My Blog

Posts for: March, 2017

By Randi C. Lempert, DMD
March 27, 2017
Category: Oral Health
Tags: pediatric dentistry   x-rays  
SafetyisaPriorityWhenImagingChildrensTeethwithX-Rays

X-ray imaging is a routine part of a child's dental care — and it undeniably makes a difference in preventing and treating dental disease. It's so routine, we can easily forget they're being exposed to an invisible form of electromagnetic radiation.  And just like other sources of radiation, too much x-ray exposure could increase the risk of cancer.

But while it's possible for your child to be over-exposed to x-rays, it's highly unlikely. That's because healthcare professionals like dentists adhere to a standard known as ALARA when considering and administering x-rays. ALARA is an acronym for “as low as reasonably achievable.” In other words, we only want to expose a patient to the lowest and safest levels of x-ray dosage and frequency that will achieve the most benefit.

To achieve that standard, professional dental organizations advocate the use of x-rays only after a clinical examination of the patient, as well as a thorough review of their medical history for any usage of x-rays for other conditions. If x-rays are warranted, we then take further precautions to protect the patient and staff, and only use the type of x-ray application that's absolutely necessary. For most children that will be a set of two or four bitewing radiographs, which are quite effective for detecting decay in back teeth.

This dosage of radiation in a session of bitewing radiographs is roughly a fifth of the background radiation in the environment a child may be exposed to every day. By spacing these sessions at least six months apart, we're able to achieve a high level of decay detection at a safe and reasonable amount of x-ray exposure.

On top of that, the digital advances in x-ray imaging have reduced the amount of radiation energy needed to achieve the same results as we once did with film. These lower exposure levels and the ALARA standard helps ensure your child's exposure to x-rays will be well within safe limits.

If you would like more information on the use of x-rays with 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 “X-Ray Safety for Children.”


By Randi C. Lempert, DMD
March 19, 2017
Category: Dental Procedures
AToothlessTiger

Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?

Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?

Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.

Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.

But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?

In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.

Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.

What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.

If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”


BondedRetainersProvideaLessNoticeableOptionforKeepingTeethStraight

If you're currently undergoing orthodontic treatment, you're no doubt looking forward to the day your braces come off. But that won't end your treatment just yet — you'll need to wear a retainer.

Teeth are held secure in the bone of the jaw by an elastic tissue known as the periodontal ligament. As the braces “pull” the teeth to their new position, the ligament stretches and the bone remodels around the teeth. But the ligament also has a tendency to rebound as the tension eases when the braces are removed. The teeth could then return to their original position, especially during the first few months.

To prevent this patients wear an orthodontic appliance known as a retainer. It maintains some of the tension once supplied by the braces to help keep or “retain” the teeth in their new position. Depending on your age and other factors, you'll have to wear one for at least eighteen months; some patients, especially adults, may have to wear one indefinitely.

You may be familiar with a removable retainer, one you can take in and out of your mouth. But there's another type called a bonded retainer that's fixed to the teeth and can only be removed by a dentist. With this retainer a dentist bonds a thin piece of wire to the back of the teeth where it can't be seen. You can feel it, though, with the tongue: an unusual sensation at first, but one easily grown accustomed to.

Unlike their removable counterparts, bonded retainers aren't noticeable, either to others or the wearer. They're especially appropriate for patients who may not be as diligent in wearing a removable retainer.

It does, though, have some disadvantages. The position of the wire running horizontally across several teeth can make flossing difficult. And as with any retainer, removing it could increase the risk of the teeth moving out of alignment.

There are a number of factors to discuss with your orthodontist about which type of retainer is best for your situation. If you do choose a bonded retainer, be sure you work with the dental hygienist on how best to floss the affected teeth. And if you do have it removed, have a removable retainer prepared so you can preserve that smile you've invested so much into obtaining.

If you would like more information on bonded retainers following braces, please contact us or schedule an appointment for a consultation.