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Frenectomy -  is the removal of a frenulum (small fold of tissue that prevents an organ in the body from moving too far). It can refer to frenula in several places on theFrenectomy Marielaina Perrone DDS human body. In dentistry, this procedure is routinely done for orthodontic purposes but can also be done for other functional reasons.

Types Of Frenectomy As Used In Dentistry

-Lingual Frenectomy – This refers to the frenum attachment between the tongue and the floor of the mouth. When this tissue is too tight, restricting movement of the tongue, it is referred to as ankyloglossia, “tongue-tied”. It is easily identified by having the patient lift their tongue up and if it is too tight you will see a heart shape form from the pulling of the tongue. Ankyloglossia comes in varying degrees from mild to one where the tongue is completely attached to the floor of the mouth. As you can imagine this restricts movement of the tongue in all directions. Ankyloglossia can have far reaching effects to include speech, oral hygiene, swallowing, and even eating.

-Labial Frenectomy – This refers to the attachments on the inside of the upper and lower lips. Most commonly, the upper frenum attachment  causes a large gap (also called a diastema) to appear between the upper two central incisor teeth as well as gum recession by pulling the gum tissue away from the bone. The frenectomy procedure is generally done on two populations of patients:

Orthodontic Patients – This procedure assists in closing the front gap between the 2 front central incisor teeth. The frenum attachment will prevent the teeth from closing on their own through normal orthodontic procedures.

Denture Patients – This attachment can and often will become uncomfortable as a patients lips move through eating and talking. This will become irritated as it rubs against the dentures and often will not allow the denture to be as stable as it should be. The frenectomy in this case will remove the discomfort and allow the dentures to fit better than before.

The labial frenectomy procedure should not be done until the permanent central incisors have erupted at least 3/4 of the way into the mouth. The timing can be delicate because scar tissue can develop in this area following the frenectomy making it much harder to close the gap between these teeth through orthodontics.

How Is A Frenectomy Performed?

A frenectomy is a fairly, simple straightforward procedure, usually taking less than fifteen minutes from start to finish. The surgeon can choose to use a scalpel or a laser to excise the frenum. The laser has distinct advantages over the scalpel. The use of the laser tends to cause minimal bleeding, does not require the use of sutures, and is usually noted with little to no post operative discomfort. A frenectomy is usually done using only local anesthesia. Very small children will probably have to use general anesthesia to tolerate the frenectomy surgery.

Conclusion

A frenectomy is only necessary when the frenum attachment is causing pain, discomfort, difficult speech, eating difficulty, or a cosmetic issue. Of course, in cases of speech and eating, it is definitely recommended as it will affect a child’s development over time. Without the procedure, they will have trouble saying certain words and many children also will have trouble breast/bottle feeding. This can be a very serious matter in children with a severe form of attachment. It is important to have your child seen regularly by a dentist so that they can monitor their development and ensure these issues can be taken care of at their proper stage.

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

We all know someone who does not look their age. Whether it be their hair, lack of wrinkles, or just the way they present themselves. They seem to defy time by stayingLas Vegas Cosmetic Dentist Marielaina Perrone DDS active and being young at heart. On the other end of the spectrum, there are those who are older than their years. This group is plagued by aging skin, may be prematurely grey or balding or just have something about them that seems aged. We say, that life has taken their toll on this group.

“A smile takes but a moment, but the memory of it lasts forever.”

Did you know we also have a dental age? As we age, our teeth will change as well. They can get darker, crack and thin, become worn down from various activities, become elongated, or shift position from periodontal disease, or we can even suffer from loss of teeth.

Changes To Teeth That Make Us Look Older

-Darkening or Yellowing of Teeth. Our teeth will darken over time just from daily life. This can include foods we eat, smoking, and even our choice of drink. Most people associate youth with a bright, white smile. Having a darkened, yellowing smile can often make you appear less attractive to others and older than you actually are.

-Worn Down Teeth. As we age, we lose some of the enamel on our teeth. As the cusps of our teeth wear down from chewing, teeth grinding, nail biting, as well as other habits. This will lead to your bite collapsing a little at a time. This coincided with our skin losing elasticity over time can create sagging skin and wrinkles around the mouth. Wear also happens with aggressive brushing, high acid foods, and cracking or chipping from brittleness.

-Gum Recession. If we do not maintain proper dental care throughout life we can develop periodontal disease. One of the consequences of periodontal disease is gum Las Vegas Cosmetic Dentist Marielaina Perrone DDStissue recession. This exposes more of our teeth making them appear longer than they actually are. “Long in the tooth”. This is another sign people perceive as something an older person would have.

-Missing Teeth. Although tooth loss can occur at any age, missing teeth makes you appear older. Having a full complement of teeth in your smile is far more attractive than one littered with spaces from missing teeth. Missing teeth cause surrounding teeth to shift, and your bite to lose it’s vertical height. Over-closed teeth make your lower face look collapsed, wrinkled, and old.

-Broken or stained dental work. Over time, both crowns and dental fillings may begin to fail and need to be replaced. This is especially true in the front of the mouth where mismatched colors, stained fillings, and chips in teeth are readily apparent when we smile.

How To Recapture A Youthful Dental Smile?

Modern dentistry has developed quite a few procedures to maintain a youthful attractive smile. These include:

-Teeth Whitening. This is quite possibly the most popular cosmetic dentistry procedure today. It is safe and effective and comes in a few forms. These forms include in office whitening, at home whitening (with dentist provided trays), as well as use of teeth whitening strips, and topical gels. All of these methods are quite effective for most people. It has been proven by research time and again, that people find a whiter smile to be more youthful and attractive.  People tend to feel better about themselves when they are happy with their appearance. Teeth whitening can give patients a dramatic change to their smile with minimal cost and time invested.

-Teeth Contouring. This might be one of the simplest and most cost effective cosmetic dentistry procedures of all. It is usually done without the need for anesthesia and can be as simple as filing down a tooth that appears longer or is slightly out of alignment with the others. Most patients are quite surprised at how such a small adjustment can alter their smile for the better.

-Dental Bonding. While dental bonding is also used to restore teeth damaged by tooth decay it can also be used as a composite veneer to change color or shape, fix chipped teeth, or close small gaps in your smile. Dental bonding is the process in which tooth colored dental materials are bonded to a tooth. This procedure is also a quicker fix and can usually be completed in a single visit. This procedure can easily alter your smile in as little as an hour. A very easy way to make your smile youthful looking again.

-Gum contouring and Gum grafting. Evening out gum levels can help teeth to look more evenly sized and can make short teeth appear longer. Gum grafts can fix areas where gum recession has occurred to make everything appear even and natural again.

-Porcelain Veneers and Porcelain Crowns. Over time our smiles change. Teeth can get worn down, can shift, or maybe you were born with a smile that was not quite perfect. 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 Las Vegas Cosmetic Dentist Marielaina Perrone DDScosmetic dentistry procedures tend to require multiple visits but the results will give you a beautiful, youthful smile. Porcelain Veneers are custom made, ultra thin, tooth colored shells that are adhesively bonded to the teeth. This allows the cosmetic dentist to not only alter color of your teeth, but shape and length as well. Porcelain veneers are sometimes called instant orthodontics. This is because porcelain veneers can change the alignment of teeth if the alignment issues are not too extreme. 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.

-Dental ImplantsDental implants allow cosmetic dentists another option in tooth replacement to recreate a youthful, attractive smile. Whether it is a single tooth or a full mouth restoration, dental implants can fill that need. Missing teeth or open spaces has long been considered a sign of old age. Having a full set of white teeth screams youth especially when they are bright, white, and sparkling. When a person is missing a tooth they have several options. There are partial and complete dentures (including the all on 4 dental implants system), traditional bridges, and dental implants. A dental implant can look and feel just like a natural tooth. It is also easier to keep clean than a traditional bridge. Dental implants are placed directly into bone creating a solid foundation for a natural tooth replacement.

-Bite Reclamation. Over time as we age, we tend to lose some height on our teeth. This loss of height of height is also referred to as loss of vertical dimension. Some other factors that cause this loss include acid reflux or teeth grinding (bruxism). Reclaiming a person’s bite utilizing dental implants and porcelain crowns will increase vertical height which will also remove some of the wrinkles around the mouth. These wrinkles develop as our we age and our mouth’s sag from this loss of dimension. Cosmetic dentistry can fix some of this.

-Botox and Dermal Fillers. Long the realm of cosmetic surgeons, dentistry has now added these procedures to give what is called a dental facelift. In combination with dental work, removing some of those wrinkles on the face and around the mouth specifically will better frame that beautiful, white, youthful smile.

Dental Age Conclusion

Most of us want to stay young as long as possible. We go to the gym, dye our hair, and try to maintain the cosmetics of a youthful smile.  Maintaining healthy teeth and gums can help you to keep feeling young and health. As always, maintain a regular schedule of dental examinations and professional cleanings for a healthy smile that will last a lifetime.

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Is the sipping of hot coffee or the eating of cold ice cream sometimes a painful experience for you? If your answer is YES, you may have a common problem called sensitive teeth.

sensitive teeth

Sensitive teeth

Tooth sensitivity is tooth or teeth discomfort that is provoked by hot, cold, sweet, or acidic foods and drinks, or breathing in cold air. The pain can be sudden, sharp, and shoot deep into the nerve endings of your teeth.

There are two very different types of sensitivity:

Dentinal Sensitivity. This occurs when the middle layer (dentin) of a tooth is exposed to the outside. Dentin is usually covered by enamel above the gum line and by cementum (bone like connective tissue covering the root of a tooth) below the gum line. There are tiny openings called tubules in the dentin. Inside each tubule there is a nerve branch that comes from the tooth’s pulp (the nerve center of the tooth). When the dentin is exposed, these nerve branches can be affected by hot, cold, or certain foods. This causes tooth sensitivity.

When the outer protective layers of enamel or cementum wear away the dentin becomes exposed to the outside. This can affect one tooth or multiple teeth. Dentin exposure can be be caused in a variety of ways. These can include:

1. Aggressive brushing. The enamel layer can be worn away from brushing too hard.

2. Plaque build up. The presence of plaque on the root surfaces can cause sensitivity.

3. Tooth wear that occurs over time from chewing and brushing.

4. Untreated dental cavities.

5. Gingival recession. When the gums recede they expose the tooth’s roots. Receding gums often are caused by periodontal diseases or by aggressive brushing. Receded gums are very common and up to four fifths of people have gum recession by the time they are 65.

6. Periodontal surgery (gum surgery) that exposes the tooth’s roots.sensitive teeth

7.  Tooth whitening.

8. Frequently eating acidic foods or liquids.

Pulpal sensitivity. This is a reaction of the tooth’s pulp. The pulp consists of a mass of blood vessels and nerves in the center of each tooth. Sensitivity of the pulpal tissue tends to affect only one tooth. Causes of this type of sensitivity can include:

1. Dental cavities or infection.

2. Placement of a recent filling.

3. Excessive pressure from grinding or clenching your teeth.

4. A cracked or broken tooth.

If you feel a sharp pain upon biting, you may have a broken or cracked filling. Pain when you release your bite is a sign of a cracked tooth.

sensitive teeth

toothpaste for sensitive teeth

You dentist will be able to diagnose the type of sensitivity you have. You want to rule out pulpal sensitivity as that requires more extensive treatment. If it is decided you have dentinal sensitivity then we will suggest a few options for you. The most conservative way is by use of a sensitivity toothpaste. I recommend Colgate Sensitive Pro-Relief which I believe to be the best on the market today. I have found it to be the most effective in eliminating or limiting the symptoms of tooth sensitivity. Other options include use of a fluoride varnish or a bonded desensitizing agent that we would apply in office. As well as use of an at home fluoride rinse.

In severe cases of hypersensitivity that is persistent and cannot be treated by other ways, your dentist may recommend endodontic (root canal therapy) treatment to eliminate the sensitive teeth issue.

If you or a loved one is experiencing either type of sensitivity, the best approach would be to schedule a dental appointment for further evaluation.

 

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