Posts for: September, 2015
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!
For over a hundred years dental amalgam — a combination of silver, mercury, tin and other metals — has been an effective filling material for teeth damaged by decay. But it has one major drawback — its metallic appearance stands out in stark contrast to the natural color of teeth.
As an alternative, composite resin fillings can match the color, shape and texture of natural teeth. These materials and the techniques used to bond them are proving just as effective as and more aesthetically pleasing than dental amalgam.
Fillings help protect and preserve a decayed tooth. By first removing decayed tooth structure through drilling, the resulting void is filled with durable material that strengthens the tooth and provides it protection from further decay.
The ultimate goal for restoration is to return the tooth to as near normal form and function as possible. Dental amalgam serves well in terms of function, providing the tooth strength in the face of the daily biting forces it encounters. In contrast, composite resins excel in appearance, but haven’t always matched the durability of amalgam. They’re material construction has improved over time, though, as well as the techniques used to bond them to teeth.
Most of these bonding techniques incorporate layering. The first step is to seal the dentin (the porous, living tissue just below the enamel); we then build up the composite material layer by layer within the tooth using special bonding adhesive and curing lights. In some cases where a large volume of tooth structure must be replaced, the restoration is first formed on the tooth and then removed for curing before being cemented into the tooth or a separate restoration is formed by a dental lab.
The end result is a tooth which both looks and functions like a fully intact tooth. Though care must be taken not to subject composite resin restorations to undue forces (no cracking open nutshells, for example), your new filling should continue to serve you and look great for a long time to come.
If you would like more information on metal-free restorations, 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 “The Natural Beauty of Tooth Colored Fillings.”
Exchanging passionate kisses with big-screen star Jennifer Lawrence might sound like a dream come true. But according to Liam Hemsworth, her Hunger Games co-star, it could also be a nightmare… because J.Law’s breath wasn’t always fresh. “Anytime I had to kiss Jennifer was pretty uncomfortable,” Hemsworth said on The Tonight Show.
Lawrence said the problem resulted from her inadvertently consuming tuna or garlic before the lip-locking scenes; fortunately, the two stars were able to share a laugh about it later. But for many people, bad breath is no joke. It can lead to embarrassment and social difficulties — and it occasionally signifies a more serious problem. So what causes bad breath, and what can you do about it?
In 9 out of 10 cases, bad breath originates in the mouth. (In rare situations, it results from a medical issue in another part of the body, such as liver disease or a lung infection.) The foul odors associated with bad breath can be temporarily masked with mouthwash or breath mints — but in order to really control it, we need to find out exactly what’s causing the problem, and address its source.
As Lawrence and Hemsworth found out, some foods and beverages can indeed cause a malodorous mouth. Onions, garlic, alcohol and coffee are deservedly blamed for this. Tobacco products are also big contributors to bad breath — which is one more reason to quit. But fasting isn’t the answer either: stop eating for long enough and another set of foul-smelling substances will be released. Your best bet is to stay well hydrated and snack on crisp, fresh foods like celery, apples or parsley.
And speaking of hydration (or the lack of it): Mouth dryness and reduced salivary flow during the nighttime hours is what causes “morning breath.” Certain health issues and some medications can also cause “dry mouth,” or xerostomia. Drinking plenty of water can encourage the production of healthy saliva — but if that’s not enough, tell us about it: We may recommend switching medications (if possible), chewing xylitol gum or using a saliva substitute.
Finally, maintaining excellent oral hygiene is a great way to avoid bad breath. The goal of oral hygiene is to control the harmful bacteria that live in your mouth. These microorganisms can cause gum disease, tooth decay, and bad breath — so keeping them in check is good for your overall oral health. Remember to brush twice and floss once daily, stay away from sugary foods and beverages, and visit the dental office regularly for checkups and professional cleanings.
So did J.Law apologize for the malodorous makeout session? Not exactly. “[For] Bradley Cooper, Christian Bale, yeah, I’ll brush my teeth,” she laughed.
Hemsworth jokingly agreed: “If I was kissing Christian Bale I probably would have brushed my teeth too. With you, it’s like, ‘Eh. Whatever.’”
If you would like more information about bad breath and oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Bad Breath: More than Just Embarrassing.”
Somewhere between bites during a recent meal, the inside of your cheek found itself in the way of your teeth. You winced with pain at the resulting bite, and while it was sore for a day or two it seemed to heal over. Now, though, you’re noticing this same area of your cheek gets in the way of your teeth a lot more often, with more bites and sores.
What’s likely happened is that you have developed a traumatic fibroma. When the soft tissues of the inner cheek, lips or tongue heal after being injured, a small bit of fibrous tissue composed of the protein collagen forms like a callous over the bite wound to protect it after it heals. If, however, the process is interrupted by another bite, the fibrous tissue that subsequently forms may be thicker and thus more raised on the surface of the skin. This higher profile makes it more likely the site will be involved in repeated episodes of biting.
If the fibroma continues to be a problem, it can be solved with a simple surgical procedure. A surgically-trained dentist or oral surgeon will remove portions of the fibroma (usually with local anesthesia) to flatten the skin profile, and then close the resulting wound with a couple of stitches unless a laser was used. Any discomfort after the procedure can usually be managed with a mild anti-inflammatory drug like aspirin or ibuprofen, and the site should heal in just a few days to a week.
Although the vast majority of fibromas aren’t dangerous, it’s routine practice to have the excised tissue biopsied for abnormalities. More than likely the fibroma tissue will be normal; but by having the fibroma removed and examined, you’ll gain peace of mind about your oral health. In the process, you’ll also eliminate a bothersome and painful problem.
If you would like more information on mouth sores, 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 “Common Lumps and Bumps in the Mouth.”