Family, Cosmetic & Implant Dental Care in a
Comfortable, Relaxed Environment.
Serving Henderson and Las Vegas, Nevada.

Dental phobia, and dental anxiety come in many forms. Anxiety may cause you to be slightly apprehensive to extremely frightened at the thought of visiting the dentist. A

Dental Phobia Marielaina Perrone DDS

Dental Phobia Can Be Overcome!

phobia, may cause a paralyzing fear that overtakes your entire body. Whichever form, dental phobia or dental anxiety, can be very difficult to overcome. Inability to have regular dental and health care can lead to health issues. Numerous studies have linked diabetes, alzheimer’s disease, heart disease, and even cancer to poor oral health. It is imperative to maintain a healthy mouth to keep our bodies happy and healthy. So, the question becomes, can dental phobia be overcome?

Dental Phobia Is A Learned Fear

There has been significant research to show that dental phobia and dental anxiety are linked to life experiences. These experiences can be direct or indirect.

-Direct experiences - are the most common way for people to develop a dental phobia or dental anxiety. Many people report fearing the dentist due to a prior traumatic or painful dental experience. However, it is often the dentist themselves who induce the dental phobia. During the many studies, patients report it was not the dental procedure that ultimately causes their fear. Instead it was the dentist’s attitude towards them. Dentists who were perceived as impersonal, uncaring, or even cold were found to be the root cause of the direct experience dental phobia. An interesting note from these dental phobia studies was, that patients who experienced a painful or traumatic treatment but had a caring dentist, failed to develop a dental phobia. This leads us to believe that dental phobia is a learned trait and can be overcome.

-Indirect Experiences - These can include:

Parental/Peer Influence – Dental phobia can develop from hearing about your parents, siblings, friends, bad experiences or their negative views on going to the dentist.

Media Influence – Many movies like to poke fun at the dentist in good and bad ways. A good example is the dentist in little shop of horrors whereby dentistry is portrayed in  a sadistic way. This extreme visual can be quite unsettling, and emotional. The fear can readily be instilled, and dental phobia can develop.

Dental Phobia Diagnosis

Dental phobia can often times be very easy to diagnose. All you have to do is ask a patient and they can tell you how they feel about the dentist. It usually produces a very profound reaction if they truly have a dental phobia. The usual method for diagnosing dental phobia is the use of a scale to assess the level of dental phobia or dental anxiety. The scale consists of a series of questions and based on the answers the dentist can assess the level of your dental phobia. Common questions on the scale include:

Dental Phobia Marielaina Perrone DDS

Unlearn Your Dental Phobia!!

-While waiting in the reception area of the dental office, do you feel nervous about the visit?

-Have you had a prior dental experience that was unpleasant?

-While in the dental chair, do you feel uneasy and anxious?

-Do you feel embarrassed that the dentist will say you have the worst mouth they have ever seen?

These questions will give your dentist an assessment of what you are afraid of. Further questioning will help narrow down the fears and their triggers, enabling the dentist to work with you to help slowly overcome those fears.

Breaking The Dental Phobia Hold On You

Overcoming dental phobia can be a very difficult proposition, there is work and time involved for both you and your dentist. The first step is believing in yourself, and your dentist.The second is, feeling that it is possible, and truly wanting to try and overcome it. Dental phobia is a learned behavior and can be overcome with hard work and the desire to do so. The biggest key to overcoming dental phobia is to find the right dentist for you. One who will always keep an open line of communication, is extremely important. This will allow you to express yourself and your emotions before, during, and after treatment.

-Feeling of Control -  A sense of control is your right as a dental patient. Understanding this, is key to confidence. Knowing that you can stop treatment as often , and whenever you want can be very freeing.The most common signal is simply raising your left hand to alert the dentist and staff of your need to communicate. A system should be established allowing you to stop for any reason, whether it be because you need more anesthesia, want to rinse out, or simply need a break.You should be part of the process of developing a treatment plan as well as have the ability to fully understand the treatment being offered and why it is needed. You need to be honest with your dentist and yourself regarding how much treatment you can tolerate initially. As time moves on, you will build confidence in yourself as well as increased trust in the dentist and staff treating you. Over time, the type and length of the appointments can be increased. You will be amazed how long you will be able to sit in the chair when it is your choice!

-Feeling Embarrassed or Self Conscious - If you have been ridiculed in the past for your behavior or if you are embarrassed by your present dental condition caused by your neglect, please express yourself honestly and give your dentist a chance to understand your concerns and show you that they care. Please know, that most dentists

Dental Phobia Marielaina Perrone DDS

Free Yourself Of Your Dental Phobia

do care, and want to treat you with the respect that you deserve. These feelings do need to be addressed, and talked through, so that you can begin to leave them behind.

-Use Of Relaxation Techniques - If you feel tense in the chair, the easiest way to relax is through forms of physical relaxation. A relaxed body promotes a clear and relaxed mind. The human body cannot be physically relaxed and mentally anxious at the same time! The brain won’t process these feelings simultaneously. Physical relaxation methods are easier to accomplish at first as compared to cognitive ones, so practice forms of physical relaxation first. Light meditation methods and music work very well. Light conscious sedation, such as valium, is a great way to start.

Examples of physical relaxation are Diaphragmatic Breathing, Progressive Muscle Relaxation, and various methods taught in yoga . If you induce relaxation in the presence of the stimuli that normally induces your fears (the dental environment), the fear response will be greatly diminished over multiple exposures and you will gradually desensitize yourself to these fears as you build confidence. The memories of traumatic visits will be replaced with more innocuous ones and this less threatening environment coupled with your relaxation methods will help you eliminate your dental phobia.

Repetition. The simple process of repeat appointments, will make you feel more comfortable. As you learn what to expect, and realize that you are in control of the appointment, you will be able to manage more time in the chair. Remember not to wait too long between appointments or to reschedule unless an emergency arises. Merely coming to the office and not having treatment that day is better than canceling.

-Distraction - As you get more comfortable in the dental environment, you can use distraction. The use of an ipod with your favorite music is a common technique. It is only suggested to utilize distraction techniques once you have established some trust and confidence, because your ability to communicate will be decreased, although it is easy to communicate by using your pre-established hand signals.

-Predictable Pain Control - Modern dentistry has many new techniques with regards to the administration of local anesthetics to help block pain. There are many people who have differences in their anatomy that do require more individualized techniques in order to predictably achieve proper local anesthesia. This variation must be respected and communicated to your dentist. The needle itself is generally the minor cause of discomfort, in fact, it is the pressure and volume of the fluids being injected that causes the major discomfort. Therefore, all injections should be given slowly. There are also great differences in the types of tissue in various locations, anatomically and from person to person, that must be considered when administering injections. There are even computer-controlled machines that are now available to standardize the injection process and make it more predictable than the conventional hand-held syringe.

Conclusion

Dental phobia and dental anxiety can be overcome! With proper guidance, trust, patience, dedication, and communication, dental phobia can be beaten. Do not allow your health to be held hostage by your fears. You can live a longer, happier, and healthier life, free of dental fear. Take that first step and find a dentist that understands dental fear, and make an appointment for a consult. Dental phobia and dental anxiety can be overcome!

 

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Marielaina Perrone
2551 N. Green Valley Pkwy #A405 HendersonNV89014 USA 
 • 702-458-2929

Many of us choose haircuts or clothes based on our facial or body shape so why not our teeth? We are all born with a set of teeth that may or may not be perfect to us. There may be minor flaws or major ones to our eyes. With modern cosmetic dentistry, teeth changes can be made to improve your overall appearance and look very natural.

Cosmetic Dentistry Marielaina Perrone DDS

Cosmetic Dentistry Can Change Your Smile!

Facial Analysis and Cosmetic Dentistry To Transform Your Smile

It is essential for your dentist to do a facial analysis in treatment planning for cosmetic dentistry. The face drives the shape and position of the teeth. If someone smiles at you and it’s a high and wide smile, the teeth might be out of balance or out of proportion to the face. If this is the case, the smile needs to be altered to bring about balance and proportion.

Simply put, the face, mouth, and lips direct the size of the teeth. The facial aesthetic drives the tooth size and position. Your dentist will need to look at the face from both the front and the side, the relationship between the lips and the teeth and the teeth’s shape, color, size and position.

“There is an important harmony that exists between teeth and facial features for a successful cosmetic dentistry result.”

The shape of the head, size and position of the eyes, nose, lips, cheekbones all play a role in determining the size, position, shape and contour of the teeth. Your cosmetic dentist should do a complete analysis with models of your mouth and records may include extra oral photographs of the full face, profile, smile and intra oral photos of the teeth, bite, gums, and arch form, and measurements. The architecture of the mouth, including the patient’s lip line (e.g., a high lip line give a “gummy smile” appearance), and gum line contours are an integral part of facial analysis.

Cosmetic dentistry utilizes many procedures to make the changes necessary to make your smile complement your face. The goal in cosmetic dentistry is to create a natural looking smile, so that only the dentist and patient know what was done. This becomes especially important as we age. Listed below are some of the cosmetic dentistry procedures that can be used to make complementary changes:

Cosmetic Dentistry Marielaina Perrone DDS-Dental BondingDental bonding is the process in which tooth colored dental materials are bonded to a tooth. This might be one of the easiest cosmetic dentistry procedures to change our look. Using dental bonding we can change shape, size, color, length, and close any spaces that might be present. Dental bonding is generally completed in the dentist office in as little as an hour. The main drawbacks of dental bonding are chipping, wearing, and staining. The final product is not as strong as a porcelain restoration and may need to be updated over time, but can be done in less time for less money. While dental bonding is also used to restore teeth damaged by tooth decay it can also be used as a cosmetic veneer. This procedure can easily alter your smile in as little as an hour, and is minimally invasive. Dental bonding is a very easy way to make your smile youthful looking again.

-Porcelain Veneers and Porcelain Crowns. Often referred to as “instant orthodontics”, porcelain veneers can change the alignment of teeth, if the alignment issues are not too extreme. Porcelain veneers and porcelain crowns can be a great way to replace lost tooth structure and alter imperfect teeth creating a more youthful appearance. These cosmetic dentistry procedures tend to require more than one visit, but the results will give you a beautiful, youthful smile that lasts. Porcelain Veneers are custom made, ultra thin, tooth colored shells that are adhesively bonded to the teeth, and do not change color over time. This allows the cosmetic dentist to not only alter color of your teeth, but shape and lengthen as well. Porcelain crowns can be used on teeth that either already have crowns or need more extensive work (having large restorations or tooth decay). Both porcelain veneers and porcelain crowns can as used in cosmetic dentistry to give the patient a flawless, more youthful and attractive smile.

Tooth Shapes To Complement Your Face Type

A good cosmetic dentist will note all factors during treatment planning. Individual facial type is one of those important factors in cosmetic dentistry. The following is a guide to different facial shapes and their complementary teeth shapes:

-Small Face: A small face requires smaller porcelain veneers or porcelain crowns. Long, square shaped tooth shapes should be avoided. If the teeth are too long it will notCosmetic Dentistry Marielaina Perrone DDS be in line with overall proportions of your face.

-Angular or Square Shaped Face: For this type of face softer edges are required. This will help soften the overall smile and merge it better with the rest of your face. Sharp angled teeth may be too harsh of a look.

-Fuller Face: Just like vertical stripes make a person look slimmer, slightly longer teeth can create a slimming effect.

-Thin Face: The key here is to avoid thin, long teeth. They will only make your face appear longer. Wider, fuller teeth will broaden your smile and add fullness to your smile.

Other factors to consider:

-Tooth color - Lighter teeth are what most of us desire when altering cosmetics. Keep in mind, that skin color, lip color, and hair color effect how whit your teeth appear. You, and your dentist should go through several options to see what will work best for you.

-Tooth size - As we age our teeth tend to shift, chip, and wear. Tooth size and shape consequently change. Restoring back to proper proportions make your teeth appear healthier and more youthful.

Cosmetic Dentistry Conclusion

Many dentists call themselves cosmetic dentists, but not all have the proper training, experience, and skill to take an ordinary smile and make it extraordinary. The key to it all, is overall improvement, while keeping it looking natural. The best cosmetic dentistry procedures is make your smile appear natural with the proper color, shape, and light reflecting properties. Your friends and loved ones will love your new smile, without realizing what you have had done!

 

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Bruxism (also called teeth grinding) – is the habitual, involuntary grinding or clenching of your teeth, usually during sleep, but can also occur during the day. The cause of Bruxism Marielaina Perrone DDSbruxism is unknown but it is often associated with anger, tension, fear, frustration, and stress.

Many people go through periods in their lives where they grind their teeth or clench them from time to time. Bruxism generally does not cause any long term damage when done occasionally. If the problem persists, over time there will be long term damage to the teeth and surrounding tissues in the mouth.

When Does Bruxism Occur?

Bruxism generally occurs during sleep, most people are unaware that they are even grinding or clenching their teeth unless they are told so by their partner or by their dentist . There are signs that should give you pause to think that you may be a bruxer. Usually it is a loved one that notices the grinding as it awakens them at night. Another sign is a dull, constant headache or sore jaw when waking in the morning. Cracked, chipped teeth, and wear facets may be noticed by your dentist. Continuous teeth grinding will lead to dental issues, which can result in  fracturing, loosening, or loss of teeth. Habitual teeth grinding will wear the teeth down, remove the cusps on the teeth,and essentially flatten them. When these issues happen, bridges, crowns, root canal therapy, dental implants, partial dentures, and even complete dentures may be needed. Bruxism can also lead to Temperomandibular Joint Disorder, hearing loss, and even change the appearance of your face.

Treatment Options For Bruxism?

Unfortunately, there is no cure for bruxism. The only way to truly get it under control is to learn to manage stress in our lives better. So what can a dentist do to help? Luckily, dentistry has developed some techniques to protect our teeth from bruxism.

Treatment options include:

-Fabrication of a Custom Mouth Guard. This will act as buffer to protect your teeth during sleep. It does not necessarily cause the bruxism habit to stop, but does protect the teeth from damage.

-Prescription for Muscle Relaxants. This can allow relief from tight muscles surrounding the face.

Other tips to help you stop bruxism include:

-Avoid or cut back on foods and drinks that contain caffeine.

-Avoid alcohol. Grinding tends to intensify after alcohol consumption.

Bruxism Marielaina Perrone DDS

-Do not chew on pencils or pens. Avoid chewing gum as it allows your jaw muscles to get more used to clenching and makes you even more likely to grind your teeth.

-Attempt to train yourself not to clench or grind your teeth. If you notice that you clench or grind during the day, re-position the tip of your tongue between your teeth, or wear a daytime soft guard on your lower teeth. This practice trains your jaw muscles to relax and also is a mental cue for the brain to stop grinding your teeth.

-Relax your jaw muscles at night by holding a warm wash cloth against your face in front of your earlobe.

New Treatment Option For Bruxism

In the past, once damage from bruxism reached the point of needing a full coverage dental crown both dentist and patient understood the treatment would see limited success. This is because of the strength of traditional porcelain crowns or porcelain fused to metal crowns was not up to the task of dealing with the extra forces over the long haul. Recent technology advances in dental materials have allowed the development of a new type of crown called the BruxZir crown.

BruxZir Solid Zirconia is a monolithic solid zirconia restoration with no porcelain overlay. This type of crown when used in patients with bruxism offers a long term restoration built to last. It is virtually chip proof, making it an ideal restoration for patients with bruxism. BruxZir crowns can even be used over a dental implant.

Bruxism Conclusion

Bruxism can be a terrible habit with the develoment of long term issues. While no known cure exists, dental materials advancement has allowed the dentist to maintain the health of your teeth under the extreme pressures and forces of bruxism. Visit your dentist regularly so bruxism can be diagnosed as early as possible to ward off potential issues.

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The use of dental implants in dentistry has been a very successful procedure. Most studies show that dental implants have a success rate of around 96-98% when placed properly. Dental implants have become a highly reliable procedure for the replacement of lost teeth. This means, almost all patients who undergo the procedure for dental

Dental Implants Marielaina Perrone DDS

implants with a highly competent surgeon, will have success. What about the other 2-4%? What can go wrong?

Success of dental implants is related to the dentist or surgeons skill, quality and quantity of the bone available at the site, quality of materials used, the patient’s healing ability, and maintenance of good oral hygiene.

Possible Dental Implants Complications

-Failed Integration of Dental Implants - This occurs when the bone does not grow and fuse between the threads of the implant. This fusion of bone to dental implant is called osseointegration. If this does not occur, the dental implants will not function properly,will become uncomfortable, become loose, or come out completely. To reduce this risk, your dental surgeon will evaluate the quality and density of the jaw bone prior to surgery. This will help to only place dental implants in areas where there is a highly predictable success rate. If osseointegration does not take place, the dental implants can be removed, and surgery can be attempted again once the area has fully healed.

-Infection –  This is the most common complication of dental implant surgery. The surrounding bone and gums can get infected during the surgical procedure. This can happen due to non-sterile technique, a contaminated implant, poor healing ability(diabetic, smoker, osteoporosis medications), pre-existing infection. The most likely time for this to occur would be during the surgical placement of the dental implant into the bone. Implant infection is a condition referred to as peri-implantitis. Peri-implantitis is characterized by inflammation or swelling of the tissues surrounding the implant area. Peri-implantitis can also present as a secondary infection later on is a form of periodontal disease that can lead to inflammation, bone loss and implant failure if not treated quickly and properly. Although implant infections are usually caused by the presence of bacteria during or immediately after the oral surgery for the placement of the dental implants, an implant infection can occur months or years after surgery.

-Post Surgical Bleeding - Some bleeding following surgery is normal and should be expected for about 1-2 days. Biting gently on a gauze pad placed over the surgery area for 30 minutes should normally stop the bleeding. Excessive bleeding is not normal and you should notify your dentist immediately if you have concerns about your dental implants.

-Damage To Surrounding Tissues - Dental implant complications related with surgical errors affecting adjacent teeth, nerves or sinus are directly correlated with the experience and skills of the dentist or surgeon. An experienced and skilled implant dentist is able to identify potential problems by examining x-rays or CT scan (computer tomography), design the proper surgical plan for ideal location and angle, and execute it successfully without complications. Even with the most skilled implant dentist there is always a possibility of dental implant complications. The complications can be limited by choosing an implant dentist with the skills and experience necessary to handle any complications if they arise.

The following areas could be damaged:

1Surrounding Teeth - During the placement of dental implants, the dentist may damage the crown or the roots of adjacent teeth. Root canal therapy may be needed to repair the injured teeth. The dentist must carefully review the x-rays or CT-scan

Dental Implants Marielaina Perrone DDSbefore drilling because the teeth are not always in ideal positions. A skilled implant dentist will be prepared for any changes necessary.

2. Nerve Damage - While rare, this is a complication of implant surgery in the lower jaw (mandible). There is a nerve (inferior alveolar nerve) that runs through the lower jawbone that can be injured during dental implants placement. Nerve injury may cause pain, numbness or painful tingling in teeth, gums, lips, tongue or chin. Similar symptoms may occur if the implant is placed right on top of the nerve, causing severe pain when chewing down. If the nerve fails to heal and the symptoms persist, the dental implant will likely need to be removed. X-rays and CT scans can help the implant dentist to identify the exact location of the nerve and minimize the possibility of nerve damage.

3. Perforation into Sinus - This occurs during placement of dental implants in the upper jaw. This occurs during implant placement, when an implant is placed into the sinus cavity. With proper planning, the bone around the sinus can be grafted and lifted (sinus augmentation) to allow for the necessary length of the dental implants. To prevent this implant complication, the dentist must check carefully the CT scans and proceed with ‘sinus augmentation’ if needed to provide sufficient bone for successful implant placement.

4. Bone Fracture - Jaw fracture is another possible complication of dental implants placement. If there is not enough bone or bone density, the jaw can fracture under the pressure during the surgical placement of the dental implants (during drilling or implant insertion).

5. Inflammation - Inflammation and swelling of the surrounding tissues is the immediate symptom of implant infection. Improper placement or size of the abutment and crown restoration, that puts under pressure and traumatizes the soft tissues around or beneath it, may also cause dental implants complications. Dental implant inflammation triggers an inflammatory response from the body’s immune system that attacks gum tissues and surrounding bone. This can result in bone loss around the dental implant and if left untreated the dental implants will become loose and will need to be removed. The dentist has to eliminate the inflammation as soon as possible to prevent further bone loss that can cause dental implants failure. The inflammation can be treated by antibiotics and cleaning if caused by implant infection, or by removing or adjusting the defective restoration if caused by trauma.

Other reasons for failure of Dental Implants

-Rejection – An extremely rare complication but it has been noted in the research literature. The dental implants can sometimes be viewed as a foreign body.

-Unusable Dental Implants – An implant that has successfully integrated with bone, but the area or extreme angle of placement deem it unrestorable.

Dental Implants Conclusion

Implant dentistry has come a long way. It has become an almost routine procedure. Understand, that just because it is done often does not make it a simple procedure thatDental Implants Marielaina Perrone DDS anyone can do. Implant surgery is an intricate and comprehensive process that involves several stages. Treatment consults, treatment planning, and treatment procedures (which can include multiple surgeries) need to be undertaken with extreme care. General dentists DO NOT have the same training as surgeons, and are generally better at restoring the implants after surgical placement. As with all types of surgery, there are risks involved during both the actual dental implants procedure as well as during the recovery period. While most dental implant complications are quite minor, it is important to be aware of them prior to surgery. These complications can be minimized by choosing an implant dentist with the skill and knowledge to overcome any challenges that may come your way before, during, or after surgery. Choose your surgeon based on skill level and not price, and you will be much more likely to have a long term success.

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