Posts for: April, 2019

By Sarah J. Morris, DDS, PLLC
April 27, 2019
Category: Oral Health
Tags: pediatric dentistry   x-rays  
SafetyisaPriorityWhenImagingChildrensTeethwithX-Rays

X-ray imaging is a routine part of a child's dental care — and it undeniably makes a difference in preventing and treating dental disease. It's so routine, we can easily forget they're being exposed to an invisible form of electromagnetic radiation.  And just like other sources of radiation, too much x-ray exposure could increase the risk of cancer.

But while it's possible for your child to be over-exposed to x-rays, it's highly unlikely. That's because healthcare professionals like dentists adhere to a standard known as ALARA when considering and administering x-rays. ALARA is an acronym for “as low as reasonably achievable.” In other words, we only want to expose a patient to the lowest and safest levels of x-ray dosage and frequency that will achieve the most benefit.

To achieve that standard, professional dental organizations advocate the use of x-rays only after a clinical examination of the patient, as well as a thorough review of their medical history for any usage of x-rays for other conditions. If x-rays are warranted, we then take further precautions to protect the patient and staff, and only use the type of x-ray application that's absolutely necessary. For most children that will be a set of two or four bitewing radiographs, which are quite effective for detecting decay in back teeth.

This dosage of radiation in a session of bitewing radiographs is roughly a fifth of the background radiation in the environment a child may be exposed to every day. By spacing these sessions at least six months apart, we're able to achieve a high level of decay detection at a safe and reasonable amount of x-ray exposure.

On top of that, the digital advances in x-ray imaging have reduced the amount of radiation energy needed to achieve the same results as we once did with film. These lower exposure levels and the ALARA standard helps ensure your child's exposure to x-rays will be well within safe limits.

If you would like more information on the use of x-rays with children, 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 “X-Ray Safety for Children.”


By Sarah J. Morris, DDS, PLLC
April 22, 2019
Category: Oral Health
DontUseBenzocaineProductstoEaseYourBabysTeethingPain

Although teething is a natural part of your baby's dental development, it can be quite uncomfortable for them—and upsetting to you. During teething, children can experience symptoms like pain, drooling or irritability.

Teething is the two or three-year process of intermittent episodes of the primary ("baby") teeth moving through the gums. These episodes are like storms that build up and then subside after a few days. Your aim as a parent is to help your baby get through the "stormiest" times with as little discomfort as possible. To that end you may have considered using over-the-counter products that temporarily numb irritated gums.

Some of those numbing products, however, contain a pain reliever called benzocaine. In recent years, this and similar ingredients have been found to increase the level of a protein called methemoglobin in the bloodstream. Too much methemoglobin can result in less oxygen delivered to body tissues, a condition known as methemoglobinemia.

This oxygen decrease can cause shortness of breath, fatigue or dizziness. In its severest form it could lead to seizures, coma or even death. Children and infants are at high risk for benzocaine-induced methemoglobinemia, which is why the U.S. Food and Drug Administration has banned marketing for benzocaine products as pain relievers for teething infants and children.

Fortunately, there are alternatives for helping your child weather teething episodes. A clean, chilled (not frozen) teething ring or pacifier, or a cold, wet washcloth can help numb gum pain. You can also massage their gums with a clean finger to help counteract the pressure exerted by an emerging tooth. Be sure, though, that you're not allowing anything in your child's mouth like lead-based paint that could be toxic. And under no circumstances should you use substances containing alcohol.

For severe pain, consult your physician about using a pain reliever like acetaminophen or ibuprofen, and the proper dosage for your child. With these tips you can help your child safely pass through a teething episode.

If you would like more information on helping your child cope with teething discomfort, please contact us or schedule an appointment for a consultation.


By Sarah J. Morris, DDS, PLLC
April 17, 2019
Category: Oral Health
Tags: toothache  
YourToothacheMightnotbeCausedbyaTooth

A toothache means a tooth has a problem, right? Most of the time, yes: the pain comes from a decayed or fractured tooth, or possibly a gum infection causing tooth sensitivity.

Sometimes, though, the pain doesn't originate with your teeth and gums. They're fine and healthy—it's something outside of your tooth causing the pain. We call this referred pain—one part of your body is sending or referring pain to another part, in this instance around your mouth.

There are various conditions that can create referred pain in the mouth, and various ways to treat them. That's why you should first find out the cause, which will indicate what treatment course to take.

Here are a few common non-dental causes for tooth pain.

Trigeminal Neuralgia. The trigeminal nerves situated on either side of the face have three large branches that extend throughout the face; the branch to the jaw allows you to feel sensation as you chew. When one of the nerve branches becomes inflamed, usually from a blood vessel or muscle spasm pressing on it, it can refer the pain to the jaw and seem like a toothache.

Temporomandibular Joint Disorder (TMD). These two joints that connect the lower jaw to the skull can sometimes become dysfunctional for a variety of reasons. This can set up a cycle of spasms and pain that can radiate throughout the jaw and its associated muscles. The pain can mimic a toothache, when it actually originates in the jaw joints.

Teeth Grinding. This is an unconscious habit, often occurring at night, in which people clench or grind their teeth together. Although quite common in children who tend to grow out of it, teeth grinding can continue into adulthood. The abnormally high biting forces from this habit can cause chipped, broken or loosened teeth. But it can also cause jaw pain, headaches and tenderness in the mouth that might feel like a toothache.

These and other conditions unrelated to dental disease can seem like a tooth problem, when they're actually something else. By understanding exactly why you're feeling pain, we can then focus on the true problem to bring relief to your life.

If you would like more information on oral pain issues, please contact us or schedule an appointment for a consultation.


By Sarah J. Morris, DDS, PLLC
April 12, 2019
Category: Oral Health
Tags: oral health   fluoride  
KeepaCloseEyeonYourChildsFluorideIntake

Fluoride has been proven to strengthen tooth enamel against decay. That’s why it’s not only added to toothpaste and other dental products, but also to drinking water — in nearly three-quarters of U.S. water systems.

While research has eased most serious health questions about fluoride, there remains one moderate concern. Too much fluoride over time, especially in infants and young children, could lead to “enamel fluorosis,” an excess of fluoride in the tooth structure that can cause spotting or streaking in the enamel. While often barely noticeable, some cases of fluorosis can produce dark staining and a pitted appearance. Although not a symptom of disease, fluorosis can create a long-term cosmetic concern for the person.

To minimize its occurrence, children under the age of 9 shouldn’t regularly ingest fluoride above of the recommended level of 0.70 ppm (parts per million). In practical terms, you as a parent should monitor two primary sources of fluoride intake: toothpaste and drinking water.

Young children tend to swallow toothpaste rather than spit it out after brushing, which could result in too much fluoride ingestion if the amount is too great. The American Academy of Pediatric Dentistry therefore recommends a small “smear” of toothpaste for children under two, and a pea-sized amount for children up to age six. Brushing should also be limited to no more than two times a day.

Your child or infant could also take in too much fluoride through fluoridated drinking water, especially if you’re using it to mix infant formula. You should first find out the fluoride levels in your local water system by contacting the utility or the health department. If your system is part of the U.S. Centers for Disease Control and Prevention’s (CDC) “My Water’s Fluoride” program, you may be able to access that information on line at //apps.nccd.cdc.gov/MWF/Index.asp.

If the risk for developing fluorosis in your area is high, you can minimize your infant’s intake with a few recommendations: breastfeed rather than use formula; use “ready-to-feed” formula that doesn’t need mixing and contains lower fluoride levels; and use bottled water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”

Fluoride can be a wonderful adjunct to dental care in reducing risk for tooth decay. Keeping an eye on how much fluoride your child takes in can also minimize the chance of future appearance problems.

If you would like more information on the possible effects of fluoride on young children, 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 “Tooth Development and Infant Formula.”


By Sarah J. Morris, DDS, PLLC
April 07, 2019
Category: Oral Health
Tags: oral health  
E-CigsCouldbeJustasHazardousforYourTeethandGumsasCigarettes

More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.

E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.

The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.

According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.

Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.

These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.

If you would like more information on the health risks of electronic cigarettes, 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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