Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

A dental emergency can arise at any time. We can limit the chance of a toothache type of dental emergency by seeking regular dental care. Most dental issues take months (and in some cases years) to develop. A dental emergency can also occur following even the slightest trauma. Being prepared with a few items in a dental emergency kit can help you to provide care in the case of a trauma or other dental emergency. What are the most common emergencies and what else can you do if a dental emergency arises?

Common Dental Emergencies

-Broken or Fractured Tooth – This dental emergency can become quite painful very quickly. If the nerve of the tooth is exposed just the simple act of breathing will begin to hurt. This may also be a “cosmetic dental emergency”, usually if it involves damage to a front tooth without pain. Unfortunately, broken teeth cannot be fixed at home and will need immediate attention by a dentist. For a back tooth, a medicated filling may be placed until you can be seen by your dentist. A product called Dentemp can be purchased at the drug store, mixed and placed by you, to help temporarily cover the hole. Whether or not the tooth can be saved depends on how severe the break is. Until you are able to get to your dentist, rinse your mouth with warm water, apply a cold compress outside the affected area, and keep the area as clean as possible. May consider taking an anti-inflammatory medication to keep the swelling down as well as take the edge off the pain that can develop. It is not suggested to take aspirin, it will cause difficulties in clotting if the tooth needs to be removed.

-Injury to your Jaw/TMJ - If you suspect you may have broken your jaw, apply a cold compress to the area and immediately go to the dentist or to the emergency room. If you have locked or dislocated your jaw, you will need to have the jawbone re positioned back into your TMJ. Ice immediately.

-Painful swelling. This is a definite dental emergency and you should call your dentist immediately for care. Dental swelling is due to an infection called an abscess. This can lead to an infection that affects your entire body and in rare cases can lead to death. To relieve some of the pressure you will want to apply cold compresses to the area, rinse with saltwater, and try to keep your head elevated. Once an infection gets to this point, most over the counter medications will not do much to ease the pain. Antibiotics will be required, and drainage of the infection will require you to be seen by your dentist.

-Biting Lip or Tongue with excessive bleeding - If you accidentally bite your lip, tongue, or part in your mouth, clean the area and apply a cold compress to help decrease swelling. If the bleeding is extensive, or will not stop in a few minutes, call your dentist or go to the emergency room.

-Tooth That Becomes Loose - If one of your teeth is loose, see your dentist right away. Your dentist may be able to save the tooth. Until you are able to get to your dentist’s office, take tylenol or aleve and apply a cold compress to the affected area to relieve pain.  If the tooth is loose due to trauma, the dentist will most likely recommend splinting the loose tooth to an adjacent tooth or two to allow for the tooth to re stabilize in the bone. a loose tooth can also be caused by periodontal disease which will develop over a period of years. In that case, you may not be able to save the tooth and it may be recommended to remove the tooth and have a dental implant placed instead. Never touch or play with a loose tooth. The more movement it receives, the less likely you will be able to save it.

-Pericoronitis. This is an infection that can happen when your molars erupt into your mouth, a flap of gum tissue remains over the back end of the tooth, becomes irritated and swollen, and can be quite painful. If you experience symptoms of pericoronitis, which may include swollen and irritated gums, a bad taste/odor in your mouth, or you are not able to fully open your mouth, call your dentist right away.

-Sudden Or Severe Toothache. If your tooth is aching, rinse out your mouth with warm water and gently floss around the tooth to make sure there is nothing lodged between your teeth. Call your dentist immediately. This could be a gum irritation or infection, or a tooth problem such as a crack or infection.

-Tooth That Has Been Knocked Out (also called avulsed tooth) - The key here is to clean off the tooth immediately to remove any dirt and debris. You want to avoid scrubbing the tooth, just a gentle rinsing will be fine. If the tooth can be re implanted you should try to do so. This is not always possible if there is bleeding and swelling in the affected area. The second best option is to place the tooth in a milk solution. The milk will act as a preservative and increase the long term chances of a successful re implantation. You should call or see your dentist immediately even if you are able to re implant the tooth yourself. The tooth will probably need to be splinted to another tooth while it heals as well as have your dentist check that it is in proper alignment. The tooth will also need to be monitored over time to gauge the success of the re implantation as well as any long term affects that might happen due to the trauma.

-Lost Dental Filling or Dental Crown - Unfortunately, this dental emergency can happen at any time even with regular dental care. If your dental crown does come off call your dentist immediately for instructions. Most drug stores do sell fixodent, or temporary cement to place it back on until you are able to be seen by your dentist. This will limit the possibility of tooth decay developing or tooth sensitivity. The same can be done for a lost filling, most drug stores sell a temporary filling material that can be applied at home. Either way, you will need to seek dental care ASAP to prevent further damage from occurring.

-Damage To Braces - If you suspect or know that you have damaged your braces in some way, you should call your dentist or orthodontist. In some cases, they will want to see you right away (especially if the break is causing pain or discomfort) or they may recommend waiting until your next appointment.

-Food Or Debris Lodged Between Your Teeth - If food or debris gets stuck between your teeth, try to swish aggressively, then gently remove it with dental floss. Be careful not to cause undue trauma to the area. If the object still will not come free, call your dentist for further instructions.

Simple Dental Emergency Kit: 

Dentemp - temporary medicated filling-to fill in broken tooth areas.

Fixodent - to temporarily cement a crown back in.

Floss - to remove lodged debris.

Tooth Saver Container - to transport an avulsed tooth in a dental emergency.

Pressure activated ice pack, advil, gauze.

Dental Emergency Conclusion

Since, a dental emergency can lead to life threatening infections or tooth loss, you should seek dental care immediately. The sooner you are able to seek dental treatment, the better your chances are to minimize any life threatening conditions. Regular dental care will lower the chances of most dental emergencies ever occurring but if they do occur you need to ensure you choose a dentist who will be available to you after hours and on weekends. Many dental offices, will not re open or even take calls directly for dental emergencies after hours. This can be an important question to ask when choosing a new dentist. Be prepared, and you and those around you will be ready if or when a dental emergency occurs.

Dental implants are a highly popular dental procedure for replacing lost teeth. Dental implants are able to restore the mouth back to full function with a highly predictive, strong, long

Dental Implants Marielaina Perrone DDS

Dental Implants – The Perfect Solution For Tooth Loss

lasting restoration. However, for many, dental implants are not even an option due to poor bone density and quality of their bone.  What if dental implants were possible for these patients? Well, new research says that is possible.

Bone Break = Stronger Bone?

A recent article in the Journal of Oral Implantology suggests that the introduction of micro cracks in the jaw bones can stimulate bone growth. This would be especially helpful in patients with compromised bone density and bone quality. In theory, micro cracks can be developed in these patients and then following healing they would be able to receive their dental implants allowing for full restoration when otherwise they would not be able to.

Currently, the only way to improve bone density in patients lacking it would be the use of a dental bone graft and/or a sinus lift. These procedures require extra steps as well as extra cost. They also come with potential pitfalls such as the bone graft not taking on the first attempt.

What Did The Research Show?

The researchers used an instrument called an Osteotensor. This instrument was designed specifically for this Dental Implants Marielaina Perrone DDSdental implants study. This instrument is able to make a series of micro cracks in the jawbone in the area of the desired dental implant placement. Researchers found that, following placement of these micro cracks, there was biological response. Proteins, stem cells, and other growth factors began work to heal and regenerate the bone. The healing process is completed in about 45-90 days. At this time, the patient would be ready for dental implant placement.

The research followed the progress of a 74 year old woman who was treated with this technique. 45 days after the initial formation of micro cracks, the osteotensor instrument was unable to penetrate the bone at 23 of 42 impact sites. After 90 days, none of the sites were able to be penetrated. Softer type IV bone had been transformed into harder type II bone and it was then deemed safe to proceed with the dental implants surgery.

Dental Implant Success Is The Goal

Dental implants are currently successful over 95% of the time but for many patients their bone density and quality do not allow them to even have the option offered to them. With this new research it opens doors to allow for even more dental implant successes in the future, as well as opening the procedure up to entire new populations.

Interceptive Orthodontics is a phased type of orthodontics. Growth is utilized to correct developmental occlusion problems. Staging the treatment can correct immediateInterceptive Orthodontics Marielaina Perrone DDS problems and future issues. Interceptive orthodontics simply means diagnosing and treating malocclusions as soon as they are detected. The American Academy of Orthodontics now says all children should have an orthodontic assessment no later than the age of seven.

In the past, orthodontic treatment did not begin until around age 12-14. This is when all the permanent teeth are already erupted or very close to it. It was also common for your dentist to remove  permanent teeth to correct the bite and allow for room for the final phase of tooth movement. Modern orthodontists now advocate a way to keep permanent teeth, with phased  interceptive orthodontics. In interceptive orthodontics, children are treated at much earlier ages (usually between age 7-11 years old) to take advantage of continuing growth. Patients at this age tend to be more receptive to, and compliant with treatment. Interceptive orthodontics allows for fewer teeth to be extracted and also allows for  better end results.

Why Does My Child Need Interceptive Orthodontics?

Parents and patients need to understand that when interceptive orthodontics is performed there is usually more than one phase of of treatment. Phase two will begin when all the permanent teeth are in place. Going through phases allows for the second phase to be shorter in duration, since the major corrections happened in the interceptive orthodontics phase. Sometimes interceptive orthodontics are needed to correct problems related to skeletal development, and sometimes it is needed as a direct result of oral habits.

-Correction of Thumb Sucking and Pacifier Habits. Persistent thumb sucking, and extended use of a pacifier effect the development of the mouth. Thumb sucking, and pacifier use after the age of three could result in:

- a reshaped jawbone given its soft and pliable nature

- mis-aligned teeth growing out of position

- narrower dental arches

-extreme tongue thrust habits

- protruding front teeth which may be more susceptible to injury

- “open bites” that would require extensive orthodontic treatment to straighten

Some developmental issues requiring interceptive orthodontics include:

-constricted palate, causes misalignment of back teeth commonly called crossbite

-crowding of teeth

-uneven development of upper and lower jaw

Interceptive Orthodontics Marielaina Perrone DDS

Examples of Interceptive Orthodontics:

-Expansion of the upper jaw to eliminate a crossbite

-Expansion of one or both jaws to create space for overly crowded teeth

-Early removal of specific baby teeth to facilitate the proper eruption of permanent teeth

-Maintaining space for permanent teeth after the premature loss of a baby tooth

-Reducing the protrusion of upper incisors to decrease the likelihood of fracture from trauma

What are the advantages of interceptive orthodontics?

Some of the most direct results of interceptive treatment are:

-Creating room for crowded, erupting teeth

-Creating facial symmetry by influencing jaw growth

-Reducing the risk of trauma to protruding front teeth

-Preserving space for unerupted teethLas Vegas Cosmetic Dentist Marielaina Perrone DDS

-Expanding the palate to properly position back molars

-Reducing the need for tooth removal

-Reducing treatment time

Is your child a candidate for Interceptive Orthodontics?

Orthodontics is not just for improving the appearance of the smile. Orthodontic treatment improves malocclusions.  Malocclusions occur as a result of tooth or jaw misalignment. Malocclusions affect the way you smile, chew, clean your teeth or even the way you feel about your smile. Recent studies have shown that malocclusions left untreated can result in problems as we age. Crowded teeth are much more difficult to brush and floss which may contribute to tooth decay and periodontal disease. Protruding teeth are more susceptible to accidental chipping. Crossbites can result in unfavorable growth and uneven tooth wear. Openbites can result in tongue-thrusting habits and speech impediments.

Interceptive Orthodontics Conclusion

In the end, orthodontics is not just about a pretty smile. It adds to ones function and ability to maintain healthy teeth throughout their lives.

Osteoporosis…What Is It?

Osteoporosis is a disease of bones that leads to a decreased density of bone and subsequent increase in risk of fracture. In osteoporosis, the bone mineral density (BMD) is reduced, bone micro architecture deteriorates, and the amount and variety of proteins in bone are altered.

Osteoporosis is a bone weakening disease that has affected millions of people worldwide. The National Osteoporosis Foundation estimates that osteoporosis is a health threat for about 44 million people in the United States alone. The disease is far more prevalent in women than men. According to The National Osteoporosis Foundation, women are four times more likely than men to develop osteoporosis.

Because of these numbers, it is important for women to maintain a healthy lifestyle and diet even in their youth. Exercise and a proper diet for young women can help build strong bone mass for the future to avoid issues (like osteoporosis) later in life. There are recent studies showing that women who drink wine in moderation tend to have higher bone density than those who abstain from alcohol.

Medications Used for Osteoporosis and their Dental Link

Certain osteoporosis medications (also called bisphosphonates) have possibly been linked to osteonecrosis

Osteoporosis - Marielaina Perrone DDS

Normal Bone Vs. Osteoporosis Bone

(or “death of bone”) of the jaw. Osteonecrosis is bone death caused by poor blood supply to the area. It is most common in the hip and shoulder, but can affect other large joints such as knee, elbow, wrist, ankle, and jaw. Osteonecrosis is a rare and serious disease that can causes destruction of the jawbone. a condition marked by pain, swelling, infection and exposed bone. The majority of cases of osteonecrosis of the jaw involve people with cancer who have been treated with intravenous bisphosphonates. A  number of cases of osteonecrosis of the jaw have been reported in people taking oral bisphosphonates for osteoporosis. These have been primarily associated with active dental disease or a recent dental procedure, such as a tooth extraction.

Osteonecrosis can occur at any age range and can affect a wide range of ethnicity’s. Osteoporosis is considered a very serious disease and is responsible for well over 1.5 million bone fractures per year.

According to the American Dental Association (ADA), osteonecrosis of the jaw linked with osteoporosis medications has mainly been seen in cancer patients who are receiving the bisphosphonates intravenously. In fact, 94% of the cases reported are linked to intravenously-administered bisphosphonates while only 6% are linked with the oral medications.

How Do Bisphosphonates Cause These Bone Issues?

Bisphosphonates are very effective in slowing down the breakdown of bone by targeting the cells which breakdown bone (osteoclasts). An unfortunate side effect is, that they also slow down the bone cells which create new bone (osteoblasts). In areas of the body where the bones do not change much after development, (leg, hip, arm bones), this is not very disruptive. In areas such as the jaw, where bone is constantly reforming and reshaping, the lack of strong bone rebuilding cells is inhibitive to forming new bone after an extraction.

Common Bisphosphonates for Osteoporosis Treatment

Osteoporosis Fosamax Marielaina Perrone DDS

Osteoporosis Medication – Fosamax

-Fosamax

-Boniva

-Actonel

-Didronel

-Skelid

What causes Osteonecrosis?

Osteonecrosis occurs when part of the bone does not get blood and dies. After a while the bone can collapse. If this condition is not treated, the joint will deteriorate and this will become severe arthritis.

Osteonecrosis can be caused by disease, or a severe trauma, that affects the blood supply directly to the bone. Many times, no trauma or disease is present. This is called “idiopathic osteonecrosis” (which means it occurs with no known cause).

Direct Causes of Osteonecrosis:

-Long term use of steroids.

-Abuse of alcohol.

-Sickle Cell Disease.

-Radiation therapy.

-Gaucher Disease. This is a genetic disease in which a fatty substance (lipid) accumulates in cells and certain organs.

-Decompression sickness from a lot of deep sea diving

-Break, Dislocation, fractures around a joint.

Diseases Associated with Osteonecrosis:

-Gout.

-Atherosclerosis.

-Diabetes.

Osteonecrosis Symptoms

-Loosening of teeth.

-Pain in the Jawbone.

-Swelling in the area affected.

-Bone becoming exposed.

-Reoccurring Infection.

Osteoporosis Conclusion

It is good to remember that osteonecrosis of the jaw bone from bisphosphonate medication use is quite rare. The drugs being used to counteract osteoporosis have proven benefits to counteract a very serious disease and reduce bone loss. If you are taking any of the bisphosphonate drugs for osteoporosis call your physician before stopping them. It is also very important to inform your dentist that you are taking such medications so they can have it in their medical history in case something arises during your course of treatment.

Maintain a proper diet, exercise regimen, along with regular visits to your dentist and physician to keep your osteoporosis under control.