Dental X-Rays

Dental radiographs (X-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam.  Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan.  Without X-rays, problem areas may go undetected.

Dental X-rays may reveal:

• Abscesses or cysts.
• Bone loss.
• Cancerous and non-cancerous tumors.
• Decay between the teeth.
• Developmental abnormalities.
• Poor tooth and root positions.
• Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!

Are dental X-rays safe?

We are all exposed to natural radiation in our environment.  The amount of radiation exposure from a full mouth series of X-rays is equal to the amount a person receives in a single day from natural sources.

Dental X-rays produce a low level of radiation and are considered safe.  Dentists take necessary precautions to limit the patient’s exposure to radiation when taking dental X-rays.  These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each X-ray.

How often should dental X-rays be taken?

The need for dental X-rays depends on each patient’s individual dental health needs.  Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.

A full mouth series of dental X-rays is recommended for new patients.  A full series is usually good for three to five years.  Bite-wing X-rays (X-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

Dental Exams & Cleanings

Dental Exam

A comprehensive dental exam will be performed by your dentist at your initial dental visit.  At regular check-up exams, your dentist and hygienist will perform the following:

• Examination of diagnostic X-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
• Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of existing restorations: Check current fillings, crowns, etc.

Professional Dental Cleaning

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists.  Your cleaning appointment will include a dental exam and the following:

• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
• Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
• Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Sealants

A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth.  More than 75% of dental decay begins in these deep grooves.  Teeth with these conditions are hard to clean and are very susceptible to decay.  A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface.

Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.

Reasons for sealants:

• Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.

• Adults – Tooth surfaces without decay that have deep grooves or depressions.

• Baby teeth – Occasionally done if teeth have deep grooves or depressions and child is cavity prone.

What do sealants involve?

Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth.

The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry.  A special solution is applied to the enamel surface to help the sealant bond to the teeth.  The teeth are then rinsed and dried.  Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions.  Depending on the type of sealant used, the material will either harden automatically or with a special curing light.

Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.

Panoramic X-rays

Panoramic X-rays (also known as Panorex or orthopantomograms) are wraparound photographs of the face and teeth.  They offer a view that would otherwise be invisible to the naked eye.  X-rays in general, expose hidden structures, such as wisdom teeth, reveal preliminary signs of cavities, and also show fractures and bone loss.

Panoramic X-rays are extraoral and simple to perform.  Usually, dental X-rays involve the film being placed inside the mouth, but panoramic film is hidden inside a mechanism that rotates around the outside of the head.

Unlike bite-wing X-rays that need to be taken every few years, panoramic X-rays are generally only taken on an as-needed basis.  A panoramic X-ray is not conducted to give a detailed view of each tooth, but rather to provide a better view of the sinus areas, nasal areas and mandibular nerve.  Panoramic X-rays are preferable to bite-wing X-rays when a patient is in extreme pain, and when a sinus problem is suspected to have caused dental problems.

Panoramic X-rays are extremely versatile in dentistry, and are used to:

• Assess patients with an extreme gag reflex.
• Evaluate the progression of TMJ.
• Expose cysts and abnormalities.
• Expose impacted teeth.
• Expose jawbone fractures.
• Plan treatment (full and partial dentures, braces and implants).
• Reveal gum disease and cavities.

How are panoramic X-rays taken?

The panoramic X-ray provides the dentist with an ear-to-ear two-dimensional view of both the upper and lower jaw.  The most common uses for panoramic X-rays are to reveal the positioning of wisdom teeth and to check whether dental implants will affect the mandibular nerve (the nerve extending toward the lower lip).

The Panorex equipment consists of a rotating arm that holds the X-ray generator, and a moving film attachment that holds the pictures.  The head is positioned between these two devices.  The X-ray generator moves around the head taking pictures as orthogonally as possible.  The positioning of the head and body is what determines how sharp, clear and useful the X-rays will be to the dentist.  The pictures are magnified by as much as 30% to ensure that even the minutest detail will be noted.

Panoramic X-rays are an important diagnostic tool and are also valuable for planning future treatment.  They are safer than other types of X-rays because less radiation enters the body.

If you have questions or concerns about panoramic X-rays, please contact our practice.

Oral Hygiene Aids

Regular dental check ups are essential for maintaining excellent oral hygiene and diagnosing potential problems, but they are not a “fix-all” solution. Thorough oral home care routines should be practiced on a daily basis to avoid future dental problems.

Periodontal disease (also called gum disease and periodontitis) is the leading cause of tooth loss in the developed world, and is completely preventable in the vast majority of cases. Professional cleanings twice a year combined with daily self-cleaning can remove a high percentage of disease-causing bacteria and plaque. In addition, teeth that are well cared for make for a sparkling white smile.

Oral Cancer Exam

According to research conducted by the American Cancer Society, more than 30,000 cases of oral cancer are diagnosed each year.  More than 7,000 of these cases result in the death of the patient.  The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.

Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable.  This makes the oral cancer examinations performed by the dentist critically important.  Oral cancers can be of varied histologic types such as teratoma, adenocarcinoma and melanoma.  The most common type of oral cancer is the malignant squamous cell carcinoma.  This oral cancer type usually originates in lip and mouth tissues.

There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:

• Lips
• Mouth
• Tongue
• Salivary Glands
• Oropharyngeal Region (throat)
• Gums
• Face

Reasons for oral cancer examinations

It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use and excessive alcohol consumption.  Your dentist can provide literature and education on making lifestyle changes and smoking cessation.

When oral cancer is diagnosed in its earliest stages, treatment is generally very effective.  Any noticeable abnormalities in the tongue, gums, mouth or surrounding area should be evaluated by a health professional as quickly as possible.  During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.

The following signs will be investigated during a routine oral cancer exam:

• Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.
• Leukoplakia – This is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.
• Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems.

Oral cancer exams, diagnosis and treatment

The oral cancer examination is a completely painless process.  During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps.  Lasers which can highlight pathologic changes are also a wonderful tool for oral cancer checks.  The laser can “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye.

If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan.  In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed.  The biopsy includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.

Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken.  Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats.  Treatment methods vary according to the precise diagnosis, but may include excision, radiation therapy and chemotherapy.

During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.

If you have any questions or concerns about oral cancer, please contact our practice.

Fluoride Treatment

Fluoride is the most effective agent available to help prevent tooth decay.  It is a mineral that is naturally present in varying amounts in almost all foods and water supplies.  The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.

Fluoride works in two ways:

Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay.  We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels.  Dentists and dental hygienists generally recommend that children have a professional application of fluoride twice a year during dental check-ups.

Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums.  We gain systemic fluoride from most foods and our community water supplies.  It is also available as a supplement in drop or gel form and can be prescribed by your dentist or physician.  Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years.  It is very important to monitor the amounts of fluoride a child ingests.  If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.

Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay.  Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:

• Deep pits and fissures on the chewing surfaces of teeth.
• Exposed and sensitive root surfaces.
• Fair to poor oral hygiene habits.
• Frequent sugar and carbohydrate intake.
• Inadequate exposure to fluorides.
• Inadequate saliva flow due to medical conditions, medical treatments or medications.
• Recent history of dental decay.

Remember, fluoride alone will not prevent tooth decay!  It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.

Digital X-Rays

Digital radiography (digital X-ray) is the latest technology used to take dental X-rays.  This technique uses an electronic sensor (instead of X-ray film) that captures and stores the digital image on a computer.  This image can be instantly viewed and enlarged, helping the dentist and dental hygienist detect problems more easily.  Digital X-rays reduce radiation 80-90% compared to the already low exposure of traditional dental X-rays.

Dental X-rays are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam.  Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan.  Without X-rays, problem areas can go undetected.

Dental X-rays may reveal:

• Abscesses or cysts.
• Bone loss.
• Cancerous and non-cancerous tumors.
• Decay between the teeth.
• Developmental abnormalities.
• Poor tooth and root positions.
• Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!

Diagnodent

Tooth decay can be extremely painful and puts the teeth at risk. Many extractions and restorative treatments are performed every single day because tooth decay has become too severe for the tooth to be saved.  Diagnodent is a safe fluorescent laser that detects hidden tooth decay accurately, quickly, and in its earliest stages.

All dentists are advocates for healthy, natural teeth. Restoration devices like crowns and bridges are popular because they allow the natural tooth to remain in the mouth.  Diagnodent accurately exposes areas of tooth decay without scratching, probing, or “opening up the tooth.”  This provides a greater chance of identifying, treating, and retaining a natural tooth without the need for expensive and time-consuming restorations.

How can Diagnodent help me?

Diagnodent accurately exposes more caries than X-rays and examinations.  In fact, this revolutionary diagnostic tool is over 90% accurate. Sometimes, caries “go underground” due to fluoridation.  This essentially means that lesions that once lay on the surface of the tooth bed down, and remain invisible to the naked eye.  Because Diagnodent exposes caries earlier, more treatment options are possible.

Here are some of the other benefits associated with Diagnodent:

    -Allows dentists to perform treatment with greater confidence.
    -Allows for the investigation of suspicious areas.
    -Completely safe.
    -Cost effective.
   - Empirically measurable results.
   - Helps reduce future dental procedures.
   -More accurate than any other diagnostic tool.
  -  No exposure to X-rays.
   - No need for invasive investigations.
   - No pain or scratching.

What does the Diagnodent process involve?

The Diagnodent process is performed within the scope of a regular dental checkup.  It is strikingly similar to having a laser pointer aimed at the teeth.  Diagnodent is a hi-tech tool, which first scans a clean tooth surface with a laser beam.  This scanning procedure serves to calibrate the instrument by providing information about the tooth structure.

The Diagnodent System is actually measuring the amount of laser fluorescence within the tooth.  As each tooth is scanned, the amount of reflected laser light is recorded to produce a digital readout.  If the tooth contains little or no decay, little or no laser light will be reflected back to the instrument.  However, if a tooth contains caries of any significance, more laser light is reflected back.  High readings (compared to the tooth originally scanned) indicate that caries are present within the structure of a particular tooth.  The amount of laser light reflected back correlates with the amount of decay within the tooth.

Once we determine which teeth are suffering from decay, a plan can be formulated and treatment options can be discussed.  In most cases, the early detection of caries means more treatment options and a greater chance of saving the affected tooth.

If you have any questions about Diagnodent, please contact our office.