Dental Radiographs

In addition to diagnosing cavities early, dental x-rays are used to examine erupting teeth, diagnose bone diseases, evaluate injury, or plan orthodontic treatment.

Dental radiographs or x-rays are an important and necessary part of your child’s comprehensive diagnosis.  X-rays provide more information for the dentist than any other diagnostic tool.  With the use of radiographs, cavities can sometimes be detected months before they are visually noted.  Radiographs display the condition of the teeth, roots, jaws, and overall facial bone composition.  They can reveal the exact location of impacted and unerupted teeth, the presence or degree of periodontal disease, abscesses and many abnormal growths such as cysts and tumors.  X-rays also help the dentist pinpoint the exact location of cavities and other signs of disease that may not be possible to detect through a visual examination.  These diagnostic pictures are the single most important tool in identifying and treating many diseases associated with the head and neck region and have actually saved peoples lives by identifying non-dental related problems before symptoms arise.  Certain radiographs also provide the dentist with information on the patient’s facial and dental development.  Such information helps to diagnose irregular growth patterns and the need for orthodontic intervention.  Early diagnosis of some growth problems followed by orthodontic care can sometimes prevent more extensive and costly troubles in the future, even possibly avoiding surgery.

In general, children need x-rays more often than adults because their mouths grow and change rapidly.  In most cases, new patients require a full set of radiographs to establish a comprehensive diagnosis.  Follow-up visits may require x-rays to monitor the conditions of your gums and supportive bone structures.  Our ability to obtain these important diagnostic tools is greatly dependant upon the child’s ability to cope with this process.  Should we feel that a child may have a cavity or other possible problem, we may be more persuasive in obtaining these pictures.  Otherwise, we will take our time introducing this procedure to them over several visits.

There are three common types of radiographs:

Bitewing X-Rays are used to help diagnose cavities between the teeth, where a visual exam is incomplete.  The American Academy of Pediatric Dentistry recommends bitewing dental radiographs every 6-months for children at high risk for dental decay.  Individuals at low to moderate risk or those with space between the back teeth will be asked to take bitewing x-rays less frequently.  And, some patients with ideal homecare, a low caries risk and good eating habits may only need these diagnostic records every 18-24 months.

Periapical X-Rays show the entire tooth, including the root and surrounding bone.  These are useful in diagnosing possible infections, impacted teeth, or bone loss secondary to periodontal disease.
Panoramic X-Rays are primarily used to evaluate the growth & development of a patient.  It allows the dentist to see a broad view of the entire structure of the mouth, including the jaw joints, in a single image.  Within one large film, panoramic x-rays reveal both the upper and lower teeth and all parts of the jaws.  Panoramic x-rays are a very useful screening tool assessing wisdom teeth and can reveal abnormal growths or cysts within the jaw bone and surrounding hard tissues.  Typically panoramic x-rays are first prescribed around the time the first permanent teeth begin to erupt or at age 6.  In a healthy individual, the American Academy of Pediatric Dentistry recommends that this x-ray be repeated every 3-years until the patient is considered completely mature
Radiation Concerns

One of the most frequent questions that dentists get asked involves radiation exposure during dental radiographs.  Dentists are sensitive to your concerns about exposure to radiation from x-rays, and are trained to prescribe them only when they are appropriate and necessary.  State-of-the-art technology and staying abreast of the latest diagnostic advances allow us to know which procedures and x-ray films can minimize exposure to radiation.

All of the necessary precautions are taken to minimize your child's exposure to x-rays during a typical dental diagnostic procedure.  Patients always wear a lead apron and thyroid collar to avoid unnecessary radiation to other parts of the body. Not everyone needs x-rays taken on a regular basis.  However, some patients may need to have x-rays taken in order to address suspected problems in their teeth or tooth structures, gums, or jaw bones.

The ionizing radiation that you receive from one dental x-ray is substantially less that the radiation you receive every day in the sun. Advances in technology, such as higher-speed x-ray film and measurement devices, have made dental x-rays even safer today. This is not to say that any unnecessary radiation, even a small amount, can harm the tissues in your body. Because x-rays can diagnose certain conditions and help a condition from becoming worse; the benefit outweighs the risk.

Because West Valley Pediatric Dentistry has both our patients and staff in mind at all time, we have taken several steps to reduce this already minimal exposure.  By utilizing lead patient aprons, high speed film that exposes at low doses, equipment filters, and digital x-ray units, we have been able to cut the typical exposure rate by over 60% as compared to offices still using conventional methods.  Along with regular testing of our equipment, these measures provide our patients and staff with the highest level of safety possible.
  

Athletic Mouth Guards

If your child participates in any extracurricular sport activities, a mouth guard could be a lifesaver in terms of preserving their teeth and, ultimately, a child's countenance later in life.

Anyone who participates in a sport should wear a mouth protector, according to the American Dental Association, especially those that involve physical contact.  Sports such as football, hockey, soccer, basketball, baseball, gymnastics, and volleyball all pose increased risks to your child's teeth and oral tissues.  We usually only think of football and hockey as the most dangerous to the teeth, but nearly half of sports-related mouth injuries occur during basketball and baseball sporting events.

A mouth guard can prevent serious injuries such as concussions, cerebral hemorrhages, incidents of unconsciousness, jaw fractures, and neck injuries by helping to avoid situations where the lower jaw gets slammed into the upper jaw.  Mouth guards are effective in moving soft issue in the oral cavity away from the teeth, preventing laceration and bruising of the lips and cheeks, especially for those children who wear orthodontic appliances.

Mouth protectors, which typically cover the upper teeth, can cushion a blow to the face, minimizing the risk of broken teeth and injuries to the soft & hard tissues of the mouth.  A blow to the face could also damage orthodontic brackets or other fixed appliances.  If your child wears braces or another fixed dental appliance on their lower jaw, a mouth protector is available for these teeth as well.  A mouth protector also provides a barrier between the braces and your cheek or lips, limiting the risk of soft tissue injuries.  Although mouth protectors typically only cover the upper teeth, our office or an orthodontist may suggest that you use a mouth protector on the lower teeth if your child has braces on these teeth too.  If your child has a retainer or other removable appliance, do not allow him to wear it during any contact sports.

Types of Mouth Guards

There are three types of athletic mouth protectors:

• Stock Mouth Guards.  Inexpensive, ready-to-wear, pre-fabricated appliances.  Unfortunately, they often don't fit well.  They can be bulky and can make breathing and talking during athletics difficult.
• Boil & Bite Mouth Guards.  Can be purchased at most sporting goods stores and may offer a improved fit over stock mouth protectors.  They should be softened in boiling water, then inserted into the mouth and allowed to adapt to the shape of your mouth.  After cooling this appliance will maintain its shape.  If you don't follow the directions very carefully you could wind up with a poor-fitting mouth protector which could possibly increase your risk for soft tissue oral injury.
• Custom-Fitted Professional Mouth Guards.  Made from a modeled replica of an individual’s mouth by a professional dental laboratory to provide ideal protection during athletics.  These appliances are more expensive than the other versions, but because they provide a customized fit, they offer the best possible overall protection against trauma.  These appliances are highly recommended for individuals involved in full contact higher athletics, such as high school football.  Because this appliance is expensive, we typically recommend that parents wait until a child has completely erupted a full collection of permanent teeth and orthodontics have been completed.  Unfortunately, these appliances will lose their fit if teeth are lost and replaced or orthodontically moved.  Therefore a new appliance is needed to restore an ideal fit.

Caring for your Mouth Guard  

Clean the mouth guard by simply washing it with soap and warm (not hot) water.  When storing the appliance, soak it in either a mouthwash or a denture rinse.  This, in turn, will help eliminate build-up, caustic stains, and poor odors.  Keep it in a well-ventilated plastic storage box when not in use.  Make sure this box contains holes to allow the mouth guard to dry.  Heat is also bad for mouth guards as it can cause distortion. Never leave a mouth guard in direct sunlight or within a closed automobile.  Never bend or distort a mouth guard when storing.  Instruct your child to not handle or wear someone else's mouth guard as this can damage its fit.  Immediately contact your dentist if there is a problem with your child’s mouth guard or they experience an oral trauma secondary to a poorly fitting appliance.

Sealants

During the early 1980’s a protective resin coating became commercially utilized by dentists to protect teeth from the development of dental decay.  This protective resin was termed, “sealants,” as it sealed-out dental decay.   Sealants work by filling in the deep pits & fissures on the chewing surfaces of the back teeth before they are colonized by cariogenic bacteria and food debris.  This, in turn, dramatically decreases the probability of developing dental decay in these areas.  Though this application only prevents cavities on the tops and sides of the back molars, these areas are the most common locations for this destruction.  Research conducted over the past 20-years has shown that the placement of sealants has reduced dental decay on the tops of these teeth by over 80%.  The sealant application is non-invasive, quick and comfortable.  If applied properly by a trained dental assistant, it will effectively protect these teeth for many years.  Sealants are particularly effective in children, as this is the most common period for the development of decay.  Sealants are best suited for placement on the permanent molars, as these tend to have the deepest pits & fissures.   

Research has shown that about 93% of adults develop one or more cavities in the pits & fissures of their back molars.

Sealant Application Process

Sealant application involves first cleaning the surface of the tooth and rinsing the surface to remove all traces of the cleaning agent.  An etchant solution or gel is then applied to the desired pits & fissures.  After 15-20 seconds, the etchant is thoroughly rinsed away with water leaving an abrasive surface to which a sealant can readily attach.  After the site is completely dried, the sealant material is applied and allowed to harden using a specialized curing light. 

During regular dental check-ups, your dentist will evaluate, touch-up and maintain these protective resins.  If completed without any moisture contamination and maintained at subsequent check-ups, sealants can provide protection against dental decay for up to 10-15 years.  Sealants are also extremely cost effective, as the placement of four sealants is equivalent to the cost of restoring one moderately sized cavity.  Insurance companies typically cover a majority, if not all, of the sealant cost as they too understand their ability to dramatically reduce the development of dental decay in these prone areas.

 Teething

When babies are teething, commonly between the ages of three months to 3-years old, they often develop sore and tender gums.  This pain is usually associated with the emergence of primary teeth as they break through the gingival tissues.  Such discomfort can be soothed by gently massaging the baby's gums with a clean finger, a chilled teething ring, a cool spoon or even a moist gauze or washcloth.  Teething pains will subside once the offending tooth breaks through the gingival tissue.  Most commonly, these symptoms present during the eruption of the back molars, as these are the largest teeth.  Analgesics such as Tylenol and Advil can be used to help manage short term symptoms associated with the eruption of these teeth.  As a last resort, parents can also purchase an over-the-counter product called, Ora-Gel or Ambisol.  These topical anesthetic agents should be used sparingly to numb the tissues located around the erupting teeth.  This may also provide temporary relief during the emergence of these teeth.  Normally teething pain is directly correlated with a child’s level of pain tolerance, as some infants become fussy and irritable with the eruption of every baby tooth, while others never experience any discomfort associated with this process.
           
MYTH: The eruption of primary teeth can cause fevers.

This is a common myth that is often manifested by pediatricians.  We commonly hear parents indicate that their child’s physician told them that their baby’s fever is due to teething and the eruption of the baby teabeth.  However, this is simply not the case.  Fevers or elevated temperatures are symptoms commonly associated with viral or bacterial infections.  It is a response by the human body to destroy the invading organisms.  The eruption of baby teeth is a normal developmental phase that does not cause infection unless a pathologic irregularity presents.  Such irregularities are extremely rare.  Secondary to the developing immune system, young children commonly develop fevers of unknown origin and thus pediatricians search for an answer to calm and soothe an anxious parent.  Because these slightly elevated temperatures normally resolve without any intervention, physicians commonly indicate that its presence is due to the eruption of the baby teeth.

Oral Healthcare During Pregnancy

A balanced diet is critical for the proper development of an unborn child.  Teeth begin to form in a fetus during the second month of pregnancy and calcify between the third to sixth months of pregnancy.  A balanced diet that provides adequate amounts of vitamins A, C, and D, protein, calcium, and phosphorous helps develop healthy teeth.  Inadequate nutrition, on the other hand, may result in poorly-formed tooth enamel that may make a child more likely to develop cavities once the primary teeth have erupted.

A mother’s decay-causing bacteria can be transmitted to her child, so it is important to have maternal teeth free of decay before the child’s birth.  Pregnant women may have the desire to eat more frequently between meals.  While this is normal, frequent snacking can be an invitation to tooth decay.  The decay process begins with plaque, an invisible, sticky layer of harmful bacteria that constantly forms on teeth.  The bacteria convert sugars and starches that remain in the mouth to an acid that attacks the tooth’s protective outer enamel.  Brushing your teeth a minimum of twice daily and cleaning between the teeth daily with floss or another interdental cleaner can reduce the risk of dental decay.

Plaque that is not removed can irritate the gums, making them red, tender, and likely to bleed easily.  This condition is called gingivitis and can lead to a more serious problem known as periodontal disease that affects the gums and bone that anchors the teeth in place.  During pregnancy, a woman’s hormone levels rise considerably.  Gingivitis, especially common during the second to eighth months of pregnancy, may cause red, puffy and tender gums that tend to bleed when brushed.  This sensitivity is an exaggerated response to plaque and is caused by an increased level of progesterone.  Poor periodontal health in an expecting mother may lead to adverse pregnancy outcomes like premature delivery and low birth weight of the baby.  Mothers should see a dentist regularly throughout pregnancy.  The dentist may recommend more frequent cleanings during the second trimester to help avoid such problems.