Dental radiographs or x-rays are an important part of a complete dental exam. A complete set of 18 x-rays for adults and 10 x-rays for children are usually taken at the initial dental exam. Thereafter 6-8 x-rays called checkup x-rays are taken every 6 -12 months depending on the individual needs. X-rays are essential diagnostic tools for finding hidden interproximal cavities, cysts, tumors, impacted wisdom teeth, determining eruption times of permanent teeth by the extent of root formation and presence of supernumerary teeth (extra teeth).
Digital Radiography, offers some positive advantages over typical film X-rays. The most remarkable is the reduction of radiation exposure, by as much as 80%, which makes dental X-ray taking safer and minimizes concerns about radiation exposure. You should know that 2 dental x-rays deliver 5,600 times less radiation to an unborn child than an upper GI series, 80 times less radiation than a chest x-ray, and 4 times less radiation than a normal day of background radiation playing in the sun. Dental x-rays are necessary and both safe and effective.
Digital imaging has been used by the medical community to make diagnostic information more accessible and more valuable. It is now available for dental offices. These dental x-rays are taken using electronic sensors that send the image directly to a computer. This image is displayed on a LCD monitor, can be enlarged, and can help the patient visualize and understand the doctor's treatment recommendations more easily. It also faciliates the doctor's diagnostic ability in "zooming in" and enlarging a specific area of the x-ray. The digital image only takes 10-15 seconds to appear on the monitor. A side benefit is that digital X-ray is also environmentally friendly. The sensors used do not contain lead foil, like conventional dental film, that needs to be recycled or disposed of as hazardous waste. Also, there are no chemicals or water involved in generating an image, reducing pollution and water consumption.
Digital X-ray generates pictures that are diagnostically equivalent to film based images. Many image enhancement tools allow many viewing options. They allow zooming, brightness and contrast control, reversing, colorization, and other features that can be used to assist the dentist in diagnosing dental problems. The images also can be transmitted electronically for either insurance purposes or to another doctor involved in treatment.
Kids really enjoy being able to actually see their X-rays on the computer screen. It helps them to understand their condition better and gets them involved in treatment. By placing a large image of an x-ray on a monitor that the child can see, we can begin to include the child in the diagnosis. It is a great teaching tool.
Taking the image:
A small, flat sensor is placed in the patient's mouth next to the teeth. The sensor is connected to a computer by a thin wire. Next, an X-ray beam is sent through your teeth and into the sensor, which records the image of your teeth and sends it to the computer. The sensor can then be repositioned to capture other sections of the mouth.
This wonderful new technology allows you to relax in your chair while simultaneously observing a real-time pictures of the inside of your mouth magnified beyond normal size on an adjacent computer monitor! Not only does this make it simple to see and understand what the doctor is telling you, but it makes it simple for us to keep incredibly accurate records from one visit to the next.
DIAGNOdent aids in the detections of caries. Even very small lesions are detected at the earliest stage, enabling you to protect and preserve the tooth substance. The DIAGNOdent is significantly more accurate in identifying early stage lesions than conventional methods.
The KaVo DIAGNOdent has the unique ability to find “hidden caries”, a widespread phenomenon associated with the pervasive use of fluoride, which fortifies tooth enamel, However, despite the benefits of stronger enamel, traditional caries diagnostics, like the sharp explorer, once effective in the pre fluoride era, are no longer reliable. The implication of the current diagnostic challenge is that decay can progress under seemingly intact tooth structure, undiscovered and untreated by the clinician. The DIAGNOdent scans tooth structure with a harmless laser light, detecting sub surface caries. The device grades the lesion using a numeric scale, allowing the clinician to take appropriate action, before the decay can progress.
DIAGNOdent has received the ADA Seal of Acceptance which provides additional validation for the DIAGNOdent and demonstrates that the instrument has emerged as a new standard of care.
Our office uses state of the art sterilization to ensure patient safety. Sterilization and disinfection are the basic steps in instrument processing and surface asepsis. Sterilization refers to the use of a physical or chemical procedure to destroy all forms of microorganisms, including the highly resistant spores.
We use Rapid Steam Autoclave at 275º F(35psi), for 15-20 minutes.
First, the instruments are prepared for the sterilization process. Patient debris and fluids are removed by placing the instruments in 3.2% glutaraldehyde for 40 minutes .Following this pre-disinfection step the instruments are transferred to an ultrasonic cleaner for another 15 minutes .Then the instruments are rinsed, dried, placed in self sealing sterilization pouches and sterilized in the autoclave. Instruments which can not be heat sterilized, are immersed in 2% glutaraldehyde for 10 hours to cold sterilize.
We use Biological, Chemical and Mechanical indicators to monitor our sterilization process.
Using bacterial spores to monitor the sterilization process is referred to as biologic monitoring (or spore-testing), and the bacterial spores used for monitoring the sterilization process are referred to as biologic indicators (BIs). Of the three methods, biologic monitoring is regarded as the most valid for monitoring the sterilization process, for it uses live, highly resistant bacterial spores. We biologically monitor our sterilizer once a week to ensure complete sterilization using spore strips and keep accurate records for our monitoring. These strips are enclosed in a glassine envelope and processed through the sterilizer. They are then sent to our spore testing center where they are tested for live spores.
Chemical monitoring involves using chemical indicators (CIs) that change color or form when exposed to specific high temperatures or to the sterilizing conditions within a sterilizer. This is referred to as chemical monitoring (or process monitoring). We use sterilization pouches that have special marking that change color when subjected to sterilizing temperatures.
Mechanical monitoring involves observing and recording the physical aspects (e.g., temperature, pressure, or time) of the cycle when the sterilizer is being operated. Our Sterilizer is serviced regularly to ensure proper functioning.
Barrier Controls - As recommended by OSHA and CDC our office staff wears protective eyewear, mask, and new gloves for each patient. For each patient light covers, head rest covers, suction tips, air water syringe tips , bibs and any item used that cannot be sterilized are discarded.
Disinfectants - These are used on chairs, counter tops, and other surface areas in all treatment rooms after each use.
Our goal is to provide the highest level of safety and comfort for our staff and patients. We are committed to staying current with the latest in infection control and sterilization guidelines. You can feel confident that your child's health is protected in our office.
All children need to brush their teeth at least two times a day, at night before bedtime, and in the morning after breakfast. By disturbing and removing the plaque formation twice a day, parents can minimize or eliminate their children's potential for decay. For younger children a parent should brush their teeth using a pea-sized amount of toothpaste. As the child gets older and you see they have the dexterity and patience to properly take care of their teeth, you may give over the task. But do periodically monitor their care. Toothpaste should be approved by the American Dental Association. Toothbrushes should be the proper size, smaller is better than bigger, and always use a soft nylon brush in a circular manner. This will prevent toothbrush abrasion, excessive wear of the enamel at the gum line. Also a toothbrush should be replaced when it is worn, bristles splayed, or after more serious colds, infection, Strep throat, etc.
Infants - Gum pads and teeth should be wiped off with a gauze or washcloth.
Toddlers - Parents should brush their teeth twice a day with a very small amount of toothpaste. Toothpaste has quite a bit of fluoride in it. If the child is allowed to swallow it, this can cause white or brown spots to occur on the developing permanent teeth. Use toothpaste sparingly with young children.
3-6 year olds - Let them brush, supervise them, and do the final brushing to make sure all surfaces of the teeth are cleaned. Also you need to floss their teeth as they get older as the posterior teeth get closer and tighter over time. Make sure they can rinse their mouth so toothpaste doesn't get swallowed.
6 and older - Continue supervision until you are sure they can brush and floss properly.
Your dentist may recommend the use of disclosing agents which help reveal the presence of plaque on teeth. Swishing with these agents before and after brushing will disclose the missed areas and motivate your child.
What is fluoride?
The fluoride ion comes from the element fluorine. Fluoride, either applied topically to erupted teeth, or ingested orally (called systemic fluoride) during tooth development, helps to prevent tooth decay, strengthen tooth enamel, and reduce the harmful effects of plaque. Fluoride also makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage is even visible.
Where is fluoride found?
Topical Fluoride is found in products containing strong concentrations of fluoride (i.e., toothpastes, mouth rinses), fluoridated varnishes and/or gels either topically applied by a dentist or other oral health professional, or prescribed as an at-home regimen (particularly for persons with a high risk of dental caries).
Systemic Fluoride can be ingested through public and private water supplies, soft drinks, teas, as dietary supplements, some bottled water supplies. Once ingested, systemic fluoride is absorbed via the gastrointestinal tract and distributed and deposited throughout the body via the blood supply.
What health risks are associated with fluoride uses?
In general, fluoride consumption is safe. Health risks associated with Fluoridation usually are limited to misuse and over concentration. To avoid misuse and over concentration: Avoid drinking overly fluoridated water - results of this may cause teeth to become discolored, and may cause the enamel of the teeth to look spotted, pitted, or stained (a condition known as dental fluorosis). Avoid swallowing toothpaste and other dental hygiene products.
Call the local water department and/or the health department to evaluate the fluoride level in your local drinking reservoir. Children are especially vulnerable to dental fluorosis as their developing teeth are more sensitive to higher fluoride levels. Consult a pediatric dentist or other oral health care professional if you notice changes in the condition of your child's teeth.
Sealants protect the occlusal surfaces, inhibiting bacterial growth and providing a smooth surface that increases the probability that the surface will stay clean. The ultimate goal of sealants is penetrating into the pit and fissures of the tooth and sealing them from bacteria.
Indications for Use
Traditionally, sealants are thought of as a preventive measure for children and teenagers when they are in their “cavity prone years”. Patients who have xerostomia (decreased salivation), are undergoing orthodontic treatment, show evidence of incipient caries, or who are prone to caries should be evaluated as candidates for sealant placement. Primary molars also can benefit from the placement of sealants.
Space maintainers are appliances made to custom fit your child's mouth to maintain the space intended for the permanent tooth when it decides to come in. They do this by "holding open" the empty space left by a lost tooth by preventing movement in the remaining teeth until the permanent tooth takes its natural position in the child's mouth. This treatment is much more affordable and much easier on your child than to move them back later with orthodontic procedures. Think of space maintainers as insurance against braces.
Why are they important to children's dental care?
Well, baby teeth usually stay in place until "pushed out" by a permanent tooth that takes its place. Unfortunately, some children lose baby teeth too early. A tooth may be knocked out accidentally or be removed due to severe disease. When this occurs, a space maintainer may be required to prevent future dental problems. Space maintainers encourage normal development of the jaw bones and muscles, and save space for the permanent teeth and help guide them into position.
How can losing a baby tooth too early cause problems for permanent teeth?
Well, teeth are strange in that regard. Teeth attempt to "fill" any space available to them. If your child loses a baby tooth to early, the remaining baby teeth may tilt, drift, or move up or down to fill the gap. When this happens, they fill the space intended for the permanent tooth, and the permanent tooth can come in crowded or crooked. And this condition, if left untreated, may require extensive (and expensive) orthodontic treatment (braces or even surgery).
Space maintainers require any special care?
Yes, they do, and you as a parent can help. Make sure your child avoids Hard/Sticky foods (suckers, caramels, gum, popcorn, etc.). Teeth should be brushed after each meal and clean the teeth with bands especially well. Once a day, a fluoride mouthwash should be used to help prevent decalcification of the teeth around the band and wire. Do not try to bend the wire for any reason with finger or tongue. Notify our office immediately if the bands come loose or the space maintainer is damaged in any way. If a tooth erupts under the wire this also needs to be checked.
In order to avoid lengthy procedures & maintain a healthy disease free mouth we recommend recare every 6 months. This allows us to detect early signs of disease & provide appropriate treatment, leading to a favorable prognosis.
A child's first dental visit is an important step towards dental health. A child's first visit should be between 3 and 4 years old. The first dental visit is to help motivate your child and familiarize him or her to the dental instruments in a playful way. The Dentist /pedodontist will examine your child’s mouth to detect decay, assess tooth development, identify abnormal facial development, teach proper oral hygiene techniques and give guidance regarding oral habits. Depending on your child's co-operation few x-rays may be taken to help detect hidden cavities.
The first tooth usually erupts between 6-9 months of age. However there is a wide range of tooth eruption and it is not unusual for a child to have delayed eruption of teeth. When your child is teething he or she will be restless, may drool, gums may be sensitive, may have a low grade fever and diarrhea. Treatment can include - massaging sore gums with a finger or teething rings, placing ice or frozen rings on gum areas. The best remedy is your child's pediatric dose of Tylenol or fever reducing medication for pain. Orajel type products may work for a short period of time, but are not recommended.
Proper oral hygiene should be instituted as early as when the first tooth comes into the mouth. Teeth should be wiped off with a gauze pad, diaper or thin washcloth. A toothbrush is not necessary as most young children will chew on it and destroy it in a day. Toothpaste is not necessary as most children will swallow it. If toothpaste is needed due to stain on the teeth, a non fluoride toothpaste should be used until a child can spit out. Wiping off the teeth and gum pads will massage them and help reduce teething discomfort. Plaque will form on any tooth and the gum pads around them causing potential inflammation and teething discomfort.
Dental problems can begin very early. The primary cause of dental decay in young children is nursing or baby bottle tooth decay. A baby may get severe decay when he or she nurses constantly from the breast or a bottle containing milk or juice during bedtime or naps. A child should not be put to bed with a bottle of milk, juice, or sweetened liquid. If a bottle is used, only water should be used. A pacifier is preferable. It is advisable to stop bottle or breast feeding by one year of age.
Baby teeth serve the important function of eating, speech, and esthetics (self image). These teeth not only help form the developing jaws, but they hold space for the permanent teeth so that a normal bite occurs. The last baby tooth falls out at about twelve years of age. A decayed baby tooth can become so badly decayed that it can do damage to the permanent tooth. At times severe infections of the face, head, and neck can be caused by infected baby teeth. So it is important to restore baby teeth as soon as decay is first detected.
Teeth with dental decay can be restored with tooth colored fillings. If the decay is extensive it will require the restoration with a crown.
Tooth Colored Fillings
In the past; cavities could only be treated with unsightly metal fillings that are alloys for silver and mercury. These fillings, especially when close to the front of the mouth, are highly noticeable and unaesthetic. Sometimes, the filling is so large that it causes discoloration of the entire tooth. These fillings (or restorations) often weaken teeth due to the large amount of the original tooth that has to be removed. Also there is a risk of Mercury poisoning that is used in the filling. Modern dentistry has increasingly turned to Tooth colored or composite fillings as a strong, safe and more natural looking alternative. Composite fillings utilize a soft white plastic substance that is hardened with a blue light.
Restorative Visit
You can help us make this next visit a successful and positive experience for your child, by working with us to accomplish this goal. While taking to your child about this visit use positive words like fun, easy, tooth asleep, silver star, water spray etc. Do not use negative words like pain, hurt , needle, shot, tooth pulled etc.
The entire procedure will be explained to your child and you before the procedure is performed. Pedodontists are trained to deliver the local anesthetic painlessly. However we do offer nitrous oxide and conscious sedation if the dentist sees the need for it. Once the procedure is completed a piece of gauze referred to as tooth pillow is placed between the cheek and the teeth to prevent your child from accidently biting into the numb cheek and lip. When the anesthesia is wearing off your child will feel tingling sensation which may be annoying to some children. Reaffirm to your child that the tooth is waking up.
After treatment is completed you can help us to continue the positive experience by praising your child and referring to the "fun" time they had. Please avoid negative comments such as: Did it hurt? That wasn¹t so bad! You were so brave! Did you get a shot? Were you afraid? These comments could persuade your child in thinking there was a reason to be afraid, even though they were cooperative, had a good time, and may make their future visits more difficult.
Injuries to the face, mouth and teeth are common among children. We are here to help you in the time of an emergency. Do not panic, stay calm and determine the extent of injury. If your child has a facial /head injury assess whether or not you child's injury caused loss consciousness even for a brief moment. If this is the case, your child should see a physician immediately. Worry about the mouth and teeth later. Stop any bleeding with a clean washcloth or gauze. If there is swelling place cold compression on the area. As you do this, check for broken teeth and/or missing teeth. If there are missing teeth, look for them.
If any permanent tooth is avulsed, clean the tooth by handling it with the crown and not the root. Gently rinse the tooth of dirt with cold water. Do not unnecessarily scrub the root. Then place the tooth back into the socket. If you are unable to place it in the socket place it in homogenized cold milk or cold water and immediately see the dentist. Time is the determining factor for saving the tooth. If more than 30minutes has elapsed since the tooth was dislodged the prognosis is guarded.
Primary teeth are not reimplanted. An x-ray is taken to make sure all portion of the tooth is out. Pain medications are prescribed and the area is allowed to heal. Then an impression is taken to fabricate a space maintainer to maintain the space for the permanent tooth to come in.
Broken or chipped baby teeth
If the fracture is superficial, it can be restored with cosmetic bonding. If the fracture extends to the pulp or nerve inside the tooth a baby root canal treatment or coronal pulpotomy is performed. This is a very simple procedure and not as extensive as a root canal treatment done on permanent teeth.
If the fracture is below the gum line the tooth is removed and a spacer is placed to prevent drifting of teeth into the space and maintain space for the permanent tooth.
Gum boil or Abscess
This is caused by an infected tooth. The pulp or nerve inside the tooth is infected by decay. The abscess extends beyond the apex of the tooth into the surrounding bone, perforating the bone into the gum tissue causing a gum boil. The infected tooth cannot be saved. It has to be extracted to protect the permanent tooth bud from getting infected. The patient is first put on antibiotics and then the tooth is extracted.
Toothache
If your child is having a toothache, clean the area around the tooth. Rinse the mouth with warm salt water and use dental floss to remove any trapped food between the teeth. DO NOT place aspirin on the gums or tooth. This will cause a burn to the gum tissues. If there is swelling, apply cold to the outside of the face. Take acetaminophen or ibuprofen for pain. Call the dentist.
Cold sore or Canker sore
Some patients get canker sores periodically.There is no definite cause for a cold sore.It could be due to stress, vitamin or zinc deficiency or it may have a viral origin.Cold sores usually last for 7 days.There is no definite treatment for cold sores.Treatment is aimed towards relieving the pain either with over the counter medication or prescription medication.
We try to accommodate all emergencies on the same day. Please call early in the morning. If it is after working hours, please call our answering service and the doctor on call will call you as soon as possible.
Please do not hesitate to call us if you have any questions. Your comfort is our priority!
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