, including all necessary x rays, and then take dental impressions of your teeth. After your dentist gathers all the necessary preliminary information, your dentist will talk with you about the recommended treatment plan. You may also discuss at this time whether or not there is a need for a bone graft. At this visit, you can ask about the dental implants vs bridge discussion. Your dentist will happily review the positives and negatives with you.

-Bone Grafting And Teeth Removal. If the tooth needs to be extracted, your dentist will evaluate the bone density and quality and decide if a bone graft is necessary. The bone graft will add 4-6 months generally to the time line. This extra time gives your bone time to heal properly and add the new bone structure.

-Dental Implant Placement. Once healing has taken place you will be ready for the dental implant placement. The procedure generally takes about 1-2 hours and completed under anesthesia. Once the dental implant is placed, you will need approximately 6 months for healing to take place and the dental implant to integrate into the bone (this process is called osseointegration).

-Healing Cap And Temporary Dental Crown. With the dental implant fully integrated in the bone, your dentist will attach what is called a healing collar to the top of the dental implant. This healing collar will allow the gum tissue to form around the implant in a natural looking way. The healing collar is simply a round piece of metal that keeps the gum tissue away from top of implant. The healing cap stays on for about 7-14 days. In some cases a temporary dental crown is fabricated as well at this visit.

-Abutment Placement. The healing cap will be removed and a dental implant abutment will be replace it. This abutment will be where the new dental crown will attach (either thru a screw or cement). Once the abutment is in place, your dentist will take a dental impression and send it off to the dental laboratory for fabrication of your new dental crown.

-Permanent Dental Crown Placement. The dental implant and dental crown should be a permanent fixture without the possibility of tooth decay forming over time like a traditional dental crown or dental bridge.

Dental Implants Vs Bridge Maintenance

This is where a dental implant will shine in the debate of dental implants vs bridge. A single dental implant will be cleaned just like your natural teeth. This means you can floss around the tooth just like a natural tooth. A dental bridge since it is one longer piece encompassing multiple teeth you will not be able to use regular floss. You will need to use what is called a floss threader. This will allow you to get under each part of the dental bridge and effectively clean around the areas of the dental bridge. This can be an issue for some patients with dexterity issues.

Dental Implants Vs Bridge Cost

The dental implant will require more time (at least 6-7 months in best case) to allow for each step to be completed and healed properly. The dental implant tends to cost more overall especially if bone grafting is involved. In my opinion, dental implants vs bridge cost will be up to the patient. Time in some cases is just as important as the financial factor.

Dental Implants Vs Bridge Pros And Cons

Dental Implants Vs Bridge Las Vegas Marielaina Perrone DDSDental Implant Positives

-Surrounding Teeth Unaffected. With a dental implant, there is no need to shave down possibly healthy tooth structure in adjacent teeth as there would be in a traditional dental bridge.

-Success Rate And Durability. Dental implants should with proper care last a lifetime and have a better than 98% success rate.

-Bone Loss Prevention. With a dental implant in place, your bone structure will remain as is and not resorb or break down. This is what happens when a tooth is missing in an area of the mouth

Dental Implant Negatives

-Surgery Required. A big negative in the dental implants vs bridge debate. This is especially true of those with dental phobia.

-Healing Time Needed. As mentioned above a minimum of 6-7 months are needed in the best case scenario to complete a dental implant procedure from start to finish.

-Financial Expense. There is generally a slightly higher fee for a single dental implant vs bridge and could go even higher if other procedures are needed like a bone graft.

Dental Bridge Positives

-Permanent. The dental bridge will be cemented in place and will never be removed to clean unless your dentist finds an issue.

-Simpler and Quicker Dental Procedure. Generally takes only 2 dental visits and can usually be completed in about 2 weeks time. This can be a huge positive for many in the dental implants vs bridge discussion.

Dental Bridge Negatives

-Dental Hygiene More Difficult. With a dental bridge, you must brush and floss under and around the false tooth. Using floss threader as mentioned above may be difficult for some. Dental hygiene maintenance is a must if there is any chance of long term success for a dental bridge.

-Lifespan Shorter. A dental bridge generally lasts about 7-10 years. Some dental bridges can last longer and some can fail sooner. This is due to the wear and tear on adjacent teeth (these teeth remain susceptible to periodontal disease and tooth decay. Either tooth decay or periodontal disease can weaken support for the dental bridge.

-Surrounding Teeth Affected. A dental bridge requires support from the surrounding teeth that are used to hold the artificial tooth in place. If these teeth are not strong enough to have dental crowns, a dental bridge might not even be possible.

Dental Implants Vs Bridge Conclusion

Choosing dental implants vs bridge can be a difficult decision. Your dentist will help guide you through the process and help you make an educated dental implants vs bridge decision that is best for your smile. It is important to maintain regular dental visits no matter which side you choose in the dental implants vs bridge decision.

© 2019, Marielaina Perrone DDS. All rights reserved. Exceptional Dentist Las Vegas

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Dental Implants Las Vegas have changed the way dentists treat patients over the last 20 years. They have been nothing less than a miracle in the replacement of teeth whether it be a single tooth, multiple teeth, or as an anchor for a denture. As the technology matures, new advancements and techniques can be offered to patients. One of those newer dental advancements is called the All On 4 Dental Implants Las Vegas system. This dental technique allows for the placement of four dental implants (hence the name all on 4 dental implants), and the restoration to be placed on the same day. Patients leave the office with a full set of teeth. For this reason all on 4 dental implants are also called “new teeth in a day“. Who Wants All On 4 Dental Implants? The patients who choose all on four, do so for many reasons including, poor fitting existing dentures, terrible trauma causing tooth loss, decay or periodontal disease causing progressive tooth loss. The most common patients to choose all on
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Dental Urgent Care Las Vegas

Dental Urgent care las Vegas is not exactly like it is in medicine. There are not stand alone businesses just to handle a dental emergency. There are however, dental offices in Las Vegas and across America ready and able to handle your dental emergency. What types of issues are considered a dental emergency that you would need dental urgent care? When you experience an abnormal dental issue, sometimes it can be hard to know if it is a true dental emergency in need of dental urgent care.
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Dental Health Challenges For Women

Maintaining good dental health is a challenge for all of us but it can be especially challenging for women. Women’s bodies have major changes that occur throughout life including monthly cycles and pregnancy. These changes are due to changes in hormones. As you may know, hormones can be responsible for dramatic shifts in our bodies chemistry.

Recent studies have shown an increased risk for periodontal disease in women due to hormonal changes. Fluctuations in female hormones seem to be the main risk factor. For women, this means it effects them over the course of their entire lives. Female sex hormone changes occur at puberty, menstruation, during pregnancy, and throughout menopause. The study found that as female sex hormones fluctuate throughout a woman’s life they can change conditions in the mouth that allow bacteria to grow and enter the bloodstream. This development can and usually does intensify certain health issues like bone loss in the body and especially the mouth.

Female Changes Through Life

Below you will find a list of some of the major hormonal events that a female must deal with that can affect her dental health as well as her overall health.

-Menstrual CycleIs the regular natural changes that occurs in the uterus and ovaries that make pregnancy possible. The menstrual cycle is required for the production of eggs, and for the preparation of the uterus for a possible pregnancy. About 80% of women report having some symptoms during the one to two weeks prior to menstruation. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes. These changes can also include increased inflammation of gum tissues and sensitivity to your gums. Maintaining dental hygiene is even more important during the menstrual cycle changes to keep symptoms to a minimum.

There may also be an increase in the development of canker sores and blisters at this time. It is probably a good idea to watch these sores and ensure they go away in a  timely manner. If the sores become inflamed or linger for longer than 5-7 days it is best to see your dentist as soon as possible.

-Pregnancy. Another major period of change within a woman’s body. During pregnancy, hormones like estrogen, progesterone, as well as others, rise and fall on a weekly basis. Because of this, dental problems can be intensified and made more serious. Problems that were once unrecognizable before pregnancy may become unbearable during it.

When you’re pregnant, you become very aware of how important it is to take extra special care of your body. You should also know that pregnancy is a time to take extra special care of your teeth and gums. That’s because hormonal changes in your body during pregnancy can increase your chances of developing tooth decay, pregnancy gingivitisand advancement of periodontal disease .Studies have shown that women with existing periodontal disease are 7 times more likely to have preterm births and low birth weight babies.

Preventive dental cleanings and regular dental exams during pregnancy are not only completely safe, but are highly recommended by both dentists and physicians alike. Pregnancy causes hormonal changes to a  woman’s body. This increase in hormones causes the gums to bleed easily, become inflamed, and trap food causing increased irritation to your gingival tissue.

Researchers believe that periodontal disease may lead to premature birth by the spread of oral bacteria to the placenta or amniotic fluid. Systemic inflammation caused by periodontitis may also lead to preterm labor and membrane rupture. The probable culprit is a chemical called prostaglandin, released into the bloodstream during inflammation, which can induce labor. Prostaglandin is released in very high levels in severe cases of periodontal disease.

Almost one half of women experience pregnancy gingivitis, starting in the 2nd or 3rd month of pregnancy. It generally increases in severity all the way through to the eighth month. This pregnancy gingivitis can be very uncomfortable and cause inflammation, bleeding, redness or tenderness in the gums. If you already have poor oral hygiene and gum disease before pregnancy begins, expect an extreme progression in your periodontal condition as you end your first trimester and onward. In some women, gums swollen by pregnancy gingivitis can react strongly to irritants and form large growths. These are called pregnancy tumors. These are not cancerous and are usually painless in nature. This tumor may require removal by a dentist if it persists.

If you are planning to get pregnant, it is a good idea to see your dentist prior to trying to concieve to ensure your oral health is fine. You should have a complete dental exam at this time along with a dental cleaning and complete treatment on any other issues you might have to ward off complications during pregnancy.

-Menopause. Menopause may also contribute to some oral ailments such as the following:

1. Xerostomia (Dry Mouth). As a woman’s estrogen levels decrease it can lead to a drier mouth. Saliva is nature’s way of keeping our mouth clean and hydrated. Without sufficient amounts of saliva our teeth become more susceptible to tooth decay and periodontal infections. Dry mouth can also come from many medications (prescriptions or over the counter) that are commonly prescribed as we get older.

2. Menopausal Gingivostomatitis. This can occur to a very small percentage of women but can be very damaging. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red are hallmarks of this condition. Estrogen supplements are usually able to help to relieve these symptoms.

3. Bone Density Changes. The decrease in estrogen that occurs with menopause also puts women at greater risk for loss of bone density. Loss of bone in the jaw area can lead to tooth loss. Gum recession can also be a sign of bone loss in the jawbone. Receding gums also expose more of the tooth surface to potential tooth decay by exposing more areas of the tooth to the acids in the mouth. Gingival grafting may be necessary to cover the receding areas.

4. Change In Taste. This is especially true for salty, peppery or sour.

5. Burning Mouth Syndrome. This can affect the tongue, gum tissues, lips, and possibly the tissues inside the cheeks of the mouth. The burning mouth sensation generally occurs from changes in taste and the sensory nerves in the mouth. It can also be caused as a result of dry mouth, poor nutrition, and even allergic reactions to food or drug. If you note any of these symptoms contact your dentist immediately for help in relieving the discomfort.

6. Eating Disorders. Nutritional changes can occur from a woman’s change in her own body self image. These changes can lead to poor nutrition and improper eating habits. These changes can make our teeth more susceptible to teeth damage.

-Birth Control Pills. Another factor that may also contribute is the use of oral contraceptives or birth control pills. These pills trick the body into thinking it is pregnant through the use of hormones so that ovulation does not occur each month. Because the body believes that it is pregnant, the same problems that women experience during pregnancy may occur if the woman is taking birth control. Utilizing this medication makes it even more necessary for you to take good care of your oral hygiene and to pay close attention to any sensitivity, swelling, or discomfort in the mouth.

Female Dental Health Conclusion

As noted above, it is important for women to see their dentist regularly for examinations and dental cleanings as well as to maintain diligent dental care at home. Make sure to follow proper brushing and flossing habits, as well as using a strengthening fluoride rinse, and your teeth and gums should feel comfortable and healthy!

© 2015, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Dental Hygiene Tips For Travel

Summer is just around the corner which means school is out and traveling for many families. It is easy to overlook dental hygiene when on the road and forget to pack the essentials to maintain healthy teeth and gums. Below you will find some essentials to pack to ensure you keep up your dental hygiene while having fun on the road.

Dental Hygiene Essentials To Pack

-New Toothbrush. Start fresh and bring a new toothbrush on your trip. Then simply throw it out at the end of the vacation.

-Toothbrush Holder. This is a simple and cheap way to maintain a sanitary environment for your toothbrush.

-Travel Sized Mouthwash and Toothpaste. Not only will these follow the newer TSA regulations for air travel, they will make it easier to pack as well.

-Sugar Free Gum (preferably one with Xylitol). Being on the road it is not always easy to brush after meals or snacks. Keeping gum with you will allow you to freshen your breath and keep your mouth as clean as possible.

-Pain Medication. This can include Motrin or Aleve. Nice to have in case of a dental emergency while on vacation.

-Wax. Another good item to have in case of a dental emergency. If you accidentally chip a tooth, the wax can be used to cover the jagged edge of the tooth.

-Floss. Do not forget to floss at least once per day.

-Package of Colgate Wisps. This handy dental hygiene tool acts as toothbrush as well as a toothpick. These can help remove foreign objects lodged between your teeth.

-Plastic sandwich or freezer bag. Ever open your suitcase to find a tube of toothpaste or mouthwas exploded all over your clothes? It’s not a pleasant surprise. This can be prevented by putting your dental hygiene products in a sealed plastic bag.

-Electric Toothbrush/Charger. If you use an electric toothbrush make sure to pack the entire kit including the charger so you do not run out of juice while traveling.

-Waterpik Flosser Travel Size. The waterpik is an excellent adjunct to any dental hygiene program. If this is a product you use at home, then you would not want to leave without it.

Dental Hygiene Tips While Traveling

-Do not forget to brush after every meal. If you are unable to brush immediately, rinse with water after every meal.

-Limit snacking.

-Carry sugar free gum with xylitol to chew if you are unable to brush.

-Always brush and floss before bed.

Dental Hygiene Conclusion

Maintaining dental hygiene on the road can be quite challenging. Carrying your routine on the road is essential to stave off any dental issues down the road.

© 2015, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Periodontal disease is a slow, progressive disease that can wreak havoc on our oral and systemic health. Many of the symptoms of periodontal disease sneak up on us and are often ignored. It is important not to ignore these signs and symptoms as periodontal disease is the #1 cause of tooth loss. Periodontal disease comes in many different forms including aggressive, chronic, necrotizing periodontitis, and periodontitis associated with systemic diseases.  Each of these types of periodontal disease has its own distinct characteristics and symptoms, and all require prompt treatment by a dentist to help halt subsequent bone and gum tissue loss. Risk of PD increases with age. For younger people, dental caries are a more important risk for tooth loss, while for older people, PD is the more important risk factor.

Risk Factors Of Periodontal Disease

-Age. Studies have shown that over 70% of all Americans aged 65 and older have some form of periodontal disease.

-Tobacco Use (including smoking). We are well aware of the health effects of smoking on our overall health. These diseases include various types of cancer, lung disease, and cardiovascular (heart) disease. Research has also shown that tobacco use also increases a persons risk for periodontal disease.

-Family History (Genetics). Some people are more susceptible to periodontal disease than others. This is because of our genetic makeup.

-Stress. Studies have shown that stress can make it more difficult for the body to fight off infection, this includes periodontal diseases.

-Prescription Drugs (Medications). Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dentist.

-Bruxism (Teeth Grinding). Bruxism can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

-Presence Of Systemic Disease. Many systemic diseases can interfere with the inflammatory process. These include cardiovascular (heart) disease, diabetes, and rheumatoid arthritis.

-Poor Diet/ Nutrition. A diet low in important, essential nutrients can compromise the body’s immune system and make it harder for the body to fight off infection. Because periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums.

Periodontal Disease Signs And Symptoms

-Bleeding Upon Brushing, Flossing, Or Even Eating. This is one of the most common signs that periodontal disease is active. It is often overlooked as not a big deal. Periodontal disease is an inflammatory disease. As the bacteria and toxins build up in the mouth, the body responds by activating the inflammatory process, rushing our cells to stop the attack. This will cause the gum tissues to become inflamed and red. It is important to also note that bleeding gums can also be the sign of something more sinister like leukemia and blood platelet disorders.

-Unexplained Pain Or Swelling. Periodontal infections present in this manner. When an oral infection occurs, it is essential that you get to a dentist as soon as possible for evaluation and treatment. If the infection is left unchecked it will cause damage to the gum tissues and the bone supporting your teeth. It can also be carried to other parts of the body through the blood stream affecting your overall health.

-Persistent Halitosis (Bad Breath). Bad breath can occur from many things but peristent bad breath can mean progressive periodontal disease . As the gum tissues are destroyed, the areas where the oral bacteria can flourish will increase causing a foul odor in the mouth. There are other causes of chronic halitosis that should also be ruled out by your dentist prior to treatment.

-Change In Your Smile Or Loose Teeth. As periodontal disease progresses, your teeth will loosen and move out of position. This will effect the way your teeth fit together and even alter your smile.

-Teeth Become Longer In Appearance. As periodontal disease progresses it will lead to destruction of the bone and gum tissues. This will show up as gum recession. Once the gum tissues pull back they expose more of the tooth and root, making them appear longer than before.

-Pus Drainage. This goes along with the periodontal infection mentioned previously. An active periodontal infection will create pus which can ooze out from between the teeth and gums causing a bad taste and bad breath (malodor).

Periodontal Disease Prevention

Dental and Periodontal Examinations

Your dentist will complete a thorough examination with x-rays and periodontal charting. Notations about the visual condition of the gum tissue will also be recorded. In its earliest stages the gum tissue is usually red, puffy, and painless or slightly tender at this point. Plaque and tartar will more than likely be present to some degree. A periodontal probe will be used to measure around the teeth to see if your periodontal disease has progressed and to what degree. It is important to note that once bone loss has occurred you now have a more advanced form of periodontal disease.

Following the examination, your dentist will recommend a course of treatment for your periodontal disease. This will include a professional cleaning along with extra home care instructions. The goal in treatment is to reduce the inflammation and not allow progression of the disease. An antibacterial rinse (example, Listerine) may also be recommended for at home use. Yourdentist may also recommend repair of misaligned or crooked teeth to aid you in your home care efforts. Your dentist may also recommend a more frequent schedule(every 4-6 months) to control your periodontal disease.

Following removal of plaque and tartar, bleeding and tenderness of the gums should begin to subside within 1-2 weeks after professional cleaning and careful dental hygiene. Warm salt water or antibacterial rinses can also reduce gum inflammation. Taking an over the counter anti inflammatory medication can also aid in pain and inflammation reduction.

Healthy gums should look pink and firm with no bleeding upon brushing, flossing, or eating. Good oral hygiene must be maintained for your whole life, or periodontal disease will come back and possibly advance past the gingivitis form into advanced periodontal disease (also called periodontitis).

Steps to prevent periodontal disease should include:

-Routine dental visits. Usually recommended every 3- 6 months for examination and professional cleaning.

-Maintain At Home Dental Care. Brushing after every meal and flossing at least once a day.

-Rinsing with an antiseptic rinse as recommended by your dentist. Choose one with the American Dental Association (ADA) seal of approval.

Consult your physician if the bleeding is severe or chronic, gums continue to bleed even after dental treatment, or you have other unexplained symptoms along with the bleeding from your gums. These could all be the sign of a more serious condition than periodontal disease and should be checked out as soon as possible.

Conclusion

Preventing periodontal disease is up to the patient. Luckily, it is preventable with diligence and effort. Maintaining good dental hygiene and seeing your dentist regularly will lead to a lifetime of healthy smiles.

© 2015, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Dental phobia and dental anxiety is a serious issue affecting over 35 million Americans alone. Many people have such an overwhelming fear of dental care that they deal with constant pain and discomfort. Research has shown a definite body/mouth connection. Not maintaining good dental care can have dramatic negative effects on your overall health and well being. In recent years sedation dentistry has become quite popular, but sleeping through dental treatment does not allow you to develop the tools to overcome dental phobia and dental anxiety in a healthy manageable way. Common dental phobias include fear of dental pain, loss of control, and fear of needles or injections.

Top Methods To Cope With Dental Anxiety

Fortunately, both dental anxiety and dental phobia can be overcome with some work from both you and your dentist. You should never let fear stop you from seeking regular dental care. With proper steps taken by patient and dentist, and some patience, those fears will minimize so that you can not only seek treatment, but actually feel comfortable in the dental office. Some of the top methods for coping with dental anxiety and dental phobia include:

-Communication – For many, the dental phobia began as a child. A dentist might have scolded or talked down to their younger patients, making them feel like they did not have a voice in their treatment or even when it was uncomfortable for them. Even adults have reported these similar feelings, where they feel they might be ridiculed for being afraid. Open lines of communication can give back a full sense of control over your dental treatment. This control helps to decrease the feeling of helplessness. Being a part of the decision making on treatment, knowing what to expect, and knowing if you feel uncomfortable your dentist will stop, can make any dental patient feel better. Communication and control can be the differentiating factor between those suffering from dental phobia and dental anxiety, and those who have found a way to work past it. A good tip is, if you are anxious about something just come right out and talk to the dentist about it.

-“Talk” with your hands. Most dentists will give their patients hand signals to communicate. This is very important for those suffering from dental phobia. This gives the patients an increased control knowing the dentist can till listen to them while dental care is ongoing.

-Distractions – Developing the ability to take control of your mind and allow yourself to be distracted from the dental treatment. The top ways to achieve distraction are:

1) meditation - a relaxation of mind and body musculature.

2) audio distraction - listening to music, or the voice of your dentist while they talk you through the process with casual conversation. Even the sound of a soothing voice can lower anxiety levels. A good tip is to listen to an audio book while undergoing treatment. This will engage your ears and your mind to distract you from the task at hand.

3) visual distraction–  watching television or a movie, even staring at a relaxing picture during dental treatment. For many, wearing headphones can help to block out much of the dental noises that increase their anxiety, listening to a personal story about  the dentist, visualizing a relaxing setting, and muscle relaxation can make the experience much more tolerable and possibly even enjoyable!

-Be Prepared - Ask your dentist in advance what you can expect during your visit and how procedures, such as injections, are handled. Some may enjoy hearing a play by play and others will not. Talk it over with your dentist when going through your initial dental examination.

-Muscle Relaxation Techniques - The key here is to place focus on your body parts, relaxing them one at a time. You can start with your toes or hands and work your way across your body, squeezing then relaxing each area of your body progressively. This removes your focus on the dental care and places it on your body achieving the goal of relaxing and calming yourself. Try squeezing a stress ball in 1 or both hands.

-Take A Mini Vacation In Your Mind! - To help ease your nerves and control pain during dental treatment, imagine yourself in a relaxing, enjoyable setting. For example, visualize calming colors or scenes such as the ocean, think about the sound of the waves as you relax on your favorite beach or, if you enjoy hiking, imagine yourself walking along a trail next to a river. The more detail you add to the image, the less focused you will be on the dental procedure. This technique takes practice initially, but once you gain confidence in yourself and your dentist it will get easier to do. If you find that your mind drifts away from your image, gently turn your attention back to the scene you created. Try practicing meditation with visualization at home before your appointment when you feel stressed about upcoming dental treatment.

-Breathing Exercises - This is a great technique for your drive over to the dental office, or while waiting for your appointment. Deep breathing can be a great technique to relax your mind and body prior to dental work. By taking in slow, deep breaths, the oxygen flow will have a calming effect on your entire body. Remember, slow and deep, NOT short and fast, as this can cause you to hyperventilate.

-Take Frequent Breaks. Patients may need to take breaks during dental procedures, when anxiety builds up or they start to feel claustrophobic. If you feel like you need a break, let your dentist know and he/she will gladly stop to give you the time and space necessary.

-Acupuncture/Acupressure - Acupuncture/acupressure have many benefits for patients who are dentally anxious. For this to be fully effective, the acupuncture  should be completed as close to the dental appointment as possible, while some acupressure can be done during the dental appointment. This will not work for all patients but it has been a successful technique for many in attempting to overcome dental phobia and dental anxiety.

Conclusion

The key to overcoming and coping with your dental fear is to remember that you are not alone. If you choose the right dentist and dental team, they will be with you every step of the way, guiding you to help you overcome your fears. In the beginning it may seem insurmountable but one step and one appointment at a time, and the visits become easier and easier. You might actually begin to wonder why you didn’t do this earlier. Do not let dental phobia prevent you from being healthy in all aspects of your life. Take control of your health today!

© 2015, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Cosmetic dentistry gives an experienced cosmetic dentist the ability to transform any smile from ordinary to extraordinary.Porcelain veneers can be a major component in that transformation. Unfortunately, not every patient who wants porcelain veneers is a good candidate for them. Below you will find what is needed to be a good candidate for porcelain veneers.

Criteria For Porcelain Veneers

-Desire For A Beautiful Smile. when one desires a change, especially one requiring a financial investment, they are usually open to being diligent to maintaining it. If the porcelain veneers are not cared for they will break down overtime. Regular dental examinations, professional cleanings, and excellent homecare are an integral part of keeping your smile transformation.

-Healthy Teeth And Gums. If extensive tooth decay, fractured teeth, or periodontal disease are present, you will not be considered a good candidate for porcelain veneers. A stable platform is needed for porcelain veneers. The mouth needs to be  in a healthy, stable state to allow porcelain veneers to be considered an option. You will need a full dental evaluation to assess your dental health. If your mouth is unhealthy, it is best to avoid porcelain veneers due to the high liklihood of failure.

-Alignment Of Teeth. Severely misaligned teeth will cause issues with preparation of teeth for porcelain veneers. Most dentists try to be quite conservative when removing natural tooth structure. If the teeth are too far out of alignment it means more tooth structure will need to be removed to accomodate the spacing. Removing too much tooth structure can lead to tooth sensitivityand even nerve exposure (requiring root canal therapy). For teeth that are severely misaligned, invisalign, 6 month smile, or traditional orthodontics may be needed to bring them into better alignment.

-Sufficient Tooth Enamel Present. Tooth enamel is needed for the porcelain veneers to bond to your teeth. If the tooth  is severely worn down or damaged, porcelain veneers will not bond well and may not be a good option for you. In this case a full crown may be a better option.

-Tooth Color. In general, veneers look best when they are thin and translucent. If you have severely stained teeth (developmental dentin staining, tetracycline staining, root canal staining), it is usually best to whiten your teeth prior to veneers. Blockout of color is possible, but doesn’t look as natural.

-Gum Tissue Alignment. Proper gum contours are necessary to proper tooth shaping of veneers. If the gum heights are out of proportion, they will need to be recontoured with a gingivectomy procedure prior to veneer placement.

- Oral Habits: Nail BitingTeeth Clenching/Grinding (Bruxism). Severe teeth clenchers or teeth grinders are not good candidates for porcelain veneers. Veneers are not able to handle the powerful stresses put forth by grinding and clenching. If a patient only grinds their teeth at night then it is possible to still complete porcelain veneers but only with the use of a night guard at night. Other oral habits such as, biting nails, chewing on pens, opening packages with your teeth, etc. will also cause damage to veneers and may cause them to fail.

Porcelain Veneers Conclusion

Porcelain veneers when done on the right individual can change a persons smile dramatically. It is important to remember that veneers are not right for every situation. Be sure to have a thorough evaluation by your dentist to see if your cosmetic options may include porcelain veneers.

© 2014, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Is Your Smile Changing?

It has been said that the only thing in life that is constant is change. The same can be said for our smiles. As we age, our smiles change. This occurs when we are younger with new teeth erupting, loss of teeth as we get older, or even just teeth being misaligned. Ever wonder why teeth are constantly on the move?

Teeth Moving Factors

-Genetics. This always plays a role when it comes to our bodies and especially our teeth. Children actually inherit their parents tooth shape and size.

-Age. Anothe rmajor factor. As we use our teeth the dimensions of them change from wear over time. The lower teeth tend to wear out facter than the upper teeth due to their smaller size. This is commonly referred to as vertical bite collapse and is one of the reasons the skin around our mouths sag as we age. As the teeth wear down they are under immense pressure to shift and change positions as the bite re aligns itself anew.

Genetics, of course, can be a major factor. You can actually inherit your tooth shape! Tracing back either one or several generations, if it’s in your genes to have small or misshapen or crooked teeth, then that will probably be your eventual (not-permanent) fate.

-Tooth Loss. A major factor in teeth shifting when we are young and old. Most people believe that primary teeth can just come out and not cause any problems. This is not the case, the primary teeth hold space for the larger permanent teeth so are vital in that capacity. The loss of permanent teeth will allow the other teeth surrounding the loss to shift into that space.  If bottom teeth are missing, the tooth above will begin to grow downward. Nothing is stopping it from doing so or pushing it back into its place.

-Tooth Grinding (Bruxism). Grinding the hard surfaces of enamel together can wear down, fracture, and chip your teeth. Your teeth may appear shorter as they wear.  Another effect of teeth grinding is actual changes in the position of the teeth.  This grinding action juts the lower teeth forward and can loosen your upper teeth over time. Over time, these stresses can allow the teeth to move or drift to a different position and dramatically change your smile.

What Can Be Done To Fix or Stop Your Smile Moving?

-Dental Implants. Missing teeth can make you feel uncomfortable with smiling, socially awkward, or may make you look older than you are. Replacing lost teeth can be done with very natural results. Dental implants are a great way to achieve cosmetics, strength, and durability. Dental implants can be used to replace a single tooth or multiple teeth. The best part is, once restored, the dental implants should last long after your big day is over.

-Dental Bonding. This cosmetic dentistry procedure involves using tooth colored materials that can be bonded to teeth to change shape, color, and length. This same material can also be used to fully cover the front surface (referred to as a composite veneer). Dental bonding can generally be completed in one visit and make dramatic changes to your smile.

-Porcelain Veneers. While the initial cost is higher than the other cosmetic dentistry options, this may be cost effective if extensive changes need to be made. Porcelain veneers can change shape, color, length, and even correct minor misalignments of teeth. This will last a long time, will not stain, and is a very strong, natural looking material. If this is an option for your big day, you will need to plan in advance as time is needed to complete lab work.

-Porcelain and Zirconia Crowns. These types of crowns are the strongest and most cosmetic options available. They are made from modern dental porcelains that range in strength and esthetics. If done properly, no one should ever be able to tell a porcelain crown from a natural tooth. Modern porcelains possesses strength, color properties, and light reflection properties that very closely mimic our natural teeth. Porcelain crowns can be used to change bite alignment issues as well as change alignment of front teeth which are more extreme such as those issues that porcelain veneers alone cannot fix. More natural tooth structure needs to be removed in preparing a porcelain crown vs a porcelain veneer.

-Snap On Smile. This is a quick, conservative way to improve your smile without any permanent dental work. All that is required is having your dentist take impressions of your teeth, choosing a color, and the dentist sending them to a lab to have your custom snap on smile fabricated. Once the snap on smile is created, you simply clean your teeth, apply a fluoride gel inside, and slip it on over your teeth. You can talk, eat and smile with it all day long.

-Tooth Recontouring. Changing the shape or alignment of teeth in a minor way can have a dramatic effect on a persons smile. Tooth recontouring involves removing small amounts of tooth structure from edges of teeth to correct a tooth that might be misshapen or slightly misaligned.

-Orthodontic Treatment. Minor tooth movement can be utilized by your cosmetic dentist to bring your smile in line and allow for a better harmony between your smile and function.

Conclusion

Gone are the days where you have to just “deal” with a smile you are unhappy with. Cosmetic dentistry is not only about esthetics. Many of the procedures listed above will also improve the form and function of your teeth to allow for better health as well.

© 2014, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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How Stress Affects Your Dental Health

Stress is the body’s internal and external reaction to a change that requires a physical, mental or emotional response. Stress can come from any situation or thought that makes you feel frustrated, angry, nervous, or anxious.

Too much stress is known to be bad for us but did you know that stress can also cause issues to your dental health?

Dental Issues That Can Be Caused By Stress

Poor Dental Hygiene

When a person is under stress they tend to lose focus on basic habits and this includes being diligent with maintaining their dental hygiene. If you do not take care of your dental hygiene, your dental health as well as your general health will begin to suffer. This is especially true if you already suffer from periodontal disease as skipping any part of your dental hygiene program can worsen the periodontal disease. Another issue with being under stress is your nutrition changes. Most people dealing with stress tend to develop very unhealthy eating habits. This can include snacking on larger than normal amounts of sugary foods and drinks. These changes will increase your risk for tooth decay.

A good way to combat stress in your life is to maintain a routine of regularly exercising. Exercising regularly can help you relieve some of that stress and give you an extra energy boost. Exercise will also boost your immune system which is always a plus.

Teeth Grinding (also called Bruxism)

One of the main reasons why people grind their teeth is due to stress. Bruxism can occur day or night but it is usually a subconscious act. Stress is not the only cause of bruxism but it does make it worse. Some of the dental issues associated with bruxism include:

-Headaches

-Ear Pain

-Worn Down Teeth.

-Temporomandibular Joint (TMJ) Issues

-Sensitive Teeth

-Chipped or cracked teeth

-Receding gums or teeth with notches in them at the gum line

Your dentist may recommend a night guard to wear while you sleep to minimize the damage caused to your teeth. Usually, if stress is the cause the bruxism will stop when the stressor is removed.

Mouth Sores

Mouth sores come in many forms. These can include:

-Canker sores. These are small ulcers with a white or grayish base and bordered in red.  There has been vigorous debate regarding what causes canker sores. Some believe it is an immune system issue, bacteria, or even a virus. Consensus is that stress can increase the risk of them showing up. Canker sores are not known to be contagious.

Canker sores generally last about 7-10 days. Spicy foods as well as highly acidic foods should be avoided as they tend to irritate the sores. One of the best forms of relief comes from a dentist prescribed medicine called Debacterol. This medicine is applied directly to the sore and can reduce symptoms as well as the length that the sores are present.

-Cold sores (or fever blisters). These sores are caused by the herpes simplex virus and are highly contagious. Cold sores are blisters that are filled with fluid that often appear on or around the lips. They can also appear under the nose or around the chin area. Emotional stress can trigger an outbreak. Other triggers include fever, a sunburn, or skin abrasion.

Cold sores often heal on their own in about a week’s time. Treatment is available, including over-the-counter remedies and prescription antiviral drugs. Ask your doctor or dentist if either could help you. It is important to start treatment as soon as you feel or notice the cold sore forming. The sooner you start treatment the effects of the cold sore will be reduced.

Periodontal Disease

Stress can lead to depression. And studies have shown that patients who are depressed have twice the risk of a poor outcome from periodontal disease treatment compared to those who are not in a depressed state. You can not make depression or the stress disappear, of course. But most experts agrees that learning healthy coping strategies can help reduce the risk of periodontal issues getting worse.  Also, people who are depressed tend to have poor overall hygiene and that includes dental hygiene.

Conclusion

Keep in mind we all have stress during the course of our day. Developing proper techniques for dealing with that stress can make a world of difference in the maintanence of our dental health as well as our overall health. As always, see your dentist regularly for dental examinations along with professional cleanings to ensure you keep your smile as healthy as can be!

Remember, eating a balanced diet, seeing your dentist regularly, and good oral hygiene help reduce your risks of periodontal disease. Make sure you brush twice a day and floss daily.

© 2014, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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In the past, orthodontics was routinely an early teen event that began once all of the baby teeth were gone and permanent teeth were in. Recent advances in the understanding of a child development as well as modern materials have re-evaluated the time for orthodontic treatment to an earlier age. It is now recommended by the American Association of Orthodontiststhat every child should receive an orthodontic evaluation by age 7. But Why?

Common Orthodontic Problems Found At Age 7

1. Buck Teeth. Do the upper front teeth stick way out of line?

2. Deep Bite. Do the upper teeth cover the lower teeth?

3. Underbite. Do the upper teeth fit inside the arch of the lower teeth?

4. Open Bite. Do only the back teeth touch when biting down?

5. Crowded or overlapped teeth. Do the teeth have too much or too little space in certain areas?

6. Misaligned front teeth. Do the spaces between the upper two front teeth and lower two front teeth not line up?

7. Crossbite. Do the lower teeth fit properly inside the upper teeth?

8 .Missing teeth. If there are baby teeth that never developed, there will not be a permanent tooth to follow. Jaw x-rays may also find that certain permanent teeth are not  presently formed or are unable to come down on their own.

9. Extra teeth. When there are double teeth, extra teeth or malformed teeth.

Generally, orthodontic treatment does not begin at age 7 but it is good to get a head start to avoid any complications down the road. However, early orthodontic treatment may be necessary before age 7 if the following appear:

-Problems Speaking

-Proper Chewing Is Difficult

-Abnormal bite development

-Clicking or popping in the jaw

-Permanent teeth that are erutping into the mouth crowded or overlapped

-A thumb sucking problem

-A teeth grinding problem

-Issues biting cheeks or biting into the roof of the mouth

Benefits Of Early Orthodontic Treatment

Early orthodontic evaluation provides both timely diagnosis of problems and increased opportunity for more effective treatment. Early intervention gives the ability to guide growth and development, preventing more serious issues later. When orthodontic intervention is not necessary, an orthodontist can carefully monitor growth and development and begin treatment when it is ideal.

Early orthodontic treatment is also referred to as interceptive treatment or Phase I treatment. Some of the most direct results of interceptive treatment include the following:

-Creating room for crowded, erupting teeth

-Creating facial symmetry through influencing jaw growth

-Reducing the risk of trauma to protruding front teeth

-Preserving space for teeth that are coming in

-Reducing the need for tooth removal

-Reducing Phase II treatment time with braces

Phase II orthodontic treatment begins when all of the permanent teeth erupt and usually involves a full set of braces and not just a localized treatment plan.

Orthodontic Conclusion

While not every child will need early orthodontic treatment, it is best to know in advance what the options will be going forward. It is important to remember, orthodontics is not strictly a cosmetic endeavor, bite alignment is the ultimate goal. The issues presented above can all be corrected fairly easily if done in a phased approach. However, allowing this early intervention time to pass can complicate treatment requiring more extreme measures (i.e. teeth removal or surgery) to fulfill the same goal.

© 2014, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Periodontal Disease – is a progressive inflammatory disease, that affects the tissues that support and anchor the teeth. These support tissues include, gums, bone, cementum, and ligament attachments.

The main area in which periodontal disease is diagnosed and treated is in “the pocket”. The pocket is the unattached tissue between the tooth and gum, measured with a tiny ruler-like instrument called a periodontal probe. A healthy tooth generally has pocket measurements of 0-3 mm, whereas diseased tissue can be 4-15 mm deep, ( The deeper the pocket, the more difficult to fully clean). The measurements vary in what they measure, for example, in Gingivitis measurements indicate how swollen the tissue is, while in Periodontitis, the measurements indicate the loss of bone and gum tissue. If  left untreated,periodontal disease results in the destruction of the support structure, bacteria growth down into pockets, toxin release (to breakdown attachments),  loosening of teeth, and subsequent tooth loss.

Stages of Periodontal Disease

Periodontal disease is said to affect over 50% of all Americans. Periodontal disease advances in 4 stages:

1. Gingivitis- Swollen, red, inflamed gum tissue. There has not been loss of attachment at this stage. Reversible with proper hygiene.

2. Early Periodontitis- Less than 25% attachment loss, as determined by x-ray and measurement with a probe.

3. Moderate Periodontitis-25-50% attachment loss as determined above.

4. Advanced Periodontitis-50% or more attachment loss.

Periodontal disease can be reversible in its earliest form. This form of periodontal disease is called gingivitis. But if the periodontal disease progresses to periodontitis then the damage is not reversible by the body on its own. Patients and dentists alike are always looking for ways to combat periodontal disease with newer and better ways to treat the disease and maintain good oral hygiene at home. The tried and true home methods have generally consisted of varying types and techniques with  tooth brushing, flossing, and antibacterial rinses. All of these methods have the same limiting factor, none of the at home methods could target the deeper pockets of 5 mm and above, until a new product was formulated in conjunction with the waterpik utilizing a special tip which places a tartar dissolving liquid  directly where it is needed. This new rinse is called Periogen.

What Does Periogen Do to Fight Against Periodontal Disease?

Periogen is a patented oral rinse that has been proven capable of dissolving tartar buildup between professional cleanings and dentist visits. Periogen works by exploiting a weakness (discovered by the research team at the Periogen Company) in the fundamental structure  of oral tartar, and its adhesive nature.

Tartar (or calculus as it is sometimes called) can be found above and below the gum line. Tartar above the gum line is referred to as supra gingival tartar and tartar below the gum line is referred to as sub gingival tartar. Dental Tartar is comprised almost entirely of Calcium Phosphate Salt. Calcium Phosphate is the basic component of tooth material. Calcium phosphate salt differs from calcium phosphate in its electron structure. The calcium phosphate salt has two less electrons than the calcium phosphate which makes it electrically unstable. This process of losing electrons happens in nature all the time. The best comparison is the buildup of lime deposits in water pipes and faucets. Microscopically, tartar is layer upon layer (can be in the tens of thousands layers) of fossilized bacteria trapped between the calcium salts.

The tartar causes periodontal disease by toxins released by the bacteria in plaque and tartar on teeth. The toxins cause the body to react by starting the inflammatory

Periogen Marielaina Perrone DDS

Periogen Oral rinse for Dissolving Tartar Between Professional Cleanings

process thereby destroying healthy gum tissue and supporting bone structures. Periodontal disease is progressive and without periodontal disease treatment will lead to tooth loss and infections throughout the mouth.

Periogen is used as an oral rinse 1-2 times per day between professional cleanings to reduce the level of tartar buildup and stain. This will in turn make for an easier dental visit but also maintain a healthier state in your mouth for your teeth and gums to heal. Periogen should in no way replace brushing and flossing, or visits to the dentist but just works as an accessory between professional dental cleanings to give you a more effective way to reduce tartar and fight periodontal disease .

Periogen Conclusion

As you know, there are many methods and products on the market to aide you in your dental hygiene and combat periodontal disease. Remember this, “The best  offense is a good defense!”.   It is up to you to find and decide what works best for you to prevent periodontal disease. Visit your dentist regularly for dental examinations and professional cleanings to ward off dental problems and stay healthy.

 

© 2014, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Reposted From Dentistry IQ

A beautiful smile is important to many. With so many adults in our practices with misaligned teeth, shouldn't cosmetic orthodontics become a bigger part of your treatment planning? In the past, many adults were afraid to wear orthodontic braces because they were either embarrassed to wear brackets or did not want to spend the time and money. Cosmetic orthodontics has addressed these concerns. Below you will see some common questions and fears about cosmetic orthodontics, which can help you help your patients with their concerns.

“I’m just too old for braces. Braces are for kids.”
When your patients make statements like these, they expect you to agree with them. Instead, you should take this opportunity to reassure your patients that it is never too late to have the smile they have always wanted. There is no age limit for adults with a healthy periodontal condition to undergo orthodontic treatment. Cosmetic orthodontics lets you have the perfect smile you have always wanted without putting your life on hold. These new options allow you to look great throughout treatment. FACT: One out of every five orthodontic patients is an adult.

“I’ve already had braces; won’t they just move again?”
Explaining to a patient the importance of retention after movement is key. If they understand why that fixed retainer or clear stent needs to be worn during bone fill after movement and that they need to be continually monitored at each recall appointment, they are more likely to be compliant with their retention. For many, they need to understand retention as a protection of their investment.

“Braces take too long.”
For many adults, cosmetic orthodontics can be completed in as little as six months. Depending upon the appliances used and the amount of movement required, treatment can be quite short in length. When addressed in this manner, a patient should understand that treatment may be completed by the time of the next recall visit.

“Orthodontic treatment is painful.”
There is a huge difference between discomfort and pain. All appliances take some getting used to, but it is only for a matter of months. Most of the discomfort is short-lived, lasting a few days after an adjustment appointment. Some of the discomfort has to do with the metal aspects, which may poke or pinch, but this can be reduced drastically with a quick application of wax. In general, the discomfort does not get past the point where a Tylenol does not bring relief.

“Orthodontic braces make it more difficult to keep your teeth clean. Will this cause cavities?"
Good oral hygiene will take a bit more attention than it did before appliances were in place, but is very manageable with the right tools. Waterpiks, electric toothbrushes, fluoride rinses, and threader floss can make it much easier to keep everything clean and cavity-free.

“Isn’t it expensive?”
Your patients need to understand that cosmetic orthodontics is usually the most conservative way to fix a cosmetic issue. Very often, the need for full bonding or veneers may reduce to just a few teeth or none. It may also be the only way to achieve optimal cosmetic dentistry results. The cost factor can be overcome using payment plans through your dentist or using a third-party provider such as CareCredit.

Cosmetic orthodontics conclusion
Whether you practice limited orthodontic movement in your office or not, cosmetic orthodontics should be offered as a treatment option for patients who would benefit from it. Orthodontic treatment can transform your patients' smiles and attitudes about their dental health. You will be surprised at the positive results and referrals!

Marielaina Perrone, DDSMarielaina Perrone DDSis a family, cosmetic, and implant dentist creating and enhancing beautiful smiles in Henderson and Las Vegas, Nevada. 

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Herbal Supplements - are made from natural plants and are utilized by some people to supplement traditional medical treatments. Herbal supplements are not considered

Herbal Supplements Marielaina Perrone DDS

Be Smart About Herbal Supplements

drugs and are not regulated by the Food and Drug Agency (FDA). This absence of regulation means that the effectiveness, quality, and quantity of the ingredients have not been independently verified.

Herbal supplements have become a billion dollar industry with many people taking herbal supplements for a variety of ailments. But did you know that whether you take echinacia or aspirin you should always tell your dentist or physician what you are taking?

Everything you ingest, even vitamins, causes a certain reaction in the body. If your dentist does not know what drugs or herbal supplements you have taken, he or she will not know how to protect you from drug interactions. This is particularly important if you are undergoing any type of surgical treatment requiring general anesthesia.

Conventional Drugs Vs Herbal Supplements

Many prescription and over the counter drugs sold around the world are derived from plants but they are very different from herbal supplements. The prescription and over the counter medications must be regulated by the Food and Drug Administration (FDA) and undergo rigorous testing before coming to market. Even though, these drugs are derived from plants they are based around an active ingredient or chemical that the manufacturer synthesizes in a laboratory.

Herbal supplements are made from natural chemicals extracted from a plant and are produced either in original form (sometimes in combination with other herbal extracts) or refined. When an herbal medication is refined, the essential extract is taken out of the plant source, concentrated and then added back to make the original herbal medication more potent.

 Herbal Supplements and How They are Thought to Benefit Oral Health:

-Coenzyme Q10 promotes gum healing and cell growth.

-Lysine combats canker sores

-Vitamin C with Bioflavonoids promotes healing, especially of bleeding gums.

-Calcium and Magnesium help prevent bone loss around the gums.

-Vitamins A and E are used for healing gum tissue.

-Grape Seed Extract is a powerful antioxidant and anti-inflammatory.

-Zinc plus Copper enhances immune function.

-Aloe Vera Gel eases inflamed gums and soothes the tissues when applied directly to the affected area.

Herbal Supplements Marielaina Perrone DDS-Tea Tree Oils are believed to be antiseptic and anti fungal.

-Chamomile Tea is soothing to gum tissues.

-Green Tea is helpful in decay prevention and decreases plaque, increased antioxidants.

-Clove Oil is good for temporary relief of tooth and gum pain.

-Echinacea keeps inflammation down and enhances immune function.

Interactions to Avoid

Even seemingly harmless vitamin and herbal supplements can have serious side effects for certain dental patients. The following are some combinations of herbal supplements to be aware of:

-Ginkgo biloba and vitamin E can be dangerous when taken with aspirin because they each can act as blood thinners. The combination may cause difficulties in blood clotting, which could be serious for patients undergoing any type of oral surgery (such as a tooth extraction or periodontal surgery).

-Taking high dosages of vitamins before receiving anesthesia can also create issues. In particular, vitamin C, often taken in high dosages for cancer treatment, can weaken the efficiency of anesthesia.

-On the other hand, calming supplements, such as Kava Kava or St. John’s Wort, can strengthen the effects of anesthesia.

-Homemade tea tree supplements should be avoided, as they can cause irritation and burning.

Herbal Supplements And Dentistry Conclusion

People tend to think herbal supplements are harmless because they are considered natural, and they think, if one is good, 10 are better. Overdoing it, with supposedly safe herbal supplements, can cause health problems as serious as internal bleeding and heart arrhythmia. That is why it is so important to let your dentist and physician know when you are taking any herbal supplements to avoid any possible drug interactions or unforeseen consequences.

Always provide your dentist with a complete medical history, including any herbal supplements and conventional drugs you are taking. Some patients who take alternative herbal supplements are afraid their physician or dentist will not understand their decision to take an herbal supplement and will advise them to stop taking it. Your physician or dentist might even recommend an alternative, herbal solution for you.

If an herbal medication could interfere with your dental treatment, your dentist may ask you to stop taking the medication until the treatment is complete. The dentist also may be able to prescribe a different drug for treatment, if one is available. As always visit your dentist regularly for dental examinations and regular professional cleanings to keep your dental health.

© 2013, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Summer is just around the corner which means school is out and traveling for many families. It is easy to overlook dental hygiene when on the road and forget to pack the essentials to maintain healthy teeth and gums. Below you will find some essentials to pack to ensure you keep up your dental hygiene while having fun on the road.

Dental Hygiene Essentials To Pack

-New Toothbrush. Start fresh and bring a new toothbrush on your trip. Then simply throw it out at the end of the vacation.

-Toothbrush Holder. This is a simple and cheap way to maintain a sanitary environment for your toothbrush.

-Travel Sized Mouthwash and Toothpaste. Not only will these follow the newer TSA regulations for air travel, they will make it easier to pack as well.

-Sugar Free Gum (preferably one with Xylitol). Being on the road it is not always easy to brush after meals or snacks. Keeping gum with you will allow you to freshen your breath and keep your mouth as clean as possible.

-Pain Medication. This can include Motrin or Aleve. Nice to have in case of a dental emergency while on vacation.

-Wax. Another good item to have in case of a dental emergency. If you accidentally chip a tooth, the wax can be used to cover the jagged edge of the tooth.

-Floss. Do not forget to floss at least once per day.

-Package of Colgate Wisps. This handy dental hygiene tool acts as toothbrush as well as a toothpick. These can help remove foreign objects lodged between your teeth.

-Plastic sandwich or freezer bag. Ever open your suitcase to find a tube of toothpaste or mouthwas exploded all over your clothes? It’s not a pleasant surprise. This can be prevented by putting your dental hygiene products in a sealed plastic bag.

-Electric Toothbrush/Charger. If you use an electric toothbrush make sure to pack the entire kit including the charger so you do not run out of juice while traveling.

-Waterpik Flosser Travel Size. The waterpik is an excellent adjunct to any dental hygiene program. If this is a product you use at home, then you would not want to leave without it.

Dental Hygiene Tips While Traveling

-Do not forget to brush after every meal. If you are unable to brush immediately, rinse with water after every meal.

-Limit snacking.

-Carry sugar free gum with xylitol to chew if you are unable to brush.

-Always brush and floss before bed.

Dental Hygiene Conclusion

Maintaining dental hygiene on the road can be quite challenging. Carrying your routine on the road is essential to stave off any dental issues down the road.

© 2014, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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Orthodontic movement does not need to be so daunting. There are amazing advances in tooth movement, from simple to more complex, that can change the way you practice dentistry.

Orthodontic movement for the general dentist - Marielaina Perrone, DDS - interceptive orthodontics

Think about all the times you have had a patient come in for a cosmetic consultation … a patient who needs movement but doesn't want braces? The bonding or veneer work may not even be possible to achieve what the patient is looking for due to extreme malposition. We have been trained to do no harm, and that can make what the patient wants to achieve, without the aid of repositioning, difficult if not impossible.

Minor tooth movement

The Hawley appliance

When cosmetics warrant movement of incisors only, minor movement can be done quickly and easily with a Hawley appliance. The fabrication of the appliance can be done by your local orthodontic lab. The appliance can help move a labial or lingually shifted tooth into proper position, or turn rotated teeth back into place.

All you need to start, after radiographs and photos, is a double set of alginates with bite registration — one set for the lab and one set to keep as a records start model. The design of the appliance can also be done by your lab. If you can properly communicate the desired teeth and movements required, a good lab can create an appliance suited to those movements. Talk to your lab about which areas to tighten, screw down, or activate, and the lab can explain how to effectively get the movement you desire.


Orthodontic movement for the general dentist - Marielaina Perrone, DDS - Hawley appliance from Great Lakes Orthodontics Ltd. showing individual tooth movement with finger springs
Hawley appliance from Great Lakes Orthodontics Ltd. showing individual tooth movement with finger springs

Orthodontic movement for the general dentist - Marielaina Perrone, DDS - image from Great Lakes Orthodontics Ltd. showing expansion plate to move multiple teeth
Image from Great Lakes Orthodontics Ltd. showing expansion plate to move multiple teeth

Major tooth movement

Short-term braces

This procedure is an excellent therapy to utilize when the patient requires rapid tooth movement for cosmetics and does not wish to change molar occlusion. The treatment allows patients to have the effectiveness of braces without feeling like they have braces.

RELATED | Orthodontic tooth movement with clear aligners: seeing results with the invisible

Four- to eight-month rapid cosmetic orthodontic treatment combines the best of traditional orthodontics with modern esthetically appealing treatments. As the names suggest, Six Month Smiles® can transform your teeth in an average of about six months. The treatments use traditional wires and brackets that are tooth-colored for a less noticeable look. The patient is seen once per month for adjustments, photos, and wire changes.

The training required is a two-day training seminar. Training includes hardware placement, case selection, debanding and retention, proper photography and documentation, and use of 24-hour customer support. There are also advanced training classes available. You are guided through the process with the ability to ask for advice on your case, and tips and tricks from highly trained staff and practitioners.

Orthodontic movement for the general dentist - Marielaina Perrone, DDS - Six Month Smiles before
Six Month Smiles — Before

Orthodontic movement for the general dentist - Marielaina Perrone, DDS - Six Month Smiles during
Six Month Smiles — During

Orthodontic movement for the general dentist - Marielaina Perrone, DDS - Six Month Smiles after
Six Month Smiles — After


Clear aligner therapy

A cosmetic alternative to traditional braces, the aligners are removable and can provide major movement of the full arch, including molars. Aligner orthodontic treatment realigns the teeth through a series of clear, custom-made retainers. Each retainer, or aligner, is created using impressions taken of your teeth for a perfect fit. Aligners can be removed while eating and brushing for added comfort and ease of practicing proper oral hygiene. The duration of treatment depends on individual needs, but in general, may take between 12 and 48 months.

Aligner therapy, specifically Invisalign, requires a one-day training course for the dentist and additional staff training. You will learn proper impression technique, case selection, retention, use of software, aspects of in-office aligner therapy procedures, and how to access customer support.

This is a procedure that can be learned in one day! There are additional advanced training technique courses, but you can start treating patients immediately. There is excellent support to help you along with case planning and treatment to guide you into your new orthodontic transition. There are also newer treatments for teens and rapid movement aligner therapy.

The benefits of teeth straightening treatments

Teeth straightening treatments can transform how you perform dentistry. Once you are able to align teeth in a minor or even major fashion, the possibilities of great cosmetic dentistry are endless. Not only will you be able to better provide your patients with the best care possible, you can help your patients to improve:

  • Confidence — Many patients feel an increased confidence after teeth straightening treatment.
  • Esthetics — Teeth straightening treatments lead to improved dental esthetics.
  • Dental function — Misaligned teeth can make eating difficult and even painful. Teeth straightening treatments can improve dental function by improving dental alignment.
  • Dental hygiene — Crooked teeth can make properly cleaning teeth difficult. Teeth straightening treatments corrects overlapping teeth, allowing for easier cleaning.

Orthodontic movement for the general dentist - Marielaina Perrone, DDS - orthodontics

General dentists have a world of opportunity open to them to improve their practices, change their approach to cosmetic dentistry and full-mouth reconstruction, and increase patient acceptance of further cosmetic treatment. You will find that once patients have had their teeth aligned, they will want more treatment. Patients will then ask you for more information about whitening, veneers, changing out older restorations to newer, more cosmetic ones, and they are more apt to tell others about the beautiful work they had done.

Orthodontic movement for the general dentist - Marielaina Perrone, DDS - pediatric dentist

The key to utilizing the orthodontic treatments is to make a commitment to it. Take a training course, pump up your staff, and your patients will feel the excitement in the office for the great new treatments you are providing. There is never a better day to start achieving your goals than today. Remember, there is no need to be afraid of something new. There is excellent customer support available with most treatments. Your training will help you choose easier cases to start with, and your own level of interest and expertise will help you continue on your journey.

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Crooked teeth (also called malocclusion) can affect almost 75% of all American adults. Malocclusion can significantly affect oral health over the course of a lifetime, leaving you with increased chances of developing periodontal disease and increased wear and trauma to teeth.

Types Of Malocclusion

-Crossbite – A crossbite is when the lower teeth overlap or come out even with the upper teeth. In a normal occlusion the upper teeth overlap the lower ones but when a crossbite (can occur on either side or both) is present, the opposite is true. This can lead to premature wear, increased risk of chipping or fracturing your teeth, development of abfraction (small notch in tooth at the gumline), and periodontal disease.

-Excessive Overjet – This occurs when the upper front teeth are too far out in front of the lower teeth. This can lead to increased trauma as well as an increase to chipping or fracturing of teeth (especially the front ones).

-Edge To Edge Bite – This occurs when the teeth touch one another edge to edge (or cusp to cusp). The teeth do not fit together propely allowing the biting surfaces to touch. This will lead to increased risk of chipping and fracturing, Temperomandibular Joint (TMJ) pain, as well as short, worn down teeth.

-Open Bite – This is a common occurence from thumb sucking or can be genetic. It is when there is a space between the front upper teeth and the front lower teeth upon closing. Not only is this an unesthetic option but it can lead to abfraction, is difficult to bite and tear food ,and causes excessive, premature wear of the back teeth.

-Over Bite- This is when the upper front teeth completely cover the lower front teeth. Often, the lower teeth hit into the backs of the upper teeth and sometimes into the roof of the mouth.

-Under Bite- This occurs when the lower jaw has grown more quickly than the upper jaw. The lower front teeth and jaw have grown in front of the upper teeth.

-Tooth Size Arch Length Discrepency- When your teeth are too large for your jaw space and cause extreme crowding or when your teeth are too small for your mouth. Crowding can lead to decay, fracture, and periodontal disease. Small teeth are generally a major cosmetic issue.

The General Health Danger

Gum disease is commonly found along with malocclusion, due to difficulty in maintaining good oral hygiene when teeth are not in proper position.

Periodontal disease has been linked to many systemic diseases through various studies. Some of these diseases include heart disease, diabetes, and alzheimer’s. Periodontal disease generally takes years of neglect to develop. There are various stages of periodontal disease progression, they include:

-Gingivitis – The earliest stage. The only stage that is reversible with proper dental care. This stage is characterized by swollen, red gum tissues, bleeding upon brushing, as well as bad breath (halitosis). If treated before it progresses, it can be reversed back to a normal, healthy, gingival state.

-Periodontitis – This is the stage that develops following ginigvitis. It is not reversible but can be controlled. Damage to teeth, bone, and gums can be limited with proper dental care. During this stage, the supporting tissues around the teeth may break down leading to gum recession and bone loss around the teeth.

-Advanced Periodontitis – This stage increases the bone loss and gum recession leading to loosening of teeth with the real possibility of losing one or more teeth.

How Do Crooked Teeth Affect Our Mouths?

When teeth are crowded and not aligned properly, the plaque and bacteria that forms on our teeth during everyday food consumption  becomes much more difficult to remove. This makes it difficult to  maintain a good state of health. Many times, flossing and brushing areas of overcrowded teeth will become very difficult. These areas are generally called a “plaque trap” for their ability to constantly trap food and debris.  As mentioned earlier, without proper care, plaque traps can lead to bone loss, gum recession, and even tooth loss.

Another cause for concern is wear and trauma to the teeth. Poorly aligned teeth can create unnatural stresses on the teeth and the jaws. Teeth subjected to excessive pressures can develop chipping, fracturing, and abfractions. Premature wear can also lead to lost teeth, loose teeth and even root canal therapy.

Finally, crowded teeth affect your systemic health by allowing bacteria to grow and flourish unabated in these crowded areas. Over time, this can lead to devastating life threatening effects like heart disease and stroke.

What Can Be Done To Combat Crooked Teeth?

Fortunately, in many cases the simple solution is increased visits to the dentist for professional cleanings as well as diligent  home care.  When there is undue stress placed on the teeth that can cause trauma and wear over time, Orthodontics is the answer in most cases. Orthodontics is a type of dentistry dealing with crowded or misaligned teeth. Proper orthodontic treatment can, in many cases, restore your smile and make it easier to maintain it.

Orthodontics Conclusion

Orthodontics is not just for cosmetic reasons. We are not all born with perfectly straight teeth and sometimes we need a little help to get there. The bottom line is to have beautiful teeth and gums that make you feel confident and healthy. Your smile should  last you a lifetime!

© 2013, Marielaina Perrone DDS. All rights reserved. Henderson Orthodontist

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