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Cosmetic Dentistry is about more then a white, perfectly aligned smile. For many of us, we may believe we have one or more flaws we might want changed or adjusted with our current smiles. These smile flaws can effect a person’s self esteem as well as a person’s self confidence leading to a lower quality of life. Cosmetic dentistry gives you the ability to make small corrections or even major transformations to your smile to boost confidence and self esteem. These changes can have a major impact on your entire life including work and personal relationships as you feel more confident about yourself.

Is A Perfect Smile Possible?

Everyone has a different idea of what a perfect smile is. So every cosmetic dentistry consultation with a well trained, experienced cosmetic dentist should begin with you telling your story to your dentist about what you are looking for in a new smile. Your cosmetic dentist will complete a thorough examination of your teeth, periodontal tissues, jaw alignment, and facial features along with taking impressions for study models. These study models can be used by your dentist to make adjustments to your smile so as to give you a visual reference of what your new smile might look like. This examination will allow your dentist to explain to you what can be done to keep a balance between cosmetics/esthetics and function and give you multiple options to choose from to achieve the look you want. It is important to note that it is imperative that you keep open lines of communication with your dentist throughout the entire process. If you are not happy with any part of the treatment plan options or the cosmetic dentistry treatment selected, you need to let them know so changes can be made.

Common Cosmetic Dentistry Changes

Straighter Teeth

Adult orthodontics have seen tremendous advancements over the last decade. Long gone are the days of wearing braces for several years to give you the smile you want. The newest development is the six month smiles system. This system uses tooth colored materials so that no one will notice you are undergoing orthodontic treatment. This treatment can transform your smile, giving you straighter teeth in an average of six months or less.

Teeth Lengthening

As time passes and every day use, our teeth change. These dental changes include becoming shorter. This can change your smile from a youthful one to one making you appear older. Lenghthening your teeth back to their natural dimensions is possible with porcelain crowns, gum contouring, and porcelain veneers. These options will add length and structure to your teeth making your smile look the way you always imagined. These changes may also reduce wrinkles around the mouth.

Teeth Whitening

A whiter, brighter smile can light up a room and give the appearance of vitality and youth. This is probably one of the easiest and most cost effective cosmetic dentistry procedures available to you. There are generally two types of teeth whitening – in office and at home treatment. The in office treatment is faster and highly effective, the at home products may take a bit longer but will still give you a whiter, brighter smile.

Restore A Lost Smile

Over time, tooth decay and periodontal disease can wreak havoc on our smiles. Our teeth can break down, shift, create dark spaces, or even be lost. To restore a lost smile, cosmetic dentistry can offer porcelain crowns, bonding, and dental implants to give you a full smile.

Cosmetic Dentistry Procedures To Change Your Smile

Teeth Whitening. This has become a billion dollar cosmetic dentistry business with products ranging from in office whitening to at home whitening with customized dental trays, whitening strips,  paint on gels and even whitening toothpastes and rinses. The differences between the types has to do with speed and depth of whitening. Teeth whitening can have a dramatic effect on almost anyone’s smile for a relatively low cost and minimal time involved.

Dental Implants. Missing teeth can make you feel uncomfortable when smiling, feel socially awkward, or may make you appear older than you actually are. Replacing lost teeth can be done with extremely natural results. Dental implants are a great way to achieve cosmetics, strength, and durability.  Dental implants can be used to replace a single tooth or multiple teeth. The best part is, once restored, the dental implants will often last a lifetime.

Tooth Bonding. This cosmetic dentistry procedure involves reshaping and blending teeth. Bonding utilizes tooth colored materials that can be bonded to teeth to change shape, color, and length. This same material can also be used to fully cover the front surface, (called a composite veneer). Tooth bonding can generally be completed in one visit, and is less expensive than porcelain restorations.

Porcelain Veneers. While the initial cost is higher than some other cosmetic dentistry options, this may be cost effective if extensive changes need to be made. Porcelain veneers can change shape, color, length, and even correct minor misalignments of teeth. This will last a long time, will not stain, and is a very strong, natural looking material. The veneer is also a conservative restoration as it generally only requires minimal enamel reduction, and sometimes no reduction.

Porcelain and Zirconia Crowns. These types of crowns combine strength with the most cosmetic options available. They are made from modern dental porcelain materials that range in strength and esthetics. If done properly, no one should ever be able to tell a porcelain crown from a natural tooth. Modern porcelains possesses strength, color properties, and light reflection properties that very closely mimic our natural teeth. Porcelain crowns can be used to change bite alignment issues as well as change alignment of front teeth which are more extreme such as those issues that porcelain veneers alone cannot fix. More natural tooth structure needs to be removed in preparing a porcelain crown vs a porcelain veneer.

Snap On Smile. This is a newer, far more conservative way to improve your smile without any permanent dental work. All that is required is having your dentist take impressions or molds of your teeth, select a color, and the dentist sends impressions off to a lab to have your snap on smile fabricated. Once the snap on smile is complete, you simply clean your teeth, apply a fluoride gel inside, and slip it on over your teeth. You can talk, eat and smile naturally.

Marielaina Perrone DDS BotoxGum Contouring. For those with a gummy smile, this can be the ultimate confidence booster. This cosmetic dentistry procedure is generally done in one visit and can give incredible results for many with an overly gummy smile. Gum contouring simply removes the excess gum tissue and reshapes the gums to ensure you obtain the desired look. For some, this may require reduction of bone also, in this case, it is recommended that you see a periodontal surgeon. This will offer you the best chance of success.

Tooth Recontouring. Changing the shape or alignment of teeth in a minor way can have a dramatic effect on a persons smile. Tooth recontouring involves removing small amounts of tooth structure from edges of teeth to correct a tooth that might be misshapen or slightly misaligned.

Orthodontics. Minor tooth movement can be completed in weeks to months by your cosmetic dentist to bring your smile in line and allow for a better harmony between your smile and function. If further movement is necessary, your dentist may refer you to an orthodontist for more extensive treatment.

Botox and Dermal Fillers. These are newer additions to a cosmetic dentist’s arsenal of techniques. A well trained dentist in the art of botox and dermal fillers can place the finishing touches on a new smile by softening wrinkles and skin around the mouth, forehead, and eyes. Giving a much younger appearance in facial and dental appearance!

Cosmetic Dentistry Conclusion

The beauty of cosmetic dentistry is that only you and your dentist should ever know it was done. A well trained cosmetic dentist can create a smile that is both beautiful and natural looking. There are so many ways in cosmetic dentistry to make changes to your smile. Talk yo your dentist to see what will work best for you.



There are certain questions we all think about when we are told we need to wear orthodontic braces…..Will it hurt?….How will I be able to brush and floss?….Can I still eat my favorite foods?….How long will I have to wear them?

For millions of adults and children they might have a far different reaction……I have allergies to metals….Will I be able to have the orthodontic treatment without an allergic reaction?

Types Of Metal Used In Orthodontics

As many of us know, orthodontic braces are made up of brackets, wires, and bands. These orthodontic components are composed of various types of metal. This gives the orthodontic braces its inherent strength to do the job of moving your teeth into proper positioning over time. There are generally a few types of metal used in orthodontics and these can include:

Stainless Steel

Nickel Titanium

Full Titanium

Gold Plated Stainless Steel

What If I am allergic to certain metals? What choices will I have?

-Ceramic Braces – These are an excellent choice, not only for people with a nickel or metal allergy, but for people who are looking for a more esthetic orthodontic option. Ceramic braces are clear and are able to blend in with the teeth much more easily than traditional metal orthodontic braces. Ceramic braces allow for tooth movement without causing a reaction. Ceramic braces are not quite as strong as the traditional metal orthodontic braces so additional care is required as well as additional trips to the orthodontist for broken parts.

Gold Plated Braces – These are especially comforting to many with a nickel allergy as they add extra security against an allergic reaction. The gold is able to form a stable bond between the teeth and the brackets and will also blend very nicely against ones teeth to soften the esthetics. These have become more popular for many simply becuase they feel they look better than traditional options but they do come with added cost.

Titanium Braces – These appear very similar to the traditional stainless steel orthodontic braces. Titanium has an added advantage (besides being nickel free) that they are often considered to be more flexible than traditional stainless steel braces. This will allow them to be more flexible upon chewing and placing forces on them. This makes them a more durable option for many.

Plastic (Polycarbonate) Braces – The main advantages to these are that they are completely metal free and can be made to be practically invisible on the teeth. This is a great option for allergy sufferers but also for many adults who do not want a mouth full of metal. The main disadvantage of these is they tend to not be as strong as traditional braces so added care is needed as well as allowance for extra visits when things break.

Invisalign- This is a clear plastic removable appliance. It is changed periodically to slowly move teeth into position. It is nice because it is very cosmetic, and can be removed for photos.  The main negatives are, they are easy to lose, and movement is limited. Therefore, it takes more time to receive less results overall.

Other Potential Orthodontic Allergies

Other potential risks for allergies exist in the use of elastic ligatures (also called rubber bands) during orthodontic treatment. These rubber bands contain latex which might pose an issue for those with latex allergies. Luckily, in modern dentistry companies have developed latex free rubber bands using the same colors as the traditional ones.

Also, the metal used for a particular patient should be the same metal used throughout orthodontic treatment with no deviation. This ensures that there is no cross contamination as it would become quite difficult to pinpoint the exact issue when and if it arises further into treatment.

Orthodontic Allergies Conclusion

Communication is the key in dealing with any dental issue but especially for those with a history of allergies. If you suspect you have any type of allergy let the dentist know. It might be a good idea to get allergy tested prior to beginning orthodontic treatment if there is any doubt. Any allergy should not be taken lightly if there is any chance it could impact treatment. This will ensure a smooth transition and trouble free orthodontic treatment.



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.

Most teens and adults who wear braces cannot wait for the day that they are free from them. They look forward to finally having the straight smile they have desired.

Braces - Marielaina Perrone DDS

Orthodontic Treatment – Braces

Whether treatment takes a few months (in cases of limited orthodontics) or 2-3 years it is still something to look forward to. But now the work begins to continue maintaining proper oral hygiene to keep those teeth straight, white, and free of tooth decay.

Tips to Maintain that Straight Smile

Schedule regular dental examinations and cleanings. Now that the braces are off it is not a time to slack off on maintaining your teeth. Most patients find dental hygiene to be easier after dealing with braces for such a long time. Most patients, especially adult patients, are extra motivated following orthodontic treatment. They want to show off their new smile and keep their teeth shining. Immediately following removal of braces it is very important to schedule an appointment to see your regular dentist to ensure there is no tooth decay, residual cement, chipped enamel or stains. Sometimes there are white spots caused by decalcified enamel under or around the brackets. The gums, and roots of teeth also need to be evaluated. The dentist will also check your orthodontic retainer to assure proper fit and hygiene.

Wear Your Orthodontic Retainer. Following most orthodontic treatment an orthodontic retainer is custom made for patients. This retainer will need to be worn for 9-12 months as your teeth “adjust” to their new positions. If you choose not to wear your orthodontic retainer regularly, your teeth will likely shift. After the first year, many people wear their orthodontic retainers at night, several nights per week, to ensure that their new smiles continue to look great. There are three basic types of orthodontic retainers. These include:

1) Hawley Retainer. This type of orthodontic retainer is made of acrylic that is custom molded to your mouth. These contain a wire to hold your teeth in position. A Hawley retainer is the most common type of retainer. The acrylic can be made available in clear, and in a variety of colors and interesting designs, so you can “personalize” your orthodontic retainer if you so choose.

Las Vegas Orthodontics Marielaina Perrone DDS

Wear Your Orthodontic Retainer To Keep Your Smile Straight!

2) Essix Retainer. These are made of clear plastic. Most people like these as they are fairly lightweight and thin, and do not look anything like traditional retainers.

3) Fixed Retainer. These are just as the name implies, meaning they do not come out. These are usually a thin wire bonded behind a section of teeth using a tooth colored material. This type of orthodontic retainer stays in the mouth 24 hours a day and patients must be extra diligent to maintain proper oral hygiene as food and debris can be trapped along this type of orthodontic retainer. This is most often used on lower teeth, as they have the highest incidence of moving back to their original positions over time. The fixed orthodontic retainer is best for those who would be unlikely to wear a removable retainer as they are instructed to, or would likely lose it.

Never stop wearing your orthodontic retainer unless advised otherwise. Wearing the orthodontic retainer will ensure the teeth do not shift over time.

Maintenance of  Your Orthodontic Retainer

How can you keep your orthodontic retainer clean? You can brush a Hawley retainer with a toothbrush. Brushing is not recommended for Essix orthodontic retainers because brushing can scratch or damage them. You can use denture cleaner such as efferdent, but there are actually several retainer cleaning products custom produced for this task. These include RetainerBrite and SonicBrite. You should also bring your orthodontic retainer to dental appointments, your hygienist can place them in a special tartar and stain removing solution to soak while you are having your teeth cleaned.

-Retainer Brite. This cleaner comes in tablet form and can be used with our without a portable sonic cleaner. The advantage of this cleaner is that the tablets are individually wrapped, which makes it easy for traveling and on the go.

SonicBrite. This cleaner is a powder that comes with a battery operated sonic cleaner bath. It works very well at getting white calculus build up off of many types of Las Vegas Orthodontics Marielaina Perrone DDSorthodontic retainers and dental appliances. Patients with Essix retainers and Invisalign -type aligners tend to like this system.

All of these systems do a very good job at keeping your orthodontic retainer smelling fresh and preventing white build up. They can be used for either plastic and wire Hawley retainers, or Essix (clear plastic) retainers and Invisalign type aligner trays.

What If I lose My Orthodontic Retainer?

Losing retainers especially for teenagers is quite common. A good tip to make sure you do not lose it is to carry a retainer case with you at all times. Get in the habit of placing the orthodontic retainer in its case whenever you need to remove it. This way it is not just left in a napkin on a restaurant table or left for a dog to chew. Be sure to keep your orthodontic retainers in their protective case when out of your mouth.  Dogs love to chew retainers, and they can be easily knocked off counters and stepped on. It is YOUR responsibility to make sure that the retainer is kept in a safe place when not in use.  Backpacks, pockets, and purses are also dangerous, unless the protective case is used.  Heavy books, keys, etc. can bend and break orthodontic retainers.

You have long awaited your new smile. You have been through a lot to get here. Make sure you do all that you need to maintain your investment. Your future should be filled with years of bright smiles. Wear your orthodontic retainer, so that your teeth don’t move out of their new, beautiful positions. Continue with excellent oral hygiene. Be diligent with your dental visits. These tips can help keep that perfect smile straight for many years to come!