Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

Many of us never think of the possibility of a dental emergency until it is upon us. One of the most critical aspects of choosing a dentist should be their emergency dental care policy. Will the dentist be available after hours to answer questions or to open the office? Will my family be prepared in case of a dental emergency? Do we know what number to call?

Fortunately, many dentists choose to give their patients 24/7 access via cell phone to at least give advice or prescribe medicine after hours. While others will even open the office after hours when needed. There are also, many who choose to use an answering service or not be available at all for an after hours dental emergency.

Common Dental Emergencies

-Chipped or broken teeth. This dental emergency may or may not be a painful event or it may be only cosmetic depending on the severity of the chip or break. Teeth can fracture or crack in all manner of ways and can create a true dental emergency. Your emergency dentist will be available to relieve pain and also restore your tooth to its natural form and function.

-Knocked-Out Tooth (also called a tooth avulsion). This occurs from direct trauma. Timing is everything!  The key here is to re-implant the tooth as soon as possible to give it the best chance for success over the long term. If it hasn’t fallen out completely, try pushing it immediately back in, your dentist can do any necessary tweaking. Retrieve the tooth, hold it by the crown or head (the part that is usually exposed in the mouth), do not touch the root. Rinse off the tooth root with water if it’s dirty. Do not scrub it or remove any attached tissue fragments. If possible, try to put the tooth back in place. Make sure it’s facing the right way. Never force it into the socket. If it’s not possible to reinsert the tooth in the socket, put the tooth in a small container of milk (or cup of water that contains a pinch of table salt, if milk is not available) or a product containing cell growth medium, such as Save-a-Tooth. Leave the rest to your emergency dentist.

-Toothaches/Infection. This can happen when tooth decay invades the nerve of the tooth, trauma causes the tooth to die, or periodontal disease is left untreated. The bacteria in the mouth invade the tooth and surrounding bone. This causes the body to respond, which leads to the swelling, pain, and infection. If left untreated this can be a life threatening situation. Call your dentist immediately for this dental emergency.

-Objects caught between teeth. This dental emergency may seem minor but it can be quite uncomfortable and scary. A dentist has the proper tools to remove any and all foreign objects in between teeth.

-Lost Dental Filling. This dental emergency usually occurs when there is tooth decay present in or around the restoration. The bond between dental material and the tooth will break down causing the restoration to break loose. Depending on how large the restoration is this can cause quite a bit of pain and discomfort.

-Broken Braces And Wires. This may seem like a minor dental emergency but a broken bracket or wire can be very uncomfortable and can even cause trauma to the oral tissues. Contact your dentist for advice in your particular situation.

Dental Emergency Conclusion

An emergency dentist that is available 24/7 is an important asset to have for you and your family. You never know when a dental emergency will arise and don’t you want the peace of mind to know your family is protected? Not all dentists make themselves available after hours for a dental emergency so it is important to ask your dentist if they will come to your rescue in the event of a dental emergency.

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.

A toothbrush is our tool to keep our teeth clean and our breath fresh but, did you know, they can harbor bacteria that grow and diversify over time? The main recommendation has always been to change to a new toothbrush every six months mainly because the toothbrush bristles eventually lose their ability to clean your teeth gently and effectively. New research says that your handy toothbrush may be a haven for bacteria and other microorganisms. Not only do they harbor the bacteria but they can also transfer them to your loved ones with each use.

Tips To Keep ToothBrush As Clean As Possible

-Leave Brush Out In Open – This allows your toothbrush to air dry. Bacteria generally thrive and flourish in cool, humid, and dark places. This describes most bathrooms. Studies have shown that toothbrushes kept in a humid, dark environment retained almost 50% of the Herpes Simplex Virus (type 1) for almost a week. Further studies have shown that placing a toothbrush too close to the toilet bowl can introduce new types of bacteria every time you flush. Water particles are launched up to a 6 foot radius surrounding the toilet possibly contaminating your toothbrush and other bathroom items in the process.

Helpful Tip: Do not keep toothbrushes stored away inside your dark medicine cabinet. Consider leaving your toothbrush in a place with dry, well lit area like a nightstand.

-Change Brush Earlier If Possible – Replacing your brush more frequently to ward off progressive bacteria growths. The American Dental Association now recommends changing out your toothbrush every 2-3 months. A good tip might be to buy 12 new toothbrushes at the start of the year and replace the old one at the start of every new month. This makes it easy to remember and keeps your toothbrushes from becoming biology experiments.

Helpful Tip: Select toothbrushes with translucent bristles. Research has shown that these brush heads contain 50% less bacteria than the colored ones. It might be also helpful to use an anti bacterial mouth rinse to protect your mouth and also to rinse your toothbrush in after brushing to keep the numbers of bacteria down to a minimum.

-Nuke Your ToothBrush? – Some studies have advocated microwaving your manual toothbrushes (do not try this with an electric toothbrush!). This technique may eliminate several forms of bacteria and viruses that can form on tooth brush heads. This is an out of the box tip and has not been endorsed by anyone. People have been microwaving pacifiers for years to sterilize them. Just be careful not to ruin the integrity of the toothbrush in the process.

Helpful Tip: Never microwave a toothbrush with metal parts!

-UV (Ultraviolet Light) Sanitizers- There are many highly effective sanitizers which utilize UV light to kill  up to 99 % of toothbrush germs. This is especially helpful when a family member is sick and there is a stronger need to protect from cross contamination onto other toothbrushes.

Conclusion

Toothbrush maintenance and cleanliness is an often overlooked part of our oral hygiene regimen. We must remember how much bacteria we carry in our mouths on a daily basis. We certainly do not want to introduce any new germs to the mix that might be growing on our toothbrushes. Change a few habits and add some simple steps to help you and your family stay happy and healthy for many years to come.

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.