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Most of us have had the occasional headache or neck ache. It comes with the stresses of the world we live in. We often overlook our teeth as a possible cause of headaches, but it should not be ruled out. The forces we each use, all day long, day after day, when eating, chewing, and talking can wreak havoc on us for many reasons. The alignment of teeth, the anatomy of the TMJ, tooth decay, bad habits such as clenching and grinding, etc. can all be causes of dental related headaches. Millions of people suffer from head and neck pain, and migraines due to issues with their teeth.

Where Does The Dentist Come In?

Your teeth, joints, muscles, and nerves all work together in the proper alignment and functioning of your jaw. When any part of this delicate balance is abused or neglected, painful conditions such as TMD, occlusal problems, and other serious dental health issues can develop. When our muscles are overworked or overstretched due to bite issues the muscles become sore and irritated. Studies have shown that about 3/4’s of all headaches are due to our bite. The pain and discomfort will vary from person to person but in many it can be life changing. Not only do the teeth need to be properly aligned but so do the surrounding muscles of the head and neck.

Head and Neck pain (as well as migraine headaches) can lead to the following symptoms:

-Poor sleep.

-Depression.

-Fatigue.

-Pain and discomfort.

Sleep Apnea and Snoring.

Many of these issues can be avoided with a proper diagnosis of dental issues. In many cases, your dentist can make simple adjustments to dramatically improve your situation. In others, more extensive treatment may be needed.

Common Dental Treatment For Headaches

Adjustment Of Teeth. Changing the direction, size, and position of slopes in the teeth will help correct and balance the bite. This is the simplest way to relieve the pressure on our muscles and can be achieved in a short dental visit.

Replacing Lost Teeth. Missing teeth may be one reason for causing imbalances in the muscles and teeth. If this happens, dental crowns, dental implants, and removable dentures will help maintain proper balance.

Opening the Bite. Loss of vertical height due to grinding, can cause TMJ misalignment and painful headaches. Restoring teeth to their proper height with crowns can give the relief needed.

Occlusal guards. These can be fabricated out of many combinations of materials to relieve many different dental issues. Grinding, clenching, TMJ decompression, etc. These can remove and dissipate painful forces which result in chronic headaches.

Medication. While certain drugs can be prescribed to bring about temporary relief, it is necessary to discover and address the root cause of the headaches. Muscle relaxers and anti-inflammatory medications can help break the cycle of pain, hormone replacement therapy also provides relief in some women. Unfortunately, use of pharmaceuticals is a temporary measure and will not be a long term cure.

Alternative Therapy. This can include acupuncture, chiropractics, change in diet, meditation, and exercise. Putting less strain on the TMJ can help relieve joint pain, just like with any other joint. Adopting a soft diet for a short time may be helpful for some patients. Corrective exercises and applying external heat can also bring relief from the pain.

Headaches Conclusion

The dental component of headaches is often overlooked. Many people often ignore dental issues when having headache issues but it can be a big mistake. If your dental condition is assessed and treated early enough, it can prevent further issues from developing. TMJ disorders, tooth damage, and even bone and gum recession need to be addressed early to avoid pain and headaches. Be smart about your health and do not ignore the warning signs. A simple problem can develop into a far more complex one over time.


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 you a more youthful look. 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.



Dental Implants were not always such a mainstream fixture in dentistry. There was a time when dental implants were for all practical purposes experiments in seeing what worked and what did not. In the last 15 years we have really entered a new age with dental implants being almost routine in their nature now. Most dentists cannot imagine a day without them anymore as a treatment for our patients.

Dental Implants are an artificial tooth root that a dentist, periodontist, or oral surgeon inserts into your jawbone to hold a replacement tooth or teeth(bridge). Dental implants are the perfect option for people with good oral health maintenance who are missing one tooth or multiple teeth due to periodontal disease, via trauma, or some other reason.

Dental Implants use the most modern materials that dentistry has to offer. Years and years of research have gone into the dental implants in use today. Dental implants are much more tooth friendly than traditional bridgework. Dental implants do not rely on neighboring teeth for support nor do the neighboring teeth need to be prepared to be part of the bridgework.

With optimal conditions and in the hands of a skilled dentist, dental implants can look as natural as your own teeth. Only you and your dentist would ever know you even have one. This gives patients the utmost in self confidence giving them the ability to broadly smile as well as eat as they choose. People missing teeth are generally self conscious about their smile and appearance. Following successful placement and restoration, dental implant patients can expect them to last a lifetime if they maintain good oral hygiene.

Modern dental implants can play a few roles in tooth or teeth replacement. These include:

-Replacement of one or more teeth without affecting the neighboring teeth.
-Act as support for a bridge. This will eliminate the need for a removable partial denture.
-Provide support and stability for a denture. Attaching a denture over dental implants make the denture more secure and comfortable. This is also called an implant supported overdenture.

Dental Implants and their advantages over Traditional Dentistry

-Cosmetics. When done properly dental implants will look and feel like your own teeth. Another plus is that since dental implants are placed directly in bone they prevent bone loss and gingival recession that happens over time in areas where teeth are missing. No one but you and your dentist will ever know you have a dental implant.

-Dental Implants allow conservation of tooth structure. Dental implants allow the dentist to save your adjacent teeth from preparations. A traditional bridge requires the preparation of neighboring teeth. Utilizing dental implants is a long term benefit to the patients dental health by saving their natural tooth structure.

-Self Confidence. The wonder of dental implants is that they allow patients to talk and eat full of self confidence. Dental implants offer security and freedom.

implant dentistry

Dental implants Diagram

-Highly Predictable. Dental implants have had a long track record of a very high success rate. Due to this they are an excellent option for tooth replacement.

Treatment

Any treatment for dental implants begins with a thorough examination to develop a proper treatment plan.  Without a good game plan the treatment will be doomed to fail.

As mentioned earlier, dental implants are ideal in the following situations:

-Single tooth replacement. Dental implants are an ideal option for patients with the quantity and quality of bone necessary to hold an implant. The dental implant will allow you to maintain the natural tooth structure of adjacent teeth while replacing a lost tooth.

-Multiple teeth replacement. Dental implants are also ideal in this situation. If you are missing several teeth, implant supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

-Replacing all your teeth. If you are missing all of your teeth, an implant supported full bridge or full denture (also called an implant overdenture) can replace them. This renders traditional dentures to the curb as dental implants used in this fashion will be more stable allowing patients to eat and talk as if they have their own natural teeth.

In some cases, patients will need help to allow for placement of dental implants. Luckily, modern dentistry has developed a few procedures to “help” patients along. These include:

-Sinus Augmentation.  Dental implants need a good quantity of bone along with good quality of that bone to succeed. The upper jaw is known to have poorer quantity and quality bone structure as opposed to the lower jaw. The maxillary sinus also plays a role in increasing difficulty in this area. Sinus augmentation can remedy these issues by raising the sinus floor and placing bone grafts in the area to aid in dental implant placement.

Ridge Modification. When the bone is not 100% adequate for dental implant placement, dentists are able to make it perfect by performing a dental bone graft. A bone graft is the placement of bone in the jaw to to build it up. This gives an excellent platform for dental implants. Ridge modification has been shown to improve both appearance and long term success of dental implants.

Expectations of patient

Following placement of implants and restoration with crowns or dentures, patients can expect a life long restoration that will be stable and cosmetic. Just because these products are man made does not mean oral hygiene should be forgotten and neglected. Dental hygiene must be maintained at a high level if the patient wants to ensure these restorations last. Follow up dental visits are required just as if you had your own natural teeth. If dental implants are well taken care of the patient should expect them to last a lifetime!



Xray showing swallowed Tongue Piercing

Radiograph Showing Swallowed Piercing

Tongue Piercing dangers. It is very hard to believe or understand how certain things ever become popular. But they do like, pet rocks, 8 track tapes, and the rubik’s cube. Fortunately over time, these fads fade away into oblivion. The latest craze over the last few years has been tongue piercing. Tongue Piercing has become very popular, especially among teenagers and young adults. Most people generally believe that tongue piercing is a safe and fun way for young people to express themselves, similar to piercing our ears. Unfortunately, tongue piercing can cause significant damage to our teeth as well as risks to our general health. According to one study, 16% of the females and 4% of the males at a prominent U.S. University had a tongue piercing. The tongue piercing fad may come and go, but for people with pierced tongues, the adverse effects could last a lifetime. Tongue piercing can result in chipped or broken teeth, infections, gum and nerve damage, excessive drooling, taste sensation loss, and tooth loss. Irritation from the jewelry can cause periodontal disease or even oral cancer. So for a teenager or young adult, it may seem cool but damaged and missing teeth, infection, and life threatening cancer are far from cool.

Approximately 45-50% of people who have worn tongue jewelry for four or more years have chipped or fractured their teeth. This damage can eventually send people to the dentist for fillings, crowns, root canal therapy, or even extractions. Because tongue jewelry from a tongue piercing can break or chip teeth, people wearing this jewelry may have to spend thousands of dollars on dental work to regain the smile they will want and desire later in life .

Infection

Tongue Piercing Infection

Infection from tongue piercing

The tongue is covered with bacteria, and when pierced, that bacteria can get in the blood stream and underlying tongue tissues. This can cause a serious infection. Unfortunately, tongue piercing jewelry wearers may not be aware of a problem since the symptoms of infection, such as swelling, redness, and pain, are quite similar to the after effects of the piercing itself. Dentists are learning very quickly that oral infections can also lead to infections in other parts of the body. If you have certain health conditions like diabetes, heart disease, joint replacements or congenital heart conditions, you will be even more susceptible to developing infection.

Dentists have reported a rise in cases of Ludwig’s angina, a very severe infection of the floor of the mouth and jaws, in patients who have a tongue piercing. In Ludwig’s angina, the tongue may swell to the point that it constricts the airway causing breathing to be difficult.

Another condition afflicting patients with a tongue piercing is endocarditis, a disease which occurs when bacteria enters the blood stream and infects the heart valves while weakening them. This can occur in certain patients with underlying ( often undiagnosed and without symptoms) heart problems.

Oral Cancer

Patients with a tongue piercing may develop ulcers in the oral cavity from constant irritation. These ulcers can possibly progress to oral cancer. Precancerous ulcers can be detected during an oral cancer screening by your dentist. For patients with a tongue piercing, it is doubly important to see your dentist regularly. Especially one using the Velscope oral cancer screening system.

velscope

Velscope Oral Cancer Screening

Broken or Chipped Teeth

Fractured Tooth

Damage from Tongue Piercing

It is not uncommon to see perfectly healthy teeth chipped or fractured from a tongue piercing. People chip teeth on tongue piercings while eating, sleeping, talking and chewing on the jewelry. The fracture can be confined to the enamel of the tooth and require just a simple filling or it may go deeper into the tooth, which may require a root canal, tooth extraction, or crown. This can often happen when a person carelessly biting on the tongue jewelry during chewing or sleeping.

Allergic Reactions

Developing an allergic reaction is not uncommon depending on the type of metal the piercing is made of. Some types of tongue piercings are not high quality surgical grade stainless steel and a person can experience an allergic reaction even if they do not typically have metal allergies. Please be aware of the type of tongue piercing being placed before going ahead with it.

Disease Transmission

Oral and tongue piercings are a potential risk factor for the transmission of hepatitis B and C and herpes simplex virus.

Nerve Damage and Prolonged Bleeding

Numbness or loss of sensation at the site of the tongue piercing or movement problems can occur if nerves have been damaged during the piercing. Blood vessels can be punctured leading to prolonged bleeding.

Periodontal Disease

Tongue piercing casuing gingival recession

Gingival Recession Caused by Tongue Piercing

People with a tongue piercing have a increased risk of periodontal disease than those without a tongue piercing. The jewelry can come into contact with gingival tissue causing injury which can cause recession of the gum tissue ( and possibly bone loss). This can lead to loose teeth and tooth loss.

Difficulties in Daily Oral Functions and Possible Aspiration of Jewelry

Tongue piercing can result in difficulty in speaking clearly and annunciating properly. Chewing and swallowing food can also be a challenge. This is because the tongue piercing jewelry stimulates excessive salivary production. Temporary or permanent drooling is another consequence of increased saliva production. Altered taste can also be present. Jewelry that becomes loose in the mouth can become a choking hazard and, if swallowed, can result in injury to the digestive track or lungs.

Another problem that is of concern is that few standards for body piercers exist. Dental offices must follow strict guidelines (developed by OSHA and the CDC) for sterilization and infection control. Contaminated tools used in tongue piercing can expose people to an increased risk for serious infections like hepatitis and HIV.

If a person does decide to have his or her tongue pierced, they should know that it will take 4-6 weeks to heal and it may be very uncomfortable during that time. The piercer

Radiograph showing bone loss from piercing

Radiograph Showing Bone Loss Due to Tongue Piercing

will place a larger, starter barbell jewelry in the tongue to give it enough room to heal when the tongue swells. After the  swelling goes down, he or she should get a smaller barbell, which will be less likely to get in the way of teeth and more difficult to chew on.

If there are no complications, the barbell can be removed for short periods of time without the hole closing. Some dentists  suggest that to protect teeth patients should remove the barbell every time they eat, sleep or participate in a strenuous activity. There are also plugs available to place in the hole, so the jewelry can be removed for as long as needed.

You will need to keep the tongue piercing clean and use an antiseptic mouthwash (example Listerine) after every meal and brush the jewelry the same as you would your own teeth to remove any unseen plaque. See your dentist or doctor at first sign of infection or change to the area surrounding the piercing.

Most importantly, people with pierced tongues should see a dentist regularly to make sure tongue, surrounding tissues, and teeth stay healthy.