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.”
With a 95%-plus success rate, dental implants are an effective and durable replacement for lost teeth. But we can't place them and forget them: if you don't clean and maintain them they could fail as a result of disease.
The inorganic materials that make up the implant aren't in danger of infection. But the living gums and bone that surround and support the implant are at risk. In fact, there's a particular periodontal (gum) disease involving implants called peri-implantitis (“peri” – around; implant “itis” – inflammation).
Peri-implantitis begins when the gum tissues around the implant become infected and inflamed. This happens most commonly because plaque, a thin film of bacteria and food particles, builds up on implant surfaces. Another less frequent cause is a buildup of excess cement used to bond the crown to the implant. We need to remove the built-up plaque or the excess cement during your dental visit.
If the infection isn't treated or you don't keep up effective, daily hygiene practices, the infection can grow and extend deeper into the tissues and finally the bone. This can destroy the all-important integration of bone and metal titanium post that has created the implant's strong hold. When that support becomes compromised the implant can lose its attachment and, if untreated, eventually fail.
It's important to keep an eye out for any indications you may have a gum infection around an implant. Look for redness, swelling, bleeding or pus formation. If the implant feels loose, this may mean that extensive bone loss has already occurred. If you encounter any of these signs, see us immediately for an examination.
The best approach, though, is to prevent peri-implantitis in the first place. So, brush and floss daily around your implant as you do your natural teeth. And be sure you keep up regular dental cleanings and checkups.
With proper care and maintenance you can avoid problems with disease that could affect your implant. Healthy gums and bone will ensure your implant will last for many decades to come.
If you've lost a tooth, you have a number of options for replacing it. Perhaps the best choice in terms of lifelikeness and durability is a dental implant.
All implants have the same basic architecture: a titanium metal post imbedded in the jawbone to replace the root; and an abutment, a metal collar that links the post with a lifelike porcelain crown. But implants can vary in how the crown attaches to the abutment and post — either cemented to the abutment or screwed through the abutment to the post.
Either method will permanently secure the crown to the implant. But there are advantages and disadvantages for each.
A screw-retained crown may better facilitate any future repair that might be needed. For a skilled dentist it's a simple matter of removing the screw and then the crown from the abutment. There's less risk of damage to the implant during repairs or crown replacement. Many dentists also prefer screws for crowns placed at the same time they're installing the implant post (a procedure called immediate loading).
The screw access hole, however, could pose a cosmetic problem. Although we can cover it over with tooth-colored filling, it may still be noticeable and unattractive especially for a tooth visible when you smile (in the smile zone). There's also the possibility the porcelain around the access hole could chip.
By contrast, cemented crowns have a smooth, unbroken surface and are aesthetically ideal for smile zone teeth. But the cement could interact poorly with gum and bone tissue in some patients, causing inflammation and possible bone loss.
And unlike screw-retained crowns, cemented crowns are difficult to remove for implant repair. We may have to drill through the crown to access the screw between the abutment and the post, and then repair it cosmetically if we use the same crown. Again, the final result may not be quite as visually appealing.
In the end, it will depend on the implant's location, how your body reacts to the cement or your dentist's preference. In either case, though, you'll have a tooth replacement that's functional, life-like and able to endure for many years to come.
If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”
You can't go wrong with an early start caring for your child's teeth and gums. In fact, dental care should begin in earnest when their first tooth appears.
You should begin by gently cleaning your infant's gums and new teeth after each feeding with a clean, water-soaked washcloth or gauze pad. Once they start eating solid food, you should transition to a soft-bristled brush with just a smear of fluoridated toothpaste. Around age 2, you can increase that to a pea-sized amount and begin teach them to brush for themselves.
The next important element in your child's dental care is beginning regular dental visits around their first birthday. There are good reasons to begin visits at this time. There primary teeth should now be erupting in earnest and you'll want to begin prevention measures against tooth decay if needed. You'll also want to get them used to going to the dentist early in life: if you wait a year or two later, they may not respond well to the unfamiliar surroundings of a dental office.
There are also a number of things you can do to support hygiene and dental visits. You should not allow your child to sleep with a pacifier covered or a bottle filled with anything but water. Milk, juices and other sugar-containing liquids will raise the risk of tooth decay. And speaking of sugar, limit their consumption to meal times: snacking constantly on sugar can create an environment ripe for decay.
Of course, dental disease isn't the only hazard your child's teeth may face. Accidents can happen and your child's otherwise healthy teeth could be injured. So, make sure they don't play too close to hard furniture or other features around the house they could fall on. If they should begin playing contact sports, invest in a custom mouth guard — avoiding an injury is well worth the cost.
Getting into dental care with your children as soon as possible will set the foundation for good oral health. And the example you set will stick with them as they take on their own dental care when they're older.
If you would like more information on caring for your child's teeth, 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 “Top 10 Oral Health Tips for Children.”
The American marketplace usually offers us plenty of buying choices — sometimes it seems too many. A case in point: the toothpaste aisle at your local supermarket.
It can be a bit overwhelming with all the razzle-dazzle packaging and exciting claims of “Whiter Teeth!” or “Fresher Breath!” But toothpaste really isn't that complicated, if you keep in mind its primary goal: to help you with your toothbrush remove disease-causing plaque from teeth surfaces.
And the vast majority can, thanks to ingredients you'll find in just about every brand. All toothpastes, for example, contain some form of abrasive material that boosts the mechanical action of brushing to remove plaque. This isn't new: the ancient Egyptians used ox-hoof ashes, burnt eggshells and pumice as abrasives. Today you'll find hydrated silica (originating from sand), hydrated alumina or calcium carbonate as abrasives on the ingredient list.
You also need some form of detergent to help loosen and break down substances that won't dissolve in water. Toothpaste detergent is much milder than that which you use on your dishes. The most common is sodium lauryl sulfate, a foaming agent found in shampoo and other beauty products. It's been used safely for half a century in toothpaste, although it can irritate the inner linings of some people's mouths. If this is a problem for you, you should look for toothpaste with a different detergent.
There is also a myriad of other ingredients, including binders, humectants (which help the toothpaste retain moisture) and flavorings. You may also find bleaching agents that help brighten your teeth, although they may not be strong enough to remove deep staining, something we would need to help you with.
And let's not forget one other frequent ingredient: fluoride. This natural chemical strengthens enamel and helps fight tooth decay as part of a disease prevention strategy. It's perhaps the most valuable ingredient you'll find in toothpaste, so make sure it's in your chosen brand.
If you want to simplify your decision, choose toothpaste with the seal of acceptance from the American Dental Association. The seal indicates the claims of the toothpaste manufacturer have been independently verified. You can trust those brands to help keep your teeth clean and free from disease. In the end, that's really what you want from your toothpaste.
If you would like more information on the right toothpaste for you, 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 “Toothpaste: What's in it?”
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