My Blog

Posts for: August, 2015

By Denise A. Perrotta DMD
August 20, 2015
Category: Dental Procedures

In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?

“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.

How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.

With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.

In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.

While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.

Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”

By Office of Denise A. Perrotta, D.M.D
August 11, 2015
Category: Oral Health
Tags: Veneers  

Loose VeneersWhen prepared and bonded correctly, porcelain veneers should not break or fall off. Accidents happen, however, and it is possible for them to come off, leaving you in need of the cosmetic dentistry expertise from Denise A. Perrotta, D.M.D. in Winston-Salem, NC.

Whether your veneers pop off on their own or they are damaged due to some type of trauma, you will need to respond appropriately to quickly restore your smile and reduce your risk of complications. Here are the four steps you should take.

1. Remove any Loose Pieces

First, remove any loose pieces that are in your mouth. Do not remove pieces that are still attached; simply remove pieces that have come all the way loose. Be careful not to swallow, drop or lose any pieces or to cut your hands or mouth in the process.

2. Examine the Damage

Next, examine the pieces in your hand and in your mouth. Are your veneers broken or did they just pop off intact? Are there any sharp edges that could cut your mouth? Do you have all of the pieces, or are some missing? You will need this information when you call to set up an appointment with cosmetic dentist Dr. Perrotta in Winston-Salem, NC.

3. Protect Your Mouth

If the part of your veneer still attached to your teeth has any rough or sharp edges, you will want to cover them up to avoid cutting your mouth. Do this with white dental wax, a bit of gauze or even a mouth guard or night guard if that is all you have on hand. Be sure to also put any loose veneer pieces somewhere safe so you can bring them in with you when you visit Dr. Perrotta in Winston-Salem, NC.

4. Visit Dr. Perrotta for Treatment

Lastly, as soon as you have assessed the area and taken steps to keep from cutting your mouth, be sure to call Dr. Perrotta right away to set up an appointment for treatment. If your veneer is still intact, she can likely just reattach it. If your veneers are lost or broken, however, you will need to have the remaining pieces removed, a new set of veneers created in a lab, and the replacements attached.

Replacing lost or broken veneers can be time-consuming and inconvenient, but it can be done. If your veneers are broken or missing or if they have simply popped off intact, call cosmetic dentist Dr. Perrotta right away to schedule an emergency dental appointment. She will have you looking better in no time!

By Denise A. Perrotta DMD
August 05, 2015
Category: Oral Health
Tags: oral health  

If you’ve noticed redness or small skin cracks at the corners of your mouth, you may have a common infection known as perleche or angular cheilitis. Depending on its cause, there are ways to treat the redness and skin cracking to lessen your discomfort.

The term perleche comes from the French word “lecher,” meaning to lick. This is derived from the tendency of perleche patients to constantly lick the area to ease irritation; unfortunately, this also helps perpetuate the inflammation. Once the skin is broken the area is commonly infected by yeast called candida albicans.

Initially, perleche may arise from a variety of sources, most of them locally from either inside or around the mouth, although it can be triggered by a general body infection or disease like diabetes or cancer, or vitamin or iron deficiencies. Inside the mouth reduced saliva flow, tissue inflammation under a rarely cleaned denture (denture stomatitis), pressure on the mouth corners caused by a collapsed bite due to missing teeth and similar conditions can elevate the risks for infection. Around the mouth wrinkling or “marionette lines,” deep lines that extend from the mouth to the chin due to aging or environmental exposure, can contribute to crack formation. Drooling during sleep or as a result of orthodontic treatment is also a contributing cause.

The main focus of treatment for perleche is to bring any infection under control. This can be accomplished with a course of oral or topical antifungal (yeast-attacking) medication. If the infection has spread into the mouth or throat we might then prescribe a troche, a small lozenge designed to dissolve, which you would rinse with and then swallow to affect other portions of the mouth. Steroid or zinc oxide ointments applied directly to the skin can control inflammation and serve as a barrier agent with antifungal properties to promote healing.

If the cause is more related to dental problems (ill-fitting dentures or missing teeth), then it’s important to have these addressed and treated. You may also consult a dermatologist for treatments to lessen wrinkling around the mouth that might also contribute to chronic cases of perleche.

If you would like more information on cracked mouth corners, 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 “Cracked Corners of the Mouth.”

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