Friday, June 10, 2016

Dental x-rays

Dental x-rays are a vital tool in the diagnosis of dental diseases such as cancer, bone infections, abscesses, cysts and decay.  Rays that were able to penetrate an object revealing the contents within were discovered by Wilheim Roentgen in 1895.[1]

Radiation is known to be accumulative in the cells of our bodies.  How much radiation do we as dental consumers get from a regular set of x-rays during a routine dental visit?  This and many more questions should be asked and understood by each dental care consumer. This article will address these and other issues that dental consumers should be made aware of.

History of dental x-rays
Dental x-rays began to be used by Dr..Otto Walkoff  in Germany, 1896[2].  The first dental x-ray was used by Dr. Edmund Kells and in 1856.  He used glass plates to capture the desired image. The first dental x-ray film was used by Dr. Frank Vanwoert.  Dental x-ray equipment and procedures have progressed over time.  Glass plates, used by Kells in 1856 were changed to film, used by Vanwoert.  Today X-ray film has been replaced by a digital form reducing almost eliminating exposure to unsafe doses of dental radiation.

Amount of radiation from dental x-rays
As a clinician I am asked a variety of questions regarding the amount of radiation received from our dental x-rays.  X-rays come from a variety of sources and are accumulative throughout our lifetime.  A unit called a “rem” is used to measure radiation. A rem is a large unit, much like a mile is a large unit of length, so we usually use a millirem (mrem) instead, much as you would measure in inches instead of miles for most purposes. (It takes 1000 mrem to equal one rem.)[3]  A typical dental x-ray image exposes you to only about 2 or 3 mrem. The National Council on Radiation Protection (NCRP) says that the average resident of the U.S. receives about 360 mrem every year from background sources. This comes from outer space, radioactive materials in the earth, and small amounts of radioactive material in most foods we consume.3

Just for your information, “Some typical sources that may expose you to radiation also include smoke detectors (less than 1 mrem per year), living in a brick house instead of a wood one (about 10 mrem per year due to radioactive materials in the masonry), cooking with natural gas (about 10 mrem per year from radon gas in the natural gas supply), reading a book for 3 hours per day (about 1 mrem per year due to small amounts of radioactive materials in the wood used to make the paper), and even from flying in an airplane (about 5 mrem for one cross-country flight because of the increased altitude.) In fact, you receive about 2 mrem per year from sleeping next to someone! This is because all of us have very small amounts of naturally occurring radioactive materials in our bodies. [4]

Why do I need a Dental X-ray?
At times dental consumers wonder, “x-rays again”.  It is important to be aware of the advantages of having regular dental x-rays taken. 

Advantages of Dental x-rays
  • Digital radiographs reveal small hidden areas of decay between teeth or below existing restorations (fillings), bone infections, gum (periodontal) disease, abscesses or cysts, developmental abnormalities and tumors that cannot be detected with only a visual dental examination.
  • Digital radiographs can be viewed instantly on any computer screen, manipulated to enhance contrast and detail, and transmitted electronically to specialists without quality loss.
  • Early detection and treatment of dental problems can save time, money and discomfort.[5]
  • Digital micro-storage technology allows greater data storage capacity on small, space-saving drives.
  • Dental digital radiographs eliminate chemical processing and disposal of hazardous wastes and lead foil, thereby presenting a "greener" and eco-friendly alternative.
  • Digital radiographs can be transferred easily to other dentists with compatible computer technology, or photo printed for dentists without compatible technology.
  • Digital sensors and PSP (photostimulable phosphor) plates are more sensitive to X-radiation and require 50 to 80 percent less radiation than film. This technology adheres to the ALARA (As Low As Reasonably Achievable) principle, which promotes radiation safety.
  • Digital radiograph features, including contrasting, colorizing, 3-D, sharpness, flip, zoom, etc., assist in detection and interpretation, which in turn assist in diagnosis and patient education. Digital images of problem areas can be transferred and enhanced on a computer screen next to the patient's chair.
Disadvantages of dental x-ray
Are there disadvantages to having routine dental x-rays?  There is always a risk involved in taking any type of x-ray especially to the physically compromised however the risk involved with digital dental x-rays outweigh the disadvantages.
Digital dental x-rays are a necessary and vital tool to the diagnosis and care of dental disease.  Exposure to digital x-rays are now so minimal that even those individuals that are at risk can safely take care of their dental needs.
Tess Hulet RDH, MHSM

[1] Assmus, Alexi.  Early History of x Rays.  Summer 1995 P24.
[2] Singer, Steven R. DDS. The History of OralRadiology Part II.


[5] Rondon Nayda, Nosti John, DMD. Digital Dental Radiography: Zooming in on the Future of          Dental Imaging.

Wednesday, August 5, 2015

Care of children’s teeth

How do I care for my child’s teeth? Are my child’s baby/deciduous teeth important?  At what age should I expect to see my child’s teeth come in?  At what age should I take my child in for their first check up?  What products are safe for my child?  These are some of the questions that mothers/fathers may have regarding the dental health of children’s teeth

Importance of baby/deciduous teeth
It is important to maintain and care for children’s teeth.  Baby/deciduous teeth are vitally important to the overall health and well being of the child.  Baby teeth hold the place for the permanent teeth that will continue with them into adulthood.  They form the frame work of the child’s face and guide the facial bones as they grow into maturity.  Children’s teeth are used to chew contributing to adequate nutrition and the health of the child.  Self worth is also framed at a young age; a healthy and vibrant smile contributes to a strong sense of individuality and character.

Caring for children’s teeth
One of the preventable diseases in children is tooth decay, carious lesions or cavities. Government data statistics states, “Dental caries (tooth decay) remains the most prevalent chronic disease in both children and adults, even though it is largely preventable.”  What can be done to insure that your child’s teeth are free from disease and that they are staying healthy?

Here are seven tips that can help you in the fight against childhood cavities/tooth decay.

1.     Limit Snacking: Whenever a person consumes any type of food or beverage, the pH level lowers and the mouth becomes more acidic to aid in digestion. This first step in our digestion process ends about 30 minutes after we eat, and the pH returns to normal to help protect our teeth. When we snack, though, our teeth remain bathing in this acidic environment, wearing down tooth enamel, and providing a breeding ground for S. mutans. The same, of course, is true with infants who feed continually, or without a long enough break. You can counter this effect by planning mealtimes with a reasonable start and finish time. Ask your dentist or GP for the best advice for your child.

2.     Avoid The Sugar Dip: Some parents are prone to dipping pacifiers in substances like honey or sugar to acclimate a child to using the device. This is generally a bad idea. For the same reasons you wouldn't want to suck on a honey stick, you shouldn't give one to your child as well, it is bad for the teeth.

3.     Don't Share The Spoon: Here's a surprise! Did you know that tooth decay can be transmitted from one person to another? By sharing your child's feeding spoon, you can actually transmit S. mutans living in your mouth to your child. If you want to use a spoon to show your child it's okay to eat in this fashion, you're best off using your own spoon, and then doing a little slight-of-hand-swicheroo.

4.     Keep A Washcloth Nearby: For children who currently do not have teeth, use a washcloth to clean their gums after eating. Think of this as tooth brushing 101.

5.     Brush Away: And, for those lucky enough to have teeth already, use a child-safe toothbrush to clean away any food debris after a meal. It's good training for your child, and good for their teeth as well!

6.     Fill The Bottle Wisely: Avoid putting anything in your child's bottle except formula, breast milk or milk. Anything sweet or sugary will just further promote decay.

7.     Obey Naptime Rules: Restrict bottle usage prior to bedtime, or at least brush or wash their mouth prior to bed. Allowing a child to sleep with a bottle is considered to be the number one reason for baby bottle tooth decay as the bottle tends to continually drip into the child's mouth. For more on why this is important, see tip, #1.

Pit and fissure sealants can be placed by your dental professional to protect the deep grooves of the teeth from bacteria invasion.

 Eruption of children’s teeth
Many questions arise as to when baby teeth come in and when they are supposed to fall out.  It is vital that the baby teeth are healthy for they hold the space for the permanent teeth.  The jaw bone is guided by these teeth creating the framework for the face.  What can you expect when your child begins teething and what can you do to alleviate the discomfort that may occur during teething?  Baby center provides these suggestions:

Symptoms of teething:
  • red flushed cheek or face
  • ear rubbing on the same side as the erupting tooth
  • heavy drooling
  • your baby might be sleepless at night and wakeful during the day
  • she may not be feeding as well
  • gum rubbing, biting or sucking
  • general crankiness and being unsettled
Things you can try to alleviate discomfort from teething:
  • Rubbing a finger or a cold spoon over your baby's sore gums to numb the pain temporarily.
  • Giving your baby a teething ring. Solid silicone-based teething rings are recommended over liquid-filled products, which could leak and cannot be sterilized. You could put the teething ring in the fridge for a while before giving it to your baby.
  • Giving your baby a pacifier or dummy. Chewing on the teat may help them to soothe themselves.
If your baby is over 6 months old, try:
  • Letting your baby chew on hard non-sweetened rusks, breadsticks or oven-hardened bread.
  • Using fresh and frozen fruit and vegetables, such as cucumber or frozen bananas, as a chewable soother.
There will be times when your baby will reject all of these offerings and, at these moments, a cuddle is the best therapy you can give.

For more information about teething tips go to:

Eruption/Shedding of Baby Teeth

Products for children’s teeth

     Product selection for children can be confusing due to the variety of dental care products available.  Care of infant’s gums can be accomplished with a soft cloth; however there are many products available to assist parents in cleaning children’s teeth.
    It is important to floss children’s teeth especially those who are touching.  There are flossing devises available that will help to encourage children to floss and assist parents in flossing their children’s teeth. 
     Gentle mouth rinses have been formulated to help fight cavities and gum disease.  These rinses should be used by children who are old enough to rinse and spit without swallowing the solution.  More information about dental products can be found at:

Dental Check up
It is essential that your child have regular dental check up and professional cleanings.  A child should have their initial dental check up at the age of 2.  At this time the child will be introduced to the dental staff, take a ride in the dental chair, and experience the sounds, smells and things to see in a dental office.  Continuing regular dental check up’s and professional cleanings for a life time will help to prevent unwarranted pain, and finance hardships.

It is important to maintain and care for children’s teeth.  Baby/deciduous teeth are vitally important to the overall health and well being of the child.  Preventable diseases such as tooth decay can be prevented by simple dental health habits.  Brushing and flossing, controlling sugar intake and providing children with a healthy diet, regular professional check up’s and dental cleanings including placement of dental sealants can help to prevent unwarranted, pain, and finance hardships.  Remember that your child’s feelings of self worth are framed at a young age; a healthy and vibrant smile contributes to a strong sense of individuality and character.

Tess Hulet RDH MHSM