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.”
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?”
Do you remember your first new car? It purred like a kitten with a brilliant finish you could see a mile away. And my, oh my, the attention you gave it: cleaning, polishing, regularly checking the fluids and other maintenance. That's what comes with pride of ownership—and it's an equally fitting attitude to have with your mouth.
World Oral Health Day is a great opportunity this month to renew your care for your mouth and its primary inhabitants, your teeth and gums. This March 20th, the FDI World Dental Federation wants you to “Be Proud of Your Mouth” for all it makes possible in your life: helping you eat, helping you speak and, of no lesser importance, helping you smile.
So how can you show pride in your mouth?
Keep it clean. Brushing and flossing are the two most important tasks you can do to prevent dental disease and ensure a healthy mouth. It takes only five minutes a day to clear away accumulated dental plaque, a thin film of bacteria most responsible for destructive tooth decay and gum disease. The only catch? To get the most from your oral hygiene efforts, you'll need to brush and floss every day, rain or shine.
Keep it fed. The food your teeth help you eat also benefits them—if they're the right foods. Fresh fruits and vegetables, proteins and dairy items like milk or cheese all contain vitamins and minerals that strengthen teeth against disease. On the flip side, there are foods you should avoid, particularly processed foods and snacks containing added sugar. Sugar feeds the oral bacteria that causes disease.
Keep it maintained. Routine dental visits are just as important for your mouth as routine mechanic visits are for your car. During these regular visits, we'll thoroughly clean your teeth of any missed plaque, especially a hardened version called tartar. It's also a time for us to look more closely at your teeth and gums to uncover any emerging problems that require treatment.
With a little time, effort and discipline, you can protect your teeth and gums from disease, and help them to be as healthy as they can be. The dividends will spill over into the rest of your life, with additional benefits for your physical, mental and social well-being. A healthy mouth is vital to a healthy life.
So, take pride in your mouth and make a commitment today to care for it. And if you haven't seen us in a while, an appointment for a dental cleaning and checkup could be your best move toward healthier teeth and gums.
If you would like more information about best dental care practices, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Dental Hygiene Visit.”
Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.
After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.
More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.
Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.
Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.
Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.
A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.
Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.
If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?”
Are you interested in improving your smile with Invisalign but aren't sure if it's a good option for you? Your Stamford, CT, dentists, Dr. Irina Pogosian, and Dr. Thomas Ohlson of Comprehensive Dental Group can help you decide if you will benefit from Invisalign.
How Invisalign Works
The Invisalign system approaches orthodontic treatment in a new way. Instead of wires, clear, removable aligner trays exert constant pressure on your teeth, gradually realigning them. Each tray is worn for about two weeks, then replaced with the next set in the series.
Trays are created from a digital 3D image of your mouth made by combining digital images, impressions, and X-rays. The Invisalign team uses the 3D model to plot your treatment and create a series of trays that will help you achieve your unique treatment goals.
Who Can Benefit from Invisalign?
Invisalign can be a good choice if:
- You're a Teen or an Adult: Invisalign is an excellent option for both teenagers and adults in the Stamford area who are concerned about the appearance of their smiles.
- You prefer a subtle straightening method: Invisalign's transparent trays become practically invisible when placed over your teeth. Thanks to Invisalign, no one has to know that you're improving your smile.
- You have mild to moderate orthodontic problems: Invisalign is an effective treatment for many mild to moderate bite problems, including overbites, underbites, crossbites, and open bites. If your orthodontic issues are complicated, you may need metal braces instead.
- You don't have any oral health problems: You'll need to treat gum disease, cavities, and other oral health issues before you can start Invisalign treatment.
- You practice good oral hygiene: Good oral hygiene will keep your teeth and gums healthy during your treatment. Daily brushing and flossing and proper cleaning of your trays are basic requirements if you want to begin Invisalign treatment.
- You're willing to follow the recommended Invisalign wearing schedule: Invisalign trays should be worn 20 to 22 hours per day for best results. If you're a parent concerned that your teens won't follow the recommendations, special tabs can be added to the trays. The color of the tabs gradually fades with wear, making it easy to see if your son or daughter is wearing the trays.
Improve your smile discreetly with Invisalign! Call your dentists Dr. Pogosian and Dr. Ohlson of Comprehensive Dental Group in Stamford, CT, at (203) 359-3296 to schedule your appointment.
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