It’s important for your child’s current and future health that we watch out for tooth decay. Taking x-rays is a critical part of staying one step ahead of this common disease.
But while x-ray imaging is commonplace, we can’t forget it’s still a form of radiation that could be potentially harmful, especially for a child whose tissues are rapidly developing. We must, therefore, carefully weigh the potential benefits against risk.
This concern has given birth to an important principle in the use of x-rays known as ALARA, an acronym for “As Low As Reasonably Achievable.” In basic terms, we want to use the lowest amount of x-ray energy for the shortest period of time to gain the most effectiveness in diagnosing tooth decay and other conditions.
A good example of this principle is a common type of radiograph known as a bitewing. The exposable x-ray film is attached to a plastic devise that looks like a wing; the patient bites down on it to hold it in place while the x-ray exposure takes place. Depending on the number of teeth in a child’s mouth, an appointment usually involves 2 to 4 films, and children are typically spaced at six months apart. Frequency of x-rays depends on your child’s tooth decay risk: lower risk, less need for frequent intervals.
Each bitewing exposes the child to 2 microsieverts, the standard unit for radiation measurement. This amount of radiation is relatively low: by contrast, we’re all exposed to 10 microsieverts of background radiation (natural radiation occurring in the environment) every day or 3,600 microsieverts annually. Even two appointments of four bitewings each year is a fraction of a percent of the background radiation we’re exposed to in the same year.
This conservative use of x-rays is well within safe parameters for children. As x-ray technology continues to advance (as with the development of digital imaging) we anticipate the exposure rate to diminish even more. Prudently used, x-rays remain one of our best tools for ensuring your child’s teeth are healthy and developing normally.
If you would like more information on the use of x-rays with children, 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 “X-Ray Safety for Children.”
X-rays revolutionized dental care in the 20th Century. The same could happen in the 21st Century as cone beam computed tomography (CBCT) becomes a fixture beside the traditional x-ray machine.
CBCT made its debut in dental offices about a decade and a half ago. It utilizes the same invisible energy as traditional x-rays to create images of the face and jaw. But unlike traditional x-rays, which can only depict structures in the two dimensions of width and height, CBCT can create three-dimensional images in amazing detail.
The CBCT's x-ray projector rotates around a patient's head. As it emits a cone-shaped beam of x-rays, the device simultaneously collects anywhere from 150 to 599 distinct image views. It transmits these views to a computer that assembles them into three-dimensional images that can be viewed on a computer display.
From the data file of images, dentists can re-format a variety of views and angles of teeth, jaws and other facial bones at various levels of magnification. Because of this wide range of views, all in striking detail, CBCTs are highly useful among other things for diagnosis of malocclusions (bad bites), the size and location of infections, obstructions at possible implant sites, or jaw problems prior to surgery.
Because they expose a patient to higher doses of radiation than a standard x-ray machine, they're normally limited to more complex oral situations. That means you'll still undergo standard x-rays for most of your dental treatment needs. CBCT radiation levels are lower, however, than medical CT scans, which use a fan-shaped beam that can expose a patient to ten times the radiation of a CBCT. For dental care, a CBCT machine also produces greater image detail than an MRI.
Depending on your needs, CBCT may one day be a part of your dental care.Â With their range and accuracy, it could play a major role in helping you attain good health.
If you would like more information on cone beam diagnostics, 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 “Getting the Full Picture with Cone Beam Dental Scans.”
It's easy to go overboard with sweets during the holiday season. But overconsumption of sugar, month after month, can jeopardize your oral and general health. A sugary diet nourishes the bacteria that cause tooth decay. Eating too much sugar over time also promotes general health problems such as diabetes and excessive weight gain.
The beginning of a new year is a great time to bring your diet back into balance. But if you really want to cut down on sugar, you'll need to be aware that there is a lot of sugar hiding in foods you where wouldn't normally suspect it. Here are some examples:
Ketchup. Do you like ketchup on your burger and fries? For every tablespoon of ketchup you use, you'll be adding about 4 grams of sugar (one teaspoon). That can add up pretty quickly into a significant amount of sugar!
Canned tomato soup. Read the label of your favorite brand and you might see as much as 12 grams of sugar per half-cup serving. That equals three teaspoons of sugar in every half cup of soup—even more in a full bowl!
Granola. You may think of granola as a healthy choice for breakfast. Yet you're likely to see sugar listed as the second ingredient on many favorite brands—right after oats. This typically adds up to 15 grams of sugar per serving. That's almost 4 teaspoons, in a food promoted as healthful!
Yogurt. Here, the amount of sugar varies widely among brands and flavors. One container of vanilla yogurt might contain 3 or more teaspoons of added sugar. Put that on a breakfast serving of granola, and your first meal of the day has already topped the 6-teaspoon daily limit recommended by the World Health Organization.
So, to prevent sugar from sneaking up on you, it's important to read those labels! And if you have any questions about sugar and oral health, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “The Bitter Truth About Sugar” and “Nutrition and Oral Health.”
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
If you're considering dental implants, they'll need to be surgically placed in the jaw bone. But don't be alarmed — it's a relatively minor procedure that usually requires nothing more than local anesthesia.
But that being said, it's still an invasive procedure that involves making incisions in gum and bone tissues. That could introduce bacteria into the bloodstream and pose, for certain individuals, a slightly greater risk of infection.
But infection risk is quite low for most healthy patients. As a result, implants enjoy a greater than 95-percent success rate ten years after installation. But some patients have health issues that increase their risk of infection. These include older adults with a weakened immune system, smokers, diabetics or those well under or over their ideal weight.
If you have these or similar health situations, we may recommend undergoing an antibiotic treatment before you undergo surgery. This can help prevent bacteria from spreading and reduce the likelihood of an infection.
Preventive antibiotic therapy is commonplace with many other dental procedures. Both the American Dental Association and the American Heart Association recommend antibiotics before any invasive oral procedure for patients with prosthetic (false) heart valves, past endocarditis, a heart transplant or other heart conditions. To lower the risk of implant failure due to infection, we often advise antibiotics for patients who fall in these categories, as well as those with similar conditions mentioned earlier.
Of course, whether pre-surgical antibiotics is a wise choice for you will depend on your medical history and current health status. We'll consider all these factors thoroughly before advising you. But if you are more susceptible to infection, antibiotics before surgery could potentially lower your risk for an implant failure.
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