Posts for: August, 2014
X-ray diagnostics have revolutionized our ability to detect early or hidden cavities, paving the way for better dental care. But x-ray exposure also increases health risks and requires careful usage, especially with children.
A form of invisible radiation, x-rays penetrate and pass through organic tissue at varying rates depending on the density of the tissue. Denser tissues such as teeth or bone allow less x-rays to pass through, resulting in a lighter image on exposed film; less dense tissues allow more, resulting in a darker image. This differentiation enables us to identify cavities between the teeth — which appear as dark areas on the lighter tooth image — more readily than sight observation or clinical examination at times.
But excessive exposure of living tissue to x-ray radiation can increase the risk of certain kinds of cancer. Children in particular are more sensitive than adults to radiation exposure because of their size and stage of development. Children also have more of their lifespan in which radiation exposure can manifest as cancer.
Because of these risks, we follow an operational principle known as ALARA, an acronym for “As Low As Reasonably Achievable.” In other words, we limit both the amount and frequency of x-ray exposure to just what we need to obtain the information necessary for effective dental care. It’s common, for example, for us to use bitewing radiographs, so named for the tab that attaches the exposable film to a stem the patient bites down on while being x-rayed. Because we only take between two and four per session, we greatly limit the patient’s exposure to x-rays.
Recent advances in high-speed film and digital equipment have also significantly reduced x-ray exposure levels. The average child today is exposed to just 2-4 microsieverts during an x-ray session — much less than the 10 microsieverts of background radiation we all are exposed to in the natural environment every day.
Regardless of the relative safety of modern radiography, we do understand your concerns for your child’s health. We’re more than happy to discuss these risks and how they can be minimized while achieving maximum benefits for optimum dental health. Our aim is to provide your child with the highest care possible at the lowest risk to their health.
If you would like more information on the use of x-rays in dentistry, 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.”
Think of a contagious disease and you may picture one of the great outbreaks of the past: the terrible flu epidemic of 1918, the ever-present threat of polio in the early 20th Century, and the ancient (and still widespread) danger of cholera in overcrowded urban areas. Or you may think of the common cold, a familiar contagious malady that’s still very much with us. Yet there’s one contagious disease you may not think of, but probably should: tooth decay.
Many people don’t realize that tooth decay is contagious. But the fact is, decay bacteria can be passed between people like a bad cold — and it happens all the time.
Sugar usually gets the blame for tooth decay; a recent survey found that 81 percent of Americans say it’s responsible for cavities. But sugar alone isn’t the culprit. Cavities are actually caused by certain types of bacteria that cling to the teeth in the absence of proper oral hygiene. These bacteria process sugar from the foods we eat, and then secrete acidic byproducts that erode the hard enamel of the teeth. This causes the formation of the tiny holes we call cavities.
Children aren’t born with S. Mutans. But studies show that most of them “catch” it from their caregivers — often, their parents. By the time they are two years old, over 80 percent of kids will have detectable levels of the bacteria. Whether or not they pick up harmful microorganisms — and how much they have — depends on the infectiousness of the strain, and on the caregiver’s attention to oral hygiene.
How can you prevent the spread of decay-causing bacteria? Essentially, by limiting its transfer from your mouth to your baby’s mouth. So don’t “clean” a baby’s pacifier by putting it in your mouth, and don’t share utensils — for example, by tasting baby’s food with his or her spoon. While it’s ever so tempting, avoid kissing baby’s lips, especially if there is a chance of transferring saliva. And don’t even think of “pre-chewing” baby’s food — no matter what some self-appointed health gurus may say.
There’s still another way to limit the spread of decay-causing microorganisms: Make sure your own practice of oral hygiene is top-notch! Oral bacteria can spread not only from parents to babies, but also between adults. Maintaining good oral health means brushing and flossing every day, and getting regular check-ups: It’s important for you, and for everyone you care about.
If you have questions about tooth decay prevention or oral hygiene care, please contact us or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Tooth Decay” and “How to Help Your Child Develop the Best Habits for Oral Health.”
If at all possible, we want to save a tooth — it’s the best outcome for your overall dental health. In many cases, we can achieve this by filling the tooth or installing a crown over it.
Unfortunately, preservation isn’t always possible if the natural tooth has been irreparably weakened by decay or trauma. Replacing the natural tooth with a life-like artificial one is the next best option: the replacement will help you regain lost function and reinvigorate your smile. Filling the missing tooth’s space also prevents neighboring teeth from drifting into it, causing further problems with function and appearance.
Dental implants are widely recognized as the best choice for tooth replacement because of their life-like qualities, durability and positive effect on bone health. Even their biggest drawback, their cost, isn’t that great an issue if you factor in their longevity — they may actually result in less dental expense over the long-term.
A dental implant, however, isn’t always a viable option. Some patients may not have enough bone mass to support an implant. Those with certain systemic diseases like uncontrolled diabetes or a weakened immune system may not be able to undergo dental implant surgery.
Fortunately, many of these patients can benefit from a fixed bridge, a restoration option that’s been used for decades. A bridge is a series of life-like crowns permanently joined like pickets in a fence. The middle crown known as the “pontic” fills the empty space left by the missing tooth. The crowns on either side of the pontic are permanently attached to the natural teeth that border the missing tooth space. Known also as “abutment” teeth, they serve as the support for the bridge.
Bridges do have one downside — the abutment teeth must be prepared by filing them down so the new crowns fit over them properly. This will permanently alter and possibly weaken the teeth. Dental implants, on the other hand, have little to no effect on adjacent teeth.
Still, a bridge remains an effective option for many people. Properly cared for, a bridge can restore function as well as enhance your smile for many years to come.
If you would like more information on bridgework as a restorative option, 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 “Crowns & Bridgework.”
Anxiety in a child during dental procedures could interfere with the care they need. But recent advances in sedation drug therapy can calm pediatric patients safely and allow us to perform more invasive procedures without general anesthesia.
In contrast to general anesthesia, conscious sedation allows a patient to relax and feel calm while still breathing normally on their own and able to respond to certain stimuli. Conscious sedation can be deep, moderate or minimal. Deep sedation is akin to sleep and will also cause the child not to remember details of the procedure when they awaken. At the other end of the spectrum is minimal sedation, the most common type used in pediatric dentistry, which allows patients to respond to touching or verbal commands. Deep sedation drugs are usually administered intravenously, while those used for minimal sedation are administered orally with syrup. Conscious sedation doesn’t prevent pain, so it must also be accompanied by local anesthesia or other pain-relieving methods.
After you arrive for your child’s procedure, we’ll normally conduct a pre-sedation evaluation to be sure there are no medical problems that might interfere with the sedation. We typically use Midazolam (under the brand name Versed) or Hydroxyzine (also known as Vistaril or Atarax) to achieve sedation. Both are very safe, fast-acting and exit the body quickly after treatment.
During the procedure, a designated member of our staff continuously monitors your child’s vital signs, including pulse and respiration rates, blood pressure, temperature, and blood oxygen level. After the procedure your child will remain in recovery until vital signs return to pre-sedation levels. You should then take your child home and monitor them for the remainder of the day — definitely no return to school until at least the next day.
Safety is a top priority when using any sedation therapy — dental professionals follow strict procedures and protocols, as well as adhere to certification requirements enforced by many states. Performed in this manner, conscious sedation can help ensure your child’s experiences in our office are pleasant, and will hopefully result in a greater willingness when they grow up to continue professional dental care.
If you would like more information on conscious sedation for 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 “Sedation Dentistry for Kids.”
Have you heard the news about red wine? Every so often, the fruit of the vine is touted for some potential health benefit. Several studies over the past few years have suggested that it could help prevent heart disease and even certain types of cancer — only to have their conclusions called into question by new research. Just recently, newspapers trumpeted a new study from the Journal of Agriculture and Food Chemistry suggesting that certain chemicals in the vino might one day be used to help prevent cavities!
So is red wine good for your health, or isn’t it?
The jury’s still out. But there’s one thing we do know: Regardless of whether it has any affect on cavities, red wine is one of the major culprits in tooth staining.
Of course, it’s not the only offender: Coffee and tea, tobacco in any form, certain foods and some types of medications can all cause extrinsic stains on teeth — that is, stains that affect the exterior surface of the tooth. In addition, intrinsic stain — those that arise from the interior of the tooth — may be caused by root canal problems, or by certain dental filling materials.
If you have stained teeth — whether from red wine or another cause — can you do anything to make them whiter?
Oftentimes, the answer is yes — but finding the best way to do so can be challenging. You can begin by identifying habits and dietary factors that could cause staining. Then, reduce or eliminate the stain-causing factors, and enhance the beneficial ones. For example: stop smoking, modify your diet, practice regular, effective oral hygiene… and come in to the dental office twice a year for a professional cleaning and check-up. In addition, check whether any of your medications could cause staining or reduced saliva flow — a major contributor to the problem.
If making these changes isn’t enough to control teeth staining, the good news is that a number of treatments are available that can help bring your teeth back to a pearly shine — or even give you the “Hollywood white” smile you’ve always wished for. Depending on the cause of your teeth staining, and your desired level of brightening, these treatments can range from professional bleaching to porcelain veneers.
If your smile needs a little help to look its brightest, contact us or schedule an appointment to find out what we can do. For more information, see the Dear Doctor magazine articles “Tooth Staining” and “Important Teeth Whitening Questions Answered.”