Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

Most people overlook the role of the general dentist in the success or failure of orthodontics. Generally, the dentist is the first line of defense in diagnosing crowding of teeth or a malocclusion. The timing of when to see an orthodontist is critical for many of our younger patients. This timing can ensure a smooth transition into orthodontic treatment as well as utilize phases of growth to help with tooth movement. A good general dentist will also be able to find a well trained orthodontist with the skills and personality to fit your child’s needs.

When To Refer To An Orthodontist?

Many children are ready for an orthodontic consult by age 7. This could be even earlier if the dentist or parent have further concerns regarding development. By age 7 enough of the permanent teeth have erupted to gauge the need for early orthodontic intervention. Luckily, most children do not need early orthodontic intervention but for those that do it makes the seemingly impossible possible again. Severe crowding of teeth can be difficult to fix without removal of teeth, so it is essential to get an early look. Many people see orthodontics as simply a cosmetic procedure but it most definitely is more than that. The benefits go beyond cosmetic as they effect our occlusion, periodontal health, and prevent trauma due to misalignment.

Top Reasons For An Orthodontic Referral

-Insufficient Space For The Eruption Of Permanent Teeth.

-Anterior Or Posterior Crossbite.

-Primary Tooth Loss Timing. Early or late loss can have its own unique implications.

-Thumb Sucking or finger sucking habits.

-Speech Difficulty.

-Extreme protrusion of teeth. This can leave them at increased risk of trauma.

-Open Bite. This occurs when the upper front teeth do not cover the lower front teeth.

-Facial imbalance or facial asymmetry.

General Dentist Role Once Orthodontic Treatment Begins

Once the general dentist refers the patient to the orthodontist the co-treatment begins. The patient will continue to see their general dentist for routine dental work including dental examinations and professional cleanings every 3-4 months. The dentist and orthodontist will confer on the case and keep the parents updated.Without proper oral hygiene maintenance, and teamwork between the dentist and orthodontist, the entire orthodontic treatment can be placed in jeopardy.

The most preventable issues with orthodontic care are periodontal disease (inflammation of the gingival tissues), decalcification of the enamel (also referred to as white spot lesions), and cavities. Maintaining good oral hygiene during orthodontic treatment requires special tools and training. Simple tooth brushing is not enough to get the job done. Some of these tools include:

-Electric toothbrush with an oscillating head. This will ensure good coverage around orthodontic brackets to remove plaque and food debris.

-Waterpik. This is a fabulous tool to clean in and around the teeth but also around the brackets and wires. It has been shown that water flossing in orthodontic patients can remove as much as 3x the plaque and bacteria vs traditional flossing.

-Floss Threaders. This can help make flossing easier, and thus be done more often.

-Mouthwash. A good antibacterial mouthrinse will help kill bacteria where the toothbrush doesn’t reach.

-Interdental Brushes. These work great to remove large particles of food from between larger spaces, they are also recommended for brushing around molars that have not yet come all the way through the gum tissue.

-Fluoride Rinses. Rinsing with fluoride should help lessen the possibility of white spots on the teeth and decay.

Orthodontic Treatment Conclusion

Communication between patient, parent, general dentist, and orthodontist should be an ongoing process. All should be intimately involved to ensure that everything is going smoothly and to head off any trouble issues as soon as possible. A team approach only works when all parties communicate their needs and issues so they can be addressed properly. Maintaining oral hygiene can be challenging during orthodontic treatment but it can be overcome with the proper tools, techniques, and more frequent professional cleanings.

 

Dental anxiety affects a large portion of the population. While many have such anxiety, some are so fearful that they can not even get themselves through the dentist’s front door.Statistics show that  15-20% of all Americans avoid the dentist due to fears or anxiety about the dentist. The reasons for anxiety are different for everyone. These can include fear about feeling rushed by the dentist, possible pain, or even just the smells and sounds of the dental office. Dental anxiety and dental phobia, when stopping someone from receiving dental care,  lead to unnecessary oral and general health problems.

Tips To Calm Dental Anxiety

-Finding The Right Dentist And Dental Team. That’s right, it is not just about the dentist. The dental team is just as important in maintaining a calm, soothing atmosphere. A well trained dentist and team can make you feel at ease throughout your dental treatment and actually make it an enjoyable experience. Ask friends or relatives for recommendations. A good review about a dentist from someone you trust can significantly reduce anxiety. Also, in the internet age read online reviews. These can let you get a better understanding of the dentist and how they treat their patients. Last, make an appointment for a consultation so that you can meet the dentist and staff to see if they make you feel comfortable enough to schedule an exam and cleaning.

-Communication. One of the most important factors in overcoming dental anxiety is a good, open line of communication between dentist and patient. You must always feel comfortable expressing your feelings, fears, and concerns before, during, and after treatment is rendered. You must also feel that the dental team is listening to you and making adjustments as needed. Communication should never be compromised for any patient but it is even more important for a patient with dental anxiety. This will allow you to feel a sense of comfort that you may have never felt in a dental office before.

-Feeling Of Being In Control. This comes from the confidence to stop or start treatment whenever you need to. You should always feel comfortable controlling your treatment.  Making treatment decisions based upon options, how long your appointments should be, and how often you are comfortable coming in for treatment. Another aspect to being in control is to give yourself the power of knowledge about your dental care. This will give you the ability to understand the steps of treatment, and why it is important for you to follow through. Being in control will allow you to properly express your feelings about how much treatment you can handle.

-Own Your Emotions. For many who have neglected their dental care due to fear there can be a sense of embarrassment. Express your feelings and allow your dentist to understand your feelings so they can be addressed properly. Panic, tears, needing your hand held, etc. are coping mechanisms to fear. It is ok to get emotional at the dental office. You can and should be able to express your emotions without embarrassment.

-Utilize Relaxation Techniques.  These can include:

1. Proper Breathing. Focus on breathing regularly and slowly during dental work. When people are feeling anxiety or nervousness we tend to hold our breaths, or breathe in short rapid breaths. This decreases oxygen levels in the body, or hyperventilation, further increasing our feelings of panic.

2. Wear Headphones. For many, the sound of the dental office is a trigger for dental anxiety. Using an ipod or mp3 player with headphones can drown out the noises and relax you.

3. Avoid Caffeine. Caffeine can raise your heart rate and blood pressure, This can trigger panic attacks, make you feel dizzy, lightheaded, or give you the feeling of a fast beating heart. Caffeine before a dental appointment should be avoided.

4. Choose Pre Dental Meals Carefully. Eating high-protein foods have the ability to produce a calming effect.

5. Timing Is Everything. The time of day for your dental appointment can be critical. Try to choose a time for your dental visit when you’ re least  likely to be rushed or feel under pressure.

-Repetition. The simple process of repeat appointments, will make you feel more comfortable and at ease. 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.

-Predictable Pain Control. Every individual is slightly different. What may work for one may not work for another. Let your dentist know if you have a history of difficulty getting numb. Be sure to let your dentist know whether or not you still feel sensitivity, or lack of complete numbness. When you can trust that your comfort will be a priority, you will find that your anxiety rapidly diminishes.

Dental Anxiety Conclusion

Overcoming dental anxiety can be a trying experience. It is important to find the right dentist and dental team so that you can move forward and free yourself from dental anxiety once and for all. Know what you are looking for in a dentist, and be prepared with questions for your meeting. Remember, it is ok to shop around, you will know when you have found the right dentist for you!

Teeth Whitening is a common procedure in general dentistry but especially so in the field of cosmetic dentistry. There are different types of teeth whitening including in

Internal Bleaching Marielaina Perrone DDS

Internal Bleaching Can Make You Smile Again!

office and at home options like the use of teeth whitening strips. But did you know there was a procedure available to perform a deeper teeth whitening from the inside of the tooth out? This procedure is commonly known as internal teeth whitening or internal bleachingInternal bleaching is used to lighten a discolored tooth that has had root canal treatment.

Internal bleaching is a more conservative option compared to restoration with veneers or crowns, but is sometimes used to lighten teeth before the application of these techniques to prevent the discoloration of the natural tooth from showing through. In addition, porcelain veneers or crowns may be required not only to achieve improved color, but also to strengthen a root canal treated tooth.

How is Internal Bleaching Performed?

Internal bleaching is a dentistry technique that is used to lighten the color or whiten the appearance of a tooth or teeth. Internal bleaching is only to be done under the direct supervision of a dentist. This is because the procedure involves inserting a chemical oxidizing agent directly into the tooth.

Internal Bleaching Before Marielaina Perrone DDS

Internal Bleaching Before

The internal bleaching procedure is performed on a non vital tooth that has received root canal treatment. The root canal treatment could have been the result of infection or dental trauma. Whatever the reason, the tooth in question did not require a crown and has maintained its natural tooth structure. When a tooth dies or becomes non vital it loses the blood and nutrient flow to it. This sometimes results in a changing of tooth color to a darker shade than the surrounding teeth.

Following completion of root canal treatment, the dentist will place a chemical oxidizing agent into the chamber of the tooth and leave it there for about 2 weeks time. This process can be done a few times over that 2-3 week period until the tooth achieves the level of whiteness desired by dentist and patient. Once the color is correct, the opening is sealed closed with a white tooth colored composite filling to keep out foreign matter and bacteria that could cause further problems.

Internal Bleaching After Marielaina Perrone DDS

Internal Bleaching After

Internal bleaching may be used by itself for whitening teeth or  in combination with exterior teeth whitening products.  Your dentist will evaluate the current condition of the teeth and determine if it is necessary to make use of two different kinds of teeth whitening procedures at the same time. When it is decided to use both products at the same time, the dentist will choose two products that are compatible to one another so that they do not interact poorly with one another. If chosen incorrectly, the interaction between the two bleaching products could ultimately damage the teeth they are designed to treat.

How well does Internal Bleaching work?

Internal bleaching is very effective for whitening teeth that have been damaged by trauma or infection. The process allows the dentist to focus on one tooth to raise its level of whiteness back to the level of the other teeth to give a more natural appearance overall.

Internal Bleaching Conclusion

Anyone who has had a tooth turn color after receiving root canal treatment can understand the difference between natural, undamaged, tooth structure, and dark, non-vital, tooth discoloration. While internal bleaching is very specific in it’s applications, it is an easy choice for someone with a dark front tooth. Internal bleaching is a great tool for cosmetic dentists to restore one or more teeth back to their natural white condition. It is a fairly simple procedure with great reward. If you have a tooth that does not whiten as all the others do, ask your dentist about internal whitening, and see if this is an option for you.

Modern dentistry has evolved from the days of just a simple nightguard for grinders. A well trained dentist can treat a number of issues that were not even considered even 15 years ago. Bite appliances can be utilized in treatment of, the combination of clenching and bruxing, obstructive sleep apnea, TMJ pain, and sports mouthguards. These appliances allow patients to live more comfortable, healthier lives while enjoying the activites they love.

Teeth Clenching and Teeth Grinding (Bruxism)

These are fairly common issues for many Americans. Studies have been unable to pinpoint the exact number of people in the population that grind or clench but it is believed, that most people at some point in their life will experience this habit. This is sometimes considered to be a stress related habit. Most patients with these habits, do so while sleeping, so they are unaware of the forces exerted on their teeth while they sleep. Teeth clenching and grinding can cause a number of dental issues that include:

-Loose Teeth.

-Temperature Sensitivity.

-Tooth Chipping and Fracturing.

-Flattened teeth.

Bite Appliances are used to protect the teeth and also to re-train us to prevent continued grinding and clenching. These bite appliances are made from polymers and acrylics. They are generally custom made for each patient for added comfort and protection. These bite appliances work by not allowing the teeth to touch, making it restrictive to clench or grind. For those with an extreme form of these habits, it is not unusual to grind through the appliance over time necessitating a new appliance to be made.

Obstructive Sleep Apnea (OSA)

This is sometimes known as the “silent killer”. Obstructive sleep apnea can be potentially a very serious sleep disorder in which breathing repeatedly stops and starts during sleep time. Obstructive sleep apnea is believed to affect about 25% of the population. Obstructive sleep apnea is characterized by:

-Excessive daytime sleepiness.

-Both habits of clenching and grinding at night.

-Episodes of breathing cessation during sleep.

-Awakening abruptly accompanied by shortness of breath.

-Dry mouth or sore throat upon waking in the morning.

There are generally two types of bite appliances available for obstructive sleep apnea. These include over the counter ones and custom fabricated ones. The idea behind either of these bite appliances is to maintain an open airway during sleep to stop the disturbances from occurring.  These bite appliances work by repositioning the lower jaw, tongue, and soft palate. The custom fitted appliances tend to work far better than the generic ones.

TMJ Disorder appliances

These bite appliances help to reposition and decompress the jaw. TMJ disorder appliances are generally worn at night, and help to decrease the inflammation and pain associated with TMJ instability.

Athletic Mouthguards

These have really come into fashion in the last decade, as more and more research has gone into sports medicine, better airway maintenance and prevention of concussions. The old days of the generic “boil and bite” mouthguard are slowly fading away. We are now in the age of custom fitted athletic mouthguards that are able to not only give better protection against injury but also increase athletic performance. The thinking is, that how an athlete clenches his/her teeth together changes the way the brain reacts. When using a proper athletic mouthguard, your brain will be better able to handle temperature regulation as well as stress.

Bite Appliances Conclusion

Bite appliance therapy has been around for quite some time but recent advances (in both technology and theory) have made the treatments even more effective than before. A small investment in a good bite appliance can make the world of difference in the health and well being of your teeth for the rest of your life.