The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.
Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).
Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.
A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.
CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.
But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.
And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.
If you would like more information on advanced dental 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.”
Do you want to give your child something that will benefit them the rest of their life? Then give them the gift of healthy teeth and gums.
Such a gift doesn't come wrapped in a box with a bow on it—you bestow it first by ensuring they receive the utmost in dental care during their formative years. Even more importantly, you instill in them good oral care habits that will protect their dental health for the rest of their lives.
Oral Hygiene 101. Daily hygiene—brushing and flossing to remove disease-causing dental plaque—is the foundation for maintaining a lifetime of optimal dental health. Early on, you'll have to perform these tasks for your child, but the true gift is in teaching them to brush and floss effectively for themselves (and your dentist can help too!).
How's my brushing? There's oral hygiene—and then there's effective oral hygiene. For a quick check, there's a simple test you can teach your child to make sure they're brushing and flossing correctly: Just after they finish, have them rub their tongue all along their teeth. If the teeth feel smooth, they've made the grade! If it feels gritty, though, they'll need to try again. (For better accuracy, you can also purchase a disclosing solution at your local pharmacy that when applied to teeth will reveal any remaining plaque.)
Eating for dental health. Instilling the values of proper nutrition not only promotes your child's overall health, it can also help them have healthier teeth and gums. Foods rich in vitamins and minerals, especially vitamin D, calcium and phosphorus, help build strong teeth and bones. Avoiding processed foods, especially those with added sugar, helps them avoid tooth decay or gum disease.
Mouth protection from injury. As your child grows and becomes more active, they're more at risk for injury to their mouth, teeth or gums. Help them break habits like chewing on hard objects, and insist on them wearing a mouthguard while playing sports. As they enter the teen years, encourage them to avoid “mouth jewelry” that could damage their tooth enamel.
These values and practices are often woven into the fabric of everyday life. They take relatively little time, but they can make a huge impact on your child's oral health future.
If you would like more information on dental care for kids, 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 to Help Your Child Develop the Best Habits for Oral Health.”
According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.
At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.
And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.
As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.
Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.
Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.
Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.
If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?”
Tooth decay is perhaps the biggest danger your child's teeth can face. Not only can it rob them of primary teeth now, but the loss of teeth at this early age could also lead to future bite problems.
That's why it's important to reduce the risk of tooth decay through daily brushing and flossing and regular dental cleanings. You child may also benefit from another measure that enhances those other hygiene efforts—topical fluoride applied directly to tooth surfaces.
Fluoride is a naturally occurring chemical that's been demonstrated to strengthen tooth enamel against contact with acid, the main cause of tooth decay. Today, fluoride is added not only to toothpastes and other dental hygiene products, but also in minute amounts to drinking water supplies across the country.
Even if your child takes in fluoride through one or more of these sources, there may still be a benefit to a topical application. For one, topical applications are usually stronger than fluoride toothpaste or fluoridated water supplies and can have greater effect. And because fluoridated water is ingested first before traveling through the bloodstream to the teeth, directly applied fluoride can strengthen them much faster.
But are these stronger concentrations of topical fluoride safe? Studies have shown no long-term health risk, but there can be temporary side effects like stomach pain, vomiting or headaches if the patient accidently swallows too much of the solution during the application. These side effects, however, can be minimized through safety measures dentists put in place during the procedure.
One study by the Cochrane Oral Health Research Group seems to show that the long-term benefit of topical fluoride is well worth this minor risk of side effects. After reviewing several scientific studies involving thousands of patients, the group found an overall 28% reduction in decayed, filled or missing teeth over a number of years among those who received a topical fluoride treatment.
Because of these and other forms of evidence, fluoride applications in either gel, foam or varnish forms have become a routine part of preventive care for children. Discussing it with your dentist, you may find it could be an extra weapon for your child in fighting tooth decay.
If you would like more information on how to protect your child's teeth from decay, 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 “Fluoride Gels Reduce Decay.”
Breastfeeding is nature's way of providing complete nourishment to a newborn in their first years of life. It can also have a positive impact on their emerging immune system, as well as provide emotional support and stability. But although nursing comes naturally to an infant, there are circumstances that can make it more difficult.
One example is an abnormality that occurs in one in ten babies known as a tongue tie. A tongue tie involves a small band of tissue called a frenum, which connects the underside of the tongue with the floor of the mouth. The frenum, as well as another connecting the inside of the upper lip with the gums, is a normal part of oral anatomy that helps control movement.
But if the frenum is too short, thick or taut, it could restrict the movement of the tongue or lip. This can interfere with the baby acquiring a good seal on the breast nipple that allows them to draw out milk. Instead, the baby may try to chew on the nipple rather than suck on it, leading to an unpleasant experience for both baby and mother.
But this problem can be solved with a minor surgical procedure called a frenotomy (also frenectomy or frenuplasty). It can be a performed in a dentist's office with just a mild numbing agent applied topically to the mouth area (or injected, in rare cases of a thicker frenum) to deaden it. After a few minutes, the baby's tongue is extended to expose the frenum, which is then snipped with scissors or by laser.
There's very little post-op care required (and virtually none if performed with a laser). But there may be a need for a child to “re-learn” how to breastfeed since the abnormal frenum may have caused them to use their oral muscles in a different way to compensate. A lactation expert may be helpful in rehabilitating the baby's muscles to nurse properly.
A restrictive frenum isn't necessarily a dire situation for an infant—they can continue to feed with a bottle filled with formula or pumped breastmilk. But employing this minor procedure can enable them to gain the other benefits associated with breastfeeding.
If you would like more information on tongue ties and other oral abnormalities in 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 “Tongue Ties, Lip Ties and Breastfeeding.”
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