My Blog

By Denise A. Perrotta DMD
February 17, 2018
Category: Oral Health
Tags: oral health  
WeCanRidYouofThatIrritatingLumpinYourMouthYouKeepBiting

You might not be aware how much force your jaws generate while you eat or chew. But you can become aware in a hurry when part of your inside cheek or lip gets in the way.

What may be even worse than the initial painful bite are the high odds you’ll bite the same spot again—and again. That’s because of a feature in the skin’s healing process.

As a surface wound heals, it often forms a cover of fibrous tissue consisting of the protein collagen. This traumatic fibroma, as it’s called, is similar to a protective callous that develops on other areas of damaged skin. In the process, though, it can become “taller” than the surrounding skin surface, which increases the chances of another bite.

This second bite often results in more fibrous tissue formation that rises even higher from the skin surface, which then becomes more likely to be bit again. After repeated cycles, the initial wound can become a noticeable, protruding lump.

These kinds of sores are typically not cancerous, especially if they’ve appeared to form slowly over time. But they can be a nuisance and the occasion of sharp pain with every subsequent bite. There is, though, an effective way to deal with it—simply have it removed.

While it involves a surgical procedure—an oral surgeon, periodontist or dentist with surgical training usually performs it—it’s fairly minor. After numbing the area with a local anesthetic, the dentist will then completely excise the lesion and close the resulting gap in the skin with two or three small sutures (it could also be removed with a laser). The wound should heal within a few days leaving you with a flat, flush skin surface.

The tissue removed is usually then biopsied. Although it’s highly unlikely it was more than an annoying sore, it’s still common procedure to examine excised tissues for cancer cells. If there appears to be an abnormality, your dentist will then see you to take the next step in your treatment.

More than likely, though, what you experienced was a fibroma. And with it now a thing of the past, you can chew with confidence knowing it won’t be there to get in the way.

If you would like more information on dealing with common mouth sores, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Common Lumps and Bumps in the Mouth.”

By Denise A. Perrotta DMD
February 02, 2018
Category: Dental Procedures
GetAheadofBiteProblemswithInterceptiveOrthodontics

At any given time some 4 million teens and pre-teens are wearing braces or other orthodontic appliances to correct a malocclusion (poor bite). While most cases are straightforward, some have difficulties that increase treatment time and cost.

But what if you could reduce some of these difficulties before they fully develop? We often can through interceptive orthodontics.

This growing concept involves early orthodontic treatment around 6 to 10 years of age with the goal of guiding the development of a child’s jaws and other mouth structures in the right direction. These early years are often the only time of life when many of these treatments will work.

For example, widening the roof of the mouth (the palate) in an abnormally narrow upper jaw takes advantage of a gap in the bone in the center of the palate that doesn’t fuse until later in adolescence. A device called a palatal expander exerts outward pressure on the back teeth to influence the jawbone to grow out. New bone fills in the gap to permanently expand the jaw.

In cases with a developing overbite (the upper front teeth extending too far over the lower teeth when closed), we can install a hinged device called a Herbst appliance to the jaws in the back of the mouth. The hinge mechanism coaxes the lower jaw to develop further forward, which may help avoid more extensive and expensive jaw surgery later.

Interceptive treatments can also be fairly simple in design like a space retainer, but still have a tremendous impact on bite development. A space maintainer is often used when a primary (“baby”) tooth is lost prematurely, which allows other teeth to drift into the empty space and crowd out the incoming permanent tooth. The wire loop device is placed within the open space to prevent drift and preserve the space for the permanent tooth.

To take advantage of these treatments, it’s best to have your child’s bite evaluated early. Professional organizations like the American Association of Orthodontists (AAO) recommend a screening by age 7. While it may reveal no abnormalities at all, it could also provide the first signs of an emerging problem. With interceptive orthodontics we may be able to correct them now or make them less of a problem for the future.

If you would like more information on orthodontic treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Interceptive Orthodontics.”

By Denise A. Perrotta DMD
January 18, 2018
Category: Oral Health
Tags: gum disease   oral health  
BoostYourOverallHealthbyReducingGumInflammation

The human body’s immune system has amazing defensive capabilities. Without it a common cold or small wound could turn deadly.

One of the more important processes of the immune system is inflammation, the body’s ability to isolate diseased or injured tissue from unaffected tissue. Ironically, though, this vital component of the healing process could actually cause harm if it becomes chronic.

This often happens with periodontal (gum) disease, an infection of the gums caused by bacterial plaque built up on teeth due to inadequate hygiene, which in turn triggers inflammation. The infection is often fueled by plaque, however, and can become difficult for the body to overcome on its own. A kind of trench warfare sets in between the body and the infection, resulting in continuing inflammation that can damage gum tissues. Untreated, the damage may eventually lead to tooth and bone loss.

In treating gum disease, our main goal is to stop the infection (and hence the inflammation) by aggressively removing plaque and calculus (tartar). Without plaque the infection diminishes, the inflammation subsides and the gums can begin to heal. This reduces the danger to teeth and bone and hopefully averts their loss.

But there’s another benefit of this treatment that could impact other inflammatory conditions in the body. Because all the body’s organic systems are interrelated, what occurs in one part affects another especially if it involves inflammation.

It’s now theorized that reducing gum inflammation could lessen inflammation in other parts of the body. Likewise, treating other conditions like high blood pressure and other risk factors for inflammatory diseases could lower your risk of gum disease and boost the effectiveness of treatment.

The real key is to improve and maintain your overall health, including your teeth and gums. Practice daily brushing and flossing to remove plaque, and visit your dentist regularly for more thorough cleanings. And see your dentist at the first sign of possible gum problems like bleeding, redness or swelling. You’ll not only be helping your mouth you could also be helping the rest of your body enjoy better health.

If you would like more information on the relationship between gum disease and other systemic conditions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Link between Heart & Gum Diseases.”

By Denise A. Perrotta DMD
January 03, 2018
Category: Dental Procedures
CharlizeTheronBackinActionAfterDentalSurgery

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”

By Denise A. Perrotta DMD
December 19, 2017
Category: Dental Procedures
Tags: orthodontics   braces  
4TipsforAvoidingDentalDiseaseWhileWearingBraces

Wearing braces takes time, but if all goes well the changes to your smile will be well worth it. In the meantime, though, you’ll have to contend with one particular difficulty—keeping your teeth clean of disease-causing, bacterial plaque.

Don’t worry, though—while keeping dental disease at bay with braces can be challenging, it is doable. Here are 4 tips for minimizing your chances of tooth decay or periodontal (gum) disease during orthodontic treatment.

Eat less sugar. Like any living organism, bacteria must eat—and they’re especially amenable to sugar. The more they have access to this favorite food source, the more they multiply—and the greater your risk of tooth decay or gum disease. Eating fewer sugary foods and snacks and more dental-friendly ones helps restrict bacteria populations in your mouth.

Brush thoroughly. Brushing with braces can be difficult, especially in areas blocked by orthodontic hardware. You need to be sure you brush all tooth and gum surfaces around your braces, including above and below the wire running through the brackets. A soft multi-tufted microline bristle brush is a good choice for getting into these hard to reach places. Brushing around braces takes more time, but it’s essential for effective plaque removal.

Use flossing tools. Flossing is important for removing plaque from between teeth—but, unfortunately, it might be even more difficult to perform with braces than brushing. If using string floss proves too daunting consider using a floss threader or a similar device that might be easier to maneuver. You can also use a water irrigator, a hand-held device that sprays water under pressure to loosen and flush away between-teeth plaque.

Keep up regular dental visits. While you’re seeing your orthodontist regularly for adjustments, you should also see your general dentist at least every six months or more. Besides dental cleaning, your dentist also monitors for signs of disease and can prescribe preventive measures like antibacterial mouth rinses. Of course, if you see abnormalities, like white spots on your teeth or red, puffy or bleeding gums, contact your dentist as soon as possible. The sooner a problem can be addressed the less impact it may have on your orthodontic treatment and overall oral health.

If you would like more information on caring for teeth and gums while wearing braces, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”





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