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Dental X-rays are an integral part of proper dental care. Most of us pose the question…Why do I need to have x-rays?? For starters, dental x-rays give your dentist a view of many oral issues that are not visible to the naked eye. This “photograph” of your dental skeleton allows your dentist information to make a better diagnosis, find potentially dangerous issues and  keep your dental health where it should be. Without routine dental x-rays small issues can develop into much bigger ones.

Benefits Of Dental X-Rays

A dental x-ray gives your dentist a closer look at the teeth, the surrounding bones, the jaws, dental decay, infection, and disease of your oral cavity. The following are some of the benefits of dental x-rays:

-Detection Of Tooth Decay. While a dentist can see some tooth decay during your visual and manual examination, they are unable to see between the teeth, under fillings, and below the gum line. A dental x-ray can allow a much better view of damage to the teeth, and roots.

-Presence Of Tumors In The Bone. A tumor can develop undetected inside the bone. If dental x-rays are taken routinely, it often gives the dentist the ability to detect developing tumors at an early stage.  Some tumors are harmless, while others are quite aggressive leading to loss of jaw bone and teeth. The best prognosis for treatment of tumors depends upon early diagnosis.

-Diagnosis Of Periodontal Disease. One of the key tools in diagnosis periodontal disease are dental x-rays. Once periodontal disease develops past its earliest stages there will be loss of supporting bone. Using dental x-rays your dentist can see the progression and even the improvement once treatment begins. Without early diagnosis, the periodontal disease will progress, and proper treatment to slow progression will not occur.

-Infections. These will be noted on dental x-rays as dark spots in the bone. An infection in the bone can be very destructive and if left untreated can lead to facial swellings,  lost teeth, lost bone, pain, and may be potentially life threatening.

-Locate Teeth. Some teeth do not develop properly, are extremely out of position, may not be present, may have extra teeth, or tooth fragments may be impacted in the bone. It is important to know what is or is not a potential problem, and some may need to be extracted or re-directed by an orthodontist so as not to harm other teeth.

-Check For Children’s Development. Dental x-rays give your dentist the ability to check your child’s development and ensure all the teeth are developing properly. Knowledge ahead of time will help you plan ahead for space management issues (crowding), growth management issues (upper and lower jaws severely out of alignment), lack of permanent tooth development (may require maintaining baby teeth for a much longer time period), extra teeth (usually require extraction).

Are Dental X-Rays Safe?

This is a common concern especially among new parents. It is important to note that dental x-rays use very little radiation. Most people living in the United States today are exposed to a 100 times more radiation in a single year just from environmental sources. Remember not to confuse medical x-rays and dental x-rays. Medical x-rays use significant amounts of radiation while dental x-rays are extremely low radiation exposure.  Your dentist will take all the necessary precautions in limiting your exposure. This includes the following:

-Follow the ALARA Principle. ALARA stands for “As Low As Reasonably Achievable”.

-Use Of The Fastest Speed Film.

-Using As Small An X-Ray Beam As Possible.

-Use Of Lead Aprons.

-Following ADA standards of care in # and frequency with which x-rays are taken.

Dental X-Rays Conclusion

If you are concerned about dental x-ray safety speak to your dentist. A good dentist will be open to your concerns and attempt to alleviate your fears while keeping you safe. If you are seeing a new dentist for the first time, request copies of your old x-rays from your previous dentist. This may help limit new x-rays being taken but also give your new dentist a history of progression of any issues you might have been developing.

Dental x-rays are an important part of a thorough dental examination. While there may be some precautions to take, the benefits definitely outweigh the risks of not having dental x-rays. See your dentist regularly for routine dental examinations and x-rays to diagnose issues early, before they become larger, more dangerous problems.

Xray showing swallowed Tongue Piercing

Radiograph Showing Swallowed Piercing

Tongue Piercing dangers. It is very hard to believe or understand how certain things ever become popular. But they do like, pet rocks, 8 track tapes, and the rubik’s cube. Fortunately over time, these fads fade away into oblivion. The latest craze over the last few years has been tongue piercing. Tongue Piercing has become very popular, especially among teenagers and young adults. Most people generally believe that tongue piercing is a safe and fun way for young people to express themselves, similar to piercing our ears. Unfortunately, tongue piercing can cause significant damage to our teeth as well as risks to our general health. According to one study, 16% of the females and 4% of the males at a prominent U.S. University had a tongue piercing. The tongue piercing fad may come and go, but for people with pierced tongues, the adverse effects could last a lifetime. Tongue piercing can result in chipped or broken teeth, infections, gum and nerve damage, excessive drooling, taste sensation loss, and tooth loss. Irritation from the jewelry can cause periodontal disease or even oral cancer. So for a teenager or young adult, it may seem cool but damaged and missing teeth, infection, and life threatening cancer are far from cool.

Approximately 45-50% of people who have worn tongue jewelry for four or more years have chipped or fractured their teeth. This damage can eventually send people to the dentist for fillings, crowns, root canal therapy, or even extractions. Because tongue jewelry from a tongue piercing can break or chip teeth, people wearing this jewelry may have to spend thousands of dollars on dental work to regain the smile they will want and desire later in life .

Infection

Tongue Piercing Infection

Infection from tongue piercing

The tongue is covered with bacteria, and when pierced, that bacteria can get in the blood stream and underlying tongue tissues. This can cause a serious infection. Unfortunately, tongue piercing jewelry wearers may not be aware of a problem since the symptoms of infection, such as swelling, redness, and pain, are quite similar to the after effects of the piercing itself. Dentists are learning very quickly that oral infections can also lead to infections in other parts of the body. If you have certain health conditions like diabetes, heart disease, joint replacements or congenital heart conditions, you will be even more susceptible to developing infection.

Dentists have reported a rise in cases of Ludwig’s angina, a very severe infection of the floor of the mouth and jaws, in patients who have a tongue piercing. In Ludwig’s angina, the tongue may swell to the point that it constricts the airway causing breathing to be difficult.

Another condition afflicting patients with a tongue piercing is endocarditis, a disease which occurs when bacteria enters the blood stream and infects the heart valves while weakening them. This can occur in certain patients with underlying ( often undiagnosed and without symptoms) heart problems.

Oral Cancer

Patients with a tongue piercing may develop ulcers in the oral cavity from constant irritation. These ulcers can possibly progress to oral cancer. Precancerous ulcers can be detected during an oral cancer screening by your dentist. For patients with a tongue piercing, it is doubly important to see your dentist regularly. Especially one using the Velscope oral cancer screening system.

velscope

Velscope Oral Cancer Screening

Broken or Chipped Teeth

Fractured Tooth

Damage from Tongue Piercing

It is not uncommon to see perfectly healthy teeth chipped or fractured from a tongue piercing. People chip teeth on tongue piercings while eating, sleeping, talking and chewing on the jewelry. The fracture can be confined to the enamel of the tooth and require just a simple filling or it may go deeper into the tooth, which may require a root canal, tooth extraction, or crown. This can often happen when a person carelessly biting on the tongue jewelry during chewing or sleeping.

Allergic Reactions

Developing an allergic reaction is not uncommon depending on the type of metal the piercing is made of. Some types of tongue piercings are not high quality surgical grade stainless steel and a person can experience an allergic reaction even if they do not typically have metal allergies. Please be aware of the type of tongue piercing being placed before going ahead with it.

Disease Transmission

Oral and tongue piercings are a potential risk factor for the transmission of hepatitis B and C and herpes simplex virus.

Nerve Damage and Prolonged Bleeding

Numbness or loss of sensation at the site of the tongue piercing or movement problems can occur if nerves have been damaged during the piercing. Blood vessels can be punctured leading to prolonged bleeding.

Periodontal Disease

Tongue piercing casuing gingival recession

Gingival Recession Caused by Tongue Piercing

People with a tongue piercing have a increased risk of periodontal disease than those without a tongue piercing. The jewelry can come into contact with gingival tissue causing injury which can cause recession of the gum tissue ( and possibly bone loss). This can lead to loose teeth and tooth loss.

Difficulties in Daily Oral Functions and Possible Aspiration of Jewelry

Tongue piercing can result in difficulty in speaking clearly and annunciating properly. Chewing and swallowing food can also be a challenge. This is because the tongue piercing jewelry stimulates excessive salivary production. Temporary or permanent drooling is another consequence of increased saliva production. Altered taste can also be present. Jewelry that becomes loose in the mouth can become a choking hazard and, if swallowed, can result in injury to the digestive track or lungs.

Another problem that is of concern is that few standards for body piercers exist. Dental offices must follow strict guidelines (developed by OSHA and the CDC) for sterilization and infection control. Contaminated tools used in tongue piercing can expose people to an increased risk for serious infections like hepatitis and HIV.

If a person does decide to have his or her tongue pierced, they should know that it will take 4-6 weeks to heal and it may be very uncomfortable during that time. The piercer

Radiograph showing bone loss from piercing

Radiograph Showing Bone Loss Due to Tongue Piercing

will place a larger, starter barbell jewelry in the tongue to give it enough room to heal when the tongue swells. After the  swelling goes down, he or she should get a smaller barbell, which will be less likely to get in the way of teeth and more difficult to chew on.

If there are no complications, the barbell can be removed for short periods of time without the hole closing. Some dentists  suggest that to protect teeth patients should remove the barbell every time they eat, sleep or participate in a strenuous activity. There are also plugs available to place in the hole, so the jewelry can be removed for as long as needed.

You will need to keep the tongue piercing clean and use an antiseptic mouthwash (example Listerine) after every meal and brush the jewelry the same as you would your own teeth to remove any unseen plaque. See your dentist or doctor at first sign of infection or change to the area surrounding the piercing.

Most importantly, people with pierced tongues should see a dentist regularly to make sure tongue, surrounding tissues, and teeth stay healthy.

Diabetes affects almost 26 million people in the United States and is a growing problem due to the obesity epidemic.  The relationship between a person’s oral health and his/her diabetes is of utmost concern to health care professionals but especially dentists.

Patients with Diabetes have an increased risk of oral health issues due to poorly controlled blood sugars. Diabetes impairs white blood cells, which are the body’s main defense against bacterial infections.  These bacterial infections can affect everything in the mouth as well as the rest of the body.

A number of oral disorders are associated with Diabetes. The association between periodontal disease and diabetes has been studied at length with a definite correlation between the two.

The common oral health issues facing Diabetic patients include:

*Increased Dental Caries. There has been no study to effectively correlate this relationship. But anecdotal evidence leads me to believe this is a real problem for Diabetic patients withBioteneout good control over their blood glucose levels. Patients who are type 2 diabetics(meaning that it is not genetically caused but caused by diet) tend to eat more carbohydrates and sugary foods enhancing the possibility of increased caries rate. Also some patients experience xerostomia, which is more commonly referred to as “dry” mouth. I usually recommend Biotene for patients.Biotene  has the added benefit of containing a bio-active salivary enzyme protein system that actively combats bacteria, reducing bad breath, improving oral hygiene and relieving oral dryness.Some of the salivary dysfunction is caused by medications and age as well.

*Oral Mucosal Disease and other infections. Different types of oral disease are found, including lichen planus and recurrent aphthous stomatitis. People with diabetes that are often taking antibiotics to fight off infections are prone to developing Oral candidiasis(a fungal infection of the mouth and tongue). Oral candidiasis is found more frequently in patients with diabetes. Candidiasis occurs due to a patient being in a weakened immune state as well as a secondary response to the “dry” mouth mentioned above. This particular fungus thrives on the high levels of sugar in the saliva of people with uncontrolled diabetes.  This fungus results in a burning sensation in areas of the mouth and sometimes a loss or change in taste.

*Periodontal Disease (gingivitis and periodontitis) have been shown to have a direct link to Diabetes. It has been noted that elevated levels of Periodontal disease also lead to complications in management of blood glucose levels. This disease tends to be more prevalent and more severe in diabetic patients than in the general population. This is mainly due to the fact that diabetics have decreased wound healing and infection fighting ability.

Diabetics who smoke are at a much higher risk of disease.  Their risk factor can be as much as 20x more likely than non-smokers to develop thrush and periodontal disease. Smoking does seem to reduce blood flow to the gums and this can also affect healing in the tissue area.

Because people who suffer from diabetes can be more prone to symptoms that may harm their oral health, it’s very important to follow dental home care instructions and to note any changes in your oral health. Promptly schedule a dental consultation if you notice any changes.

Dental Hygiene for Diabetics

We always recommend visiting the dentist and hygienist at least twice a year but it is doubly important in patients with diabetes. They need to strive to keep their mouths as bacteria free as they can. In conjunction with proper brushing we also recommend that patients floss after every meal if possible. A daily mouthwash can be beneficial as well.

For most of us brushing our teeth is a mundane routine part of the day. Brushing is a foundation for maintaining good oral hygiene. But, how many of us brush our teeth the right way? We generally learn how to brush our teeth from our parents. However, parents are often misinformed on the proper method of brushing which they then pass on to their children. Very few adults know how to properly brush their teeth. Incorrect brushing habits can lead to dental problems such as plaque accumulation, gum bleeding, halitosis (bad breath), gum disease (gingivitis, periodontitis), tooth decay etc.Rotadent

1. You should always try to choose a toothbrush with soft bristles. Tooth brushes can be chosen on individual preference.  Basically, choose one that you are comfortable with.  Also size of brush head is important. If the toothbrush is too large to fit properly in your mouth, you will be unable to reach the further most areas. For many an electric toothbrush will work best. Our office recommends the Rotadent (made by Zila) electric toothbrush but any would be fine if it is effective for you.

2. Rinse your brush before using it. A small amount of tooth paste is enough for brushing. You do not need to cover all  the bristles with toothpaste. Just want enough on there for the paste to do its work.

Proper brushingProper brushingProper brushing

3. Hold the tooth brush angulated at 45 degrees to your teeth towards the  gums. Do not hold the brush flatly against your teeth. You want to be able to have the brush go all the way down to the gum line where most of the plaque resides. Paying extra attention to the gum line, hard-to-reach back teeth and areas around fillings, crowns or other restoration.

4. Start from the back of the upper jaw. You need to ensure you are cleaning all surfaces of the teeth effectively. There are three surfaces…..

1. The chewing surface of teeth.

2. The outer surface of the teeth facing the cheek.

3. Inner surfaces of the teeth.

Start with 3 teeth at a Clean on all 3 surfaces of the teeth. Use gentle pressure with short back and forth movements. Avoid using vigorous pressure as it is unnecessary. Let the brush and paste do the work for you.

5. After cleaning the 3 back most teeth, move on the next 3 teeth…..and so on.

6. After you have completed brushing your upper teeth, move on to your lower teeth and complete brushing in the same way as the upper teeth.

7. After brushing your teeth, brush along the gum line gently to remove any lodged food particles. Also, brush your tongue. Brushing your tongue will remove bacteria and buildup there to help with bad breath.

Proper brushingShould also replace your toothbrush at least once every three months or sooner if it looks to be worn down.

One last tip, would be the use of a plaque disclosing solution. This would give you a visual aid to see what areas you are missing or need work on.

Well, now you know how to brush teeth correctly. Pass it on!