Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

Many believe that periodontal disease is a disease that is solely based on genetics. My grandparents had dentures, my parents had dentures, so will I. The truth is, that genetics plays a role, but is not a sentence for dentures. There are risks and limitations in the progression of periodontal disease… Can each patient limit the risks of developing full blown progressive periodontal disease?….The answer is a resounding…YES! It takes a good oral hygiene regimen, knowledge of the current state of your condition, and frequent professional cleaning to keep our mouths in a healthy, disease-free state.

Risk Factors Of Periodontal Disease

Patient Caused Risk Factors

-Poor Oral Hygiene – This is an obvious one that each individual can control. Brushing, flossing, rinsing, and seeking regular dental care are essential steps to remain periodontal disease free and avoid progression beyond gingivitis.

-Age - Research has shown that older people have the highest rates of periodontal disease. The research shows that over 70% of Americans 65 and older have periodontitis.

-Smoking Or Tobacco UseTobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

-Poor nutrition- Eating an unhealthy diet will not supply you with the essential vitamins and minerals necessary for tissue healing and repair.

-Anatomy - The local anatomic risk factors for periodontal disease include:,

1. Furcation anatomy. These are the spaces between roots of molars.  In many instances, the entrance of  such furcations are restricted enough to limit access for proper hygiene maintenance. Risk factors for periodontal disease are classified according to their involvement in tooth furcations. A Grade I CEP presents with minimal projection of enamel toward the entrance of the furaction. A Grade II CEP approximates the entrance of the furcation, and the tip of a Grade Ill CEP is well within the furcation.

2. Common anatomic deformities. These interfere with a patient’s ability to effectively remove plaque biofilm which are one of the risk factors for periodontal disease. An example are Cervical enamel projections (CEP). CEPs are tooth developmental deformities of the CEJ found on molars.

4. Palato-gingival grooves (PGG). POGs are tooth developmental deformities of maxillary central and lateral incisors. They begin in lingual pits and extend vertically onto root surfaces. PGGs could, on rare occasions, extend to the root apex. PGGs are commonly associated risk factors for periodontal disease with increased gingival inflammation, plaque accumulation, and probing depth.

5. Open contacts, loss of interdental papilla, and food impaction. Open contacts between teeth may allow for easy food impaction. Food impaction is defined as the forceful wedging of food between teeth. Loss of the pointed papilla between teeth leaves another area for food impaction.

-Medications - Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can have an affect on your oral health, causing dry mouth, inflammation and gum tissue overgrowth. It is important to tell your dentist the medications you might be on so they can tailor a treatment schedule for your needs.

-Other Disease - These include cardiovascular disease, diabetes, and rheumatoid arthritis.  These diseases can interfere with the inflammatory process, causing healing problems, and may worsen the condition of the gums.

-Poor Nutrition – A diet without all the essential nutrients for our bodies to function can compromise our immune systems, decrease healing ability, and make tissue weaker and easier to breakdown. This will make it harder to fight off infection. Since, periodontal disease essentially begins as an infection, this lack of nutrition can make the periodontal disease develop and progress faster than it normally would. Studies have also linked obesity with an increased risk of periodontal disease.

Dentist Caused Risk Factors

-Overhanging dental restorations – A poorly completed dental restoration typically has dental material overhanging the tooth. This creates an issue keeping the area clean and also creates an area for food and bacteria to build up. These overhangs can be irritating to the tissues and retain plaque and food more easily.

-Violation of the “biologic width” –  is the height between the deepest point of the gum pocket and the bone. This distance is important to consider when fabricating any dental restorations, because they must respect the natural architecture of the gingival attachment if harmful consequences are to be avoided. These consequences include bone and tissue recession.

-Open contacts and food impaction - If a dentist places a new dental restoration and does not create the proper tight contact between adjacent teeth, that area becomes a food and plaque trap. It will necessitate improved dental hygiene in that area to keep it clean. More often than not, food and debris will accumulate creating a localized area of periodontal disease.

-Occlusal trauma – If a new restoration is not properly set in alignment with the other teeth, a patient can create damage to the tooth as well as the surrounding tissue just from the act of chewing. The bite should always be checked and adjusted after dental work to prevent trauma to an individual tooth.

Periodontal Disease Conclusion

Luckily, with the exception of the anatomy we are born with, all of these periodontal disease risk factors can be overcome. The first step is to practice good oral hygiene by brushing, flossing, and using an antibacterial mouthrinse. The second step is to choose a well qualified dentist and keep a regular schedule to help give you the best fighting chance at preventing,  treating and stabilizing periodontal disease.

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!

 

Let’s face it, going to the dentist is usually not a the top of most people’s fun list. Going to the dentist does not have to be an unpleasant experience that we dread. WhateverDentist Marielaina Perrone DDS the reason, many Americans skip visits to the dentist. In the United States alone, approximately 65 % of us go to the dentist, but in some states, that number is much lower, even below 52% percent in Mississippi.

Missing out on dental care can lead to real health issues including oral cancer, heart disease, and even alzheimer’s disease. If dental issues are caught early on they can be treated quite easily and at a reduced cost. Once the issues progress, not only does the level of treatment increase but so does the cost.

Why Do We Avoid The Dentist?

1. Dental Phobia – A large segment of the population has an unhealthy fear of the dentist. This can be due to previous bad experiences or a learned trait from their parents. Luckily, dental phobia can be overcome with good communication between patient and dentist. Choosing the right dentist goes a long way to creating a positive dental experience.

2. Cost – Money is always a factor in consumer choices and that includes our health needs. We all make choices every day based on cost. The reality is that visiting the dentist twice a year and finding dental issues early on are far less expensive than waiting until there is a problem developing. For example, in the early stages of tooth decay it can be easily fixed with dental bonding and be done in less than an hour. If left untreated it can enter the nerve of the tooth thus causing the need for root canal therapy and possibly a crown to save the tooth. The difference in cost could be as much as 10-12x the cost of the dental bonding. Also maintaining good oral hygiene at home can go along way to saving you money and discomfort over time.

 

Dentist Marielaina Perrone DDS3. Time – We all have a lot going on in our lives between work and family commitments. Finding the time to take care of our bodies should be a top priority but sometimes it is not. This is where making going to the dentist a routine from an early age comes into play. Dental health is vital to living a long happy and healthy life.

4. Fear of Being Reprimanded – No one likes getting yelled at but many have faced a hygienist or dentist who has lectured them on doing a better job with at home oral hygiene. Again it comes down to choice of dentist and staff. You need to choose a dentist who is open to communication and finding better ways that work for you to maintain your hygiene.

5. Ignorance – Many people have grown up to believe certain myths or wives tales. A good example is that if my gums bleed just a little when I brush that is normal. Bleeding gums are never normal from routine brushing. This is a sign of the development of periodontal disease. The earliest phase, gingivitis, can be reversed but once it advances to periodontitis it can be maintained but not reversed. Ignorance or lack of education is not an excuse to take care of your teeth and gums.

Conclusion

Going to the dentist is as important as seeing your physician. Studies have shown our oral health and our general health are linked. To stay healthy we need to maintain our oral health. That includes regular visits to the dentist for regular dental examinations and professional cleanings. Developing a routine is essential to staying in good health. A routine will make it even easier to keep healthy over the course of your lifetime.

Erectile Dysfunction (ED) – also called male impotency. Male Impotency is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance.

Recent studies have shown that men with advanced periodontal disease (also called periodontitis) are at greater risk for erectile dysfunction. The same study also says young men under age 30 are at risk as well. The study was based on almost 33,000 men with erectile dysfunction and then randomly selected another group of men without erectile dysfunction. About 12% of the participants had advanced periodontal disease. This group with advanced periodontal disease included about 27% of the men with erectile dysfunction and about 9% of those without erectile dysfunction issues. The study lasted for five years.

This particular research study found advanced periodontal disease was much higher among the men with erectile dysfunction than those without. After taking into account other lifestyle factors (example, income level and pre existing medical conditions) the researchers found periodontal disease was still linked to erectile dysfunction.  This was  especially the case in men younger than 30 and those older than 70.

The study did not show or prove that advanced periodontal disease causes erectile dysfunction. But it does show that an association between the two does exist. One theory as to why the link exists is that both are likely caused by inflammatory processes in the body. The Periodontal disease process is directly linked to the inflammatory process in the gum tissues and bone, and has been found to be linked to heart disease,vascular disease (damage to blood vessels), pregnancy issues, and other overall health problems. Researchers believe the same inflammatory process is affecting sexual function. The inflammatory process is systemic (throughout the body) and is thought to be causing damage to the vessels supplying the penis.

While these results are far from set in stone they tell a tale of a link between the inflammatory breakdown in advanced periodontal disease and erectile dysfunction. So this means, it is doubly important for men of all ages and not just the ones mentioned in the study to maintain their dental hygiene to not only maintain their teeth and gums but also to maintain their sexual function. Luckily for us, periodontal disease is very treatable. Periodontitis and advanced periodontitis are very preventable. Brush your teeth, floss and schedule routine dental visits to keep your gums and teeth healthy. While the linkage between periodontal disease and erectile dysfunction requires more research at this very early stage, it would be wise to think of full body health and do all that you can to guard against preventable illness.