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Comprehensive dental care is when a dentist provides a full range of dental health services for diagnosis, treatment, follow-up, and rehabilitation of a patients smile. This will include thinking about not only a person’s smile as a singular item. It will include a person’s functional health as well as facial esthetics.

“We believe in a comprehensive dental care approach to restorative and cosmetic dentistry, that fully integrates health, comfort, and beauty.” – Marielaina Perrone DDS

The human body acts as a complex group of systems and never acts in isolation. In comprehensive dental care, it is very similar in how we look at the patient and their smile. The teeth may be the focus of our smiles but they do not work in isolation either. In comprehensive dental care, we look at the soft tissues as well as the hard tissues to create a treatment plan that is personalized for you. This can and will include the TMJ joint, the muscles of the face, and how the teeth fit together (also called occlusion). Often times, a deeper dental examination Comprehensive Dental Care Las Vegas Marielaina Perrone DDSwill reveal issues with the occlusion or over active muscles. This can show as uneven wear of the teeth which can be due to genetic issues or stress. A comprehensive dental care examination will reveal these deeper functional flaws that can affect the cosmetics of your smile.

Comprehensive Dental Care Personalized

A well trained dentist with comprehensive dental care experience will know to look beyond the issue at hand and ask why did that happen? If we examine the smile in a comprehensive dental care way of looking at things, we realize a tooth extraction is not a singular event. Once that tooth is removed, there will be changes to our occlusion as well as our esthetics. This can have long term implications to a person’s overall dental health. Treating “just one tooth” is often not the best interest for your long term dental health. Below are some dental procedures that are included in comprehensive dental care to treat function and cosmetics as one:

Porcelain Crowns. This type of dental crown combines strength and beauty into one package. Porcelain crowns have the esthetics patients desire for their smile but the strength demanded by patients and dentists for function. When porcelain crowns are used properly, a patient will begin to see an immediate improvement in their occlusion and in the cosmetic appearance in the skin around the face as wrinkles will lessen. The wrinkles will lessen because the occlusion will be “raised” forcing the skin around the mouth to stretch slightly. Using dental crowns for this purpose is called bite reclamation.

Porcelain Veneers. Known as part of the Hollywood smile. Porcelain veneers are sometimes referred to as “instant orthodontics” because they have the ability to realign teeth vs wearing orthodontic braces. Porcelain veneers are more conservative than porcelain crowns and are purely cosmetic in nature and cannot be used to reclaim lost occlusion height.

Dental Implants. Dental implants are highly successful for replacing one or more teeth. These would be an integral part of comprehensive dental care especially for larger scale smile restorations.

Orthodontic Braces Or Invisalign. Many people see orthodontics or invisalign as a purely cosmetic treatment for adults. However, in comprehensive dental care your dentist will see that re aligning the bite will result in straighter teeth but it will also bring those teeth into harmony with one another. This will place less stress on the teeth thru their daily functions as well.

Tooth Bonding. can be used to repair a tooth damaged by trauma or tooth decay. These tooth colored restorations can make an immediate improvement to your smile.

Facial Asymmetry. In comprehensive dental care, your well trained dentist will evaluate not just the smile but also the entire face. By looking beyond the smile, they may be able to see certain asymmetry’s in the alignment of your face. The use of botox can be used to balance the facial muscles and bring them into harmony with your smile. An eyebrow lift or aComprehensive Dental Care Marielaina Perrone DDS depression of the brow can also be enhanced using botox applications.

Gummy SmileThis occurs when too much gum tissue is exposed upon smiling. This usually is the result of the lip rising too high when smiling. Injecting Botox into the upper lip weakens the retractor muscles of the upper lip so that it won’t raise as high and your smile will appear better balanced. In comprehensive dental care, your dentist will see this immediately and factor this into your treatment plan.

Crown Lengthening. This is a comprehensive dental care surgical process whereby your dentist will remove bone around a tooth to expose more of the tooth into the mouth. This is often needed in patients with a severe grinding issues to reclaim lost occlusal height.

Gum and Bone Grafting and Recontouring. Both gum tissues and bone tissues can be grafted in to replace lost tissues in comprehensive dental care. These have both functional and esthetic concerns. Functionally, adding more bone will aid in support of teeth and adding gingival tissues can cover exposed roots alleviating tooth sensitivity and stop tooth decay from forming on the roots of your teeth. Cosmetically, these grafts can restore your smile to its youthful glory.

Teeth Whitening. Many of our worn teeth are also dark and discolored. The color you desire to reach may require a dental whitening process, or simply a whiter color bonding restoration or a whiter colored porcelain restoration. Teeth whitening is included in comprehensive dental care because it will be usually a priority for most patients when trying to rejuvenate their smiles.

Juvederm Dermal Fillers. These fillers can be used to turn back the clock and fill in areas that time has changed. Again bringing about a balance between function and smile is a hallmark of comprehensive dental care.

Comprehensive Dental Care Conclusion

A dentist who is well trained in comprehensive dental care will be able to spot problem areas quite easily. Some areas are hidden but a deeper look during a dental examination and they will be revealed. Some issues will not have longer term implications while others may. It is important to recognize the difference between the two so the proper recommendations can be made to the patient.

 

Dry socket (also called medically as alveolar osteitis) is a very painful dental condition that can sometimes happen following removal of a permanent adult tooth. Dry socket occurs when the blood clot at the area of tooth removal fails to develop, or it dislodges or dissolves before the wound has fully healed. Having a tooth removed by your dentist comes with certain expectations. This includes discomfort following the tooth removal. However, this discomfort should last a day or 2 at the most and be fairly mild. Dry socket pain can become very intense quickly and last for almost a week in some cases. Dry socket is actually the most common complication of a tooth extraction. Even with that fact it still only occurs a little less than 2% of the time (about 200,000 cases in US each year) and most often following removal of wisdom teeth. It is also prevalent in those with poor blood flow, smokers, and diabetics. Dry socket generally occurs 2-3 days following tooth removal procedure.

When a tooth is removed, a blood clot forms to protect the opening in your gums as it heals. If the blood clot does not form properly or becomes dislodged, it can create a dry socket. A dry socket leaves the nerves and underlying bones exposed, so it is important to see your dentist immediately. If left untreated, this can lead to dental infection and other complications. Dry socket most often occurs in those  who smoke, are on oral contraceptives (estrogen can interfere with clotting mechanisms), or do not follow post care instructions properly.  Interesting for women, the oral contraceptives also tend to lower pain tolerance which will lead to increased pain sensation if dry socket occurs.

What Is A Dry Socket? Symptoms

Dry Socket Las Vegas Marielaina Perrone DDSSigns and symptoms of dry socket may include:

-Sharp, aching pain usually starting 2-3 days after removal of a tooth or teeth

-Blood Clot Missing. If you peek into your mouth you would see an opening where tooth was and if there is no blood clot present then you probably have a dry socket. In a normal situation a blood clot forms and covers the exposed opening.

-Visible Bone Present. Bone that can be seen upon visual examination in the socket.

-Radiating Pain. Radiating from the tooth socket to your ear, eye, temple or neck on the same side of your face as the tooth removal.

-Abnormally bad breath or a foul odor emanating from your mouth. This will include having a bad taste in your mouth as well.

-Swollen Lymph Nodes. If you have swollen lymph nodes around your jaw or neck, this is a sign of dental infection and you need to be seen by your dentist immediately as this can be a serious medical emergency if untreated. Signs of a dental infection can include fever, swelling, redness, and pus discharge from extraction site.

-Over The Counter Pain Medications Do Not Work. Generally, tylenol, aleve and advil will not be strong enough of a pain reliever to be able to control dry socket pain.

How Can A Dry Socket Be Treated?

Your dentist will relieve the area of pain using a local anesthetic. If the infection has spread this may not relieve all pain and discomfort at this time but it will help. Your dentist will need to inspect the tooth removal site and clean it of any debris or food particles. Once the area is cleaned sufficiently, your dentist will probably place a medicated dressing over the area to promote healing and soothe the dry socket symptoms. These medicated dressings usually need to be changed daily until dry socket symptoms subside. Use of a warm cloth on outside of face can also aid in healing by promoting increased blood flow to the area. If there is infection present or your dentist suspects one is forming an antibiotic may be prescribed. You will also be given detailed instructions on at home care. Usually includes rinsing with warm, salt water and just being careful with area while it heals. Healing of a dry socket at this point will take between 1 and 2 weeks.

Possible Home Help Remedies For Dry Socket

Home remedies to help with dry socket pain can include:
-Rinsing with Warm salt water. Rinsing can help eliminate bacteria and reduce or prevent further infection.
-Cold and heat therapy. This can promote blood flow to area of dry socket. For the first 24 hours or so following a tooth extraction, use cold against your face for 15 minutes at a time to reduce swelling. After 1st day you can use heat in the form of warm cloth to help manage pain.
-Clove oil. This contains eugenol (this is traditional dental office smell), which has anesthetic, anti-inflammatory, and antibacterial properties. It can help to soothe pain and help prevent infections. Some people have reactions to clove oil so speak to your dentist before using. You can place clove oil on a sterile gauze and place it over dry socket area for 15 minutes or so to help relieve dry socket symptoms.
-Honey. Honey has anti-inflammatory and analgesic properties. Clinical studies have found that honey when used for dry socket applications resulted in a significant reduction in inflammation, swelling, pain, and discomfort. There was also evidence honey possibly prevents further dental infection. Honey can be applied similar to the clove oil. Place a small amount of honey on a sterile gauze and place over dry socket wound.
-Black tea. Contains tannic acid. Tannic acid can act as a natural antibacterial agent while also having the ability to reduce both swelling and pain.
-Tea tree oil. Also has antiseptic, antibacterial, and analgesic properties.
-Oregano oil.  Has antibacterial benefits and studies have shown it may even be effective against some drug-resistant strains of bacteria.
-Chamomile tea. Chamomile has anti oxidant properties. This can promote wound healing.

What Is A Dry Socket? Conclusion

It is important to follow your dentist’s instructions especially following a tooth removal. Communicate concerns and questions immediately so they can be addressed immediately to avoid unforeseen complications. A dry socket can be quite painful and can have serious consequences if ignored. See your dentist regularly to maintain a healthy smile for a lifetime.

Wishing Everyone A Happy And Healthy New Year 2020



Tourette syndrome is a a neurological disorder characterized by involuntary motor and vocal tics and often the compulsive utterance of obscenities. This syndrome can be especially hard for self esteem and self confidence. Those suffering from Tourette syndrome can feel isolated and alone. There is no cure for Tourette syndrome but what if your dentist could help relieve these tics? Recent research at Osaka University may give some hope using an oral splint to circumvent these tic events associated with Tourette syndrome.

What Is Tourette Syndrome?

 

Tourette Syndrome Henderson NV Marielaina Perrone DDS

Dr Georges de la Tourette

Tourette syndrome (TS) is a neurological disorder known for its repetitive, stereotyped, involuntary movements and vocalizations referred to as tics. The disorder is named after Dr. Georges Gilles de la Tourette. This French neurologist was the 1st to describe this condition in an 85 yr old French woman. Tourette syndrome is usually first noticed between the ages of 3 and 9 yrs old. Males are afflicted with this syndrome between 3 and 4x more than women. There are about 300,000 Americans with Tourette syndrome. Surprisingly, the syndrome’s tics generally but not always reach their high point in the early teens and tend to improve as we age.

Symptoms Of Tourette Syndrome

The main characteristic of a tourette syndrome patient is one with uncontrolled motor tics as well as involuntary vocalizations. These tourette syndrome tics are classified by the medical community as simple or complex. Simple tics are ones that use a small amount of muscle groups. These include eye blinking, shoulder shrugging, and even facial grimacing. Simple vocalizations will include reptitive throat clearing and grunting sounds. Complex tics are a distinct and coordinated series of movements involving several muscle groups together. An example of a complex motor tic is one in which two movements are combined. This can include a facial grimace in combination with a head twist and shoulder shrug. More complex vocalization tics can include words or phrases vs a simple grunting sound.

These tics are often made worse with increased excitement or anxiety and can be relieved during calm, hyper focused activities. Physical experiences can also trigger or worsen tics. A good example is a neck tie might trigger a neck shrug due to the feeling of the tie around ones neck. Tics do not go away during sleep but are often significantly decreased.

How Does The Dentist Help With Tourette Syndrome?

Traditionally, there is no cure for Tourette Syndrome. There are only interventions which can help alleviate these motor and vocal tics. The medical community has used behavioral methods (like psychotherapy) as well as pharmaceutical ones (like medications that block dopamine in the brain). These medical treatments have not been as successful as hoped. Researchers at Osaka University have tackled the problem thru a study on an oral splint to help alleviate these tics. These researchers developed a custom made oral splint similar to a teeth grinding oral appliance. The custom oral splint is applied over the molars in the back of the mouth. The splint helps to increase occlusal vertical dimension (opens mouth wider than natural). This opening of the jaws changes the alignment of the nose, lips, and chin. The study was published in the scientific journal Movement Disorders.

The research while small (only 22 participants) may be significant. The team found that biting on the custom made oral appliance immediately improved both vocal and motor tics. For the children over 70% saw immediate improvement. For the adults, it was very similar (about 75%). The most fascinating part of this research was that the improvement stayed over the longer haul. Long term improvements after 100 days of use of this oral splint was especially noticeable in patients who were diagnosed at an early age.

It is believed that the custom oral splint helps to act as a sensory trick on the brain. Tourette syndrome patients have long been taught to use sensory tricks to control movements and vocalizations. These have included touching the face or chin when they feel the sensation coming on.

The research team acknowledges larger scale studies will be needed but the oral splint has definite potential for helping hundreds of thousands of people in the US alone.

Tourette Syndrome And Your Dentist Conclusion

Those dealing with the effects of Tourette syndrome know first hand how devastating these tics can be to every day life. They have the ability to affect you socially and in business. A tourette syndrome patient could hopefully see new relief as these studies move further along. For now, your dentist may be able to help by experimenting with you and see what might work best to relieve the Tourette syndrome tics for you.