My Blog

Posts for: February, 2017

By Denise A. Perrotta DMD
February 13, 2017
Category: Oral Health
Tags: toothache  
WhatsCausingYourThrobbingToothache

There are few more painful experiences than a toothache. You can't ignore it: it's as if your mouth is screaming for relief.

But while the throbbing pain can tell you something's wrong, it may not be clear exactly what's wrong. There's more than one possibility — it could be with the tooth itself, the gums around the tooth or a combination of both.

In the first case, a toothache could be a sign of severe tooth decay within the tooth's innermost layer, the pulp. The pain you feel comes from the nerves within the pulp under attack from the infection.

For this level of decay there's one primary way to save the tooth and stop the pain: a root canal treatment. In this procedure we remove all the infected and dead tissue from the pulp and fill the empty chamber and root canals with a special filling. We then seal and crown the tooth to prevent further infection.

Another source of toothache happens when your gums have become painfully inflamed due to infection. This is usually caused by periodontal (gum) disease, triggered by a thin film of bacteria and food particles on tooth surfaces known as plaque. In this case, we must remove all plaque and calculus (hardened plaque deposits) from tooth and gum surfaces, including on the roots. Your gums can then heal and return to health.

But your situation could be more complex. Untreated tooth decay can advance to the roots and subsequently infect the gums. Likewise advanced gum disease can pass the infection from the gums to the root and into the pulp.  For such cases you may need a specialist, either an endodontist specializing in root canal issues or a periodontist specializing in the gums.  They can better diagnose the origin and extent of the problem and offer advanced techniques and treatments to deal with it.

It's possible in these more complex situations your tooth has become diseased beyond repair and must be replaced. It's important, then, that you see us if you experience any significant tooth pain, even if it seems to go away. The sooner we diagnose and begin treating the cause of your pain, the better your chances of regaining your dental health.

If you would like more information on treating dental disease, 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 “Confusing Tooth Pain.”


By Denise A. Perrotta DMD
February 07, 2017
Category: Dental Procedures
Tags: cosmetic dentistry  

Cosmetic dentistry is gaining in popularity and becoming an often-requested, versatile and effective form of dentistry. cosmetic dentistryHowever, choosing the right procedure for you can seem overwhelming with all of the choices available. Learning about the top five cosmetic procedures can help make your choice easy. Find out more with your Winston Salem, NC, dentist, Dr. Denise Perrotta.

Top Five Cosmetic Dentistry Procedures in Winston Salem

Teeth Whitening: Depending on your preference, professional teeth whitening treatment in your dentist’s office can greatly change the appearance of your smile or subtly lighten the color of your teeth to a more pleasing color. When compared to over-the-counter variations which require weeks or months of continuous use, professional teeth whitening proves to be much more effective and provides faster, more obvious results in a single session.

Dental Implants: Dental implants permanently replace your missing tooth. However, implants also replace that tooth’s root, making them the only tooth replacement which fights against bone atrophy due to lack of stimulation. Implants last a lifetime and hold a porcelain replacement tooth in place to provide a full, beautiful smile. Dental implants are versatile and can replace one, several or all of your teeth depending on your situation.

Veneers: Dental veneers attach to the front of your teeth to change their shape, width, length, color or imperfections. Your dentist can use veneers on all of your teeth for a more impressive transformation or only a few teeth for a more subtle change. Veneers, made from porcelain, have the same light-reflecting qualities and general appearance as natural teeth, allowing them to blend right into your smile.

Crowns/Bridges: Crowns and bridges are porcelain dental restorations which fall under both the cosmetic and restorative dental specializations. While their natural appearance can cover an existing tooth or replace a missing tooth, crowns and bridges also provide stabilization to a damaged or weakened tooth and help strengthen teeth which have large fillings, such as after root canal therapy.

Orthodontics: Orthodontic treatment is beneficial in giving you the straight, perfect Hollywood smile you desire and also in correcting tooth and bite issues to reduce the chances of tooth decay or other conditions like temporomandibular joint (TMJ) disorder. Additionally, orthodontics no longer mean wearing the traditional metal brackets and wires. With treatments like ceramic, tooth-colored braces or Invisalign, you can straighten your smile without compromising your look.

For more information on cosmetic dentistry or one of the procedures listed above, please contact Dr. Perrotta in Winston Salem, NC. Call (336) 760-9258 to schedule your appointment with Dr. Perrotta today!


By Denise A. Perrotta DMD
February 05, 2017
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”




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