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What causes periodontal disease? Periodontal disease comes in different stages. The earliest stage of periodontal disease is gingivitis. This stage is reversible with proper treatment. If caught and treated before progression there will be no long term affects. If it advances to the next stage, periodontitis, there will be long term effects to your smile. These effects can include gum tissue recession and bone loss surrounding your teeth. Below we will discuss what causes periodontal disease as well as how to bring it under control for good dental health.

What Causes Periodontal Disease?

What causes periodontal disease? Bacteria and Plaque. Periodontal disease is a chronic dental infection of the periodontal tissues surrounding our teeth. This disease can result in the breakdown of the tissue as well as the loss of bone that surrounds and supports our teeth. Periodontal disease begins when bacteria and plaque form a sticky film on your teeth. This film acts as an irritant to the  surrounding tissues and causes inflammation of the periodontal tissue.  Periodontal disease will continue and progress and become more advanced over time What Causes Periodontal Disease Las Vegas Marielaina Perrone DDSwithout dental intervention. Periodontal disease is the #1 cause of loss of teeth in adults. According to the Centers For Disease Control (CDC), it is estimated that 65 million American adults, have mild, moderate or severe periodontitis (advanced form of periodontal disease)In our senior population aged 65 and older, prevalence rates increase to over 70%.

Bacteria That Causes Periodontal Disease

Periodontal disease and tooth decay are triggered by different types of bacteria and are considered to be two separate and distinct disease conditions. However, they work hand in hand to break down our teeth and gum tissues if left unchecked. Swollen and receding gums allow the more vulnerable areas of the tooth (root areas) to be exposed to cause an increased incidence of tooth decay.  On the other side, patients with extensive tooth decay, the broken down teeth allow for food trap areas which keep periodontal tissue chronically inflamed.

Stages Of Periodontal Disease

-Gingivitis – This is the earliest stage of what causes periodontal disease. Ginigivitis is simply the inflammation of the periodontal tissues surrounding the teeth. Gingivitis is the mildest form of periodontal disease and is wholly reversible with professional care and a good at home dental hygiene regimen. Symptoms of Gingivitis Include red, swollen gum tissue with inflammation as well as gum tissues bleeding easily upon brushing, flossing, or even eating. Often these symptoms are unnoticed by patients. Bad breath may be another sign of advancing periodontal disease.

There are only a few signs at this stage and most are painless. This is what makes periodontal disease so common and so concerning. It is silent until it is not. Periodontal disease does not typically break its “silence” until the fourth and final stage. Beginning signs to watch out for include bad breath on occasion, swelling and redness of the gums, and bleeding when brushing or flossing. Good overall dental hygiene and regular professional examinations can treat and reverse gingivitis as well as stop it from progressing further.

This is a critical period for the patient, as gingivitis 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 can commonly be seen during puberty, pregnancy (also called pregnancy gingivitis), times of high stress, and menopause. As for the rest of the population, poor dental hygiene is generally the most common cause, followed by medication and certain medical conditions (like diabetes).

-Periodontitis – If left untreated the next phase is early periodontitis. Once it enters this stage, the disease can be difficult to control. In this stage, the bone surrounding the teeth is now being affected. The bacteria will invade between the tooth and gums causing a separation of connective fibers. The result is what is called a periodontal pocket (normal pocket depth should be about 3mm without inflammation). These pockets will now approach 4-5mm in depth and can get filled with bacteria, plaque, and food. This will in turn begin to breakdown the bone below the gum line. Simple at home dental hygiene will not be the answer to bring back to a healthy state. Periodntitis signs include increased swelling or redness of the gums, increasingly bad breath, bleeding upon brushing or flossing, and pocket depths that are between four and five millimeters.

-Advanced Periodontitis – This is where the real destruction lies. At least 50 % of bone support is lost if not more. Teeth will begin to loosen and shift if they have not already. Deep periodontal cleanings and possibly surgical intervention are necessary to salvage teeth. This professional cleanings may occur using a periodontal microscope, (Perioscope), grafting of gum tissue or bone, placement of growth factors (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets, (Arestin), open periodontal flap surgery, and, possibly even removal of teeth.

How To Treat What Causes Periodontal Disease?

Luckily, the earliest stages of periodontal disease are easily treated. Following a good at home dental hygiene program (including brushing, flossing, and antibacterial mouthwash) along with regular visits to a dentist we can halt gingivitis in its tracks. Failing to to do the above steps will allow periodontal disease to advance unchecked leading to loss of teeth as well as systemic health issues.

Treatment For Periodontal Disease Can Include Any Of The Following:

Pocket Reduction SurgeryA surgical procedure to reduce the size of the periodontal pockets around your teeth. This will ensure the ability to keep the areas clean at home. The surgery is made up of tiny incisions in your gum tissues so that a section of gum tissue can be lifted back, exposing the roots for more effective teeth cleaning. Because periodontitis often causes bone loss, the supporting bone tissue may be recontoured before the gum tissue is sutured back in place. This surgery can take from 1-3 hours and is performed under local anesthesia.

-Periodontal Tissue Grafts. Periodontal or Gum tissue is often lost due to periodontal disease. When the gums recede your teeth will appear longer than normal as root surfaces are exposed. You may need to have damaged tissue replaced for cosmetic as well as functional reasons. It is important to note that root surfaces are not protected by enamel. This can cause extreme tooth sensitivity. This grafting procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetic lift.

Bone graft. The addition of the bone graft helps prevent tooth loss by increasing support structure around our teeth. It also serves as a building block for the regrowth of natural bone.

-Antibiotics and Antibacterial Medications – These medications will aid in healing and removal of bad bacteria from around our teeth. These include:

-Peridex – Prescription antibacterial rinse.

-Periostat – Oral antibiotic. Another type of antibiotic used is called minocycline.

Arestin – placed directly into the periodontal pocket to help aid in healing.

Chlorhexidine – A prescription anti bacterial mouthwash. This is used to control bacteria when treating periodontal disease and after surgery. Patients use it as they would a regular mouthwash.

-Guided Tissue Regeneration. This periodontal procedure helps to regrow destroyed bone. Your dentist or periodontist 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 in a stable environment. The goal is to regenerate periodontal tissue and repair defects that have resulted from the development of periodontitis.

-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.

What Causes Periodontal Disease? Conclusion

Periodontal disease if left untreated can cause aggressive destruction of your smile. Regular dental visits can prevent periodontal disease from developing. A good way of looking at this is that it is far cheaper and less painful to go to your dentist every 6 months than it is to wait for periodontal disease to develop and chase after your health. Visit your dentist regularly for a happy, healthy smile.



Cosmetic dentistry deals with much more than just an esthetic result. A well trained cosmetic dentist will be just as concerned with function as well as cosmetics. Without proper function, any cosmetic dentistry will ultimately fail over the long term. Below will be some of the most common cosmetic dentistry procedures your dentist can perform to bring new life to your smile.

Common Cosmetic Dentistry Procedures

Cosmetic Teeth Whitening. Probably the most popular cosmetic dentistry procedure due to its quick results and relatively low cost. Teeth whitening can be performed at home by the patient or in the office by your cosmetic dentist. Your teeth have pores and anything we eat or drink that has color will absorb into those pores. Wine, coffee, dark berries, and smoking are the main culprits in staining our teeth. As we get older, the natural color of your teeth becomes darker and darker due to these stains. These stains will not go away without intervention by your cosmetic dentist. Not every patient will achieve the same cosmetic dentistry results, so it is very important to check with your dentist first to see what to expect.

Cosmetic Dentistry Henderson NV Marielaina Perrone DDSCosmetic Porcelain Veneers (or even composite veneers). Porcelain veneers are a thin shell of porcelain similar to a fingernail. They are custom made in a dental laboratory and cemented in place over your teeth to transform your smile. Porcelain veneers are sometimes called “instant orthodontics” in cosmetic dentistry because they have ability to realign slightly crooked teeth. Porcelain veneers also have the ability to change the color of your smile, repair chipped teeth, or close gaps between your teeth. This is a staple of cosmetic dentistry and a well trained cosmetic dentist can dramatically change your smile quickly.

Cosmetic Porcelain Crowns. These are custom fabricated to restore function and esthetics to your smile. Porcelain crowns are utilized in cosmetic dentistry by your cosmetic dentist to restore teeth that have been damaged to trauma, tooth decay, or to close gaps between teeth. All porcelain crowns are ideal to restore a front tooth as they are translucent and designed to look like your natural teeth.

Cosmetic Dental Implants. A dental implant is a titanium root structure designed to replace a missing tooth or teeth. A dental implant is surgically implanted into the jawbone where the tooth is missing. Unlike a dental bridge, a dental implant is permanent, this is because the dental implant becomes one with surrounding bone (process is called osseointegration). A dental implant is designed to act as the tooth root. Once integrated it can be used as a platform to replace a single tooth, multiple teeth, or even be support for a full denture. Dental implants are the closest you can get to a natural tooth in function. They give you the freedom to confidently eat, smile, laugh, talk, and enjoy all of your everyday activities without worrying about your smile. These can be used in cosmetic dentistry along with other procedures to restore your smile.

Cosmetic Teeth Recontouring. Also called tooth enamel shaping. A misshapen tooth can be lightly shaped by your cosmetic dentist in a painless procedure but it can have a dramatic effect on your smile. It is common to do this if you have protruding mamelons. A mamelon is a rounded protuberances which are present on the cutting edge of an incisor (front) tooth when it first erupts into the mouth. Generally, they wear away over time as we grow up but for some they need help in removing them.

Cosmetic Dental Bonding. Also called tooth bonding. Dental bonding is the cosmetic dentistry procedure in which tooth-colored materials are bonded to the tooth to repair tooth decay, repair a chipped tooth, or even close a gap between teeth.  These tooth colored materials are bonded using chemistry and a special light which hardens the material in seconds.

Cosmetic Orthodontic Braces. Adult orthodontics have become very popular in cosmetic dentistry especially with introduction of invisalign orthodontic system. Your cosmetic dentist can make small adjustments to one or a few teeth or a major overhaul using more traditional orthodontics treatment.

Cosmetic Dentistry Conclusion

Cosmetic dentistry can transform any smile but function is the key. Make sure you see a well trained dentist who knows that function trumps cosmetics. If a dental restoration is not functional it will not last and withstand the stresses of the mouth. Cosmetic dentistry can be what is missing from your smile. Ask your dentist today to transform your smile.



Ketogenic or Keto diet is a very popular low-carb, high-fat diet that offers many benefits to our health. The keto diet menu is very similar to that of the Atkin’s diet.  Many clinical studies have shown the keto diet menu can help you lose weight and improve your overall health. It has also been linked to improvements in the fight against diabetes, alzheimer’s disease, and even cancer. But is the keto diet menu good for our dental health?

What Is On The Keto Diet Menu?

The keto diet menu is rich in meats, fish, nuts, cheese and low carbohydrate vegetables (yes….some vegetables are high in carbs!). The keto diet menu involves drastically reducing intake keto diet menu Marielaina Perrone DDSof carbohydrates and placing fats into your diet. This carbohydrate reductions puts your body into a metabolic state known as ketosis. Once in the state of ketosis, your body becomes extremely efficient at burning fat for use in our energy needs. Your body will also be able to turn the fat into ketones. This occurs in the liver and can supply energy for the brain. Since, carbohydrates are reduced, your body will experience a huge reduction in blood sugar and insulin levels.

Types Of Keto Diet Menu

Standard ketogenic diet (SKD). This is a very low carbohydrate, moderate protein and high fat diet. The typical dietary ratios are 75% fat, 20% protein and only 5% carbs.
Cyclical ketogenic diet (CKD). This keto diet involves periods of higher carbohydrate consumption. An example of this is 5 ketogenic days followed by 2 high carbohydrate days.
Targeted ketogenic diet (TKD). This diet allows you to add carbohydrates around your fitness workouts.
High-protein ketogenic diet. This is similar to the standard ketogenic diet, but includes more protein. The typical dietary ratio is about 60% fat, 35% protein and 5% carbs.

Health Benefits Of A Keto Diet Menu

Research has shown that the keto diet menu can have wide ranging health benefits beyond just weight loss. These can include:

-Cardiovascular disease. The keto diet menu can increase HDL cholesterol levels (good cholesterol), decrease blood pressure, body fat, and blood sugar.

-Cancer. The keto diet menu has been used to slow tumor growth in certain cancers. Cancer thrives in a high sugar environment.

-Alzheimer’s disease: The keto diet may slow progression and reduce symptoms of Alzheimer’s disease.

-Epilepsy. Research has proven that following keto diet menu can cause massive reductions in seizures in children with epilepsy.

-Parkinson’s disease. More research needed but there have been small studies to show the diet slowed the effects of this disease.

-Polycystic ovary syndrome. Due to the keto diet menu effectiveness in reducing blood insulin levels. Increased insulin levels are believed to play a key role in polycystic ovary syndrome.

 

Research will need to continue on the keto diet menu but early results are positive.

Foods To Avoid On Keto Diet Menu

Any food that is high in carbs should be limited. Avoid carb-based foods like grains, sugars, legumes, rice, potatoes, candy, juice and even most fruits.

-Foods High In Sugar. Examples include sodas, fruit juice, candy, cake, and ice cream.

-Grains or starches. These include rice, pasta, and cereals.

-Fruit. All fruit with the exception of small portions of berries. Raspberries and blackberries contain as much fiber as digestible carbs.

-Beans or legumes. Includes Kidney beans, lentils, chickpeas.

-Root vegetables and tubers. Includes potatoes, sweet potatoes, carrots, and parsnips.

-Low-fat or diet products. Often highly processed and high in carbohydrates.

-Unhealthy fats. Limit your intake of processed vegetable oils, mayonnaise, etc.

-Alcohol: Due to their high carbohydrate content, alcohol can throw you out of ketosis.

-Sugar-free diet foods. These are often high in sugar alcohols, which can affect ketone levels in some cases.

Foods To Eat On Keto Diet Menu

-Meat. Includes red meat, steak, ham, chicken and turkey.

-Fatty fish. Includes salmon, trout, and tuna..

-Eggs. Preferred eggs are pastured or omega-3 whole eggs.

-Butter and cream.

-Cheese: Unprocessed cheese including cheddars, blue, and mozzarella.

-Nuts and seeds. Include almonds, walnuts, flax seeds, and chia seeds.

-Healthy oils. Primarily extra virgin olive oil, coconut oil and avocado oil.

-Avocados. Whole avocados or freshly made guacamole.

-Low carb vegetables. Most green veggies, tomatoes, and onions.

-Condiments. You can use salt, pepper and various healthy herbs and spices.

How Does Keto Diet Menu Affect Dental Health?

Bad Breath (also called Halitosis). Since the popularity of the keto diet menu, a new term has emerged….Keto Breath. Keto breath usually has a fruity smell. This keto breath develops from the way our bodies are able to break down the fats we are ingesting off the keto diet menu. As mentioned earlier the development of ketones occurs thru the bodies processing of a higher fat diet. One of these ketones, acetone, is unusable by our bodies processes. Acetone is released from the body via urine and our lungs. Acetone is what gives the keto diet advocates their bad breath.

Tooth Decay. While bad breath may be a negative side effect there are positive side effects of the keto diet menu to our dental health. By avoiding carbohydrates we are also avoiding processed sugars. These sugars and carbohydrates are necessary for the oral bacteria to grow and flourish and cause dental damage.  A reduction in sugar will likely equal a reduction in tooth decay.

Periodontal Disease (Gingivitis and Periodontitis).  A low carbohydrate diet may also help reduce inflammation in the mouth. Recent clinical studies have found that a diet low in carbohydrates and high in omega-3 fatty acids actually helped decrease rates of gingivitis and inflammation.

Dental Health Tips For Fresh Breath

-Chew sugar free gum for saliva stimulation and to freshen your breath.

-Make keto diet menu adjustments. Adjust your intake of complex carbohydrates (like leafy green vegetables and whole grains) while continuing to avoid refined carbohydrates.

-Brush your tongue daily with a tongue blade or separate toothbrush just for your tongue. The bacteria on your tongue is different than bacteria found in the gums. The papilla on the tongue can hold more debris increase malodor, and change the way things taste.

-Brush and floss. Just because you are eating less sugar does not mean that debris is less worrisome. While lack of sugar helps prevent decay food debris can increase plaque and periodontal problems.

-Drink Plenty Of Water Throughout The Day.

-Avoid alcoholic beverages. Alcohol will dry your mouth by decreasing saliva flow. This increases malodor.

-Try oil pulling after brushing. The oil will help lubricate your mouth, decrease bacteria, and increase saliva.

-Add fresh herbs to water and tea. Herbs such as clove, cinnamon, mint and fennel can act as natural fresheners of your breath.

Keto Diet Menu And Dental Health Conclusion

While the keto diet menu has many perks there are some drawbacks to be aware of. Following a few simple steps can make your body healthier as well as your smile. Remember to maintain regular dental visits and good dental hygiene while on any diet.

 



Gummy smile is a smile that shows an excessive amount of gum tissues under the upper lip. The goal is to create a more toothy smile. There several treatment options for those with a gummy smile. Some surgical and some non surgical. The presence of a gummy smile should not be considered an abnormal condition or even unhealthy. It is just a normal variation of our anatomy. This does not stop those with a gummy smile from feeling self conscious in the way they smile. This may cause them to refrain from wide smiles.

What Is A Gummy Smile?

A gummy smile will make our teeth look short and stumpy. In reality, the gum tissue is just showing in proportion to your teeth than the rest of us. There are a variety of reasons for this. These can include:

Gummy Smile Las Vegas Marielaina Perrone DDS-Higher than normal bone levels.

-Possibility of Incomplete Eruption Of Teeth.

-Excess Gingival Tissues.

-Abnormally Thick Gingival Fibers.

-Thin lips.

-Upper Lip pulls up too high while smiling.

The gummy smile may present challenges beyond esthetics. Dental hygiene can be a real issues for the patients with excess tissue. This can lead to increased incidence of tooth decay as well periodontal disease development. The excessive gingival tissues will hinder attempts to keep areas clean and free of plaque and tartar. People with a gummy smile tend to present with puffy, red gum tissues. This is called gingivitis and is the earliest form of periodontal disease. It is reversible. Another note, is that most people notice a gummy smile only on front teeth but it can be present on back teeth as well.

Treatment For A Gummy Smile

An experienced, well trained cosmetic dentist will be well versed in treatment for a gummy smile. In fact, the gummy smile procedure can be one of the most rewarding for both dentist and patient alike. The change is immediate and patients report increased self confidence and ability to interact socially better than before.

Below you will find detailed list of gummy smile treatment options. The procedure used will depend on why the gummy smile exists.

Surgical Treatment Of Gummy Smile

Gingivectomy (another term is gingivoplasty which includes gum contouring). This dental procedure is simply removal of excess gingival tissue from around the teeth. Removing excess gingival tissue is just the first step. Your cosmetic dentist will remove and reshape the tissues for an esthetic result. You would be surprised how little gingival tissue is actually removed in most cases. Your dentist a laser, an electrical cautery unit, or make periodontal incisions to remove and reshape the gum tissues. Local anesthetic is necessary during gummy smile procedure for comfort. This gummy smile treatment will not require any sutures and generally the gum tissues heal within 1-2 weeks following the procedure. A gingivectomy is usually the recommended gummy smile procedure when only a few teeth are affected by the gummy smile issue. In other cases, bone tissues may need to be remodeled as well.

-Crown Lengthening. This gummy smile procedure allows for your dentist to remove bone tissues as well as gum tissues. This procedure can be a bit more advanced in technique but still fairly easy for most periodontists.

Non-Surgical Treatment Of Gummy Smile

Botox For Gummy Smile. The use of Botox is fairly new for treatment of gummy smile. The botox application relaxes the muscles (levator) in the upper lip causing the lip to not curl under or lift as high upon smiling. The botox relaxes the lip for a more balanced smile. This still allows you to smile, it just limits the height of the upper lip movement. The treatment lasts about 3 months so no worries about permanent changes.

Both surgical and non surgical procedures have very low risks and are easily completed. Obviously, the botox injections will be the least invasive but in some cases botox alone will not give the desired results. Using dermal fillers along with Botox may also help those with thinner lips.

Can A Gummy Smile Be Fixed? Conclusion

Upon healing, the results of a gummy smile treatment can be quite dramatic and striking. Both patient and Doctor alike will be in awe of the change. It is that dramatic generally. This treatment can be a real change for some in their outlook on life. Study after study has shown when we feel good about ourselves it changes how others perceive us opening doors socially and in business. Most patients return and have one complaint. Why didn’t we do this sooner? Don’t wait if this is an issue for you. See your dentist and talk over the best options for your smile.