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Blog At larkspur Family Dentistry

Are x-rays necessary?

1/21/2013

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This is a topic that is well discussed with patients in every dental office. Dental radiographs (commonly called x-rays) are useful diagnostic tools that help dentists detect dental problems during an exam. Radiographs are taken to assess ones cavity, fracture, and gum disease risk.  People who often get caries (cavities) require x-rays more frequently in order to identify, prevent, and lower a patients risk for dental issues.  

If you have not had a full mouth X-ray series (FMX) within the last 5 years, a new set should be taken in order to properly diagnose your gum, bone, and smile. These radiographs will act as a baseline to compare any changes that may occur later with your teeth. If you have taken an FMX recently, you should request a copy if  transferring to a new dentist. 

Dental X-rays are safe. In dentistry, only low levels of radiation exposure are needed to diagnose disease and significantly minimize the risk of potentially harmful disease processes. Dental X-ray equipment and techniques are specifically designed to limit the body's exposure to radiation to As Low As Reasonable Achievable. The apron that your dentist provides prevents radiation exposure to the abdomen and the thyroid. The use of a leaded apron is recommended for  anyone requiring dental x-rays.

If you are pregnant, please inform your dentist of any dental concerns. During your pregnancy, X-rays are  taken to address an urgent dental issue. Every means will be taken to protect you and your baby from radiation exposure. In special situations, a set of full mouth x-rays should be taken to treat severe existing dental problems that would otherwise compromise the health of your child during pregnancy. 

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Why does my tooth need a crown and not a filling?

10/12/2012

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In order to fix a tooth with a filling (whether it was due to a cavity or a fractured tooth), there are certain parameters that must be met. First, internal walls of a tooth are necessary in order to hold a filling within the tooth. If a fracture or a cavity has caused more than two thirds of a tooth structure to be lost, a filling will not suffice. If, however, at least two thirds of the tooth is intact, using a composite or amalgam material to replace the void will work. 

It is possible to get a new cavity around an existing filling. When recurrent cavities require frequent removal and replacement of tooth structure, the remaining tooth becomes extremely brittle. Large fillings and prolonged clenching or grinding habits put teeth at a high fracture risk. When fractures occur, they can be difficult to deal with. Small cracks in our teeth can be similar to a small crack on the windshield of our car. The crack usually starts small and then gets bigger as time progresses. If the cracks are identified early on, we can usually prevent it from propagating into the nerve or root of the tooth. If, however, the fracture continues into the center of the tooth, a root canal or extraction may be necessary. To prevent the advancement of an existing fracture, a crown is placed over the tooth to support the remaining tooth structure and prolong the life of the tooth.

For specific questions or concerns, consult with your dentist. He or she will make recommendations based on your specific needs and risk factors.  

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Teach me how to brushy!

8/15/2012

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A video brought to you by the Oregon Dental Association. We hope this encourages you and your loved ones to maintain good oral hygiene. 
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Can I get cooties from kissing?

8/15/2012

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Cooties (in this case, oral bacteria) can be passed on from one person to another any time saliva is shared. This transmission of bacteria can occur when kissing. In the dental field, the evidence of these cooties are seen in the form of cavities, also known as dental caries. The bacteria that cause cavities, such as Streptococcus mutans and Streptococcus sobrinus, can introduce cavities into a once cavity-free environment. Yes, cavities are contagious.  This phenomenon can be seen in the transference of these bacteria from mother to child, even if the baby does not yet have teeth!
When these specific bacteria exist in the mouth, they feed on food we leave behind, and create very acidic waste. By nature, anything that feeds, has to create waste. There is no bathroom in our mouths for the bacteria to use for waste disposal. When the bacteria create waste, it changes the environment on the exposed surfaces of our teeth, and this acidic environment breaks down our enamel. Over time, if the bacteria and their waste products are left unchecked, the enamel will develop a soft lesion known as caries.
One way to decrease your risk for cavities is to improve your oral hygiene. Excellent oral hygiene ensures that there are no food particles left for the bacteria to feed on. With no food left in your mouth after eating, the bacteria don't have as much food to use in creating waste, and thus decreasing your chances of getting dental caries. Also, improving your diet by eating more complex carbohydrates will prevent bacteria from easily digesting simple sugars into waste. Another way to prevent these bacteria from populating the mouth, is to be cautious with whom you are sharing your drinks, foods, and kisses! 
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If Elmo had teeth!

6/12/2012

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We have all grown up watching Sesame Street. It was such a great show because it was educational and entertaining. While browsing through the internet we came across "Sesame Streets healthy habits for life!" Please click here to see Elmo sing about great dental habits and share it with your young ones. We hope you enjoy it as much as we do. 
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What do I do if I accidentally loose a tooth?

6/5/2012

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Avulsion, or accidental loss of permanent teeth, is the most serious of all dental injuries. The outcome of treatment is dependent on the measures taken immediately after a traumatizing incident. Replanting the avulsed tooth is the treatment of choice accompanied by emergency management and treatment plan.
 
If a tooth is easily replanted in its original location, replace the tooth  and visit your dentist within the next 60 minutes from the time of the avulsion. (If it is not possible to replant the tooth, save the tooth in a small container with saliva from the original source and get to the nearest dentist within the hour.) Your dentist will clean the tooth and affected area with necessary rinses, splint the tooth, and provide  a prescription for systemic antibiotics. A tetanus booster may be recommended by your primary care physician if the tooth has contacted soil. You should undergo soft food diet for the next two weeks and maintain proper oral hygiene with a soft bristle toothbrush and a prescription for chlorhexidine mouth rinse. Within 7-10 days a root canal treatment will be performed. 

If you see someone loose their tooth due to trauma, follow these directions and call your family dentist for immediate treatment. 

 cited article:Volume 23, Issue 3, pages 130–136, June 2007 
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What do I do about my cold sores?

5/3/2012

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Cold sores, or ulcerations of the mouth, are caused by multiple factors. Cold sores are caused by the Herpes Simplex Virus (HSV) most commonly, but they can also be caused by things like stress or trauma. Sore spots caused by mechanical trauma from aggressive brushing or poorly fitting dentures can be problematic for many people. Sore spots from trauma can last 2 weeks or longer, depending on the cause of the sore. For these ulcerations, the treatment includes careful oral hygiene so that the ulcer is not irritated further and visiting a dentist for any necessary denture adjustments. 

Cold sores caused by HSV are found around the borders of the lips, hard palate, and certain parts of the gums. The virus can be dormant for long periods of time, and occasionally a patient may experience a tingling sensation prior to a cold sore outbreak. There are over the counter and prescription medications that can be applied topically or taken in tablet form to shorten the duration and severity of the cold sores. In dentistry, the use of a diode laser can be a great alternative to traditional cold sore medications. With a short and painless laser treatment, the pain associated with a cold sore is alleviated immediately, and complete healing takes place within 3-4 days. For patients who suffer from frequent and severe cold sores, laser treatment can decrease the severity and frequency of their cold sore outbreaks. 

If you have an ulcer causing you discomfort, please visit your dentist and ask about dental laser treatment.   





 

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Should I save my tooth and have a root canal or should I have it taken out and place an implant?

1/23/2012

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A patient recently asked this great question during our routine dental exam. The question stemmed from the high success rates that have been found with dental implants over a ten year period. Should he bother saving his tooth with a root canal? Would it be better to take the tooth out and place a dental implant in the space? Let's review these procedures.

Root canal treatments are sometimes necessary to save a tooth, and it's viability can depend on the amount of tooth that is available to be restored and what a patient is willing to invest financially. Root canal treatments are like fillings that extend into the canals found in the root of each tooth. It involves a process of cleaning, shaping, and rinsing the canals to clean the infected nerve of the tooth. A rubberized filling material is then used to seal the canals to prevent re-population in the canal with bacteria that may have previously caused tooth sensitivity. The long term success of root canal treatment is dependent on a patients' caries activity, oral hygiene, and diet. If all factors are ideal, root canal treatment can extend the life of a tooth at least 10 years. Restoring a tooth into a functional state can be better than a man made material (a dental implant), so your dentist can help you weigh all available options.

Implants are also great way of maintaining space and bone in an area where a tooth is planned for removal. A dental implant is like a screw placed into the bone in the space of the removed tooth. The implant integrates with the bone, and then a crown can be attached to the screw. It allows one to function and benefit from the esthetic results of a porcelain crown. Dental implants have a 99% success rate. This success is dependent on the amount of bone around the implant, the forces exerted on the crown, and the medical condition of the patient. Every tooth (and every patient!) is different, so please consult your local dentist for more information and advice regarding the best treatment for you.


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How can I maintain my smile in this economy?

8/9/2011

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I was asked this question at a birthday gathering while the debt ceiling was being determined by our government. In this economy, people, including our patients, have all shared the same concerns: How can we save and conserve our finances? In terms of dental care, here are a few penny pinching tidbits. 
  • FLOSS! 
I cannot emphasize this enough. Flossing is a mechanical means of removing food that becomes trapped in between our teeth. Traditional toothbrush bristles are thick and unable to clean in tight spaces. Leaving food behind these areas will act as a nutrient source for the bacteria that can cause caries (cavities). When bacteria is allowed to feed, by nature, it has to create waste. It is their acidic waste products  that leads to tooth decay. Flossing and maintaining ones oral hygiene deprives the bacteria of a nutrient source and thus decreasing the cycle of waste production and chances of decay formation. 
  • Use an anticavity toothpaste. 
Fluoride has been proven to harden our teeth much better than calcium. It can be found in many toothpastes and mouth rinses. Harder teeth and remineralized enamel results in fewer cavities. 
  • Eat more complex carbohydrates and eat fewer simple carbohydrates.
This is a dietary advise that I give all patients. Aside from the general health benefits, consuming more complex carbohydrates makes it harder for bacteria that reside in our mouth to break down any nutrients in their environment. When breakdown of carbohydrates becomes harder, it decreases the amount of waste produced, thus decreasing the chances of caries. 
  • Drink water instead of sport drinks, juice, or other high fructose beverages.
Decreasing or eliminating the intake of drinks with high sugar levels will decrease the risk of caries. Increasing the intake of water further decreases our chances of getting caries. Water acts as a buffer to decrease the acidity level in our mouth, helping to prevent the acid erosion of our teeth. 



In maintaining your oral hygiene and following this dietary advice, you can avoid costly dental problems. If you currently have cavities, addressing them now will prevent them from growing into larger and costly treatment. Allowing a cavity to grow larger leads to root canals and worst yet extractions. The treatment necessary to address these advanced issues leads to higher expense. Maintaining your oral hygiene and regular check ups can decrease your overall expense in the long run. 
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My teeth are getting really flat!

3/4/2011

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Over dinner, my dad told me that he has noticed his teeth wearing over the last five years. He also mentioned that he makes loud grinding noises at night as he sleeps. 

Teeth grinding, or bruxism, is a phenomenon that has eluded many dentists for years. Some studies claim that the problem is neuromuscular in nature, while others claim that grinding is a habit developed throughout childhood; misaligned teeth and stress have also been implicated. In any case, the end result of this issue is common--flattening of the biting surfaces of the teeth. According to literature, teeth should wear at a rate of 0.01 millimeters (mm) per year, thus requiring 100 years for one to wear through 1 mm of tooth structure. Most people that notice the wear patterns on their teeth have usually already lost more than 1 mm of tooth height. Treatment is highly dependent on the severity of the wear and the current status of the grinding. If one has noticed that their facial profile has shortened within the last five years, there is a likelihood that the bite may need to be re-established as close to the original height as possible. If the grinding has only been noticed recently, the best form of treatment is to provide protection for the dentition with a night guard. In addition, the patient should be consciously aware that teeth should only ever be touching when swallowing and occasionally when eating. 
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    As your family advocate for dental care we would like to provide you with some tips on how to save your money and have a beautiful smile.

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