Posts for: May, 2019

By Kent S. Denton, D.D.S., P.A.
May 27, 2019
Category: Oral Health
Tags: x-rays  
HowDentistsProvideYourChildtheBenefitofX-RaysasSafelyasPossible

X-ray imaging is such an intricate part of dentistry, we usually don't think twice about it. Without it, though, the fight against dental disease would be much harder.

At the same time, we can't forget that x-rays are a form of electromagnetic radiation that can penetrate human tissue. It's that very quality and the difference in the absorption rate between denser bone and teeth and softer diseased tissue that makes disease diagnosis possible.

But this same penetrative power can potentially harm the tissues it passes through. For that reason when practicing any form of x-ray diagnostics, dentists follow a principle known as ALARA, an acronym for "As Low As Reasonably Achievable." In lay terms ALARA means getting the most benefit from x-rays that we can with the lowest dose and exposure time possible.

While practicing ALARA with x-rays is important for patients of any age, it's especially so for children who are more sensitive to radiological energy given their smaller size and anatomy. We can't use the same settings, dosages or exposure times with them as with an adult.

To protect children, dentists have developed techniques and protocols that lessen their exposure time and rate, while still providing usable images for diagnosing disease. The bitewing is a good example of safe and effective pediatric x-ray imaging.

A bitewing is a plastic device holding exposable film that patients bite down on and hold in their mouth while x-raying. The x-rays pass through the teeth and gums and expose the film behind them on the bitewing. Using a bitewing we can capture a set of two to four radiographs to give us a comprehensive view of the back teeth, while exposing the child less radiation than they normally receive daily from background environmental sources.

This and other advances in equipment and digital imaging greatly reduce the amount of radiation patients receive during x-rays. If, though, you're still concerned about your child's x-ray exposure, talk with your dentist who can explain in more detail the x-ray safety protocols they follow. Just like you, they want your child to be as safe as possible while still benefiting from the diagnostic power of x-rays.

If you would like more information on safety precautions using 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 Kent S. Denton, D.D.S., P.A.
May 17, 2019
Category: Dental Procedures
RootCanalsareaSafeWaytoSaveTeeth

Every year U.S. dentists perform around 25 million root canal treatments and save countless teeth from the ravages of decay. But if you search "root canal" on the Internet, you might encounter an unsettling charge against this tooth-saving treatment—that it causes cancer.

Root canal treatments are routinely used when tooth decay has infected the pulp, the innermost layer of a tooth. During the procedure, we access the pulp and remove all the infected tissue. We then fill the empty pulp and root canals, seal the access hole and later crown the tooth to prevent further infection. Without this intervention, the decay can continue to advance toward the roots and supporting bone, putting the tooth in imminent danger of loss.

So, is there any credibility to this claim that root canal treatments cause cancer? In a word, no: there's no evidence of any connection between root canal treatments and cancer—or any other disease for that matter. On the contrary: root canals stop disease.

As with other types of urban legends and internet hype, the root canal-cancer connection may have arisen from another discredited idea from the early 20th Century. A dentist named Weston Price promoted the notion that leaving a "dead" organ in the body led to health problems. From his perspective, a root canaled tooth with its removed pulp tissue fit this criterion.

In the mid-1950s, dentistry thoroughly examined Dr. Weston's theory pertaining to treatments like root canals. The Journal of the American Dental Association devoted an entire issue to it and found after rigorous scientific inquiry that the theory had no validity in this regard. Another study in 2013 confirmed those findings. In fact, the later study instead found that patients who underwent a root canal treatment had a 45 percent reduction in oral cancer risk.

Given the freewheeling nature of the Internet, it's best to speak with a dental professional about your oral health before trusting a post or article you've found online. Not only are they more informed than an unverified online source, they would certainly not knowingly subject you to a procedure to save a tooth at the expense of your health.

If you would like more information on root canal treatment, 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 “Root Canal Safety.”


By Kent S. Denton, D.D.S., P.A.
May 07, 2019
Category: Oral Health
Tags: oral health  
PreservingthePulpisPriorityOnewithaNewlyEruptedPermanentTooth

The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.

While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.

To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.

That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.

If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.

These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.

If you would like more information on caring for your child's teeth, 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 “Saving New Permanent Teeth after Injury.”