Posts for: July, 2014
X-ray diagnostics have revolutionized our ability to detect early or hidden cavities, paving the way for better dental care. But x-ray exposure also increases health risks and requires careful usage, especially with children.
A form of invisible radiation, x-rays penetrate and pass through organic tissue at varying rates depending on the density of the tissue. Denser tissues such as teeth or bone allow less x-rays to pass through, resulting in a lighter image on exposed film; less dense tissues allow more, resulting in a darker image. This differentiation enables us to identify cavities between the teeth — which appear as dark areas on the lighter tooth image — more readily than sight observation or clinical examination at times.
But excessive exposure of living tissue to x-ray radiation can increase the risk of certain kinds of cancer. Children in particular are more sensitive than adults to radiation exposure because of their size and stage of development. Children also have more of their lifespan in which radiation exposure can manifest as cancer.
Because of these risks, we follow an operational principle known as ALARA, an acronym for “As Low As Reasonably Achievable.” In other words, we limit both the amount and frequency of x-ray exposure to just what we need to obtain the information necessary for effective dental care. It’s common, for example, for us to use bitewing radiographs, so named for the tab that attaches the exposable film to a stem the patient bites down on while being x-rayed. Because we only take between two and four per session, we greatly limit the patient’s exposure to x-rays.
Recent advances in high-speed film and digital equipment have also significantly reduced x-ray exposure levels. The average child today is exposed to just 2-4 microsieverts during an x-ray session — much less than the 10 microsieverts of background radiation we all are exposed to in the natural environment every day.
Regardless of the relative safety of modern radiography, we do understand your concerns for your child’s health. We’re more than happy to discuss these risks and how they can be minimized while achieving maximum benefits for optimum dental health. Our aim is to provide your child with the highest care possible at the lowest risk to their health.
If you would like more information on the use of x-rays in dentistry, 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 Safety for Children.”
Anxiety in a child during dental procedures could interfere with the care they need. But recent advances in sedation drug therapy can calm pediatric patients safely and allow us to perform more invasive procedures without general anesthesia.
In contrast to general anesthesia, conscious sedation allows a patient to relax and feel calm while still breathing normally on their own and able to respond to certain stimuli. Conscious sedation can be deep, moderate or minimal. Deep sedation is akin to sleep and will also cause the child not to remember details of the procedure when they awaken. At the other end of the spectrum is minimal sedation, the most common type used in pediatric dentistry, which allows patients to respond to touching or verbal commands. Deep sedation drugs are usually administered intravenously, while those used for minimal sedation are administered orally with syrup. Conscious sedation doesn’t prevent pain, so it must also be accompanied by local anesthesia or other pain-relieving methods.
After you arrive for your child’s procedure, we’ll normally conduct a pre-sedation evaluation to be sure there are no medical problems that might interfere with the sedation. We typically use Midazolam (under the brand name Versed) or Hydroxyzine (also known as Vistaril or Atarax) to achieve sedation. Both are very safe, fast-acting and exit the body quickly after treatment.
During the procedure, a designated member of our staff continuously monitors your child’s vital signs, including pulse and respiration rates, blood pressure, temperature, and blood oxygen level. After the procedure your child will remain in recovery until vital signs return to pre-sedation levels. You should then take your child home and monitor them for the remainder of the day — definitely no return to school until at least the next day.
Safety is a top priority when using any sedation therapy — dental professionals follow strict procedures and protocols, as well as adhere to certification requirements enforced by many states. Performed in this manner, conscious sedation can help ensure your child’s experiences in our office are pleasant, and will hopefully result in a greater willingness when they grow up to continue professional dental care.
If you would like more information on conscious sedation for 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 “Sedation Dentistry for Kids.”