Posts for: June, 2019
X-ray imaging is such an intricate part of dentistry, we usually don't think twice about it. Without it, though, the fight against dental disease would be much harder.
At the same time, we can't forget that x-rays are a form of electromagnetic radiation that can penetrate human tissue. It's that very quality and the difference in the absorption rate between denser bone and teeth and softer diseased tissue that makes disease diagnosis possible.
But this same penetrative power can potentially harm the tissues it passes through. For that reason when practicing any form of x-ray diagnostics, dentists follow a principle known as ALARA, an acronym for "As Low As Reasonably Achievable." In lay terms ALARA means getting the most benefit from x-rays that we can with the lowest dose and exposure time possible.
While practicing ALARA with x-rays is important for patients of any age, it's especially so for children who are more sensitive to radiological energy given their smaller size and anatomy. We can't use the same settings, dosages or exposure times with them as with an adult.
To protect children, dentists have developed techniques and protocols that lessen their exposure time and rate, while still providing usable images for diagnosing disease. The bitewing is a good example of safe and effective pediatric x-ray imaging.
A bitewing is a plastic device holding exposable film that patients bite down on and hold in their mouth while x-raying. The x-rays pass through the teeth and gums and expose the film behind them on the bitewing. Using a bitewing we can capture a set of two to four radiographs to give us a comprehensive view of the back teeth, while exposing the child less radiation than they normally receive daily from background environmental sources.
This and other advances in equipment and digital imaging greatly reduce the amount of radiation patients receive during x-rays. If, though, you're still concerned about your child's x-ray exposure, talk with your dentist who can explain in more detail the x-ray safety protocols they follow. Just like you, they want your child to be as safe as possible while still benefiting from the diagnostic power of x-rays.
If you would like more information on safety precautions using 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.”
Root canal therapy is the unsung "hero" of dentistry. Although often falsely maligned as an unpleasant experience, millions of decayed teeth have been saved thanks to this routine treatment.
But although root canal therapy can save your tooth, we can't guarantee it won't be affected by another infection. There are other factors to consider how long a treated tooth will remain healthy.
Root canal therapy stops and limits the damage from tooth decay that has infected the inner pulp and root canals. A dentist or endodontist (a root canal specialist) drills into the tooth to gain access to the pulp. They remove the diseased pulp tissue and then fill the empty pulp chamber and root canals with a specialized filling called gutta percha. The tooth is then sealed and later crowned to protect it against future fracture or infection.
The probability of that occurring may depend on when a dentist performs the root canal in the disease progression—and the earlier the better. If decay has already infected the underlying bone, the tooth's long-term prognosis even with root canal therapy could be dim. That's why you should see a dentist as soon as possible for any tooth pain, even if it goes away.
The type of tooth could impact long-term health. Teeth with single roots are usually easier to treat. But those with multiple roots and an intricate root canal network can be more difficult to treat, and require specialized equipment and techniques.
Age can also impact root canal therapy longevity. The older a root canal-treated tooth is, the more brittle and susceptible to fracture it can become, which can pose complications. That's why we typically place crowns on treated teeth to protect them from both future infection and undue stress created while biting and chewing.
To help mitigate these possible factors, you should see your dentist regularly for checkups and at the first sign of pain or other abnormalities for the earliest treatment possible. And for more complex tooth issues, your dentist may refer you to an endodontist to perform your root canal. With early intervention and attentive care, your root canaled tooth could enjoy many years of life.
If you would like more information on root canal treatment, 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 “Root Canal Treatment: How Long Will It Last?”
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.