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Crooked teeth (also referred to as a malocclusion) can affect approximately 75% of all American adults. Malocclusion can significantly affect dental and oral health over the course of a lifetime, leaving you with increased chances of developing periodontal disease and increased wear and trauma to teeth.

Types Of Malocclusion

Crossbite – A crossbite is when the lower teeth overlap or come out even with the upper teeth. In a normal occlusion the upper teeth overlap the lower ones but when a crossbite (can occur on either side or both) is present, the opposite is true. This can lead to premature wear, increased risk of chipping or fracturing your teeth, development of abfraction (small notch in tooth at the gumline), and periodontal disease.

Excessive Overjet – This occurs when the upper front teeth are too far out in front of the lower teeth. This can lead to increased trauma as well as an increase to chipping or fracturing of teeth (especially the front ones).

Edge To Edge Bite – This occurs when the teeth touch one another edge to edge (or cusp to cusp). The teeth do not fit together propely allowing the biting surfaces to touch. This will lead to increased risk of chipping and fracturing, Temperomandibular Joint (TMJ) pain, as well as short, worn down teeth.

Open Bite – This is a common occurence from thumb sucking or can be genetic. It is when there is a space between the front upper teeth and the front lower teeth upon closing. Not only is this an unesthetic option but it can lead to abfraction, is difficult to bite and tear food ,and causes excessive, premature wear of the back teeth.

Over Bite– This is when the upper front teeth completely cover the lower front teeth. Often, the lower teeth hit into the backs of the upper teeth and sometimes into the roof of the mouth.

Under Bite– This occurs when the lower jaw has grown more quickly than the upper jaw. The lower front teeth and jaw have grown in front of the upper teeth.

Tooth Size Arch Length Discrepency– When your teeth are too large for your jaw space and cause extreme crowding or when your teeth are too small for your mouth. Crowding can lead to decay, fracture, and periodontal disease. Small teeth are generally a major cosmetic issue.

The General Health Danger

Periodontal disease is commonly found right along with malocclusion, due to difficulty in maintaining good oral hygiene when teeth are not in proper position.

Periodontal disease has been linked to many systemic diseases through various studies. Some of these diseases include heart disease, diabetes, and alzheimer’s. Periodontal disease generally takes years of neglect to develop. There are various stages of periodontal disease progression, they include:

-Gingivitis – The earliest stage. The only stage that is reversible with proper dental care. This stage is characterized by swollen, red gum tissues, bleeding upon brushing, as well as bad breath (halitosis). If treated before it progresses, it can be reversed back to a normal, healthy, gingival state.

-Periodontitis – This is the stage that develops following ginigvitis. It is not reversible but can be controlled. Damage to teeth, bone, and gums can be limited with proper dental care. During this stage, the supporting tissues around the teeth may break down leading to gum recession and bone loss around the teeth.

-Advanced Periodontitis – This stage increases the bone loss and gum recession leading to loosening of teeth with the real possibility of losing one or more teeth.

How Do Crooked Teeth Affect Our Mouths?

When teeth are crowded and not aligned properly, the plaque and bacteria that forms on our teeth during everyday food consumption  becomes much more difficult to remove. This makes it difficult to  maintain a good state of health. Many times, flossing and brushing areas of overcrowded teeth will become very difficult. These areas are generally called a “plaque trap” for their ability to constantly trap food and debris.  As mentioned earlier, without proper care, plaque traps can lead to bone loss, gum recession, and even tooth loss.

Another cause for concern is wear and trauma to the teeth. Poorly aligned teeth can create unnatural stresses on the teeth and the jaws. Teeth subjected to excessive pressures can develop chipping, fracturing, and abfractions. Premature wear can also lead to lost teeth, loose teeth and even root canal therapy.

Finally, crowded teeth affect your systemic health by allowing bacteria to grow and flourish unabated in these crowded areas. Over time, this can lead to devastating life threatening effects like heart disease and stroke.

What Can Be Done To Combat Crooked Teeth?

Fortunately, in many cases the simple solution is increased visits to the dentist for professional cleanings as well as diligent  home care.  When there is undue stress placed on the teeth that can cause trauma and wear over time, Orthodontics is the answer in most cases. Orthodontics is a type of dentistry dealing with crowded or misaligned teeth. Proper orthodontic treatment can, in many cases, restore your smile and make it easier to maintain it.

Orthodontics Conclusion

Orthodontics is not just for cosmetic reasons. We are not all born with perfectly straight teeth and sometimes we need a little help to get there. The bottom line is to have beautiful teeth and gums that make you feel confident and healthy. Your smile should  last you a lifetime!



Recent studies have shown an increased risk for periodontal disease in women. Why are women more prone to the disease, and what can be done to help decrease the risks? While there are many risk factors, which seem to be more prevalent?

Female hormones seem to be the main risk factor.  The study done at Case Western University has shown a link between female sex hormones and periodontal disease. For women, this means it effects them over the course of their entire lives. Female sex hormone changes occur at puberty, menstruation, during pregnancy, and throughout menopause. The study found that as female sex hormones fluctuate throughout a woman’s life they can change conditions in the mouth that allow bacteria to grow and enter the bloodstream. This development can and usually does intensify certain health issues like bone loss in the body and especially the mouth.

What can women do to prevent Periodontal Disease?

Some preventive steps  are the same for men and for women. These include, maintaining proper oral hygiene, regular dental examinations, and professional cleanings. For women, the steps may need to be brought to the next level.  Women are presented with different challenges in  life that can at different periods increase the risk for periodontal disease and progression. In its earliest stages, periodontal disease (called ginigivitis at this point) is reversible, but if periodontal disease progresses to the stage called periodontitis it is much more difficult to combat. The following are some tips for women to prevent periodontal disease:

Maintain proper oral hygiene at home. This is doubly important for women especially during the times of their lives when sex hormones are elevated. This includes brushing at least twice a day (after every meal is even better when possible), flossing at least once per day, using an antibacterial mouth rinse, an electric toothbrush and waterpik with periogen, and drinking water. Decrease snacking and try to maintain a healthy diet. You may even want to try oil pulling therapy.

Regular dental visits and professional cleanings. It is recommended to have a dental exam every 6 months and at least 2 professional cleanings per year. The number of cleanings recommended by your dentist is based on your risk factors. Hormonal fluctuations, advancement of gum disease, and bone loss are reason to increase cleanings to every 3-4 months. It was long believed that women should not seek dental care during pregnancy. The opposite is true,  women who are pregnant need to be diligent to avoid developing periodontal disease. Periodontal disease has been linked to pre term birth as well as low birth weight of children. Women going through hormone fluctuation (menses, pregnancy, menopause) are also at higher risk for tooth decay.

Be Healthy. Smokers are at an increased risk for periodontal disease as are diabetics. Quitting smoking and changing to a healthy diet can help your body increase it’s healing capability and decrease periodontal disease.

Periodontal Disease Conclusion

All of us need to be diligent with oral hygiene to keep healthy. The fact that women need to be extra diligent in maintaining proper oral hygiene throughout their lives is important to understand. We are only beginning to understand many of the hormonal risk factors for women. The research has made us aware that women need to work harder to maintain their oral health.




Gingivitis is simply inflammation of the gum tissue in the mouth. It is a reversible, non-destructive form of periodontal disease. While there are many causes of gingivitis, the

Gingivitis Marielaina Perrone DDS

Gingivitis Can be Prevented!

number one cause is poor dental hygiene.

Gingivitis can develop as

-a side effect to medication

-surges in hormones

-mouth breathing

-dry mouth

-poor nutrition

-disease state

-tobacco use

-poor oral hygiene.

When dental hygiene is not sufficient, bacteria in dental plaque release acids that stimulate the inflammatory response by the body. This in turn cause the gums to appear puffy, red, and bleed easily upon brushing. It takes some work to restore the gums back to a healthy state. Frequent professional cleaning along with regular tooth brushing and flossing can help to remove plaque and keep it from building up on the teeth and gums.

Signs Of Gingivitis

-swollen, shiny, and tender gums

-blood on toothbrush while brushing

– pink toothpaste when spitting out

-pus around teeth

-bad breath

-gum redness

-visible tartar deposits

-bad taste in mouth

-gums bleed easily

-gum ulcers

Other Causes Of Gingivitis

Medications. Many prescription and over-the-counter medications come with the side effect causing dry mouth or xerostomia, and sometimes gum overgrowth. Saliva is important to help keep your teeth clean by controlling the growth of bacteria as well as maintaining a neutral environment to prevent tooth decay. That means that the less saliva you have, the greater your risk for gingivitis (and tooth decay!). Many common medications including antidepressants, blood pressure meds,  asthma inhalers, and cold medications can reduce the amount of saliva in your mouth. Seizure medications, and some blood pressure medications can cause the gum tissue to grow. This extra tissue, makes it more difficult to keep clean. It is important you always read the side effects for any medications you are taking to ensure you take the proper steps like drinking more water and brushing more often following meals.

-Infection/ Disease: Various types of viral infections or fungal infections can cause periodontal disease. Oral Thrush is an example. Thrush occurs when a type of fungus that occurs normally in the mouth gets out of control and forms lesions that can infect the tongue and gums. Also, an infection caused by the herpes virus can cause

Gingivitis Marielaina Perrone DDS

periodontal disease. It is important to get these infections under control as soon as possible as they are quite treatable in most cases. There are also other diseases that can effect the oral tissue, such as oral cancer, and diabetes.

-Nutrition: If you follow a fad diet or a diet that is severely lacking in calcium and vitamins B and C, you may be at increased risk for periodontal disease.

Mouth Breathing: leaving the mouth open to breathe while awake or sleeping, dries the mouth substantially. Oral dryness  allows gingivitis to occur more readily.making healing more difficult

Tobacco use: Smoking directly effects the gums by decreasing blood circulation and thereby increasing inflammation. Smokeless tobacco cause irritation in direct response to the product eroding the tissue.

Hormone surges: Hormonal imbalance during puberty, menstruation, pregnancy, and menopause can cause gingivitis. The drastic hormone changes allow gum tissues to become inflamed quite readily.

Possible Complications From Gingivitis

In most cases, if gingivitis is properly treated and the patient follows good dental hygiene there will be no complications. However, if left untreated, gingivitis can worsen and develop into a more advanced version of periodontal disease called periodontitis. This form of periodontal disease is quite destructive and will cause loss of bone and eventually loss of teeth.

Possible complications from gingivitis can include:

-Abscess in the gum tissues.

-Abscess in the jaw bones.

-Infection in the jaw bone or gum tissues.

-increased susceptibility to heart disease.

-Loss of esthetic gum contours. The points of gum tissue between the teeth disappear, leaving behind a “black triangle”. Red, jelly-roll margins at the gum line of the tooth. Pink stippling disappears.

-Periodontitis.

-Recurrent gingivitis.

-Trench mouth, or ANUG.  Ulcerations of the gums caused by bacterial infection.

Gingivitis can cause damage in other areas of the body if allowed to remain untreated. The bacteria from the gums can enter the bloodstream and cause infections elsewhere. Periodontal disease has been linked to heart disease, stroke and erectile dysfunction. It may also cause the delivery of premature infants as well as low birth weight infants to gingivitis-infected mothers. Those with diabetes may have problems controlling blood sugar levels if they also suffer from gingivitis.

Prevention of Gingivitis

Gingivitis may be prevented or cured by following some simple preventative measures:

-Brush teeth, gum line, and tongue daily. Teeth should be brushed at least twice a day. Both morning and night and after meals when possible.Gingivitis Marielaina Perrone DDS

-Use a soft bristled toothbrush, which is less likely to damage teeth or gums. Replace toothbrush every three months or sooner if needed.

-Use a fluoride toothpaste.

– Do not snack in the middle of the night. Chew gum after daytime snacks.

-Floss at least once a day.

-Rinse with an effective mouthwash, such as listerine.

-Visit the dentist at least once every six months for cleaning and examination to keep gingivitis away.

-Avoid sugary foods, tobacco and drinking excessive amounts of alcohol.

Conclusion

Gingivitis is very treatable. The first step, is understanding what is making it occur. Following a regular dental hygiene regimen will keep gingivitis at bay and not allow it to progress to periodontal disease. A few minutes a day is all it takes to maintain a healthy teeth and gums. Remember to visit your dentist regularly for dental examinations and professional cleanings to avoid the onset of gingivitis.

 


Periodontal Disease is most frequently associated with adults and most people believe that periodontal disease as well as other major dental issues are strictly an adult problem.

Periodontal Disease Marielaina Perrone DDS

Maintain Good Oral Hygiene To Keep Away Periodontal Disease

This is simply not the case. Children and adolescents are also at risk of developing periodontal disease and associated health problems. When children have periodontal disease, signs and symptoms include bleeding gums, especially when brushing, swelling of gums, red and tender gums, receding gums, bone loss, and persistent bad breath.

Factors That Put Children at Risk for Developing Periodontal Disease

According to the American Academy of Periodontology, periodontal disease rarely occurs in young kids and is uncommon in teenagers. Hygiene, genetics, hormones, medications, and disease put you at greater risk for developing periodontal disease. The most frequent type of periodontal disease seen in children is gingivitis, which is the earliest stage (and only stage that is reversible) of periodontitis. Without dental treatment, gingivitis can and will progress to periodontal disease. While uncommon, there are certain factors that increase the risk of children developing  juvenile periodontal disease. Juvenile periodontits affects the first permanent molars and incisors.

Genetic Factors

Genetic factors help determine whether children are at risk for developing periodontal disease. Research studies have shown that genetic factors increase the risk of developing periodontal health problems in children. Children of parents with periodontal disease have an increased risk of having the periodontal disease bacteria that can lead to increased gum infections. If one or both parents or a member of the family has or has had some form of periodontal disease, it is strongly recommended that these parents ensure their kids practice proper dental hygiene daily and visit the dentist regularly.

Teenagers – Effect Of Hormonal Changes

The risk of developing periodontal disease increases as children approach puberty. Teenagers experience increases in hormonal levels, which can promote hormonal periodontal disease. Hormones such as progesterone increase blood circulation to the gums making the tissue even more sensitive and easily irritated by plaque and bacteria that cause periodontal disease. Most teenagers also lack the motivation to practice proper dental care due to the pressure of growing up and the effect of these hormones. This increases the risk of periodontal disease such as ANUG (acute necrotizing ulcerative gingivitis) even more. Flaming red tissue, bleeding ulcerated tissue, pain, and gum recession are characteristic of ANUG. It is essential for adolescents to take good care of their teeth and visit the dentist regularly for periodontal evaluations.

Periodontal Disease Marielaina Perrone DDSPoor Dental Hygiene Maintenance

Poor dental hygiene maintenance puts children at increased risk of developing periodontal disease. When children do not take good care of their teeth and gums, plaque builds up and bacteria breaks it down causing periodontal health problems. Teeth clenching and grinding increases the risk of periodontal disease in children. The best way to prevent periodontal disease in children and reduce the risk is to teach good dental care habits early in their lives. Since children copy their parents’ habits, so parents should also take proper care of their teeth.

 Diseases and medications that Can  Effect Periodontal Disease

-Diabetes, poor healing

-Asthma ( inhalers can cause oral tissue damage)

-Cancer and cancer therapies(radiation and chemotherapy can cause severe damage to oral tissues)

-autoimmune disease , poor healing

-some medications can cause tissue overgrowth, such as the anti-seizure medication, dilantin.

Forms Of Pediatric Gum Disease

Gingivitis is the and mildest stage of periodontal disease. It is the most common form of gum disease in children and adolescents. Chronic gingivitis may affect children and teens causing gums to swell, redden and bleed easily.  Professional treatment and proper dental care is the way to treat and prevent this gum condition. If left untreated, gingivitis will progress and cause further damage  to oral tissues.

Aggressive (Juvenile) periodontal disease is not common in children and adolescents, sometimes it can develop even in healthy children. It mostly affects the visible molarsPeriodontal Disease Marielaina Perrone DDS and incisors, and causes loss of the bone supporting the teeth without plaque or calculus formation.

Generalized aggressive periodontal disease is rare in children but less so in teens. This form of periodontal disease has serious symptoms including gum inflammation, calculus, plaque and loose teeth.

Advanced gum disease that contributes to systematic health conditions may also occur in children and teenagers. This type of periodontal disease is especially common in children with Down syndrome, Type 1 diabetes, Kinder Syndrome, and Papillon-Lefevre syndrome.

Since kids are at risk of developing periodontal health problems just like adults, it is important for parents to take good care of their children’s teeth and gums and instill in them a lifetime habit of proper dental care including brushing and flossing.

Understanding The Risks Can Help You To Help Your Child Fight Periodontal Disease

When kids start early, they will continue practicing proper oral care, hopefully carrying that habit into adulthood.  It is essential for parents to ensure their children have regular dental checkups, periodontal health evaluations and professional cleaning. If a parent or member of the family has gum disease, it is especially important that other family members undergo a professional gum evaluation and take serious care and consideration of their teeth and gums.