Family & Cosmetic Dental Care in a Relaxed Environment.

Exceptional Dentistry Las Vegas and Henderson NV Since 1999.

Dental Implants, Teeth Whitening, Porcelain Veneers, &
Botox Cosmetic.

Call Today For Consultation!

Email Us
Directions



In the past, orthodontics was routinely an early teen event that began once all of the baby teeth were gone and permanent teeth were in. Recent advances in the understanding of a child development as well as modern materials have re-evaluated the time for orthodontic treatment to an earlier age. It is now recommended by the American Association of Orthodontists that every child should receive an orthodontic evaluation by age 7. But Why?

Common Orthodontic Problems Found At Age 7

1. Buck Teeth. Do the upper front teeth stick way out of line?

2. Deep Bite. Do the upper teeth cover the lower teeth?

3. Underbite. Do the upper teeth fit inside the arch of the lower teeth?

4. Open Bite. Do only the back teeth touch when biting down?

5. Crowded or overlapped teeth. Do the teeth have too much or too little space in certain areas?

6. Misaligned front teeth. Do the spaces between the upper two front teeth and lower two front teeth not line up?

7. Crossbite. Do the lower teeth fit properly inside the upper teeth?

8 .Missing teeth. If there are baby teeth that never developed, there will not be a permanent tooth to follow. Jaw x-rays may also find that certain permanent teeth are not  presently formed or are unable to come down on their own.

9. Extra teeth. When there are double teeth, extra teeth or malformed teeth.

Generally, orthodontic treatment does not begin at age 7 but it is good to get a head start to avoid any complications down the road. However, early orthodontic treatment may be necessary before age 7 if the following appear:

-Problems Speaking

-Proper Chewing Is Difficult

-Abnormal bite development

-Clicking or popping in the jaw

-Permanent teeth that are erutping into the mouth crowded or overlapped

-A thumb sucking problem

-A teeth grinding problem

-Issues biting cheeks or biting into the roof of the mouth

Benefits Of Early Orthodontic Treatment

Early orthodontic evaluation provides both timely diagnosis of problems and increased opportunity for more effective treatment. Early intervention gives the ability to guide growth and development, preventing more serious issues later. When orthodontic intervention is not necessary, an orthodontist can carefully monitor growth and development and begin treatment when it is ideal.

Early orthodontic treatment is also referred to as interceptive treatment or Phase I treatment. Some of the most direct results of interceptive treatment include the following:

-Creating room for crowded, erupting teeth

-Creating facial symmetry through influencing jaw growth

-Reducing the risk of trauma to protruding front teeth

-Preserving space for teeth that are coming in

-Reducing the need for tooth removal

-Reducing Phase II treatment time with braces

Phase II orthodontic treatment begins when all of the permanent teeth erupt and usually involves a full set of braces and not just a localized treatment plan.

Orthodontic Conclusion

While not every child will need early orthodontic treatment, it is best to know in advance what the options will be going forward. It is important to remember, orthodontics is not strictly a cosmetic endeavor, bite alignment is the ultimate goal. The issues presented above can all be corrected fairly easily if done in a phased approach. However, allowing this early intervention time to pass can complicate treatment requiring more extreme measures (i.e. teeth removal or surgery) to fulfill the same goal.



In today’s modern world, dentistry comes in all forms. How do you know which dentist is right for you and your growing family? There are various specialties in dentistry and many of them overlap between different populations of patients. This overlap is very pronounced between family dentists and pediatric dentists. If you have  children, do you choose a dentist for yourself and a different one for your children?

What Is Family Dentistry?

Family dentists are trained to treat patients of all ages. Family dentists care for your child’s baby teeth, older child’s mixed dentition, adult teeth, and senior dental care. Everyone in the family going to the same dentist can be quite convenient. A child can become easily acclimated to the family dentist by simply watching and modeling another family member. It is usually a very easy transition.

Family dentistry provides preventative dental care, such as regular professional cleanings and oral cancer screenings, and other basic dental care that may be needed. It is important to schedule regular appointments for checkups, so that your dentist can catch any problems before they require the care of a specialist like an oral surgeon or orthodontist. Specialists offer advanced services like treatment of difficult root canals, periodontal surgery, bone surgery, braces, etc. While specialists are still used routinely many of these procedures can be done at the family dental practice. Most dentists will also take x-rays of the teeth on a timely basis to examine for cavities, TMJ problems, diseased tissues, and infection. Your family dentist can fill the cavities, use dental sealants to help to prevent cavities, monitor growth and development to evaluate need for braces, tooth extractions, etc.

If you see your dentist every six months, you will be less likely to have severe breakdown and tooth loss. Your family dentist is trained to help you keep your teeth healthy and can even provide cosmetic dentistry services to keep your smile bright and healthy. Your dentist will educate you and give recommendations for brushing, flossing and rinsing to prevent plaque and tooth decay between appointments. Finding a family dentistry practice that your whole family is comfortable with can take a lot of stress out of making and keeping your regularly scheduled appointments with a variety of dentists.

What Is Pediatric Dentistry?

Where a family dentist will see patients from age 2 to 102, pediatric dentists only see patients from approximately 2 to 18 years old. The pediatric specialty is only related to a young population and does not offer many advanced services of dental care for permanent teeth. Root canals, crowns, impacted teeth, and braces are generally not treated by a pediatric specialist. Many of the services offered do overlap with the family dentist such as x-rays, exams , fillings, sealants, dental cleanings, tooth extractions, baby root canals/crowns, space maintaining appliances. The Pediatric dentists role is important for patients who need specialized care like children with disabilities, those that need sedation, children with severe, full mouth breakdown, and those with behavior issues.

Conclusion

When making the choice between a pediatric dentist and a family dentist, it comes down to you and your child’s comfort levels. Feeling scared or uncomfortable in the exam chair or being scared of the dentist can ruin a child’s confidence and create a situation of dental anxiety or dental phobia. A good dentist, whether family or pediatric, will understand your child’s needs, make the experience a good one, and give great dental treatment. You want a dentist who will  provide a smooth, positive experience so that the little patient is motivated to continue good oral hygiene habits and regular appointments. When she/he is older and has to make health decisions on his/her own, they should have learned to establish a rapport and ease with their dentist. Choose wisely, but realize that a pediatric dentist may or may not be the best choice for your little ones if you have a good family dentist now.

Most family dentists will be happy to see your child even just to meet them and bring them back to get comfortable with the office.If you already have a family dentist that is experienced and willing to take on young children, you may want to start out in this environment to save the the hassle of going between various offices. Selecting a dentist who will treat your child throughout his or her growth has its distinct advantages, and a steady knowledge of patient history is one of them.  Family dentistry is a good choice for many due to the ease of having everyone in the family treated by the same doctor or at least in the same office.

When making any decision for your family it is always best to be informed and have options. There are many dentists with varying personalities, abilities,and skill levels. Find the one that fits you best, and you and your family will be much happier with your choice!


Peri-implantitis – is a destructive  process affecting the gums and bone surrounding dental implants. The various periodontal bacteria found surrounding failing dental implants (those affected by peri-implantitis) are very similar to those found in association with various forms of periodontal disease.

Peri-implantitis is a unique complication when dealing with dental implants. Dental implants have a very high success rate but do fail for various reasons. These can include failure to integrate with bone, poor oral hygiene by patient, rejection by the body, trauma, or peri-implantitis. Peri-implantitis becomes a factor in patients with poor oral hygiene, diabetes, smoking, and when there is residual cement stuck to the implant surface.  Peri-implantitis will cause the destruction of bone and gum tissue exposing part of the dental implant to the outside. This will cause the possibility for the dental implant to become less stable and cause the patient to lose the implant and restoration if not treated in a timely manner.

How Is It Diagnosed?

A dentist will use x-rays and measuring instruments to determine the level of the bone surrounding the dental implant. If it is found there is some level of bone loss beyond normal surrounding the dental implant, then the diagnosis becomes that of peri-implantitis. It is normal to see some minor bone loss 1-2 years out following placement of the dental implants. It should be no more than 1-1.5 mm in the first year and no more than 0.2 mm in each subsequent year. As stated earlier peri-implantitis of a  dental implant that goes undiagnosed will lead to complete failure and have to be removed.

Peri-implantitis can be diagnosed early or once clear clinical evidence has developed. The most common signs and symptoms are:

– Color changes of the gum tissue around the implant.

– Bleeding during brushing, probing or measuring.

– Increased pocket depth around the implant.

– Pus drainage from around the dental implant.

– Thinning of the tissue causing transparency around the implant..

– Progressive loss of bone height around the implant.

-X-rays showing loss of bone around the implant.

Peri-Implantitis Treatment Options

The course and success of treatment revolves around when the peri-implantitis is diagnosed. If the initial bone loss is limited there will be a higher chance of success in saving the dental implant. However, the later treatment begins the lower the chance of saving the dental implants. There are various methods used to treat peri-implantitis. All have varying degrees of success. These include the following:

-Mechanical Debridement (professional cleaning using instruments). A patient with dental implants must follow normal treatment schedules to maintain his/her dental implants. This includes regular dental visits. At these visits radiographs will be taken to ensure the dental implant and surrounding tissues are in a  healthy state. At these visits the patient will also undergo a professional cleaning for the dental implants and/or natural teeth. Dental implants require special tools for cleanings. The standard dental implant instruments used for cleaning include plastic, graphite, or gold tipped instruments. Ultrasonic tips may be used. The goal in cleaning the implant is to remove debris and bacteria without damaging the exterior coating of the dental implant.

Perioscope. A microscope guided cleaning deep below the tissues to remove debris and otherwise  undetectable cement residue.

-Localized Drug Delivery. Since dental implants by nature have rough surfaces (to allow better integration with surrounding bone), removing infection tends to be quite a challenge using just hand instruments. It is recommended that a chemical anti microbial agent be used along side hand instrumentation. Recent studies have shown the combination of hand instruments and chemical agents have proven effective in eliminating peri-implantitis in its earliest stages. Drugs used can include chlorhexidine rinse, oral antibiotics such as tetracycline, minocycline, doxycycline hyclate, or Arestin, an antibiotic placed directly into the pocket.

-Bone regrowth factors. Emdogain can be placed along with bone grafting material to help stimulate new bone growth.

Conclusion

The primary goal once peri-implantitis has been diagnosed is to stop the disease process from progressing. If untreated, it will ultimately lead to loss of the dental implants. The #1 goal should be to see your dentist regularly to avoid the complication of peri-implantitis. It is important to note any signs that may be occurring so you can be proactive about your dental health.



Cosmetic dentistry has become such a common term that almost every dentist calls themselves a “cosmetic dentist”. The American Dental Association does not recognize

Cosmetic Dentistry Marielaina Perrone DDS

Cosmetic Dentistry As An Art

cosmetic dentistry as a specialty in dentistry. The fact is, that even though cosmetic dentistry is not officially recognized,  it does take extra skill, experience, and training. A good cosmetic dentist is concerned with both the esthetic outcome as well as the functional outcome working together in harmony.

Common procedures used in cosmetic dentistry include teeth whitening, porcelain crowns, dental implants, limited tooth movement, gum sculpting, dental bonding, and porcelain veneers. With the exception of teeth whitening, all of the other procedures require extra skill on the part of the cosmetic dentist. The goal in any cosmetic dentistry procedure is to have the final product look and feel as natural as possible. This includes proper treatment  planning before and skilled preparation during the procedure. Choosing the ideal procedures, utilizing the highest quality materials, and pairing with the best dental laboratories are what makes for ideal cosmetic dentistry results. Being able to correct or fix any issues that might arise are just as important.

Cosmetic Dentistry Case Example

Patient came to the dentist with a  list of things she did not like about her teeth. She did not like spaces between teeth, wanted whiter teeth, and also had a badly decayed tooth in the upper molar area.

Step 1 – Fully explain your wants and needs. You and your cosmetic dentist need open lines of communication. An agreement should be reached about what can and cannot be done based on time, budget, and  function.

Step 2 -Full treatment planning records need to be taken. Pre operative x-rays, study models, and digital photographs. These are essential for a good cosmetic dentistry outcome.

Before Cosmetic Dentistry Marielaina Perrone DDS

Cosmetic Dentistry – Before

Step 3 – Options for treatment should be presented. Discuss options and develop an agreed upon treatment plan. In the pictured case, the mouth was healthy (except for decayed molar) and free of periodontal disease. Patient was shown what the final treatment could look like. Such visual cues can be very helpful in decision making. In this case the treatment plan decided upon included:

-Removal of an extremely decayed molar, and replacement with a dental implant.

Porcelain Veneers to correct shape, size, color, and spacing of the front six upper teeth.

Teeth Whitening – This will allow the patient to whiten the teeth to a more desirable color, so that the new porcelain veneers, and implant crown can be matched to a more visually appearing, cosmetic color.

Step 4 – Patient has badly decayed molar removed and is referred to periodontist for implant consultation and placement. Following placement of dental implant patient will wait 4-6 months for healing and bone strengthening to occur before final porcelain crown can be placed.

Step 5 – Begin Teeth Whitening. This procedure can either be done in office (in one hour), or the patient can complete teeth whitening at home over the course of 2-4 weeks. This step is important as the final porcelain veneers and porcelain crown will be fabricated to match the new, lighter, final shade following teeth whitening.

Step 6 – Following teeth whitening, porcelain veneers procedure can begin. Porcelain veneers (also referred to as porcelain laminates) are super thin, custom fabricated

After Cosmetic Dentistry Marielaina Perrone DDS

After Cosmetic Dentistry

shells of tooth colored porcelain designed to cover the front surface of teeth to improve your smile’s overall aesthetic appearance. These shells are adhesively bonded to the front of the teeth changing their color, shape, width, and/or length. At end of this appointment patient will be sent home in temporary veneers while the laboratory can fabricate the custom porcelain veneers.

Step 7 – Placement and bonding of final veneers. This is a critical step in this case as the porcelain veneers must not only line up properly to close gaps but also be the right color and shape.

Step 8 – Placement of porcelain crown following healing of the dental implant.

Step 9 – Happy Smile!

Cosmetic Dentistry Conclusion

There you have the steps involved in a typical cosmetic dentistry case. Sometimes there are extra visits if any issues arise but if planned for properly the patient should know exactly what to expect in terms of the cosmetic dentistry treatment schedule as well as finances. Cosmetic dentistry can transform an ordinary smile into one that makes the patient smile bright for a long time to come.