My Blog

Posts for: February, 2015

By Denise A. Perrotta DMD
February 27, 2015
Category: Dental Procedures

Not long ago, Glee star Lea Michele had all of her wisdom teeth removed. This is a very common procedure that people in their twenties, like Michele, often undergo to prevent serious dental problems down the road. The actress found that the procedure really was actually not very difficult to tolerate.

“Feeling all better from my surgery!” she tweeted to fans a few days later. “Back to work tomorrow.”

Why do wisdom teeth so often cause problems? For one thing, they come in years later than the other 28 permanent teeth — usually between the ages of 17 and 25. By that time, there is often no room in the jaw to accommodate them. As man has evolved, the jaws have actually become smaller in size — often creating a lack of space for the wisdom teeth to erupt into proper position. If wisdom teeth become blocked (impacted) by other molars that are already there, infection and damage to neighboring teeth may result.

Sometimes the wisdom teeth themselves cause the problem by growing in at an odd angle. They push against other teeth, often compromising the adjacent tooth's supporting bone. While you would think pain would occur if any of these problems were present, that does not always alert us to a wisdom-tooth problem. It's usually diagnosed with the help of x-rays.

Wisdom tooth extraction is often performed in the dental office using a local anesthetic (numbing shot) to keep you from experiencing any pain, along with conscious sedation to help you relax. The type of anesthesia that's best for you will be determined before the procedure.

After we gently remove the tooth or teeth, you may need to have the site sutured (stitched) to promote healing. You will rest for a short time before going home, and may need to have someone drive you, depending on what type of anesthesia you were given.

Once you get home, you should apply an ice pack on the outside of your cheek for about five minutes on, five minutes off for as many hours as possible to help reduce any postoperative swelling on the first day. Starting on the second day, the warm moist heat of a washcloth placed on the cheek and hot salt water rinses will make you more comfortable. You may want to eat soft foods and brush your teeth very carefully during the recovery period, which lasts only a few days as Lea Michele discovered. Before you know it, you'll be “feeling all better!”

If you have any questions about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Wisdom Teeth.”

By Denise A. Perrotta, D.M.D.
February 17, 2015
Category: Dental Procedures
Tags: Countouring  

Are your teeth crooked, misshapen, bent, or otherwise out-of-line in your mouth? Unfortunately, many people today suffer from teeth that are far from perfect, sporting an unflattering smile that won't leave anyone with a good impression.

But help is on the way with Denise A. Perrotta, D.M.D., as she and her helpful cosmetic dentists are on a mission to fix the dental Cosmetic Dentistryproblems residing in your mouth so that you can have that winning smile you've been searching for! Whether your teeth are discolored or bent out of shape, crooked or cracked, chipped or misaligned, don't worry - these cosmetic dentists have got your (teeth's) back!

One of the leading methods Dr. Perrotta and her crew of trusted dental associates use for constructing the perfect grin is contouring and reshaping, which involves expert cosmetic dental techniques that gently transform each asymmetrical tooth into one that leaves your entire set something to marvel at! After all, any and every stray tooth has to be brought back into place if you want a smile that turns heads and drops jaws.

You'll know you're a candidate for contouring and reshaping your teeth if:

  • You have a healthy bone density
  • You don't have any underlying tooth or periodontal decay
  • You have the time and the resources to maintain good dental hygiene once your teeth have been taken care of, which includes:
    • Brushing at least twice daily
    • Flossing daily
    • Seeing your dentist for regular check-ups

If you meet these simple requirements, you'll have no problem maintaining the perfect teeth that contouring and reshaping will bring your mouth.

For more information on how you can achieve the perfect smile with Dr. Perrotta and her expert cosmetic dental staff, give her office a call today at (336) 760-9258 for all the dental answers you've been looking for right here in Winston Salem, NC!

By Denise A. Perrotta DMD
February 12, 2015
Category: Dental Procedures
Tags: orthodontics   retainers  

Orthodontics can produce an amazing smile transformation. With today’s advanced appliances and techniques even the most difficult malocclusions (bad bites) can be overcome. All of this innovation, however, depends on one basic anatomical fact: though firmly set in the mouth, our teeth can still move.

Teeth are actually held in place by the periodontal ligament, a strong, elastic tissue that attaches to them through tiny collagen fibers on one side of the ligament and to the jawbone with similar fibers on the other side. When pressure is placed against a tooth, the bone on the opposite side of the force begins to dissolve (resorb), allowing the tooth to move. As it moves, new bone is built up behind the tooth, to stabilize it. Orthodontists take advantage of this natural mechanism through orthodontic hardware like braces that applies pressure in the desired direction of movement, while the ligament and bone do the rest.

There is, though, a downside to this process. The teeth, bone and gum tissues can contain a kind of “memory” for the former natural position of the teeth. Over time, the lower front teeth tend to take a gradual migratory movement back towards their original position. Also, as we age the lower front teeth may crowd each other as there is a genetic influence for teeth to move to the midline of the face, causing a pressure that allows the skinny lower front teeth to slip behind each other. As a result of both of these tendencies, corrected teeth may retreat from their new positions.

To stop these tendencies, we use an appliance known as a retainer after braces or other hardware is removed. As the name implies, this appliance “retains” the teeth in their new position. For structural “memory,” the retainer will keep the teeth in their new position until the impulse to return to the old one has faded, about eighteen months. Retainers can also slow or stop the natural genetic influence of movement, but it may mean wearing a retainer for an indefinite period, especially individuals who’ve undergone orthodontic treatment later in life.

The length of time you’ll need to wear a retainer after braces — and what type, whether a removable appliance or one permanently attached — will depend on a number of factors including the type of malocclusion, your individual mouth structure and age. We’ll recommend the best option that ensures the best chance of keeping your teeth in their new position.

If you would like more information on retainers after orthodontic treatment, 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 “Why Orthodontic Retainers?

By Denise A. Perrotta, D.M.D.
February 04, 2015
Category: Oral Health
Tags: No Prep Veneers  


People looking for a quick, pain-free route to a whiter, straighter smile may want to explore no-prep or minimal-prep veneers. They're not a solution suitable for everyone, but they're definitely worth asking your cosmetic dentist about. Patients in the Winston Salem, NC, area can consult Denise A. Perrotta, DMD, about all sorts of cosmetic dentistry options, including no-prep veneers.

Porcelain Veneers

Traditional porcelain veneers are used to fix imperfections like gaps, chips, malformations and discoloring of the teeth, and No prep Veneersthey require the dentist to remove enamel from your natural teeth in order to effectively and comfortably attach the thin shell to the front-facing surface of your teeth. As a result of this preparation, the patient may experience heightened tooth sensitivity. Veneers are not a reversible cosmetic dentistry treatment and sometimes require a few appointments to complete.

No-prep or minimal-prep veneers

are pretty much what you'd assume they'd be: Materials that cover tooth imperfections that don't require your cosmetic dentist to grind down any (or as much) of the tooth before attaching the exterior shells. Some patients may not need to receive anesthesia during the procedure, which makes it even quicker than the already speedy process that makes no-prep veneers attractive to many dental patients.

As with all cosmetic dentistry solutions, no-prep veneers may not be the best option for you, and there are pros and cons to be aware of. By eliminating the removal of part of the natural tooth, it's possible no-prep veneers will give your teeth a larger appearance. Because of the lack of (or minimal) preparation work on your natural teeth, no-prep veneers are likely not the best solution for severely malformed or misaligned teeth — even traditional porcelain veneers may not be the best option for such patients.

No-prep veneers certainly appeal to people as a quick way to improve their smiles, but before setting your sights on a cosmetic dentistry solution, you should have a professional assess your smile and help you review all the options available to you. Visit our veneers page to learn more about veneers in general. To schedule an appointment with Denise A. Perrotta General & Cosmetic Dentistry in Winston Salem, NC, call (336) 760-9258.

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