Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

For many people, eating disorders are part of every day life. These  abnormal eating habits may involve either insufficient or excessive food intake to the detriment of an individual’s physical and psychological health. The resulting effects of the dietary issues involved directly and indirectly relate to oral health problems.

Common Types Of Eating Disorders

-Anorexia Nervosa (commonly called,  ”anorexia”) -  This eating disorder is characterized by a refusal to maintain a healthy body weight, an obsessive fear of weight gain, and an unrealistic perception of current body weight. Anorexia can cause menstruation to stop, and often leads to bone loss, loss of skin integrity. It is a big stressor on the heart, there is an increase in the risk of heart attacks and related heart problems. This disorder also presents with an increased risk of death. Peer pressures play a role in an individuals’ obsession with their outer appearances. Recent research suggests it is not only about a person’s outward perception but genetics may play a role in the disease process.

-Bulimia Nervosa (commonly called, “bulimia”) – This eating disorder is characterized by recurrent binge eating followed by purging. The purging can include self induced vomiting, excessive use of laxatives/diuretics, or excessive exercise. Fasting may also be used as a method of purging (self inflicted vomiting) following a binge.

-Compulsive over-eating- This eating disorder is characterized by eating large quantities of food even when not feeling hunger. The food is generally consumed quickly and often with little to no regard for proper nutrition.

Dental Issues That Arise From An Eating Disorder

Tooth Enamel Erosion and Tooth Decay – It is quite common to see an increased incidence of tooth decay in all forms of eating disorder. It is also not unusual to see very extensive decay that leads to tooth loss. For bulimic and over-eaters, high calorie, high carbohydrate foods put the enamel at risk due to increased sugar levels in the mouth. Vomiting (either self inflicted or from eating an enormous amount of food) exacerbates the problem by incorporating stomach acid into the oral environment. Anorexics are also prone to regurgitation of stomach acid due to lack of food in the stomach.

It is quite common in patients with an eating disorder to need extensive dental work over and over again. This is especially true to the backs of the teeth, (facing the tongue) since these surfaces would be exposed the most to the stomach acids released from vomiting. The gum lines of teeth are also prone to decay when habits of snacking through the night and not brushing occur frequently.

Soft Tissue Damage – The force of repeated vomiting also takes a toll on the soft tissues in the mouth. This can result in swelling of the tonsils and the uvula in the back of the throat. Another indicator of an eating disorder may be a red and swollen tongue or a lacerated palate caused by vomiting induced by placing a finger into the back of your throat (fingernails and other implements will damage the palate).

Other Eating Disorder Dental Issues Include:

-Gum pain

-Chronic sore throat

-Inflamed esophagus

-Palatal hemorrhages

-Decreased saliva production - leading to dry mouth (xerostomia)

-Enlarged Parotid glands

-Problems swallowing

-Jaw alignment abnormalities

Dental Treatment Options

An eating disorder is a major health issue and create all kinds of problems both to our dental health and systemic health. Communication is important to not only get help to overcome the disease but also to get proper dental treatment.

Dental hygiene becomes extra important in patients with an eating disorder because some of the damage from stomach acids in the mouth can be minimized if patients brush, floss, and rinse following vomiting. This can lessen the effect of the acids on the teeth. Damage will still be done if the habits remain for long or short periods of time.

Standard dental treatment for an eating disorder can include:

-Dental Fillings

-Root Canal Therapy

-Tooth Extractions

-Periodontal Surgery

Eating Disorder Conclusion

An eating disorder is a very difficult disease to diagnose and treat. Dentists need to know the warning signs to be able to get patients in need to seek proper help. Eating disorders can ultimately kill and should not be taken lightly. The dentist should be able to speak openly about oral symptoms of eating disorders if signs are present. This is a difficult topic to discuss for most but is nevertheless important. The patient must feel comfortable enough with their dentist to tell them they think they have an eating disorder. The dentist should  be clear about everything, portray empathy and care at every opportunity. Body language is very important. Trust between the dentist and patient is very important to establish before moving on.

Once habits are addressed, treatment and restoration of healthy teeth and smile go hand in hand.. The power of a beautiful, healthy smile can do wonders do our emotional well being. A positive self-image and self-esteem are critical for recovery from bulimia and a restored, healthy smile is evidence of those feelings. Does having a new smile help that process? Absolutely. It has been shown time and again to be life changing. Even more important is restoration of the teeth to a healthy state so that the patient can eat without pain and regain health.

A Smile is the universal language we all share.  Having a smile you are happy with allows you to exude self confidence and self esteem. This makes you feel more attractive to others and appear more successful. According to recent surveys, about 1/3rd of all Americans are unhappy with their smile. Luckily, for most of us this situation is easily correctable with some simple and some more involved cosmetic dentistry procedures.

Easy Cosmetic Dentistry Fixes For That Perfect Smile

For many of us, the imperfections that bother us can be quite small and easily correctable with cosmetic dentistry. These simple cosmetic dentistry procedures can include:

-Teeth Whitening. This is the most popular cosmetic dentistry procedure in the U.S. and the world. It can dramatically alter ones smile and also ones perception of themselves. Teeth whitening can be achieved in a variety of ways with varying results. One of the most popular ways to whiten is, the use of teeth whitening strips. These strips can give your smile a brighter look for very little cost but they do not work for everyone, and may not get your teeth as white as you’d hoped.  The dentist can offer an at home teeth whitening kit or a one hour procedure in office. Professional whitening is very effective but comes at a higher financial cost. Professional whitening procedures can whiten your smile by as much as 4-6 shades in as little as an hour.

-Dental Bonding. While a bit more extensive than teeth whitening. Dental bonding can usually be completed in under an hour and give a dramatic effect if one or more teeth are affected by tooth decay or fractures. A good cosmetic dentist will be able to make the dental bonding appear natural and no one should be able to tell you have any dental bonding present. This has been a staple of cosmetic dentistry for many years.

-Tooth and Gum Recontouring. Many people are unhappy with one or two teeth which may be out of alignment. The dentist can recontour one or more teeth to give them the look of being more in line with one another. Uneven gums can also make teeth appear to be longer or shorter.  You would be amazed at how simple it is to reshape and contour teeth and gums to give a beautiful appearance. Recontouring is often overlooked by patients and by many general dentists. A good cosmetic dentist will look at the teeth and face as one big picture allowing them to make adjustments in the big scope of things.

-Snap-On Smile. This is a fairly recent advancement in cosmetic dentistry. It allows for a prosthetic to be fabricated that fits over the existing teeth. This procedure requires little to no tooth preparation and can be a cost effective option. This procedure is far less expensive than permanent changes to teeth, and can be completed in just a short time. Snap on Smile patients are happy to leave with  the smile they wanted at reduced cost and chair time.

More Complex Cosmetic Dentistry Fixes For An Imperfect Smile

-Porcelain Veneers. When you see an “A” list celebrity in magazines or in movies, chances are they have had porcelain veneers placed on their front teeth.Porcelain veneers are wafer thin custom fabricated shells made of modern dental porcelain that are adhered to the outer surface of your natural teeth.  Porcelain veneers are also referred to as “instant orthodontics”. This is because the cosmetic dentist is able to change the shape, width, length, and alignment of your teeth. In extreme cases of misalignment, your cosmetic dentist may recommend a porcelain crown or orthodontics prior to doing porcelain veneers.  When completed properly, no one but you and your dentist should know that you have porcelain veneers.

-Orthodontics. This is not just for kids any more. Adults are often turning to orthodontics to get the smile they dream of. Having straight teeth helps in chewing function, decreases wear and fracture, and has the benefit of being cosmetic. Straight teeth are beneficial for optimum hygiene,  it allows you to be able to clean your teeth more effectively since you will not trap as much food particles when they are properly spaced.

-Dental Implants. Many do not consider dental implants to be a part of cosmetic dentistry but they play a very big role in modern dentistry. Replacing a lost tooth will not only improve function but will also return your smile to its original form. A lost tooth, to many, is a sign of old age, poor hygiene, and low dental priority. Having a full complement of teeth can give someone a youthful, healthy looking appearance.

-Periodontal Plastic Surgery. Many of us have a smile that shows too much gums or might have some areas with receding gums. This can be corrected with surgical addition of or removal of  gingival tissues to the areas of concern.

Cosmetic Dentistry Conclusion

It is so important to feel good about smiling. There are so many options to help with most of your dental concerns. Cosmetic dentistry has come a long way over the last 10-15 years, making the procedures more affordable to many. Choosing a good cosmetic dentist along with the use of high quality modern dental materials you can assure yourself of getting the smile you have always dreamed of. A good cosmetic dentist will be able to advise you of what cosmetic dentistry procedures would be best for you to fulfill your wants and desires.  You can achieve your perfect smile, and confidently show it off to the world!

Peri-implantitis - is a destructive  process affecting the gums and bone surrounding dental implants. The various periodontal bacteria found surrounding failing dental implants (those affected by peri-implantitis) are very similar to those found in association with various forms of periodontal disease.

Peri-implantitis is a unique complication when dealing with dental implants. Dental implants have a very high success rate but do fail for various reasons. These can include failure to integrate with bone, poor oral hygiene by patient, rejection by the body, trauma, or peri-implantitis. Peri-implantitis becomes a factor in patients with poor oral hygiene, diabetes, smoking, and when there is residual cement stuck to the implant surface.  Peri-implantitis will cause the destruction of bone and gum tissue exposing part of the dental implant to the outside. This will cause the possibility for the dental implant to become less stable and cause the patient to lose the implant and restoration if not treated in a timely manner.

How Is It Diagnosed?

A dentist will use x-rays and measuring instruments to determine the level of the bone surrounding the dental implant. If it is found there is some level of bone loss beyond normal surrounding the dental implant, then the diagnosis becomes that of peri-implantitis. It is normal to see some minor bone loss 1-2 years out following placement of the dental implants. It should be no more than 1-1.5 mm in the first year and no more than 0.2 mm in each subsequent year. As stated earlier peri-implantitis of a  dental implant that goes undiagnosed will lead to complete failure and have to be removed.

Peri-implantitis can be diagnosed early or once clear clinical evidence has developed. The most common signs and symptoms are:

- Color changes of the gum tissue around the implant.

- Bleeding during brushing, probing or measuring.

- Increased pocket depth around the implant.

- Pus drainage from around the dental implant.

- Thinning of the tissue causing transparency around the implant..

- Progressive loss of bone height around the implant.

-X-rays showing loss of bone around the implant.

Peri-Implantitis Treatment Options

The course and success of treatment revolves around when the peri-implantitis is diagnosed. If the initial bone loss is limited there will be a higher chance of success in saving the dental implant. However, the later treatment begins the lower the chance of saving the dental implants. There are various methods used to treat peri-implantitis. All have varying degrees of success. These include the following:

-Mechanical Debridement (professional cleaning using instruments). A patient with dental implants must follow normal treatment schedules to maintain his/her dental implants. This includes regular dental visits. At these visits radiographs will be taken to ensure the dental implant and surrounding tissues are in a  healthy state. At these visits the patient will also undergo a professional cleaning for the dental implants and/or natural teeth. Dental implants require special tools for cleanings. The standard dental implant instruments used for cleaning include plastic, graphite, or gold tipped instruments. Ultrasonic tips may be used. The goal in cleaning the implant is to remove debris and bacteria without damaging the exterior coating of the dental implant.

-Perioscope. A microscope guided cleaning deep below the tissues to remove debris and otherwise  undetectable cement residue.

-Localized Drug Delivery. Since dental implants by nature have rough surfaces (to allow better integration with surrounding bone), removing infection tends to be quite a challenge using just hand instruments. It is recommended that a chemical anti microbial agent be used along side hand instrumentation. Recent studies have shown the combination of hand instruments and chemical agents have proven effective in eliminating peri-implantitis in its earliest stages. Drugs used can include chlorhexidine rinse, oral antibiotics such as tetracycline, minocycline, doxycycline hyclate, or Arestin, an antibiotic placed directly into the pocket.

-Bone regrowth factors. Emdogain can be placed along with bone grafting material to help stimulate new bone growth.

Conclusion

The primary goal once peri-implantitis has been diagnosed is to stop the disease process from progressing. If untreated, it will ultimately lead to loss of the dental implants. The #1 goal should be to see your dentist regularly to avoid the complication of peri-implantitis. It is important to note any signs that may be occurring so you can be proactive about your dental health.

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!