Posts for: February, 2014
Your dental care would be much more limited without our ability to see “below the surface” with x-ray imaging. But since x-rays passing through the body are a form of radiation, could your exposure from them be hazardous to your health?
It depends on exposure dosages and, of course, the amount you have been exposed to over your lifetime. But, decades of research have demonstrated that exposure to dental x-rays during your regular office visits are only a fraction of the radiation you normally encounter from the natural environment every year.
X-rays have the ability to pass through body tissues, but at different rates for soft tissue like skin and muscle and hard tissue like bone. This effect creates shadows on exposed film; the differentiation is in such detail that a trained technician can interpret not only internal structures, but defects such as fractured bone or, in the case of dentistry, signs of tooth decay and bone loss from gum disease.
But like other energy sources in our environment, x-rays do emit radiation that in high doses can be dangerous to living tissue. The amount of exposure is measured in millisieverts (mSv), a unit that allows for comparison of doses from different sources of radiation. Scientists have calculated that we’re normally exposed to between 2 and 4.5 mSv every year.
By contrast, a single digital periapical image taken of a tooth is equal to 1 microsievert (μSv), or one thousandth of an mSv; a full mouth series (between 18 and 20 images) creates an exposure of 85 μSv, or 85/1000 of one mSv. In addition, advances in technology have further reduced the radiation exposure from x-ray imaging. For example, digital imaging has reduced exposure during full mouth x-rays from seven to ten days of equal exposure from normal background radiation to half a day, and with no loss in image quality.
In effect, dental x-rays pose little to no risk for patients. Still, understanding that x-ray imaging does expose patients to radiation, dentists follow certain protocols and safety precautions. For example, dentists will place a lead apron around their patients’ chest area during an x-ray exposure.
As your dentist, we’re happy to address any concerns you may have about x-ray radiation exposure. But rest assured, the x-ray devices used in your dental care, so necessary in the fight against tooth decay and other diseases, are safe and reliable.
If you would like more information on the use of x-ray technology and safety, 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 Frequency and Safety.”
Teeth are composed of layers of different types of tissue. The main inner layers — the pulp and dentin — help the teeth respond and adapt to external forces. But they’re vulnerable to decay and quite sensitive to environmental extremes. They are protected from all these by a coating of enamel, made of the hardest material found in the human body.
But while enamel is strong, it’s not invincible — it can soften and dissolve (de-mineralize) if the mouth environment becomes too acidic. While de-mineralization occurs normally whenever the mouth becomes too acidic after eating or drinking, saliva helps neutralize the acid (buffering); in fact, saliva can restore to the enamel some of the calcium and other minerals it has lost (a process called re-mineralization).
If the acidic level remains too high for too long it can overwhelm saliva’s buffering ability and cause permanent mineral loss to the enamel. This erosion leaves teeth more susceptible to decay and disease and could lead to tooth loss. With this in mind, here’s some ways you can help preserve your enamel:
- Wait about thirty to sixty minutes after eating or drinking to brush your teeth. Counterintuitive as this may sound, it takes about thirty minutes for saliva to restore a normal pH level and re-mineralize the enamel. If you brush within this window of time, you could brush away some of the softened minerals from the enamel.
- Only brush twice a day. Over-brushing causes undue enamel wear, as well as contributing to receding gums.
- Take advantage of less acidic or mineral-rich beverages. Drink milk or water most of the time, rather than juices, sodas or sports drinks. The calcium in milk or as an additive to acidic beverages aids in buffering and re-mineralization.
- Use a straw for acidic beverages. With a straw your teeth avoid direct contact with most of the beverage’s acid, a key factor in de-mineralization.
- Avoid eating just before bed. Saliva flow decreases significantly when we sleep. If you eat right before bed, there may be less saliva available for buffering and re-mineralization.
Following these tips, along with effective oral hygiene, will go a long way in protecting your teeth’s enamel coating — and preserving your teeth in the long run.
If you would like more information on enamel erosion and how to prevent it, 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 “6 Tips to Help Prevent the Erosion of Tooth Enamel.”
Periodontal (gum) diseases like gingivitis (inflammation of the gum tissues) can exist in a chronic form for some time, while gradually worsening. But given the right conditions, gingivitis could elevate quickly into an acute, painful condition known as Acute Necrotizing Ulcerative Gingivitis (ANUG). While it can be effectively treated, it’s important to diagnose ANUG early and begin treatment as soon as possible.
ANUG is also known as “trench mouth” as it was commonly recognized among soldiers in the trenches during World War I. Its name describes it as “necrotizing” and “ulcerative,” because when left untreated it kills (“necrotizes”) soft gum tissue, particularly the triangular tissue between teeth known as papillae, and causes severe and painful sores. A person with ANUG may also exhibit very bad breath and taste, with an odor peculiar to the disease. It’s believed that acute stress, poor nutrition and a lack of sleep can trigger the condition in individuals with pre-existing gingivitis.
As with other forms of gum disease, the first priority of treatment is to alleviate the symptoms. Besides initial cleaning (also known as scaling), we would also prescribe antibiotics (particularly Metronidazole, which is effective against the specific bacteria responsible for ANUG), an antibacterial mouthrinse like chlorhexidine, and a mild saline rinse. We would also control pain and inflammation with non-steroidal anti-inflammatory drugs like aspirin or ibuprofen.
As the symptoms come under control, it’s then necessary to treat the underlying gingivitis by continuing the thorough cleaning of the affected surfaces, including the roots, of as much plaque and tartar as possible. Good oral hygiene with semi-annual professional cleanings must become regular habits to inhibit future reoccurrences of the disease. Quitting smoking, eating a healthy diet and managing stress are also advisable.
Without treatment, ANUG symptoms will persist; you could eventually lose the affected papillae, and experience other detrimental effects to other periodontal tissue and bone structures. If you suspect you may have gingivitis or this acute form, you should visit us as soon as possible for a full evaluation and treatment. The earlier we diagnose and treat gum disease, the better your long-term outlook.
If you would like more information on painful gums, 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 “Painful Gums in Teens and Adults.”
Periodontal or gum disease is a serious condition that could lead to tooth and bone loss. Unfortunately, you may not even realize you have it — the disease in its early stages can be difficult to detect. If you know what to look for, however, a few signs can tell you something isn’t quite right.
Bleeding gums after brushing, for example, are a likely indication that your gum tissues are inflammed due to an infection caused by bacterial plaque. Coupled with chronic inflammation from the body’s response to the infection, the unhealthy tissues bleed easily.
As the disease progresses, you may also notice changes in your gums’ appearance: redness at the gum line, as well as some slight swelling. Receding gums expose more of the tooth below the enamel crown. As roots become exposed to the oral environment, you’ll begin to notice painful sensitivity to hot or cold. In time, the disease may cause bone loss producing other signs like loose teeth or teeth shifting from their original position.
In some cases, gum disease can cause a painfully acute abscess. This occurs when the bacterial infection becomes isolated in a pocket of space between the teeth and gums. As the body attempts to fight the infection, its defenses are overwhelmed and the abscess becomes painful, swollen and filled with pus.
If you encounter any of these signs, it’s important to take action quickly to minimize the damage and stop the disease’s progress. Our first priority is to remove as much bacterial plaque and calculus as possible and may consider antibacterial and antibiotic treatments. This may take more than one session, but it’s necessary in stopping the disease.
Long-term success, though, will depend on improved oral hygiene (brushing and flossing), regular office cleanings to remove difficult to reach plaque and calculus, and checkups to monitor the condition of your gums. You can also lower the risk of reoccurrence with improvements in diet and life-style (such as quitting smoking). Instituting better hygiene and lifestyle habits, as well as keeping alert to any signs of recurring disease will go a long way in preserving your teeth and overall oral health.
If you would like more information about periodontal disease and its effect on your health, 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 “Warning Signs of Periodontal (Gum) Disease.”