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Posts for: August, 2016

By Denise A. Perrotta, D.M.D Cosmetic Dentistry
August 25, 2016
Category: Oral Health
Tags: Cavity  

Are you worried that you might have a cavity? Dr. Denise Perrotta, who practices cosmetic dentistry in Winston Salem, NC, shares a few common cavity signs.

What are the signs of a cavity?Cavity

You may have no symptoms during the early stages of tooth decay. As the decay progresses, you might notice one or more of these signs:

  • A Toothache: An aching or throbbing sensation can occur occasionally or may be constant.
  • Pits or Holes: Small hole in your teeth are a telltale sign of cavities.
  • Stains: Black, brown or white stains on your teeth may indicate that you have a cavity.
  • Pain When Chewing: Putting pressure on your tooth can cause pain if tooth decay is present.
  • Sensitivity: Cavities can cause sensitivity to hot, cold and sweet foods. Sensitivity occurs when tooth decay eats away at your enamel, exposing tubes in the underlying dentin that transmit sensations to the nerves in the pulp

How did I get a cavity?

Plaque, a colorless, sticky, bacteria-laden film covers your teeth every day. You've probably felt it if you've run your tongue over your teeth and noticed that they felt a little rough. When you eat, plaque combines with the sugars in food to create acids that attack your enamel, causing cavities. Eating or drinking foods and beverages that are very acidic or high in sugar can increase your cavity risk. Although brushing and flossing help remove plaque, it can be difficult to remove every speck of it, particularly if it accumulates in the pits of molars or in other hard-to-reach places.

How can I reduce my cavity risk?

In addition to daily brushing and flossing, visiting your dentist every six months is an excellent way to decrease your risk of developing cavities. During your regular visits, you'll receive a thorough cleaning to remove plaque and tartar. Visits also include a complete dental examination and yearly or bi-yearly X-rays that help your dentist find cavities.

Whether you're concerned about a painful tooth, or it's time for your next dental exam, Dr. Denise Perrotta in Winston Salem, NC offers comprehensive cosmetic dentistry services that will help you enjoy good oral health. Call her at (336) 760-9258 to schedule an appointment. Reduce your cavity risk with regular dental exams.


A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.

We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?

Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.

When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?

In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.

So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.

If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”

By Denise A. Perrotta DMD
August 01, 2016
Category: Dental Procedures
Tags: oral hygiene  

Undergoing regular dental cleanings is an essential part of periodontal (gum) disease prevention. While a daily habit of brushing and flossing cleans bacterial plaque from most tooth surfaces, it’s difficult to remove from places your brush or floss can’t access well. That, as well as hardened plaque deposits known as calculus, must be removed by a hygienist or dentist with a technique known as scaling.

Scaling is traditionally performed manually using specialized hand instruments known as scalers. Although hand scalers are quite effective, they must be used carefully to avoid damage to gum tissue or, during deeper cleaning known as root planing, the tooth roots. A different method for plaque removal known as ultrasonic scaling has grown in popularity as an alternative to manual scaling.

Ultrasonic scaling uses equipment emitting vibrational energy that crushes and loosens plaque and calculus, and disrupts growing bacterial colonies in biofilm. Plaque particles are then washed away using water irrigation. The most recent models of ultrasonic scalers have matched the effectiveness of hand scaling in removing plaque and calculus in shallow gum pockets, and surpassed the manual technique in cleaning out pockets greater than 4 mm. In experienced hands, they’re kinder to tooth structure and other tissues. Water irrigation also improves healing by removing bacteria and scaling by-products, which also makes the area easier to view by the hygienist.

On the other hand, any type of power scaler must be used with caution with patients who have pacemakers, and are not recommended for those with hypersensitive teeth or teeth that are in the early stages of de-mineralization. The technique may also produce an aerosol of finely misted particles (with possible contamination) that requires added measures to contain them.

For most patients, though, ultrasonic scalers are an effective tool for plaque and calculus removal. As ultrasonic devices continue to evolve, patients will ultimately benefit from greater comfort and reduced treatment times.

If you would like more information on plaque removal with ultrasonic scalers, 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 “Dental Cleanings Using Ultrasonic Scalers.”

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