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Dental anxiety is defined as a feeling of worry, nervousness, or unease, typically about dental care with an uncertain outcome. This can definitely include visiting the dentist especially after years of dental neglect. Dental anxiety is actually a very common fear but it can get out of control. A paralyzing dental anxiety can cause you to avoid dental care for years and in some cases decades. This dental anxiety and neglect can have long lasting impacts not only on your smile but your overall health. Recent clinical studies have linked dental disease (like periodontal disease) to cardiovascular disease, alzheimer’s disease, and even diabetes.

Dental Anxiety Feelings

Many people with dental anxiety have had a bad experience or have heard from a loved one about a significant dental experience. But that is not only reason some people avoid the dentist. Below you will find some common reasons why dental anxiety and dental neglect can occur:

Dental Anxiety Marielaina Perrone DDSFear Of Pain. Let’s face it no one wants to feel pain or discomfort. While dentistry has come a long way there are some parts that can cause some slight pain for some. For many they are OK but for others they are overly sensitive to oral discomfort. This is quite normal for us all to react differently to different events in our lives. Dentistry does not have to be a painful event and in most cases with a properly trained dentist and staff it is not. Choose wisely.

Fear Of Unknown. Not knowing what the dentist will say or find can cause a great deal of dental anxiety. Will I have a cavity? Will the dentist say I need a lot of treatment? All valid questions and concerns. Most people fail to realize going to the dentist every 6 months for routine checkups and cleanings will make things easier going forward. This is because any issues are caught immediately and can be handled before they get out of hand. Your gum tissues will also be healthier making the teeth cleaning easier and more comfortable.

Embarassment. A dentist or doctor is perceived as an authority figure by many. No one wants to be told they have a bad smile or have not done a good job with dental hygiene at home. A well trained dentist would never make you feel embarassed. Your dentist has seen it all. It will not phase them in the least what they find, so it should not bother you either.They would communicate the steps forward to fix the issues at hand. There is nothing to feel embarassed about.

Past Experiences. This can be a direct experience by you or an indirect experience by a loved one. Either way it will add to the dental anxiety as your dental visit approaches.

Overcoming Dental Anxiety – Communication Is The Key

Relay your fears to the dental staff and dentist. A well trained, experienced dentist will handle all patients the same and make you feel at home in the dental chair. Below are a few tips for you at your dental visit.

Be Honest and Upfront. Communicate your dental anxiety to the team and dentist so they can help you thru your visit. A well trained dentist will communicate with you and try to alleviate your fears in a variety of ways. These can include inviting you to the office prior to your appointment to just meet and talk. It can also include giving you a detailed explanation of what is to be completed at your visit so you do not have any surprises pop up.

Early Morning Appointment. For those with dental anxiety, getting the dental care done first thing in morning is best. This way there is no dwelling all day on it. Put your mind at ease and get it done first thing in the morning.

Bring Support. Bring a close friend or family member with you.

Use a STOP sign or word. You and your dental team can use a stop word or sign for when you feel the dental anxiety building and you need a break.

“Communication Is The Key To Overcoming Dental Anxiety.” – Marielaina Perrone DDS

Other Dental Anxiety Relieving Methods

-Exercise. Regular exercise can help lower stress and anxiety. Exercise helps by releasing endorphins and improving your sleep and self-image.

-Supplements Use. Certain supplements can reduce stress and anxiety. These can include ashwagandha, omega-3 fatty acids, green tea and lemon balm.

-Aromatherapy. Lighting a candle can help lower anxiety and stress. Lighting a candle or using essential oils can benefit dental anxiety from calming scents.

-Baby Steps. Try not to take on more than you can handle. Saying no is one way to control your dental anxiety. Your dentist will be cognizant of your dental anxiety and space out appointments in what is best for you. Obviously you will not be able to sit in chair for extended periods of time in the beginning so your appointment schedule will reflect your dental anxiety needs.

-Yoga. Just like exercise mentioned earlier yoga can be used for stress reduction and dental anxiety relief. It may help lower stress hormone levels and blood pressure.

-Power Of Music. Listening to your favorite music can be a good way to relieve stress and anxiety.

-Breathing Exercises. Deep breathing activates the relaxation response helping relieve dental anxiety. Focus on evenly inhaling and exhaling. This will help slow down and re-center your anxious mind.

How To Ease Dental Anxiety Conclusion

Dentistry has come a long way and patients comfort is of the utmost concern for most dentists. A well trained dentist will be able to handle your dental anxiety and design a dental schedule that is right for you. The bottom line is to keep you healthy both dentally and overall. Most people with dental anxiety report that the visit to the dentist ended up not being what they had imagined all along. It was much easier. Dental anxiety can be overcome but communication is the key.



Maintaining cleaner teeth at home can be a real challenge for many. A diligent dental hygiene program is necessary to maintain cleaner teeth at home between dental visits. So what steps are necessary to maintain cleaner teeth at home? Below you will find some helpful tips to maintain cleaner teeth at home and make each dental visit easier. Your dental visit will be quicker and less stressful knowing you are doing your best at home for cleaner teeth.

Top Tips For Cleaner Teeth At Home

Brush With Proper Technique. The brushing technique used is just as important as the frequency of brushing to maintain cleaner teeth at home. If you are doing a weak job with technique it is almost as bad as not brushing your teeth at all. An important step for cleaner teeth at home.

Cleaner Teeth At Home Las Vegas Marielaina Perrone DDSProper Tooth Brushing Technique For Cleaner Teeth At Home Should Include:

Toothbrush should be angled at a 45 degree angle to your teeth and gum tissues.

-Brushing should be done with a gentle circular motion encompassing each individual tooth.

-Do not forget to brush all surfaces of your teeth. This includes the inside (also called lingual side), the outside (also called the Buccal side) and the tops of teeth (also called occlusal side).

-Tilt tooth brush vertically to reach the inside of your front teeth. Many people neglect this area and it is just as important as the back teeth.

-To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes.

Plaque that is not removed will harden over time, leading to calculus buildup and possible development of tooth decay and periodontal disease. Cleaner teeth at home should start with proper brushing.

Brush Your TongueThis is important for fresh breath as well. Plaque and bacteria can build up in the crevices of your tongue. The easy solution is to gently brush your tongue every time you brush your teeth. You can use your tooth brush or buy a separate tongue cleaner at the drug store. Ask your dentist how cleaning your tongue can lead to cleaner teeth at home.

-Bedtime Brushing. In an ideal world, we would brush after every meal and then again before bedtime. But for many of us this is not possible. Brushing at bedtime can be very important because generally we have more time to devote to doing it properly vs maybe in the rush of our mornings. Bedtime brushing will help remove build up of food and plaque that occurs throughout our day. Bedtime brushing will lead to cleaner teeth at home because your dental hygiene will be maintained thru the night.

-Choose A Fluoride Toothpaste. Fluoride is a staple of good dental hygiene. It helps defend against tooth decay by strengthening the outer layer (enamel) of our teeth giving us a protective barrier against bacteria. There have been reports of fluoride being harmful to our overall health but rest assured it is safe and effective in toothpaste for brushing to keep cleaner teeth at home.

-Incorporate Flossing Into Dental Hygiene Regimen. Less than 30% of all people floss daily. That is a very low number for an extremely beneficial part of dental hygiene. It is recommended to floss after every meal or at least once per day to get flossing benefits. Flossing will help stimulate periodontal tissues, show a reduction in plaque, and lower inflammation of gum tissues.

Proper Flossing Technique

Use index fingers to guide dental floss between the contacts of your teeth. “Gently” guide floss between the teeth by using a zig-zagging motion. Gently wrap the floss around the side of the tooth. Slide floss up and down against the tooth surface and under the gum line gently. Flossing too hard can cause trauma to tissues.

 -Use An Anti Bacterial MouthwashA good mouthwash like Listerine can help in many ways. They can act to reduce the amount of plaque in the mouth, act as an acid reducer, and destroy harmful bacteria growth in the mouth. It is important to ask your dentist for a recommendation as some are good for kids while others are good for sensitive teeth. A good mouth wash can lead to a cleaner mouth at home between dental visits.

-Stay Hydrated With Water. It is recommended to rinse your mouth with water after every meal. This will help remove food from the mouth but also lower the pH level in the mouth. Some foods can be very acidic. An acidic environment is ideal for development of tooth decay. Drinking water will lead to cleaner teeth at home by rinsing your mouth but also by limiting tooth decay development.

-No Tobacco Or SmokingTobacco and smoking has many negatives for our health but it also will cause staining of our teeth. Avoid smoking for cleaner teeth at home between dental visits.

-Limit Sugars. This is not only important for dental health but also for overall health. This has been proven time and again by scientific studies. Limiting sugars will also limit chance of tooth decay. The World Health Organization Guideline on intake of sugar for Adults and Children recommended to limit free sugars to no more than 5% energy intake to protect dental health over a lifetime. Cleaner teeth at home has a definite nutrition component.

Cleaner Teeth At Home Conclusion

Cleaner teeth at home is the foundation of a good dental hygiene program. This will also include regular dental visits for examinations and professional cleanings. Cleaner teeth at home will lead to a happier, healthier smile for a lifetime.


What causes periodontal disease? Periodontal disease comes in different stages. The earliest stage of periodontal disease is gingivitis. This stage is reversible with proper treatment. If caught and treated before progression there will be no long term affects. If it advances to the next stage, periodontitis, there will be long term effects to your smile. These effects can include gum tissue recession and bone loss surrounding your teeth. Below we will discuss what causes periodontal disease as well as how to bring it under control for good dental health.

What Causes Periodontal Disease?

What causes periodontal disease? Bacteria and Plaque. Periodontal disease is a chronic dental infection of the periodontal tissues surrounding our teeth. This disease can result in the breakdown of the tissue as well as the loss of bone that surrounds and supports our teeth. Periodontal disease begins when bacteria and plaque form a sticky film on your teeth. This film acts as an irritant to the  surrounding tissues and causes inflammation of the periodontal tissue.  Periodontal disease will continue and progress and become more advanced over time What Causes Periodontal Disease Las Vegas Marielaina Perrone DDSwithout dental intervention. Periodontal disease is the #1 cause of loss of teeth in adults. According to the Centers For Disease Control (CDC), it is estimated that 65 million American adults, have mild, moderate or severe periodontitis (advanced form of periodontal disease)In our senior population aged 65 and older, prevalence rates increase to over 70%.

Bacteria That Causes Periodontal Disease

Periodontal disease and tooth decay are triggered by different types of bacteria and are considered to be two separate and distinct disease conditions. However, they work hand in hand to break down our teeth and gum tissues if left unchecked. Swollen and receding gums allow the more vulnerable areas of the tooth (root areas) to be exposed to cause an increased incidence of tooth decay.  On the other side, patients with extensive tooth decay, the broken down teeth allow for food trap areas which keep periodontal tissue chronically inflamed.

Stages Of Periodontal Disease

-Gingivitis – This is the earliest stage of what causes periodontal disease. Ginigivitis is simply the inflammation of the periodontal tissues surrounding the teeth. Gingivitis is the mildest form of periodontal disease and is wholly reversible with professional care and a good at home dental hygiene regimen. Symptoms of Gingivitis Include red, swollen gum tissue with inflammation as well as gum tissues bleeding easily upon brushing, flossing, or even eating. Often these symptoms are unnoticed by patients. Bad breath may be another sign of advancing periodontal disease.

There are only a few signs at this stage and most are painless. This is what makes periodontal disease so common and so concerning. It is silent until it is not. Periodontal disease does not typically break its “silence” until the fourth and final stage. Beginning signs to watch out for include bad breath on occasion, swelling and redness of the gums, and bleeding when brushing or flossing. Good overall dental hygiene and regular professional examinations can treat and reverse gingivitis as well as stop it from progressing further.

This is a critical period for the patient, as gingivitis can be reversed (since the bone and connective tissue that hold the teeth in place have not yet been adversely affected) at this point if it is recognized, diagnosed, and properly treated by a dental professional. Gingivitis can commonly be seen during puberty, pregnancy (also called pregnancy gingivitis), times of high stress, and menopause. As for the rest of the population, poor dental hygiene is generally the most common cause, followed by medication and certain medical conditions (like diabetes).

-Periodontitis – If left untreated the next phase is early periodontitis. Once it enters this stage, the disease can be difficult to control. In this stage, the bone surrounding the teeth is now being affected. The bacteria will invade between the tooth and gums causing a separation of connective fibers. The result is what is called a periodontal pocket (normal pocket depth should be about 3mm without inflammation). These pockets will now approach 4-5mm in depth and can get filled with bacteria, plaque, and food. This will in turn begin to breakdown the bone below the gum line. Simple at home dental hygiene will not be the answer to bring back to a healthy state. Periodntitis signs include increased swelling or redness of the gums, increasingly bad breath, bleeding upon brushing or flossing, and pocket depths that are between four and five millimeters.

-Advanced Periodontitis – This is where the real destruction lies. At least 50 % of bone support is lost if not more. Teeth will begin to loosen and shift if they have not already. Deep periodontal cleanings and possibly surgical intervention are necessary to salvage teeth. This professional cleanings may occur using a periodontal microscope, (Perioscope), grafting of gum tissue or bone, placement of growth factors (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets, (Arestin), open periodontal flap surgery, and, possibly even removal of teeth.

How To Treat What Causes Periodontal Disease?

Luckily, the earliest stages of periodontal disease are easily treated. Following a good at home dental hygiene program (including brushing, flossing, and antibacterial mouthwash) along with regular visits to a dentist we can halt gingivitis in its tracks. Failing to to do the above steps will allow periodontal disease to advance unchecked leading to loss of teeth as well as systemic health issues.

Treatment For Periodontal Disease Can Include Any Of The Following:

Pocket Reduction SurgeryA surgical procedure to reduce the size of the periodontal pockets around your teeth. This will ensure the ability to keep the areas clean at home. The surgery is made up of tiny incisions in your gum tissues so that a section of gum tissue can be lifted back, exposing the roots for more effective teeth cleaning. Because periodontitis often causes bone loss, the supporting bone tissue may be recontoured before the gum tissue is sutured back in place. This surgery can take from 1-3 hours and is performed under local anesthesia.

-Periodontal Tissue Grafts. Periodontal or Gum tissue is often lost due to periodontal disease. When the gums recede your teeth will appear longer than normal as root surfaces are exposed. You may need to have damaged tissue replaced for cosmetic as well as functional reasons. It is important to note that root surfaces are not protected by enamel. This can cause extreme tooth sensitivity. This grafting procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetic lift.

Bone graft. The addition of the bone graft helps prevent tooth loss by increasing support structure around our teeth. It also serves as a building block for the regrowth of natural bone.

-Antibiotics and Antibacterial Medications – These medications will aid in healing and removal of bad bacteria from around our teeth. These include:

-Peridex – Prescription antibacterial rinse.

-Periostat – Oral antibiotic. Another type of antibiotic used is called minocycline.

Arestin – placed directly into the periodontal pocket to help aid in healing.

Chlorhexidine – A prescription anti bacterial mouthwash. This is used to control bacteria when treating periodontal disease and after surgery. Patients use it as they would a regular mouthwash.

-Guided Tissue Regeneration. This periodontal procedure helps to regrow destroyed bone. Your dentist or periodontist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back in a stable environment. The goal is to regenerate periodontal tissue and repair defects that have resulted from the development of periodontitis.

-Enamel Matrix Derivative Application. Another technique involves the application of a specialized gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue. An example of this is the use of emdogain.

What Causes Periodontal Disease? Conclusion

Periodontal disease if left untreated can cause aggressive destruction of your smile. Regular dental visits can prevent periodontal disease from developing. A good way of looking at this is that it is far cheaper and less painful to go to your dentist every 6 months than it is to wait for periodontal disease to develop and chase after your health. Visit your dentist regularly for a happy, healthy smile.



Cosmetic dentistry deals with much more than just an esthetic result. A well trained cosmetic dentist will be just as concerned with function as well as cosmetics. Without proper function, any cosmetic dentistry will ultimately fail over the long term. Below will be some of the most common cosmetic dentistry procedures your dentist can perform to bring new life to your smile.

Common Cosmetic Dentistry Procedures

Cosmetic Teeth Whitening. Probably the most popular cosmetic dentistry procedure due to its quick results and relatively low cost. Teeth whitening can be performed at home by the patient or in the office by your cosmetic dentist. Your teeth have pores and anything we eat or drink that has color will absorb into those pores. Wine, coffee, dark berries, and smoking are the main culprits in staining our teeth. As we get older, the natural color of your teeth becomes darker and darker due to these stains. These stains will not go away without intervention by your cosmetic dentist. Not every patient will achieve the same cosmetic dentistry results, so it is very important to check with your dentist first to see what to expect.

Cosmetic Dentistry Henderson NV Marielaina Perrone DDSCosmetic Porcelain Veneers (or even composite veneers). Porcelain veneers are a thin shell of porcelain similar to a fingernail. They are custom made in a dental laboratory and cemented in place over your teeth to transform your smile. Porcelain veneers are sometimes called “instant orthodontics” in cosmetic dentistry because they have ability to realign slightly crooked teeth. Porcelain veneers also have the ability to change the color of your smile, repair chipped teeth, or close gaps between your teeth. This is a staple of cosmetic dentistry and a well trained cosmetic dentist can dramatically change your smile quickly.

Cosmetic Porcelain Crowns. These are custom fabricated to restore function and esthetics to your smile. Porcelain crowns are utilized in cosmetic dentistry by your cosmetic dentist to restore teeth that have been damaged to trauma, tooth decay, or to close gaps between teeth. All porcelain crowns are ideal to restore a front tooth as they are translucent and designed to look like your natural teeth.

Cosmetic Dental Implants. A dental implant is a titanium root structure designed to replace a missing tooth or teeth. A dental implant is surgically implanted into the jawbone where the tooth is missing. Unlike a dental bridge, a dental implant is permanent, this is because the dental implant becomes one with surrounding bone (process is called osseointegration). A dental implant is designed to act as the tooth root. Once integrated it can be used as a platform to replace a single tooth, multiple teeth, or even be support for a full denture. Dental implants are the closest you can get to a natural tooth in function. They give you the freedom to confidently eat, smile, laugh, talk, and enjoy all of your everyday activities without worrying about your smile. These can be used in cosmetic dentistry along with other procedures to restore your smile.

Cosmetic Teeth Recontouring. Also called tooth enamel shaping. A misshapen tooth can be lightly shaped by your cosmetic dentist in a painless procedure but it can have a dramatic effect on your smile. It is common to do this if you have protruding mamelons. A mamelon is a rounded protuberances which are present on the cutting edge of an incisor (front) tooth when it first erupts into the mouth. Generally, they wear away over time as we grow up but for some they need help in removing them.

Cosmetic Dental Bonding. Also called tooth bonding. Dental bonding is the cosmetic dentistry procedure in which tooth-colored materials are bonded to the tooth to repair tooth decay, repair a chipped tooth, or even close a gap between teeth.  These tooth colored materials are bonded using chemistry and a special light which hardens the material in seconds.

Cosmetic Orthodontic Braces. Adult orthodontics have become very popular in cosmetic dentistry especially with introduction of invisalign orthodontic system. Your cosmetic dentist can make small adjustments to one or a few teeth or a major overhaul using more traditional orthodontics treatment.

Cosmetic Dentistry Conclusion

Cosmetic dentistry can transform any smile but function is the key. Make sure you see a well trained dentist who knows that function trumps cosmetics. If a dental restoration is not functional it will not last and withstand the stresses of the mouth. Cosmetic dentistry can be what is missing from your smile. Ask your dentist today to transform your smile.