Posts for: March, 2014
From its development and first use over a century ago, radiography — the use of x-rays to view internal images in the body — has revolutionized how dentists diagnose and treat patients. Now, a new technology known as Cone Beam Computing Tomography (CBCT) promises to take us “light years” beyond even today's most modern conventional x-ray devices.
X-rays expose images on special film after passing through a mass, like the human body. Because they pass more easily through soft tissues than through hard structures like teeth or bone, the softer tissues will appear darker. This property can reveal even subtle distinctions in density such as might be the case with a fracture or a tooth cavity.
Standard radiography, though, has its limitations. It takes extensive training and experience for a dentist to interpret exactly what they're seeing in an x-ray. Their two-dimensionality (like a photograph) limits the amount of information we can derive from the physical structures being examined. And due to radiation exposure to patients, we must limit the amount of their use for each individual patient.
CBCT improves on those limitations. The device projects a cone-shaped beam of x-rays as it rotates around a patient's head. During this rotation it records hundreds of images that a computer can later digitally format in a variety of ways. The result: instead of a two-dimensional flat view, we can now three-dimensionally view the mouth from a variety of different angles and in greater detail. Best of all, one scan can provide enough imagery data to view in detail the entire skull or a jaw, or something as minute as a single root canal within a tooth.
CBCT is already improving the accuracy of diagnostics and treatment in a variety of dental specialties, including orthodontics, implantation and oral surgery. And properly set, the radiation exposure is no more or less than a full-mouth series of x-rays, and up to ten times less than CT scanning.
Advances like CBCT increase the range and accuracy of diagnostics and improve treatment for a variety of conditions. As they grow in use, the result will be more successful dental outcomes for you and your family.
If you would like more information on CBCT 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.”
The “wear and tear” nature of gingival (gum) tissue enables it to readily handle the chewing and biting actions of eating and still perform its most important function: protecting the roots of your teeth from decay and environmental exposure. But while they're resilient, they're not invincible: it's quite possible for them to lose their attachment to a tooth and begin to recede, leaving the root surfaces exposed.
Gum recession can occur for a number of reasons: poor oral hygiene; over brushing and flossing; malocclusion (a poor bite); personal habits, like biting down on hard foreign objects; or poorly fitted dentures or other appliances. From a genetic point of view, people with thinner gingival tissues are more prone to gum recession than those with thicker tissues. Whatever the cause, the result is the same — the exposed tooth becomes more sensitive to environmental factors (such as heat, cold, abrasion or erosion). More importantly, it now has a higher susceptibility to decay and disease, leading to its possible demise.
But there may be a solution. Although the original tissue may be lost, periodontal plastic surgery can restore a protective layer of tissue to the tooth, and at the same time give you back the smile you once had.
From the Greek word “plastik” for sculpting or modeling clay, plastic surgery procedures restore both form and function to a bodily structure. While the term “plastic surgery” can apply to other procedures in medicine such as rhinoplasty or face lifts, the periodontal procedure particularly involves grafting similar tissue to an area of recession, and then “shaping” it into a natural, life-like form.
To graft means to remove tissue from a donor site and attach it to a recipient site. In the case of periodontal tissue, the recipient patient can also be the donor with the tissue coming from some other area of the same mouth (the graft can also come from another human or an animal). Using advanced techniques and a touch of artistry, the surgeon positions and sutures the graft in place.
The result: not only a new protective covering for your tooth, but a more pleasing appearance when you smile.
If you would like more information on periodontal plastic surgery, 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 “Periodontal Plastic Surgery.”
If you’re missing a tooth, you’re not alone; in fact 35 million Americans are missing all of their teeth in at least one jaw! Whether it’s one tooth or many, it’s important to replace what’s missing. Depending on the number of teeth lost, the potential drawbacks to doing nothing may become hard to ignore: impediments to eating, interference with speech, and unaesthetic appearance, for example.
Traditional bridges and dentures are the most affordable options for replacing teeth. Tooth implants — tiny titanium, screw-like substitutes for a tooth’s natural root to which natural-looking dental crowns are attached — are pricier but offer an important extra benefit. In addition to addressing the common problems previously mentioned, by acting like the original tooth root, an implant can maintain or stimulate “remodeling,” of the jawbone below. Without a tooth root to provide stimulation, mature bone cells will continue to be removed, or resorbed, but no new bone cells will regenerate to replace them, leading to a progressive loss of bone width, height and density. The more teeth are lost, and with less bone structure to support it, the whole shape of the face can change.
Unfortunately, when greater numbers of teeth must be replaced, implants can become financially unrealistic for some people. But in appropriate cases there is a third option: a bridge or denture/implant hybrid. In the case of a bridge intended to fill a gap when multiple teeth are missing, an implant can be used on either side of the gap to support the bridge, leaving the natural teeth undisturbed. Strategically placed implants can be used to support a removable denture, too.
If you would like more information about 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 “Dental Implants: Your Best Option For Replacing Teeth.”
Chewing tobacco, especially among young athletes, is considered fashionable — the “cool” thing to do. Many erroneously think it’s a safe alternative to smoke tobacco — it is, in fact, the source of numerous health problems that could ultimately lead to disfigurement or even death.
Chewing or dipping tobacco is especially linked with the sport of baseball. Its traditions in baseball go back to the late Nineteenth Century when players chewed to keep their mouths moist on dusty fields. The habit hit its greatest stride after the surgeon general’s warning on cigarettes in the late 1950s. Now, players wishing to emulate their major league heroes are prone to take up chewing tobacco at an early age.
But the habit comes with a price tag. Individuals who chew tobacco are more susceptible to oral problems like bad breath, mouth dryness, or tooth decay and gum disease. Users also increase their risk for sexual dysfunction, cardiopulmonary disease (including heart attack and stroke) and, most notably, oral cancer.
Derived from the same plant, chewing and smoke tobacco share a common trait — they both contain the highly addictive drug nicotine. Either type of user becomes addictive to the nicotine in the tobacco; and like smoking, a chewing habit can be very difficult to stop.
Fortunately, many of the same treatments and techniques for quitting smoking can also be useful to break a chewing habit. Nicotine replacement treatments like Zyban or Chantix have been shown effective with tobacco chewing habits. Substituting the activity with gum chewing (non-nicotine, and with the sweetener Xylitol), or even an herbal dip can also be helpful.
Like other difficult processes, it’s best not to try to quit on your own. You should begin your efforts to quit with a consultation with your doctor or dentist — they will be able to prescribe cessation medications and provide other suggestions for quitting. You may also find it helpful to visit a behavioral health counselor or attend a tobacco cessation support group.
Rather than just one approach, successful quitting usually works best with a combination of techniques or treatments, and perhaps a little trial and error. The important thing is not to give up: the improvements to your dental health — and life — are worth it.
If you would like more information on quitting chewing tobacco, 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 “Quitting Chewing Tobacco.”