Posts for: May, 2018
Radiographic (x-ray) images are an indispensible diagnostic tool in dentistry. One of the most routine and useful types of x-rays dentists take is the so-called bitewing. Here are some things you may want to know about this common diagnostic procedure.
What are bitewing x-rays?
Bitewings reveal the presence and extent of decay in the back teeth, specifically in areas where adjacent teeth touch each other. Unlike other areas of the teeth, these contacting surfaces between adjacent teeth can’t be examined visually. Bitewings can also show areas of bone loss around teeth — a sign of periodontal disease; however, they are not taken for that purpose because bitewings will not show the complete root surface that is surrounded by bone.
Why are they called that?
The name “bitewing” refers to how the film — or sensor, in the case of a digital x-ray — is positioned in the mouth: The patient bites down on a little tab or wing that holds the apparatus in place.
How often do I need them?
This is determined on a case-by-case basis, with the goal of not exposing you to any more radiation than necessary — even the minimal amount found in a series of bitewing x-rays. Your individual susceptibility to caries (tooth decay) and personal dental history will play a major role in determining how frequently you need radiographic examination — and, for that matter, how often you need to come in for routine cleanings and exams.
Are they safe?
The safety of bitewing x-rays is best illustrated with a comparison to the regular daily radiation exposure we get every day from environmental sources, which is about 0.01 millisieverts — the unit of measure we use for radiation. A series of 4 bitewing x-rays exposes you to 0.004 millisieverts of radiation — less than half of the daily exposure. Undetected tooth decay, which can spread quickly through the softer inner layers of teeth, is considered much more dangerous!
If a bitewing x-ray shows that there is tooth decay, what happens next?
If the cavity is very small, we may be able to treat it during the same appointment. If not, we will make a separate appointment to make sure it is taken care of promptly. The sooner tooth decay is treated, the better!
When your baby’s first teeth come in, you might not think it necessary yet to worry about tooth decay. But even infants can develop this common dental disease. In fact, it has a specific name in children 6 and under: early childhood caries (ECC).
About one-fourth of U.S. children have ECC, and poor or minority children are at highest risk. Because of primary (“baby”) teeth’s thin enamel layer, ECC can spread to healthier teeth with unnerving speed, causing extensive damage.
While such damage immediately affects a child’s nutrition, speech development and self-esteem, it could also impact their future oral health. Permanent teeth often erupt out of position because of missing primary teeth lost prematurely, creating a poor bite. And children with ECC are more likely to have cavities in their future permanent teeth.
While there are a number of effective treatments for repairing ECC-caused damage, it’s best to try to prevent it before damage occurs. A large part of prevention depends on you. You should, for example, begin oral hygiene even before teeth come in by wiping their gums with a clean, damp cloth after feeding. After teeth appear, switch to daily brushing with just a smear of toothpaste.
Because refined sugar is a primary food source for decay-causing bacteria, you should limit it in their diet. In the same vein, avoid sleep-time bottles with fluids like juices, milk or formula. As they grow older, make sure snacks are also low in sugar.
You should also avoid spreading your own oral bacteria to your baby. In this regard, don’t put their eating utensils or pacifier in your mouth and don’t drink from the same cup. Avoid kissing your baby on the lips. And above all, take care of your own oral health to prevent your own encounter with dental disease.
Finally, start regular dental visits on or before your baby’s first birthday. Regular cleanings and checkups increase the chances for early decay detection, as well as provide for treatments and prevention measures that can reduce the disease’s spread and destruction.
ECC can be devastating to both your baby’s current and future dental health. But with vigilance and good dental practices, you may be able to help them avoid this serious disease.
If you’ve just received a dental implant restoration, congratulations! This proven smile-changer is not only life-like, it’s also durable: more than 95% of implants survive at least 10 years. But beware: periodontal (gum) disease could derail that longevity.
Gum disease is triggered by dental plaque, a thin film of bacteria and food particles that builds up on teeth. Left untreated the infection weakens gum attachment to teeth and causes supporting bone loss, eventually leading to possible tooth loss. Something similar holds true for an implant: although the implant itself can’t be affected by disease, the gums and bone that support it can. And just as a tooth can be lost, so can an implant.
Gum disease affecting an implant is called peri-implantitis (“peri”–around; implant “itis”–inflammation). Usually beginning with the surface tissues, the infection can advance (quite rapidly) below the gum line to eventually weaken the bone in which the implant has become integrated (a process known as osseointegration). As the bone deteriorates, the implant loses the secure hold created through osseointegration and may eventually give way.
As in other cases of gum disease, the sooner we detect peri-implantitis the better our chances of preserving the implant. That’s why at the first signs of a gum infection—swollen, reddened or bleeding gums—you should contact us at once for an appointment.
If you indeed have peri-implantitis, we’ll manually identify and remove all plaque and calculus (tartar) fueling the infection, which might also require surgical access to deeper plaque deposits. We may also need to decontaminate microscopic ridges found on the implant surface. These are typically added by the implant manufacturer to boost osseointegration, but in the face of a gum infection they can become havens for disease-causing bacteria to grow and hide.
Of course, the best way to treat peri-implantitis is to attempt to prevent it through daily brushing and flossing, and at least twice a year (or more, if we recommend it) dental visits for thorough cleanings and checkups. Keeping its supporting tissues disease-free will boost your implant’s chances for a long and useful life.
If you would like more information on caring for your 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 “Gum Disease can Cause Dental Implant Failure.”