The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.
Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).
Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.
A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.
CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.
But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.
And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.
If you would like more information on advanced dental diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”
Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.
Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.
But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).
It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.
Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.
But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.
What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.
If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.
If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”
It wasn't too many years ago that e-cigarettes were promoted as a healthier alternative to traditional cigarettes. “Vaping” was in and “smoking” was out.
But vaping's recent link with certain lung disorders, especially among younger users, has slowed the promotion train down considerably. And if respiratory health isn't enough, there's another reason to be wary of the practice—it's possible effect on oral health.
An e-cigarette is a handheld device with a reservoir that holds a mixture of water, flavoring, nicotine and other chemicals. The device heats up the liquid to transform it into a vapor that's then inhaled by the user. Technically, the vapor is an aerosol, a gaseous substance containing solid particles from chemical compounds.
Within this aerosol are a number of ingredients that can have a harmful effect on your teeth and gums. Foremost among them is nicotine, a chemical that's also a major ingredient in regular tobacco. Nicotine causes constriction of blood vessels, including those supplying the teeth and gums.
As these vessels constrict, they deliver to the teeth and gums fewer nutrients and antibodies to control infection. As a result, users of nicotine products, whether tobacco or e-cigarettes, will have a compounded risk for dental disease over a non-user.
E-cigarettes may in fact be worse than regular cigarettes in regards to nicotine. Cigarette nicotine is primarily inhaled into the lungs, while e-cigarette nicotine is absorbed by the mouth's mucous membranes, a much more efficient transfer. It's estimated that the amount of nicotine in one e-cigarette cartridge equals the nicotine from 20 cigarettes.
Nicotine isn't the only ingredient in e-cigarettes that could harm your mouth. Chemicals within the flavorings can irritate and dry out the mucous membranes of the mouth, as well as damage tooth enamel. There are a variety of other chemicals present like formaldehyde that could raise your risk for oral cancer.
Rather than a healthy alternative to smoking, e-cigarette users may simply be trading one form of health risk for another—and, in the case of your oral health, just as bad or worse. The best alternative for healthier teeth and gums is to leave both habits—smoking and vaping—far behind.
If you would like more information on vaping and oral 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 “Vaping and Oral Health.”
Narcotics have long played an important role in easing severe pain caused by disease, trauma or treatment. Healthcare professionals, including dentists, continue to prescribe them as a matter of course.
But narcotics are also addictive and can be dangerous if abused. Although addictions often arise from using illegal drugs like heroin, they can begin with prescriptive narcotics like morphine or oxycodone that were initially used by patients for legitimate reasons.
As a result, many healthcare providers are looking for alternatives to narcotics and new protocols for pain management. This has led to an emerging approach among dentists to use non-addictive non-steroidal anti-inflammatory drugs (NSAIDs) as their first choice for pain management, reserving narcotics for more acute situations.
Routinely used by the public to reduce mild to moderate pain, NSAIDs like acetaminophen, ibuprofen or aspirin have also been found to be effective for managing pain after many dental procedures or minor surgeries. NSAIDs also have fewer side effects than narcotics, and most can be obtained without a prescription.
Dentists have also found that alternating ibuprofen and acetaminophen can greatly increase the pain relief effect. As such, they can be used for many more after-care situations for which narcotics would have been previously prescribed. Using combined usage, dentists can further limit the use of narcotics to only the most severe pain situations.
Research from the early 2010s backs up this new approach. A study published in the Journal of the American Dental Association (JADA) concluded that patients receiving this combined ibuprofen/acetaminophen usage fared better than those only receiving either one individually. The method could also match the relief power of narcotics in after care for a wide range of procedures.
The NSAID approach is growing in popularity, but it hasn't yet displaced the first-line use of narcotics by dental professionals. The hesitancy to adopt the newer approach is fueled as much by patients, who worry it won't be as adequate as narcotics to manage their pain after dental work, as with dentists.
But as more patients experience effective results after dental work with NSAIDs alone, the new approach should gain even more momentum. And in the end, it promises to be a safer way to manage pain.
If you would like more information on dental pain management, 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 “Are Opioids (Narcotics) the Best Way to Manage Dental Pain?”
There are great health benefits to eating better, including for your teeth and gums. But to determine your ideal diet, you'll have to come to terms with carbohydrates, the sugars, fiber and starches found in plants or dairy products that convert to glucose after digestion.
Carbohydrates (also known as carbs) are important because the glucose created from them supplies energy and regulates metabolism in the body's cells. But they can also create elevated spikes of glucose in the bloodstream that can cause chronic inflammation. Besides conditions like diabetes or heart disease, chronic inflammation also increases your risk of periodontal (gum) disease, a bacterial infection arising from dental plaque.
Many concerned about this effect choose either to severely restrict carbs in their diet or cut them out altogether. But these hardline approaches deprive you of the benefits of carbs in maintaining good health. There's a better way—and it starts with understanding that not all carbs are the same. And, one difference in particular can help you properly manage them in your diet.
Here's the key: Different carbs convert to glucose at different digestive rates of speed measured on a scale known as the glycemic index. Carbs that digest faster (and are more apt to cause glucose spikes in the bloodstream) are known as high glycemic. Those which are slower are known as low glycemic.
Your basic strategy then to avoid blood glucose spikes is to eat more low glycemic foods and less high glycemic. Foods low on the glycemic index contain complex, unrefined carbohydrates like most vegetables, greens, legumes, nuts or whole grains. High glycemic foods tend to be processed or refined with added sugar like pastries, white rice, or mashed potatoes.
Low glycemic foods also tend to have higher amounts of minerals and nutrients necessary for healthy mouths and bodies. And fresh vegetables in particular often contain high amounts of fiber, which slows down the digestion of the accompanying carbohydrates.
Eating mainly low glycemic foods can provide you the right kinds of carbs needed to keep your body healthy while avoiding glucose spikes that lead to inflammation. You're also much less likely to experience gum disease and maintain a healthy mouth.
If you would like more information on nutrition and dental 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 “Carbohydrates Linked to Gum Disease.”
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