Patient Education

Dental X-Rays

Patients often wonder about the reason we require x-rays, their frequency, and why there are different types.

The visual exam--using our eyes--gives us half the picture of your dental condition. The reasons we take x-rays include:

To look for hidden cavities (infections).
To determine the amount of bone health or disease.
To determine the presence of dental abscesses.
To determine the presence of cysts.
To determine the condition of root canal treatment.
To determine the presence of impacted teeth.
To determine the health of the sinuses.
To determine the presence of tumors.
To determine whether or not a child's mouth is growing properly.
To determine the condition of any dental restorations-fillings and crowns.
To determine if you are a candidate for implants.
To locate a fistula.
To determine the presence of foreign bodies.
To locate hidden calculus.
To determine root fractures.

Video examination

The usual way to examine the mouth for cavities was the explorer (you know it as that "picking" instrument). While it is still useful, it is not very accurate. It actually misses more decay than it finds.

We deal in microscopic details in dental health. Visualization is of utmost importance. The openings between teeth and fillings are so small that they are nearly invisible and the dental explorer cannot pick them up. The tip of the explorer is larger than these openings. Dental x-rays are not the answer either-old metal fillings block them out.

The most predictable method to discover these openings, gaps, and breakdowns is to magnify the size of the tooth. From this magnification, we can see gray shadows next to the filling (a sign of decay is that the joint between the tooth and filling is open). We can also see the size of the gap--there are 10 million bacteria in the area of the explorer tip!!! Imagine what happens in that small gap!!!

Dental Amalgam (so called silver fillings)

This is a product that has been around a very long time. It is made up of a combination of approximately 50% percent mercury and 50% silver, copper, tin, and zinc; with silver being in the 40% range. We do not use this product for many reasons: Read the advisory published by the American Dental Association in July 1999.

Some thoughts- if the ADA does not want the dental office to discard amalgam in the sewer, why is it ok in your mouth? If the ADA wants amalgam scrap (leftover after treating a patient) stored in a tightly closed container covered by water, not dry or open to the room air,since the mercury vapor could escape into the air, why is it okay to put in your mouth? You can read the article and determine other reasons why this product is not used in our office.

A very important point to make is that the American Dental Association has come out stating that dental amalgam is safe and effective. We choose not to use it because our patients do not want to see black fillings in their teeth when they smile. We should also state that we do not recommend removing them unless they are defective or our patient wants them removed for cosmetic purposes.

Bruxism

What Exactly is Bruxism?

Bruxism is the technical term for teeth grinding and clenching that may cause facial pain. We do this while we sleep. Bruxers may also bite their fingernails, pencils and mash their teeth together during the day. I call this clenching/grinding. People usually aren't diagnosed with bruxism/clenching until it is very late in the process because 1. They don't realize they have the habit, 2. Many dental professionals do not look for it, 3. Patients do not see their dentists regularly. What we see clinically is the wearing down of teeth, chipping of teeth, and stress fracture lines that can turn into the tooth breaking or pain.

Who Suffers From Bruxism?

Bruxism may be triggered by people with certain types of personalities. They may have nervous tension and a hard time handling stress. Anger, pain and frustration can cause people to start showing the beginning signs of bruxism with out them even knowing it. People who are aggressive, competitive and hurried may also be at a greater risk for bruxism. There are also theories that an imbalance in brain neurotransmitters or a "bad bite" is the cause.

What Can Be Done?

Your general dentist should check for physical signs of bruxism every time you are examined. The objective of therapy is to get the bruxer/clencher to change behavior by learning how to rest the tongue, teeth and lips properly. Simply becoming aware of the problem and changing behavior may be enough for some to cease this pathology. Others will wear a plastic mouth appliance called a night guard that's worn to absorb the force of this destructive disease. This appliance will prevent further damage to the teeth. To give you an idea of the extent of this problem I would say we make at least 100 night guards a year-that is two a week!

TMJ

What is Temporomandibular Joint Disorder?

Temporomandibular joint disorder (TMD) describes a variety of conditions that affect jaw muscles, temporomandibular joints (the joint of your lower jaw-slightly in front of you ears) and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw. They can develop after an injury, if you have missing teeth, if you wear down your teeth, if your bite is out of alignment with the position of the jaw joints. TMD affects more than twice as many women then men.

What is the Temporomandibular joint?

The temporomandibular joint (TMJ) is a joint that slides and rotates just in front of your ear, consisting of the temporal bone( side of the skull) and the mandible ( lower jaw). Chewing muscles connect the lower jaw to the skull, allowing you to move your jaw forward, sideways and open and close.

The joint works properly when the lower jaw and its joint both the (right and left) are synchronized during movement. TMD may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

What causes TMD?

Trauma to the jaw or jaw joint sometimes plays a role in TMD, but in most cases the cause of the disorder is unknown. Most experts suggest that certain tasks, either mental or physical, may cause or aggravate TMD, such as stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism). These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain.

What TMD symptoms can I experience?

Jaw pain or soreness that is more prevalent in the morning or late afternoon
Jaw pain when you chew, bite or yawn
Clicking when opening and closing your mouth
Difficulty opening and closing your mouth
Locked or stiff jaw when you talk, yawn or eat
Sensitive teeth when no dental problems can be found
An earache without an infection

You do not need all these symptoms to be classified as a TMD patient.