Dental Questions: What are digital x-rays?

Most of our patients will remember the transition from film to digital dental x-rays with a positive stance. Gone are the days of sharp film holders, waiting for the developer and difficulties in duplication. But what are the biggest advantages of digital x-rays? Are they safe? How to they work? Read on to find out the true benefits behind this new technology!

Digital dental x-rays work on the same principles as modern digital cameras. In fact, our x-ray sensors use the same CMOS technology found in many modern DSLR, pocket and cell phone cameras. The main difference is that dental sensors are calibrated to react to x-ray radiation rather than the photons in visible light. Beyond that, the images are digitally decoded and rendered using much of the same technology as digital photography. The sensor itself contains no hazardous material and emits no radiation. 

The two main principles that drive the digital revolution in dental x-rays are lower radiation and increased efficiency. "Exposing" a digital x-ray sensor requires less radiation than a similarly sized film, even when comparing the most sensitive film available. Digital images are also easier to manipulate, enlarge and change contrast, which allows us to gather more information off of a single picture. Finally, we can now judge the need for re-takes immediately, which translates to less waiting during your appointment. 

Whenever discussing dental x-rays, the topic of safety always comes to light. We are here to assure our patients that dental radiography is extremely safe, with the benefits largely outweighing any drawbacks. Even after a full-mouth set of x-rays (taken about once every five years), you experience roughly the same amount of radiation as a trans-atlantic flight. Furthermore, four bitewings (taken about once every year to 18 months) require less radiation than spending a day outside in the sun. Particularly with our ultra sensitive digital sensors, your effective radiation exposure is negligible. 

It is important to note that traditional film x-rays still play an important role in dentistry. Many practitioners still rely on film with excellent results and high patient satisfaction. This is particularly true of pediatric offices, where the thin profile and gentle flex of film allows dentists to get clearer images in smaller mouths. If you would like to know about digital x-rays or any other new trends in dental technology, please give our office a call!

Lower Incisor Implant Restoration

The top photos show the shade guides used by the lab to match the adjacent teeth. The metal pieces indicate the location of the implants for the impressions. The bottom photo highlights the great job Opus One Lab did in matching the colors of the teeth and gums!

Bet you've never seen implants like this! Today's patient came to us after having lost their lower anterior incisors due to periodontal disease. Periodontal problems are common in this area due to a combination of plaque buildup, poor access due to crowding and (sometimes) tension of the lower lip on the gum tissues. Unfortunately, losing these teeth can have many undesirable effects, such as problems tearing food and lack of esthetic support for the lower lip. 

In treating this patient, two implants were placed by a specialist next to the lower canines. Once the surgical sites were healed, impressions were taken and sent to Opus One Dental Laboratory. At the lab, Four prosthetic teeth were created in a bridge from implant to implant. To correct for the missing bone, pink porcelain was added to the bottoms of the teeth to simulate gum tissue. The result is a very functional and natural looking replacement! If you would like to know more about amazing transformations we can achieve with dental implants, please give our office a call!

Examining the Anti-Flossing News

If you've been on the internet in the last month, chances are you've seen the AP article titled "Medical Benefits of Dental Floss Unproven." In this article, the author postulates that as the Department of Agriculture and Health and Human Services dropped flossing from its dietary recommendations, it comes to light that there is little to no scientific evidence that flossing is beneficial to oral health.

In dissecting this article, it is important to understand why dentists recommend flossing. The primary goal of flossing is to physically remove bacterial film (plaque) from the pockets between the gums and the teeth. As a secondary action, floss can dislodge food that gets stuck between teeth and help prevent decay. Floss cannot remove hard bacterial film (calculus/tartar) nor can it clean deep periodontal pockets. That being said, regular flossing will help prevent the development of these conditions to begin with. 

It becomes clear that the author of this story does not have a solid understanding of periodontal disease, oral health or scientific studies. One of the main points of the article is that there aren't any quality scientific papers that show the benefits of flossing. This fact more-so highlights the high costs and extreme difficulty in performing a study of this nature. Much of scientific research pivots on having reliable metrics and a large enough sample to get valuable data. Since flossing is so universally accepted in the dental community, securing the millions of dollars necessary to perform this study would be nearly impossible. 

Furthermore, the author argues that any evidence on flossing points to its benefits in reducing bleeding gums, removing plaque and stopping gingivitis. He seems to view these attributes in a vacuum, when in reality they are all part of the periodontal disease process. Plaque, when left undisturbed, eventually hardens into tartar. This then causes an inflammation of the gum tissue known as gingivitis. Gingivitis is responsible for the bloody, puffy and sensitive gums that many patients experience. With time, the inflammation spreads to the bone surrounding the teeth and causes it to recede creating deep pockets. At this point, the disease is called periodontitis. While it is true that floss will not reach the bottoms of these deep pockets, any reduction in bacterial load is beneficial and crucial to the treatment of periodontal disease.

The author is quick to note that "early gingivitis is a long way from severe periodontal disease" and that "severe periodontal disease may take five to 20 years to develop." What he fails to mention that slight or moderate periodontitis can develop much quicker (we usually see the first signs around age 30) and that the technical "severe" periodontal disease is a debilitating condition marked by loose teeth, chronic bad breath, pain and tooth loss. This is the exact same disease that started out as gingivitis. Why wouldn't you do everything in your power to mitigate this problem from the start? 

If you would like more reasons to keep flossing, just read any statements made by the ADA, the California Dental Association or the American Academy of Periodontology. The dental community shows unanimous support for the regular, daily use of dental floss. Furthermore, evidence shows that controlling periodontal disease is associated with less heart disease, better glucose control in diabetics and better outcomes in at-risk pregnancies. Flossing is an important part of your oral health home care! If you need any more information on the benefits of flossing or instructions on how to floss, feel free to contact our office!

Braces for Adults

With more nearly 1.5 million patients last year, adult orthodontics are certainly on the rise. Adulthood can certainly be a time where finances and resources align to make the dream of straighter teeth a reality. Wether used on their own or in combination with other cosmetic dental procedures, braces can create a dramatic change in almost any smile. 

Many adult patients will opt for traditional wire-and-bracket braces. These orthodontic appliances are the most versatile option, achieving most tooth movements with ease. The entire procedure is overseen by an orthodontist, who directs and refines treatment on the fly.  The most obvious drawbacks to this type of orthodontics is the esthetics of the exposed appliance. In fixing this, some specialists place tooth colored brackets that better blend in with the surrounding tooth enamel. A second drawback is the increased time devoted to oral hygiene. Brushing and (particularly) flossing become more difficult with a metal bar running across the teeth. However, there are many readily available products that make keeping your braces clean a no brainer. 

For those wishing to avoid the appearance of traditional orthodontics, removable Invisalign trays might be an ideal choice. Here, a series of trays are custom fitted to your teeth to gently push them to their desired positions. Since nothing is truly anchored to the teeth/mouth, tooth movements take a longer time. Additionally, some types of adjustments are difficult/impossible without traditional braces. Invisalign works great for minor corrections, crowding, or correcting orthodontic relapse (for those who have reoccurring tooth movement after finishing childhood orthodontic treatment). 

There are always a number of great options for perfecting and maximizing your smile. Braces and trays represent the ideal solution for those looking for straighter and more evenly spaced teeth. If you would like to know more about your cosmetic options, please call our office to schedule an exam!

Dental Questions: What's the difference between sealants and fillings?

A recent study released by the Journal of the American Dental Association identified dental sealants as one of the most effective means of reducing cavities in children. Sealants were found to be more effective than fluoride varnish at preventing decay and are associated with a 70%-80% reduction in cavities in the pits and grooves of teeth. 

A dental sealant is administered by cleaning the tooth surface, fillings the grooves with a resin material and adjusting any high points that interfere with biting/chewing. This may sound similar to the way that a traditional dental filing is performed because it is essentially the same procedure. The main differences come from the goals of the treatments and the amount of modification to the tooth. 

A dental filling is provided to remove active decay from a tooth's enamel and dentin. They usually extend 3-5 millimeters into the tooth and are used as a reparative treatment. By taking out the damaged areas, we can halt bacteria's progression into the tooth. In contrast, a sealant is performed on an undecayed tooth as a preventative measure. Typically, no tooth structure is removed. The end goal is to "seal out" food and bacteria from the deep grooves in our teeth. These tiny nooks create a perfect spot to catch food, harbor bacteria and avoid cleaning (most times the grooves are too thin to be reached by a toothbrush bristle!). 

In total, there are many similarities between traditional fillings and sealants. However, placing a sealant takes less time, requires less tooth structure to be removed and is an overall less traumatic experience for young patients. If you would like to know if you or a family member would benefit from sealants, please call our office to schedule an appointment!

Stimulating Stem Cells With Dental Fillings

You have probably seen headlines across the internet discussing new a newly invented dental filling that stimulates stem cells within the teeth. Researchers at The University of Nottingham and Harvard University came together and created this material that is proposed to change the face of dentistry. While this discovery has huge implications for dental care, many articles oversell its proposed abilities. 

In discussing how this material is supposed to work, it is important to understand the anatomic structure of teeth. Every tooth has three general layers: enamel, dentin and pulp tissue. The enamel is mostly mineral and happens to be the hardest structure in the human body. It is also the layer most resistant to tooth decay. Beneath the enamel lies the softer and porous inner dentin. The pulp tissue is the innermost layer that contains nerves, blood supply and stem cells. These new fillings rely on changing the pulp's response to trauma and inflammation. 

Unfortunately, dental pulp tissue is not very resilient. Trauma, extreme temperatures, deep fillings and bacteria can all cause the pulp to become inflamed and/or die, necessitating a root canal. However, if the attack is moving slowly enough, the pulp may shrink itself by laying down new dentin and "move away" from the irritating source. The new filling material hopes to capitalize on this mechanism when placing deep fillings near the pulp tissue. Instead of causing the nerve to die, the substance hopes to induce the tooth to lay down more dentin, creating a safe and natural barrier between the tooth and filling. 

It is important to understand that (by design) this material is not an end-all solution to cavities and root canals. For starters, it would have little benefit over traditional fillings when used in shallow cavities far from the pulp. It would also not be of use in teeth that need root canals due to fracture, trauma or decay that extends entirely to the pulp. Many times, teeth need root canals not due to deep fillings that aggravate the pulp tissues, but rather because the bacteria have travelled through the enamel and dentin and have infected the inner tooth. Once the pulp comes in contact with outside microbes, it will almost certainly need a complete root canal treatment. 

Still, this new material has wonderful applications in the modern dental office. Many fillings that were previously given with a questionable prognosis can now be provided with increased likelihood of success. Likewise, this invention paves the road for future regenerative dental technologies. Who knows what the future holds in store! For more information on these new fillings and how they work, feel free to give our office a call or email us at staff@thousandoaksfamilydentistry.com

The Benefits of Sugar Free Gum

Are you a frequent gum-chewer? Men's Health Magazine recently published an article discussing how chewing sugar free gum can save you thousands of dollars in dental expenses. Find out why adding gum to your daily routine can help fight cavity causing bacteria!

Every time we eat or drink anything made with sugars or carbohydrates, our mouths turn acidic for a thirty minute period. This is caused by bacteria in our mouths processing sugars into their associated acids. Over time, the acid buildup weakens dental enamel and begins to form cavities in our teeth. These cavities tend to develop in areas that trap food, as bacteria have more fuel to turn into acid. This is one of the reasons why decay in common in between teeth and in the pits/grooves of posterior teeth. 

The Men's Health article correctly identifies that sugar free gum lacks the necessary ingredients to fuel bacterial acid production. In addition to this, gum helps loosen food that gets packed into our teeth after meals. Finally, chewing gum stimulates saliva flow which is a crucial factor in preventing tooth decay. Our saliva has incredible natural remineralizing properties and can have a tremendous effect on the progression of cavities.  

One topic the article does not address is the type of sweetener to look for in sugar free gum. Most brands use typical sugar substitutes like sorbitol and aspartame. However, chewing gum made with xylitol will add even more protective factors into your daily routine. Xylitol is a natural sugar alcohol that inhibits ability of bacteria to grow and stick to our teeth. While xylitol gum can be purchased at many stores, health food markets typically carry the best variety. You can also order it online from companies like Dr. John's Candies (our office's favorite!).

It is currently believed that Xylitol's maximum dental benefit comes from using it three to five times a day. However, it is not a substitute for flossing or brushing with a fluoride toothpaste. If you would like to know more about the protective factors of xylitol gum, how it is best used and what it does for our teeth, please give our office a call!

Link to Men's Health Article: www.menshealth.com/health/habit-save-money-dentist

Dentistry and Children's Teeth

If you ever took a fall or had a cavity as a child, you're probably thankful that we get two sets of teeth. Our primary dentition can certainly seem like a second chance to recover from youthful mishaps. You may be wondering why, if adult teeth will eventually take their place, do we perform restorative dental procedures on kids teeth? Crowns, fillings and even braces may seem excessive when you could simply "extract and wait" for the adult teeth to come in. On the contrary, primary teeth serve a number of important roles in establishing a healthy adult dentitition. 

One of the most basic goals of primary teeth is to hold space for the permanent teeth. They create markers for where the adult teeth need to erupt and keep adjacent teeth from crowding into the open spaces. Once you lose a primary tooth, the teeth on either side can start to drift into its space, blocking the adult tooth from eruption. Many times, children who lose a primary tooth prematurely will receive a space maintainer- a cemented retainer that keeps two teeth from coming closer together.

Primary teeth also play an important role in the development of the jawbones. This is the guiding principle behind interceptive orthodontics, where braces and orthodontic appliances are placed on baby teeth. By ensuring these teeth are in ideal locations, an orthodontist can guide the development of the jaws and palate while lessening the need for future adjustment. 

Beyond the developmental importance of primary teeth, they are critical in psychological and social factors as well. Missing multiple anterior teeth can be embarrassing or humiliating, particularly when children are not at the appropriate age of tooth loss. Moreover, the posterior teeth are important in chewing and processing food. Without the ability to chew, we miss out on important nutrients in our diet. Molars allow us to break down food, increase surface area and ultimately facilitate healthy digestion. 

In short, the primary teeth are an incredibly important part of childhood development. With this in mind, dentists do all they can to maintain these teeth through their healthy lifespans. If you want to know more about childhood dentition, the importance of brushing and flossing or dental development, please give our office a call!

Dental Questions: What is a flipper?

With the rise of dental implants, many patients are electing to have teeth extracted rather than spending time and money on a losing battle. Since implants can take months to heal before a crown is placed, there is now a question on what to do with the missing spaces in the meantime. While you can elect to leave these areas open in the interim, this is not an option when the implant is placed in the smile zone. For these situations, you may be made a flipper- or temporary denture. 

Flippers are also known as stay plates or temporary partial dentures. They are made of a hard, pink acrylic resin that supports the prosthetic teeth. They may also have a series of metal clasps that hold the frame firmly in place. Flippers differ from permanent dentures primarily in the way they rest on the teeth and gums. Partial dentures are fitted to the mouth so that the teeth serve as the primary supporting structures. If the gums have to be utilized in holding the denture, very specific areas are used, as to not cause any lasting damage. In contrast, flippers rest entirely on the gums and soft tissues. Over time, the constant pressure on gums can cause the underlying bone to resorb or irritate the periodontal tissues. With this in mind, they are inappropriate as permanent appliances. However, they can be a great interim solution in implant placement. 

Flippers are created by a dental laboratory and take about two weeks to complete. They typically blend seamlessly with the natural tissues and aren't noticeable as "denture teeth." If you would like to know more about flippers and how they can be a part of your implant treatment, please give our office a call!

Photographs at the dentist's office

If you have had a new patient exam at Thousand Oaks Family Dentistry, part of your appointment was dedicated to taking pictures of your face, smile and teeth. Depending on where you previously received care, this may have seemed like a strange proposition. However, photography is an increasingly useful tool in the modern dental practice that allows us to better serve our patients. 

In it's most simple form, photography gives us a baseline idea of how your teeth look. While x-rays allow us to see cavities, infections and bone levels, nothing short of a traditional photograph can clue us into the cosmetic history of your teeth. If, God forbid, you were in an accident that damaged your anterior teeth, these images would help us recreate your smile most accurately. Additionally, photos help us track changes over time. Acid erosion, staining and orthodontic movement are all best recorded using traditional photography.

In addition to creating a cosmetic record, photographs can help us in billing your insurance. Many times, insurance companies will not cover certain treatments unless they were used to treat tooth decay. This becomes a problem on the chewing surfaces of teeth,  where decay is usually visible to the naked eye but poorly imaged on x-rays. By the time decay on these surfaces is visible on an x-ray, the cavity usually extends almost entirely to the tooth nerve. In contrast, photographs allow us to document decay early and reduce the number of hiccups between you and your insurance provider. 

In total, photography is not a replacement for standard x-rays. However, they are a safe, quick and reliable supplement that helps us better serve our patients. If you have any more questions about dental photography, our exams or any other service offered at Thousand Oaks Family Dentistry, please give us a call. We are always here to serve any and all of your dental needs!