Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

Periodontal disease – is the infection and inflammation of the gums and other supporting tissues of the teeth caused by oral bacteria. While periodontal disease is considered a localized infection that affects the teeth, gums and surrounding oral tissues, it can also have dramatic negative effects on a person’s overall health. Recent research shows there is a connection between periodontal disease and Alzheimer’s disease. Periodontal inflammation has been shown to be  associated with inflammation in the brain that increases the risk for cognitive dysfunctions linked to Alzheimer’s disease.

Alzheimer’s disease is the most common form of dementia and the 6th leading cause of death in America today. Approximately five million Americans have this progressive condition that involves loss of cognitive function and short term memory. Alzheimer’s disease appears o be on the rise in the United States with more and more cases being diagnosed each year. The most common risk factors of Alzheimer’s disease include old age, heredity and family history. Most of the patients diagnosed with Alzheimer’s disease also have periodontal disease. This has led researchers to believe that there is a connection between these two disease states.

Periodontal Inflammation = Increased Risk For Alzheimer’s Disease?

Periodontal disease increases the risk of developing the cognitive disorder linked to Alzheimer’s disease. According to recent studies conducted to find out the causal relationship between these two conditions, people with periodontal inflammation face an increased risk of having lower cognitive functions compared to those without periodontal inflammation. The risk increases as the level of inflammation increases. Researchers believe that periodontal disease also causes an increased decline in  cognitive functions in people with already declining cognitive functions.

In 2005, a group of researchers noticed an increased presence of antibodies and inflammatory chemicals linked to periodontal disease in patients with Alzheimer’s disease compared to those of healthy individuals. Alzheimer’s disease patients also showed higher levels of periodontal bacteria in their brains. Researchers believe that when the oral periodontal bacteria multiply, they enter the blood stream and travel to the brain, where they cause infections and damage there.

researchers think there are three possible ways that periodontal disease can lead to Alzheimer’s:

1. Periodontal bacteria causes infections and damages brain cells.

2. Periodontal bacteria triggers inflammation on the brain. This inflammation is involved in Alzheimer’s disease.

3. Oral bacteria responsible for periodontal disease causes vascular changes that can promote Alzheimer’s disease.

Relationship Between Periodontal Disease and Lowered Cognition

Reserachers used the Digital Symbol Test for cognitive function for people aged 70, those with periodontal inflammation had lower DST scores compared to those with little inflammation or none at all, even after considering other risk factors for low DST scores such as obesity and other forms of tooth loss unrelated to periodontal disease.

Early Periodontal Health and Alzheimer’s Disease

According to an article published in the Journal of American Dental Association, any kind of Inflammation as a child increases the risk of developing Alzheimer’s disease as an adult. Developing periodontal disease or losing teeth before the age of 35 increases the risk of having Alzheimer’s disease in old age. This makes it so important to maintain good oral hygiene throughout life.

Common Shared Risk Factors

Common risk factors for both Alzheimer’s disease and periodontal disease include genetics and smoking cigarettes. These risk factors could explain the connection between these two disease states. Periodontal inflammation and any kind of tooth loss are risk factors for Alzheimer’s disease.

It is also possible that periodontal disease can cause cerebrovascular injury to the brain.  Stroke is also a major risk factor for Alzheimer’s disease, and periodontal disease increases the risk of developing stroke.

Alzheimer’s As a Risk Factor for Periodontal Disease

Patients of Alzheimer’s disease are not always able to practice the required oral and dental hygiene needed to maintain a healthy teeth and gums. This places them at a higher risk of developing periodontal disease.

While there is no conclusive evidence that gum disease causes Alzheimer’s disease or that taking proper care of teeth can reduce the risk of this form of dementia yet, numerous studies conclude that preventing periodontal disease is an effective way of avoiding or delaying Alzheimer’s disease. Along with a healthy lifestyle, including regular exercise and a nutritious diet, regular visits to the dentist as well as practicing proper dental hygiene by brushing teeth and flossing are effective ways of preventing both diseases.

Angular Chelitis - is inflammation of one, or more commonly both, of the corners of the mouth. The inflammation is caused by yeast development in the area. The condition may show itself as deep cracks or splits in the lips, and the inflamed area may extend onto the skin of the face. In severe cases, the splits can bleed when the mouth is opened and shallow ulcers or a crust may form. It is a fungal disease, which is difficult to treat long term, and commonly recurs.

Angular chelitis has long been a curious disorder to treat. It is difficult to know the cause of the angular chelitis from individual to individual. The usual culprits include poor diet and nutrition (specifically Zinc or Vitamin B2 deficiencies) and certain medications. Angular chelitis can also be caused by the loss of vertical dimension of the teeth. Vertical dimension refers to the height of our teeth, which over time becomes less and less as our teeth wear or our dentures break down. This in combination with the aging process can lead to loose flabby skin at the corners of the mouth. These folds cause a warm, moist, dark environment in which, yeast flourishes.

Solutions For Angular Chelitis

There have been many home remedies tried in treating angular chelitis. These include vitamin regimens, tea tree oils, fish oil, and even a combination of grapefruit and vodka. None of these angular chelitis treatments work. The best approach is to eliminate the source of the issue. Dentists have long known that the loss in vertical dimension coupled with the flabby skin at the sides of the mouth are the triggers in most cases of angular chelitis. Angular Chelitis treatments include:

-Topical Antibiotic/Antifungal Treatment – monostat topical cream is a very effective solution. It needs to be applied externally only, and throughout the day for 2-3 weeks. In many cases this is a temporary solution at best as the root cause of the problem, the mouth folds in the corners, has not been solved. As the patient loses more tooth height, the folds of skin will increase in depth causing the angular chelitis to become harder and harder to treat.

-Increase Vertical Dimension – Once the yeast has been treated and eliminated, the only way to keep it from returning is to address the corner folds. This can be done in a variety of ways but the goal is to open the bite, or increase tooth height, to remove or lessen the presence of the folds around  the mouth. This can be achieved through the fabrication of a new denture (for denture wearers) or through the use of crowns to modify the bite.

-Use of Dermal Fillers – Luckily, we have a third option which many prefer. It includes the use of dermal fillers (such as Restylane and Juvederm) to replace lost volume in the tissues of the lower face. These dermal fillers are generally used in combination with Botox to relax the muscles and subsequently smooth out the wrinkles surrounding the mouth.

Angular Chelitis Conclusion

Angular chelitis can be a long term problem if not treated correctly. It can become quite uncomfortable and unsightly. Some may only be able to utilize the topical antifungal treatment, while others may be able to remove the problem permanently by increasing dental height with the aforementioned dental treatments. Fortunately, we have options at our disposal to treat this condition. You no longer need to be frustrated or embarrassed by this infection. See your dentist to see which treatment is best for you!

AAAHH!! The dreaded brain freeze  (also called an ice cream headache)…we have almost all experienced it when drinking an ice cold drink or eating ice cream way too fast.

Brain Freeze Marielaina Perrone DDS

The Dreaded Brain Freeze!

But, did you know that the dreaded brain freeze is actually considered a short duration headache? Do you know what causes brain freeze or how to stop it?

What Is A Brain Freeze?

A brain freeze is a form of  cold stimulus headache. The medical term for this type of headache is sphenopalatine ganglioneuralgiaThe brain freeze occurs when something cold touches the roof of our mouths (also called the palate). The sudden onset change in temperature of the tissue stimulates nerves to cause rapid dilation and swelling of blood vessels. There is an attempt by the body to direct blood to the area and warm it back up. The dilation of the blood vessels triggers pain receptors, which release pain-causing prostaglandins, increases sensitivity to further pain, and produces inflammation, while sending signals through the trigeminal nerve to alert the brain to the problem. The trigeminal nerve can sense facial pain, strangely the brain interprets the pain signal as coming from the forehead. When the body senses pain in a different area than the source this is called “referred pain”.

Generally, the headache appears in about 10 seconds after placement of cold in the mouth and usually lasts around 20 seconds, although some people may experience much longer instances of pain. The sensation can become intense and hit fast as nerve endings go into overdrive. Only about a third of the population ever experience brain freeze from eating or drinking something cold, though most people are susceptible to a related headache from sudden exposure to a very cold climate.

Can Brain Freeze Be Prevented?

Since the brain freeze is caused by the rapid chilling and subsequent warming by the body, there are a few ways to help prevent brain freeze. They are as follows:

Brain Freeze Marielaina Perrone DDS-Eating ice cream or drinking cold drinks slower instead of rushing through.

-After drinking or eating something cold use your tongue to warm the top of your mouth. This can alleviate the onset of brain freeze.

-Tilting your head back for about 10-15 seconds allows blood flow to equilibrate and not rush to the area as quickly.

-Drink a liquid that has a higher temperature than whatever caused the brain freeze.

Conclusion

A brain freeze is not really a serious issue but it is annoying. Recent research has also shown that those who experience migraines seem to be more susceptible to brain freeze. This can possibly lead research teams to develop new medications that help prevent or treat the vasodilation that is causing the headaches. These drug therapies could  lead to significant advances in many peoples lives.

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.