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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.



Periodontal disease (or commonly called gum disease) is a very serious and chronic dental infection of the periodontal tissues that can result in the breakdown of the tissue as well as the loss of bone that surrounds and supports your teeth. This dental infection disease begins when bacteria and plaque form a sticky bio film on your teeth and causes inflammation of the periodontal tissue.  Periodontal disease will continue a downward progression if this is not resolved by maintaining proper dental care and hygiene. Periodontal disease is the leading cause of tooth loss in adults. Scientific studies show that somewhere between 75% and 95% of all adults are suffering from some stage of periodontal disease.

Periodontal disease and tooth decay (cavities) are caused by different types of bacteria, and are considered to be two separate and distinct conditions, however, you can suffer from both issues. Poor oral hygiene promotes the risk of both cavities and periodontal disease. Swollen and receding gums open up the more vulnerable areas of the tooth…The root areas, which, are not protected by enamel and can break down quickly to form root decay.  On the flip side, in patients with significant tooth decay, the broken down teeth allow for food trap areas which keep periodontal tissue chronically inflamed.

Gingivitis

Periodontitis

Stages of Periodontal Disease

The earliest stage of periodontal disease is gingivitis (or simply inflammation of the gum tissues). This is the most mild form of periodontal disease. Symptoms include red, swollen (or puffy) and inflamed gums due to plaque-bacteria build-up. The gums may also bleed easily during brushing or eating of hard foods. During the earliest of stages the periodontal disease process it can be reversed thru proper brushing, flossing and professional dental care to remove the excess bacterial plaque. If the required oral hygiene does not occur, the periodontal disease then progresses  to the next stage. The majority of people with this early form of periodontal disease, do not even know a dental problem exists. This is a crucial period for the patient, as the condition can be reversed (since the bone and connective tissue that hold the teeth in place have not yet been adversely affected) at this point if it is recognized, diagnosed, and properly treated by a dental professional. Gingivitis is commonly seen during puberty, pregnancy, times of high stress, and menopause, as raging hormones can make you more prone to inflammation. As for the rest of the population, poor dental hygiene is generally the most common cause, followed by medication and certain medical conditions.

Periodontitis

As the periodontal disease progresses it is now becoming harder to treat and control. The difference between gingivitis and periodontitis is that gingivitis only infects the gum tissue that surrounds the teeth while the periodontal disease process also invades the bone that provides support and stability for the teeth. The bacteria eventually invades past the initial the gum line area and destruction begins to the point that gums may begin to separate or pull away from the teeth (taking away support and connective fibers with it). What results are called periodontal pockets. These pockets allow for bacteria to invade below the gum line.  They eventually become loaded with toxic plaque and bacteria that moves and works its way deeper. It begins to erode the bone below the gum line. A patient’s bite will be affected (as the teeth shift or loosen) by the lost support which then affects chewing and other daily functions.

Advanced Periodontitis

As the periodontal disease process advances further, the fibers and bone that provide support for the teeth are broken down and  destroyed. At least half (50%) of the bone support (if not more) will have broken down at this late stage of periodontal disease. It does not grow back naturally. Teeth may begin to loosen. Deep root cleanings and surgical intervention are typical at this stage. This may include cleaning with a periodontal microscope, (Perioscope), grafting of tissue, bone, placement of growth factors, (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets, (Arestin), open periodontal flap surgery, and, possibly even tooth removal.

How Do I Know If I Have Periodontal Disease?

Periodontal disease can happen to a person of any age. It is most common among adults. Remember, if periodontal disease is detected in its earliest stages it can be reversed so it is important to see your dentist right away if you notice any of the following symptoms:

-Gums that are red, puffy or inflamed, or tender.

Periodontitis

X-Ray showing Periodontal Disease Progression

-Gums that bleed easily during routine brushing or flossing.

-Teeth that appear longer due to recession of gum tissue.

-Changes in the way your teeth fit together when you bite or chew.

-Pus coming from between your teeth and gums

-Bad breath odor or bad taste in your mouth.

Treatment of Periodontal Disease

Periodontal Disease

Arestin use in Periodontal Disease

The earliest stages of periodontal disease are reversible. This is accomplished thru proper brushing, flossing, and maintaining a regular schedule with your dentist. A professional cleaning by your dentist or hygienist is the only way to remove plaque and tartar especially below the gum line. The hygienist will clean (also called scaling) your teeth to remove the tartar and plaque buildup from above and below the gum line. If the periodontal disease condition worsens, then a root planing procedure may be necessary. Root planing helps smooth irregularities on the roots to make it more difficult for plaque to deposit and stick there. Also makes it easier for you to keep your teeth clean at home. Treatment may also include use of antibiotics.

If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, your periodontitis treatment may require dental surgery. This surgical intervention may include:

-Pocket Reduction Surgery (also called Flap surgery). In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. The procedure generally takes from one to three hours and is performed under local anesthesia.

Soft tissue grafts. Gum tissue is often lost as part of the periodontal disease process making your teeth appear longer than normal. You may need to have damaged tissue replaced to return your cosmetic appearance back to normal. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetically pleasing appearance.

Bone graft. This procedure is needed when periodontitis has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.

-Antibiotics and medicaments – A wide array of antibacterial rinses(Peridex), antibiotics taken in pill form, (Periostat) or localized placement directly into the affected pockets(Arestin), can aide in and promote healing of the affected gum tissue.

-Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.

-Enamel matrix derivative application. Another technique involves the application of a specialized gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue. An example of this is the use of emdogain.

To ensure a successful result following periodontal therapy, patient cooperation in maintaining excellent oral hygiene is essential. More frequent professional cleanings can help reduce the likelihood of the periodontal disease ever returning.

By scheduling regular checkups, early stage periodontal disease can be treated before it leads to a much more serious condition. If your periodontal disease is more advanced, treatment in the dental office will be required. Periodontal disease can be managed and controlled for most patients. Following a regular routine of brushing, flossing, and seeing your dentist should be enough for most to keep periodontal disease at bay.