Posts for: November, 2015

By Sarah J. Morris, DDS, PLLC
November 26, 2015
Category: Dental Procedures
Tags: x-rays  
BitewingX-RaysProvideEarlyDetectionofToothDecayinBackTeeth

One of the most widely used forms of dental imaging is the bitewing x-ray. So called because of the shape of the device that holds the exposable film a patient clenches between their back teeth, the bitewing x-ray is an effective means for detecting the earliest stages of tooth decay.

These early signs are small lesions on a tooth surface caused by mineral loss in the enamel. While we can identify them on front teeth through visual examination or bright lighting, they’re nearly impossible to see on the biting surfaces of back teeth. The bitewing x-ray solves this problem.

During the procedure, a narrow beam of x-rays is directed at the back teeth area. Since X-rays can transmit through solid matter, they pass through the teeth and gums to expose the film attached to the bitewing assembly.

X-rays pass through matter at different rates depending on the density of the tissue — a slower rate for harder tissues like teeth and bone and a faster rate for soft tissues like the gums. As a result, x-rays through teeth expose less of the film and appear as a lighter image than the gums. This difference is so precise even a tooth’s softer dentin appears slighter darker than its harder outer enamel.

This precision helps us identify decay lesions. Because the lesions on the enamel are less dense than the normal enamel, they’ll appear as dark spots. By detecting them at this stage we have a better chance for reversing the effects of decay or at least minimizing damage that’s already occurred.

Because x-rays emit radiation, there’s a natural concern about over-exposure and we go to great lengths to reduce it. Children may undergo a bitewing x-ray twice a year for developing teeth, while adults with healthy teeth are typically x-rayed just once a year. Advances in digital film and other technology have also helped lower the exposure rate.

Today’s standard 4-film bitewing x-ray produces about four days worth of what we receive on average from normal background radiation, so the health risk is quite negligible. The benefit, on the other hand, is much greater — the early detection of tooth decay could ultimately save a tooth.

If you would like more information on the use of bitewing x-rays in dental care, please contact us or schedule an appointment for a consultation.


By Sarah J. Morris, DDS, PLLC
November 18, 2015
Category: Dental Procedures
Tags: crowns  
CrownDifferencesCouldUltimatelyAffectYourCost

Crowns are a mainstay of cosmetic dentistry used to improve your smile’s appearance in a variety of situations. Not all crowns are alike, though — and the differences could affect your cost.

Crowns or caps are needed to cover remaining tooth structure which was previously damaged. Tooth decay and trauma are the major reasons for damage or loss of tooth structure that make crowns necessary. After preparing the remaining healthy tooth to fit into the new crown, we then make an impression mold of the tooth for a dental technician to use to create the new crown. It’s at this point where the road to your new smile can take different paths, both in construction and how much artistry goes in to your crown’s formation.

Porcelain crown construction falls into two general categories. The first category involves life-like porcelain fused to an inner core of metal. Because many older types of porcelain tend to be brittle and subject to breaking under pressure, metals are used to strengthen the crown. A fused crown can thus provide both durability and a life-like appearance.

In recent years, though, new dental materials have made the second category — all porcelain crowns — a viable option. Either lithium disilicate or zirconium oxide account for nearly two-thirds of crowns made today. Although research on their durability is relatively new, initial results have been encouraging, showing advanced all-ceramic crowns can tolerate forces comparable to porcelain fused to metal (PFM) crowns used in bridges.

On the downside, these newer materials may be more expensive than PFM crowns. Costs for manufacturing may also increase depending on how life-like the matching of color with other teeth you desire your crown to be. For example, individual teeth aren’t a uniform color — there are gradations of color that can vary from the tip of the tooth to the root. To capture these gradations in an individual crown requires a high level of artistry and time by the dental technician, which increases the final cost.

If you’re in need of a crown, it’s best to first make an appointment for a consultation to review your options, and to consider both your expectations and financial ability. Together we can determine what it will take to create a new look for your teeth that fits your expectations and your budget.

If you would like more information on dental crowns, please contact us or schedule an appointment for a consultation.


By Sarah J. Morris, DDS, PLLC
November 10, 2015
Category: Dental Procedures
RegeneratingLostBoneCanMakeDentalImplantsaReality

Every day the forces you generate when you bite or chew can exert enormous pressure on your teeth. And day after day your teeth remain stable and secure, thanks to an intricate system of periodontal ligaments, attaching gum tissue and bone. The latter element is especially important — healthy bone makes healthy teeth.

And vice-versa — the same biting forces are transmitted through the tooth root to the bone via the periodontal ligament to stimulate new bone growth to replace older bone that has dissolved (resorbed). If a tooth’s missing, however, the bone doesn’t receive that stimulation, and the resorbed bone isn’t replaced at a healthy rate. In fact, you can lose up to a quarter of bone width in the first year alone after tooth loss.

And this can cause a problem when you’re looking to replace that missing tooth with what’s considered the best restorative option available: dental implants. Known for their life-likeness and durability, implants nonetheless need sufficient bone to anchor properly for the best outcome. Without it, implants simply aren’t practical.

But that doesn’t have to be the end of the story: it’s quite possible to regenerate enough bone to support implants through bone grafting. Bone material from the patient (or another donor, human, animal or synthetic) is placed under the gum at the missing tooth site to serve as a scaffold for new growth. The new bone growth will eventually replace the graft material.

The size of the graft and extent of the procedure depends of course on the amount of bone loss at the site. Loss can be kept to a minimum, though, if the graft is placed immediately after a tooth extraction, a common practice now. After a few months, the bone created through the graft is sufficient for supporting an implant and gives you the best chance for a beautiful outcome.

If you’re considering an implant for a missing tooth, you should schedule a consultation appointment with us as soon as possible. After a thorough dental exam, we’ll be able to tell you if bone grafting to support implants is a good idea for you. It adds a little more time to the overall implant process, but the results — a new, more attractive smile — will be well worth it.

If you would like more information on bone regeneration, 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 “Can Dentists Rebuild Bone?


By Sarah J. Morris, DDS, PLLC
November 02, 2015
Category: Dental Procedures
Tags: tooth extraction  
SimpleorSurgicalChoosingtheRightKindofToothExtraction

There are instances when a general dentist will remove (extract) a problem tooth. At other times, though, the same dentist may refer a patient needing an extraction to an oral surgeon. Why the difference?

The procedure performed by a general dentist is referred to as a “simple tooth extraction.” “Simple” doesn’t mean easy and requiring no skill or expertise — it certainly does. In this case, the term refers to the anatomy of the tooth being extracted, particularly its roots.

Teeth that respond well in a simple extraction have an uncomplicated root system. The path of removal, usually with a single root involved, is fairly straight and without extreme angles. In the hands of a skilled and experienced dentist, it can be removed with little to no discomfort.

Dentists actually must use finesse to remove a tooth from its socket. The tooth is held in place with tiny collagen fibers that extend from a tough, elastic gum tissue known as the periodontal ligament, which lies between the teeth and the bone. With some manipulation, a dentist can loosen these fibers, which then makes removing the tooth much easier. All of this can usually be performed with local anesthesia.

Of course, to determine if a tooth can be removed this way, we must conduct a thorough dental examination first, including x-ray imaging to determine the exact nature and location of the roots. If the exam reveals the root system is more complex, or that there are defects to the bone or the tooth that could make a simple extraction difficult (resulting, for example, in not removing the crown and root in one piece), then the tooth may need to be removed surgically.

Such situations require the skill and resources of an oral surgeon. These specialists perform a number of surgical procedures related to the mouth and face; as procedures go, extraction is among the most routine. Using local anesthesia and post-operative pain management, undergoing a surgical extraction involves only minimal discomfort and a very short recovery time.

After examining your tooth we’ll recommend the best course for extraction, whether simple or surgical. In either case, we’ll see that your problem tooth is extracted as efficiently and painlessly as possible.

If you would like more information on tooth extractions, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction?


By Sarah J. Morris, DDS, PLLC
November 01, 2015
Category: Oral Health
Tags: antibiotics  
ChangingAntibioticUseTodaywillHelpEnsureTheirEffectivenessTomorrow

It’s hard to imagine, but little more than a century ago today’s “minor” bacterial and viral infections were often deadly. This changed with the advent of antibiotics, drugs which kill disease-causing microbes. Decades after the development of penicillin and similar antibiotics, we routinely rely on them for treating infection. They’re quite prominent in dental care in treating advanced forms of periodontal (gum) disease or reducing bacteria that cause tooth decay.

But the age of antibiotics may be in danger: their overuse in medicine and the food industry has led to the rise of resistant microbial strains — “superbugs” — that no longer respond to first line antibiotics or, in some cases, to second or third line drugs. The U.S. Center for Disease Control (CDC) estimates more than two million people annually will contract one of these superbugs of which more than 20,000 will die. If current practices continue, the growth of resistant strains (as well as allergic reactions among users of antibiotics) will increase. The answer is a more modified use of antibiotics.

For healthcare providers, this means adopting new protocols in which we attempt to prescribe antibiotics that specifically target an identified microbe (which we’ve determined through more rigorous diagnostic testing), and in limited amounts. We must also rein in the practice of antibiotic use in the food industry, routinely administered to livestock to prevent disease or to enhance growth. Many countries, including the U.S., are now moving toward a more limited practice in which only animals that are demonstrably sick receive antibiotics. This will limit their release into the greater environment, which is a contributing factor to growing microbial resistance.

Patients also play a role in the better use of antibiotics. We must first change the perception that antibiotics are a “cure-all” — the answer to every illness. It’s also important for patients who’ve been prescribed antibiotics to complete the course of treatment, even if after a day or two they feel better; stopping antibiotic treatment prematurely increases the chances targeted microbes develop a resistance to that particular drug.

Altering our perception and use of antibiotics will require a tremendous effort for all of society. But making these changes will help ensure antibiotics continue to serve humanity as an important health benefit well into the future.

If you would like more information on the role of antibiotics in dentistry, please contact us or schedule an appointment for a consultation.




Dentist - Fort Worth
2551 River Park Plaza
Fort Worth, TX 76116
817-732-4419

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