Posts for: February, 2019
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!
Every February, the American Dental Association sponsors a campaign called National Children’s Dental Health Month. The purpose of this operation is to raise awareness about how important it is to get an early start on developing good dental hygiene habits — and how this can lead to a lifetime of healthy teeth and gums. So we thought this might be a good time to answer some of the most frequently asked questions about how to do exactly that:
When is it time to start cleaning my baby’s teeth?
As soon as you see one! The earlier your child gets used to a daily dental hygiene routine, the better. Baby teeth that have not fully emerged from beneath the gums can be wiped with a clean, moist washcloth after feedings. A tooth that has grown in completely should be brushed twice daily (once in the morning and once in the evening) with a soft, child-sized tooth brush and a thin smear of fluoride toothpaste. Fluoride is an important weapon against tooth decay, but you don’t want your child to swallow too much.
Can babies get cavities?
Absolutely — especially if they are allowed to fall asleep routinely with a bottle filled with anything but water. Milk, formula — even breast milk — all contain sugars that should not be left to pool around your baby’s teeth during sleep, facilitating decay. Juice is an even bigger no-no because it is not only sugary but also acidic.
Can’t I give my child sweets once in a while?
We realize total avoidance of sweets may not be realistic, as beneficial as this would be for your child’s teeth. If you are going to allow your child to have sweets once in a while, better that the treat be given immediately following a meal, and not as a between-meal snack. Soda should really be avoided completely — it’s that bad.
When should I take my child to the dentist for the first time?
The experts say: Get it done in year one. That’s right — even though your child won’t have many teeth by age 1, there’s a lot we can do at that first visit to ensure good oral health now and well into the future. We will do everything possible to make sure your little one has a positive first experience in the dental chair; this helps set the tone for the many important preventive visits yet to come. It’s also a great opportunity for you to ask any specific questions you may have, and receive hands-on instruction on how to care for your child’s teeth and gums.
If you would like more information about children’s oral health, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Age One Dental Visit.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”