Dental Radiation

Dental Radiation

Radiation exists in many forms, not all of which are ionizing, the form of radiation that poses a risk to our health.

Low frequency radiation, such as radio waves, thermal/microwaves, infrared, and visible light waves are to low penetrating power to cause changes to the atoms and molecules that make up our body, therefore classifying these types as non-ionizing.

However, higher frequency radiation such as UV, x-ray, and gamma-rays are able to displace electrons from their natural state, and therefore have the capacity to cause cellular damage and pose a risk to human health.

We are constantly and continuously exposed to radiation in the environment (i.e., cosmic sources, radioactive nucleotides) as well as through man-made sources (i.e., medical imaging).

All dental and medical professionals must always weigh the direct benefit and consequences to their patient when prescribing diagnostic imaging (such as chest x-rays, mammograms, CT scans, dental x-rays, etc.). They must ask themselves, “Is the information I will receive from this x-ray worth the size of the risk to my patient?”  They must also ask, “Is there an alternative to this x-ray?”

In the case of dental x-rays.  Most dental professionals can prescribe either 2D dental x-rays or a 3D x-ray, known as a CBCT.

The CBCT allows the clinician to see the teeth and their location in the jaw bone in all 3-dimensions and allows them to map critical structures, to view the quality and quantity of the bone, and to perform a ‘virtual periodontal or endodontic surgery’ without the need for gloves!

In many cases, this amount of information is unnecessary and a single (or multiple) 2D x-rays are sufficient for diagnosis of tooth decay, periodontal disease, or other common dental issues.

Although a dental CBCT does emit more radiation to the patient than a conventional 2D digital x-ray, the amount of radiation is still negligible compared to many other medical imaging devices and other common sources of radiation.

Concerns about radiation exposure and your risk are valid, but you should take every opportunity to speak to your dentist or periodontist about the safety measures and considerations to your personal health when they prescribe an x-ray to help in your dental care.

My dental implant/crown is loose – What should I do?

My dental implant/crown is loose – What should I do?

Your dental implant and artificial crown have been very carefully designed to fit together like two puzzle pieces.  Sometimes, for a multitude of reasons, these two pieces can be dislodged.  When the implant and crown do not fit together perfectly, over time, the dental crown can become loose.

If your dental crown becomes loose, it is important to see the dentist as soon as possible.  If left untreated, a loose fitting crown can cause damage to the underlying implant.  With many many small impacts from chewing and grinding our teeth, the crown applies pressure to the implant in a direction and angle that was not initially intended.

This repeated impact and pressure can impact the integration of the implant with the jaw bone and cause it to become loose.  Eventually, this can cause implant failure.

The decision to replace a missing tooth with an implant and a crown is an important one.  And therefore, if it becomes loose it is important to protect and care for it immediately by seeking the help of your dentist or periodontist.

Post-Dental Surgery Meal Planning

Post-Dental Surgery Meal Planning

Proper care after your periodontal surgery will help your mouth to heal quickly.  This includes a healthy, soft food diet.

At first, your temporary soft food diet may seem challenging, but with some planning you can ensure that you have all of the nutrients you’ll need for your body to heal quickly.

As soon as you are able (after your local anesthetic has worn off), start drinking nutritious fluids such as real fruit juices, milk, milkshakes, and fruit and vegetable smoothies.

REMEMBER: Do not drink from a straw for at least two weeks.  The suction and force created when using a straw will be disruptive to the sutures and the delicate healing tissues.

A general rule of thumb for the first two weeks following periodontal surgery is to avoid any foods that take more than 3 chews to swallow.

Avoid hot food or drink for the first two weeks.  The heat of your food can increase the flow of blood to the area and can cause your surgical site to bleed.

Just because your diet is of a soft consistency, it is still important to eat a variety of nutritious foods.  Below are some general guidelines according to Health Canada’s Food Guide and some examples of food choices.

Fruit & Vegetables

Consume at least 7 servings of soft fruit and well-cooked vegetables per day:

  • apple sauce
  • stewed or canned fruit
  • peas
  • smoothies
  • soups
  • well cooked or pureed vegetables (potatoes, broccoli, cauliflower, carrots, turnip, other root vegetables)

Protein

Two servings of tender protein:

  • tuna
  • salmon
  • flakey fish served without a crispy coating
  • well-cooked poultry cut into small, bite-sized pieces
  • eggs
  • baked beans
  • lentils
  • Greek yogurt

Milk & Dairy

Two servings of milk or dairy products:

  • milk
  • calcium-fortified soy or almond milk
  • ice cream/frozen yogurt
  • yogurt
  • fruit sorbet
  • puddings
  • soft cheeses such as cottage cheese

Whole Grains

Chose whole grain foods over processed, simple carbohydrates:

  • porridge
  • oatmeal
  • cream of wheat
  • cereals without nuts or dried fruit
  • whole-grain pastas or noodles
  • soft bread without hard crust

Beverages

Make water your drink of choice.  It is important to stay hydrated.

Avoid alcohol and tobacco as much as possible during the healing period.

How much is my dental surgery going to hurt?

How much is my dental surgery going to hurt?

Many of our patients experience fear and extreme anxiety at the dentist and while we do our best to create a calm and tranquil environment, the fear of pain associated with periodontal treatment may still be a deterrent for some.

Therefore, to answer one of the most commonly asked questions “Is this going to hurt?”, we conducted a study that was published in the Journal of Clinical Periodontology.

Over a period of two years, we enrolled 213 patients requiring either dental implant or grafting surgery.  The average age of the patients that were recruited was 51 years, but ranged from 19-80 years.  Prior to their surgery, patients were asked to rate the amount of pain that they anticipated feeling from No Pain to Worst Pain Imaginable.  For 7 days following their surgery, patients were asked to rate the amount of pain they experienced on the same scale.

When all of the data was analyzed, we found that the actual pain that patients experienced after periodontal surgery was lower than the pain they anticipated feeling.

With these findings, we are now able to provide our patients with an evidence-based answer when they ask us “Is this going to hurt?”  Happily, we are able to put them at ease by sharing with them that in fact, periodontal surgery hurts less than they expect!

Some factors that we found did predict the amount of pain a patient would feel are:

  1. Anticipated Pain – if you expect it to hurt, you’ll report it hurting more
  2. Age – older individuals reported it hurting less
  3. Sedation – those who had their periodontal surgery under sedation with one of our Registered Nurses reported experiencing less pain

Some factors that we found did not predict the amount of pain a patient would feel are:

  1. Nervousness
  2. Gender
  3. Surgery Type (dental implant vs. soft tissue grafting)
  4. Smoking Status

Also collected as part of the study, we found that patients needed only 600mg of Ibuprofen for relief of their post-operative pain and discomfort.  This reinforces Dr. Fritz’s mandate of never prescribing narcotics to any of this patients.

This study was conducted by Jennifer Beaudette as part of her Master’s of Science research through the Faculty of Applied Health Sciences at Brock University.  Jen has since completed her M.Sc. and is currently pursuing a Ph.D at Brock University.

Tooth Anatomy

Tooth Anatomy

The structure and function of a teeth all play an important role in how we eat, drink, speak, and smile.

The root is the part of the tooth anchors it into place in the jaw bone.  Like an iceberg, most of our tooth is located below the surface.

The root is made up of several parts, the root canal, cementum, periodontal ligament, nerves, and blood vessels.

The crown is the part of the tooth that is visible when we smile.

The crown is layered with enamel and dentin.  Enamel is the outermost layer and protects the crown both from bacteria and from pressure when chewing.  Enamel is the hardest tissue in the body.  Dentin is the layer of mineralized tissue below the enamel. 

The gingiva divides the root and the crown.  A healthy gingival margin forms the link between where the root meets the crown.

Each of the different aspects of the tooth are susceptible to different conditions.

The crowns can be susceptible to cavities, grinding or clenching (causing the crown to wear down), tooth erosion (caused acidic foods, chronic dry mouth, or some medications).

The roots and gingiva can be susceptible to periodontal disease and other bacterial infection (i.e., tooth abscess).  Left untreated, periodontal disease can cause tooth loss.

To keep all aspects of the tooth healthy, it is important to take good care by:

– brushing twice daily for at least 2 minutes using a power toothbrush
– daily use of floss and interdental brushes
– visiting your dentist for regular supportive periodontal therapy and maintenance
– limiting your intake of sugary foods and drinks
– quitting smoking
– controlling your diabetes and blood sugar