The Latest Dental Scare – Here We Go Again…

While we were on vacation this April the media latched on to a study that seemed to link dental bitewing x-rays with non-cancerous brain tumors. Seems as though every couple of years there’s a story that feeds of the fear people have about going to the dentist.

Whenever we hear about one of these studies Dr. Boyd reads the study and makes a determination on risks v. benefits based on his education and experience. As you may know Dr. Boyd graduated from Georgetown University Dental School with a Doctorate of Dental Surgery (DDS). He has treated tens of thousands of patients, has attended hundreds of hours of continuing education, and has kept our office up to date with the latest and safest equipment, including digital x-rays.

Dental x-rays are a valuable and necessary tool when examining the health of your mouth. A visual exam (no x-rays) tells a dentist very little about the condition of the teeth, bones, and gums. X-rays are need to discover hidden decay, infection of the pulp, bone loss, gum disease, etc. Dr. Boyd takes every precaution with the fastest films and the latest technology (digital x-rays) to ensure that he, his patients, and his staff receive the minimal amount of radiation possible while providing any necessary treatments.

Dr. Boyd and staff are happy to discuss his recommendations before any x-rays are taken.

Here is the American Dental Association’s response to the recent “self reported” study:

CHICAGO, April 10, 2012 —The American Dental Association (ADA) is aware of a recent study that associates yearly or more frequent dental X-rays to an increased risk of developing meningioma, the most commonly diagnosed brain tumor. The ADA’s long-standing position is that dentists should order dental X-rays for patients only when necessary for diagnosis and treatment. Since 1989, the ADA has published recommendations to help dentists ensure that radiation exposure is as low as reasonably achievable.

The ADA has reviewed the study and notes that the results rely on the individuals’ memories of having dental X-rays taken years earlier. Studies have shown that the ability to recall information is often imperfect. Therefore, the results of studies that use this design can be unreliable because they are affected by what scientists call "recall bias." Also, the study acknowledges that some of the subjects received dental x-rays decades ago when radiation exposure was greater. Radiation rates were higher in the past due to the use of old x-ray technology and slower speed film. The ADA encourages further research in the interest of patient safety.

As part of the ADA’s recommendations to minimize radiation exposure, the ADA encourages the use of abdominal shielding (e.g., protective aprons) and thyroid collars on all patients. In addition, the ADA recommends that dentists use E or F speed film, the two fastest film speeds available, or a digital x -ray. In addition to the X-ray recommendations, the ADA’s Council on Scientific Affairs will publish clinical guidance on the use of cone-beam computed tomography in an upcoming issue of The Journal of the American Dental Association. The ADA will share these recommendations as soon as they are available.

Dental X-rays are valuable in helping dentists detect and treat oral health problems at an early stage. Many oral diseases can’t be detected on the basis of a visual and physical examination alone, and dental X-rays are valuable in providing information about a patient’s oral health such as early-stage cavities, gum diseases, infections or some types of tumors. How often dental X-rays should be taken depends on the patient’s oral health condition, age, risk for disease and any signs and symptoms of oral disease that the patient might be experiencing.

The ADA encourages patients to talk to their dentists if they have questions about their dental treatment. As a science-based organization, the ADA fully supports continuing research that helps dentists deliver high-quality oral health care safely and effectively.

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Am I At Risk for Tooth Decay?

Everyone with teeth is at risk for tooth decay, but there are some factors that increase risk:

The first one is pretty obvious -- Plaque forms quickly so you should clean your teeth as soon after eating and/or drinking as you can.

• Back teeth are more susceptible to decay because they have lots of pits and grooves that can collect food particles. Being further back in the mouth they are harder to clean.

• Foods that cling to your teeth for a long time are more likely to cause decay since they aren’t as easily washed away by saliva. Some of these foods include milk, ice cream, honey, soda, dried fruit, cake, cookies, hard candy, breath mints, etc.

• When you continually snack or sip soda your mouth is constantly producing the acids that are harmful to your teeth. Drink your soda and be done with it !

• Putting a baby to bed with milk, formula, juice or other liquids that contain sugar allows liquids to remain on a baby’s teeth for hours as they sleep and can cause rampant decay in a baby’s new teeth. This is sometimes called baby bottle tooth decay. You should give your child only water in the bottle and bed and for all day sipping.

• Tooth decay is the most common chronic disease among children and teenagers. Older adults are also at higher risk as more of us keep our teeth as we age. Over time teeth can wear down and gums may recede, making teeth more vulnerable to root decay.

• When you have dry mouth there is a lack of saliva in the mouth and as a result, food and plaque aren’t naturally washed away.

• Over the years, dental fillings can weaken, begin to break down, or develop rough edges. This allows plaque to build up more easily and makes it harder to remove.

• Eating disorders such as anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated vomiting dissolves the enamel outer layer. Eating disorders can also interfere with saliva production.

• GERD, acid reflux, and heartburn can cause stomach acid to flow into your mouth wearing away the enamel of your teeth, especially at night.

• Radiation treatments to your head or neck and certain chemotherapy drugs can reduce saliva production which prevents cavity-producing bacteria from being washed away and remineralization from saliva.

• Not flossing allows the plaque layer to remain between your teeth at the point where the teeth touch each other.

As you can see there are a lot of risk factors to getting cavities, it is not just a matter of neglecting to brush and floss your teeth.

In our next blog we will talk about what happens when you have been diagnosed with having tooth decay.

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Why is there decay in my tooth?

It’s time for your dental exam and what is it that you fear? Probably, it is having the dentist tell you that you have a cavity. Ugh! Maybe you are familiar with those Crest commercials from the late 50s that show a child running with a piece of paper as they call out, “Look, Ma, no cavities!” We’d all like to leave our dental exam appointments with that news, but sometimes it just doesn’t happen. So, why is it that sometimes the dentist finds that we have a cavity, - what we also call caries - or tooth decay?

Tooth decay is the destruction of tooth structure. Decay occurs when that sticky stuff that forms on your teeth (plaque) combines with sugars or starches from the foods that you have eaten. When plaque and the sugars and/or starches combine it produces acids that attack tooth enamel. These acids break down the enamel and weaken the teeth which then creates cavities. Cavities are permanently damaged areas in the hard surface of your teeth that develop into tiny holes or openings.

If cavities aren’t treated, they get larger and affect the deeper, softer layers of your teeth. When a cavity is beginning you may not have any symptoms at all. As it gets larger it gets closer to the pulp which may become swollen and irritated from the bacteria. The bone supporting your tooth can also be affected. You may experience a toothache, tooth sensitivity, pain when eating or drinking something sweet, hot, or cold, visible holes or pits in your teeth, pain when you bite down, or even pus around a tooth, especially when you press on your gums. Yes, that’s right, I said pus. Ick!

When tooth decay becomes severe and painful it can interfere with daily living. You may not be able to go to school or work. It may be too painful or difficult to chew or eat, leading to poor nutrition. In rare cases, an abscess from a cavity can cause serious or even life-threatening infections when not properly treated.

In our next blog we will talk about the risk factors for tooth decay.

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Why Don’t You STA…

We are always looking for ways to increase our patients' comfort and take away their fear of going to the dentist. One thing we have incorporated into our practice is the STA- a Single Tooth Anesthesia system. So what, exactly, does the STA do that makes it great for patient comfort? It is a computer controlled local anesthesia system that allows us to numb a very specific area in the mouth for treatment. The computer allows us to find the precise location to apply the anesthetic for the best effect. It also lets us know exactly how much anesthesia is needed. It's kind of wild when you hear it working. If we are just removing decay and placing a filling in one tooth we are now able to numb just that tooth and not everything around it.

When we are able to use this system our patient doesn’t have to leave the dentist office with that awful feeling of having no control over their lip or tongue, or feeling like their lip or tongue is twice its normal size. For a lot of people the worst part about dental work is having their mouth numb for hours AFTER your appointment. The STA takes that discomfort away and we love it!

We have had a number of patients come in and tell that if they need work done they want the kind of anesthesia their family member had. When we look at the family member’s record we see that we used the STA. There’s no better recommendation than that!

If it is so great why don’t we use it for all procedures? The main reason we don’t is that the effects of the anesthesia don’t last a long time. That’s one thing that makes it so great when you have having a filling done, but when you are having a long procedure such as root canal therapy or a crown prepared it’s not so great. With those long procedures you want to stay numb. Good thing Dr. Boyd takes care and aims for painless injections.

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How Old is Your Toothbrush?

How often do you replace your toothbrush? Maybe you only change your toothbrush after you go to the dentist for your cleaning and they give you a new one. I think that’s what a lot of people do. I know I’ve read that the average American changes their toothbrush every nine months.

The American Dental Association recommends that you change your toothbrush three to four times a year and every time that you are sick. Maybe you think that sounds excessive. Did you know that studies show that after three months of normal brushing the bristles of the toothbrush begin to break down and lose their effectiveness at cleaning. I'm sure you want your brushing to be as effective as possble!

A new toothbrush has clean bristles with round edges. When you brush your teeth properly the bristles sweep away plaque, bacteria, and food debris without damaging your teeth or gums. Once they get older the bristles start to break down and fray and they are less effective at removing plaque and bacteria from your teeth and gums. If they have sharp edges on the bristles they can actually damage your gums.

And let's talk about germs and toothbrushes. Older toothbrushes can be contaminated with bacteria and for this reason it is often recommended that you replace your toothbrush if you have had a cold, cold sores, or flu. However, in January 2002, the CDC reported that there was no evidence that showed that reusing a toothbrush after an illness would lead to becoming re-infected by these germs. They suggest that you rinse your toothbrush thoroughly after brushing and let it air dry standing upright. Tthat sounds like good advice after every brushing!

While we are on the subject of toothbrushes it should be noted that we all recommend and use Sonicare toothbrushes. They are fantastic at cleaning the teeth and even remove some stain. If you don’t already use a Sonicare consider it a good investment in your dental and general health! Of course, even with an electric toothbrush you need to change your brush head every few months. Sonicare electric toothbrushes move at 31,000 strokes per minute so you can figure that anything that moves that fast is going to wear out and need replacing. Because they don't wear out the same way your regular toothbrush does, most electric toothbrush heads don't look worn after three or even six months – but they still need to be replaced. Studies have shown that after 3 months of use a Sonicare brush head is 28% less effective in removing plaque as a new one.

Remember, it is important for the health of your teeth and gums that you properly maintain and replace your toothbrush. It will also make your dental hygienist very happy!

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Children’s Dental Health

February is Children’s Dental Health month so in light of that here’s a little about children’s dental health.

Did you know that proper dental care begins before any teeth appear. That’s right. Just because you can’t see the teeth doesn’t mean they aren’t there. In fact, teeth begin to form in the third trimester of a woman’s pregnancy. When your child is born they already have 20 teeth developed in their jaw! Amazing!

Even before your baby has teeth it is a good idea to wipe your baby’s gums with a damp washcloth after feedings. This prevents the buildup of nasty bacteria. Once teeth start coming in you can use a soft child’s tooth brush or you can rub their teeth with gauze at the end of the day. There are even rubber “toothbrushes” that fit over your finger. Once your child has two teeth that touch it is time to start flossing.

Never put your baby to bed with with a bottle of juice or milk. If the sugars from the juice or milk sit on the baby’s teeth for hours, as they do while in bed, they can eat away at the enamel and you could find your baby with baby bottle mouth. Sometimes cases of baby bottle mouth are so severe that the teeth need to be pulled out and your beautiful baby will have to wait until the permanent ones grow in years down the road.

The American Dental Association recommends that you should take your child to the dentist by the time they turn one. This is really just a visit to let the dentist look in the mouth and do a modified exam while the child is sitting on your lap. The idea is that the earlier they start visiting the dentist the less fear they will have as they grow old. In reality, where we try to live, we haven’t seen a lot of 1 year olds who are happy having the dentist look in their mouth. We are happy to have you bring them in and have them sit in your lap while we make the chair go up and down. If your child is willing we will see if they will open their mouth to let us take a quick peek, but don’t expect that they will be willing to have a “modified exam.” If your child is very young and seems to be having dental problems it is best for them to be seen by a pedodontist. They specialize in children’s dentistry. We are always happy to give you a referral if that is the case.

Sometimes we hear that people think baby teeth aren’t important and when we find decay they wonder if they could just wait until the tooth falls out. This is not a good idea at all. When baby teeth decay it can cause pain and infection, just like in adult teeth. The baby teeth also hold space in the arch so that the permanent teeth can erupt properly. If a baby tooth is lost too early the adjacent teeth can collapse into the space leaving no room for the permanent tooth. So, as you can see baby teeth are important and we want to keep care of them, just like we do with permanent teeth.

Giving your child an early start on checkups and good dental hygiene is an effective way to help lower the risk of extensive dental work in the future.

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Valentine’s Day

It’s Valentine’s Day! Do you have plans for the day? Do you like to go out and fight the crowds in the restaurants? Or do you plan on sitting in front of the tv in your sweats with a good movie?

Cathy and I have been married for many years and when we think about it we have only been out to dinner on Valentine’s Day once or maybe twice. I really can only remember one time when I was in dental school and we bought into the idea that you were “supposed to” go out to dinner on that night. All we remember was that it was crowded, the service was slow, it was not romantic, and we wished we were home. I love going out to dinner, but not on Valentine’s Day!

There seems to be a lot of pressure about this day. Should you do flowers, candy, jewelry? A number of years ago we started something in our house that really works for us. I pick up a nice bouquet of flowers at the grocery store for Cathy, she goes to See’s and has them refill two tuxedo candy boxes for me, we pour a glass of wine and make a pizza for dinner. A heart shaped pizza. We love it! All the pressure that Valentine’s Day can bring is gone and we are both happy. In fact, this year I made some comment about needing to do Valentine’s Day shopping and she looked at me like I had a screw loose. She assured me that our Valentine’s Day tradition was what she liked and what she wanted.

Whatever you do for Valentine’s Day, make it a good day for you. And if you get a box of chocolates - like I will - make sure you brush your teeth after enjoying your treats. Another good tip before heading out for a Valentine’s date night is to be sure your pearly whites are just that – pearly white - and your breath is fresh! Then let Cupid work his magic…

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