Posts for: March, 2020
The CAT scan is a relatively recent technique in dentistry, used to get an image of what’s happening deep within your jaws. You may be wondering what a CAT scan tells us that a conventional x-ray picture does not, and whether it is worth the extra expense to get one. And how does a CAT scan compare with a conventional x-ray in terms of radiation exposure?
CAT stands for “computer assisted tomography.” Often it’s just called a CT scan, for “computerized tomography.” The word “tomography” comes from roots meaning “slice” and “write.” Tomographic techniques take repeated two dimensional pictures, similar to repeatedly slicing through an object, and then assembles them with a computer to produce a three dimensional (3-D) image.
The latest type of CT scan used in dentistry is called CBCT, or Cone Beam Computed Tomography. The Cone Beam refers to a spiral beam of x-rays, which is used to create a series of two dimensional images from which a computer creates a 3-D image. Such an image is of great value in assessing problems and planning treatment.
Here are just a few examples of how a CBCT scan can be used. Orthodontists can see skeletal structures and developing teeth that are still inside the jawbone while planning strategies for directing the teeth in order to arrive at a better bite. Oral surgeons can find impacted or missing teeth, see their locations, and view their proximity to nerves and sinuses, assisting them in planning surgeries. These scans are particularly useful for root canal specialists because they show root canals that are less than a millimeter wide and even reveal accessory canals that may not be visible on conventional x-rays. In cases of sleep disorders such as sleep apnea, a CBCT during sleep can be used to view a person’s airway and how it may be blocked by the tongue and other soft tissues in a person’s throat during sleep.
Compared to background radiation, the amount of radiation delivered in dental x-rays is minimal. A CBCT delivers a dose of radiation that is less than a typical full mouth x-ray series but more than a typical two dimensional panoramic radiograph. Generally CBCT scanners deliver lower doses than medical CT scanners.
With one low-dose CBCT scan, we can get an accurate idea of the internal structure of your bones and teeth and how they are situated in relation to each other. Prior to the availability of such images, many of these relationships had to be discovered in the course of a surgery or other treatment. Thus such a scan can aid greatly in the quality of treatment you will receive.
Miley Cyrus's rise to fame began when she was cast in the Disney series Hannah Montana. She played the title character, Hannah Montana, a famous singing star hiding her true identity, ordinary girl, Miley Stewart. In her real life at the time, Miley Cyrus had her own little secret—she was undergoing orthodontic treatment to straighten her smile.
Like many teenagers (as well as many adults), Cyrus's dental bite wasn't in proper alignment. She could have gone the traditional way by straightening her smile with braces fixed to the front of her teeth. It's an effective treatment, but the metallic hardware can overwhelm a person's appearance.
With her various roles in the public spotlight, Cyrus and her family wanted an effective but out-of-sight method for moving her teeth. They chose a relatively new one called lingual braces. Unlike traditional braces, the hardware for lingual braces is fixed on the back of the teeth (or the tongue side, hence the term “lingual”).
Lingual braces can correct any bite problem labial (“lip”) braces can, just through different mechanics of movement. Its main appeal is that the hardware is hidden behind the teeth, so only you and your orthodontist need know you're wearing braces.
There is also less risk of damage to the mouth or the braces themselves if you're in a sport or profession where you're at high risk for facial blows. And unlike patients with traditional braces, you'll have an unobstructed view of your progress over the course of treatment.
Lingual braces do tend to cost more than traditional braces. Some patients also have difficulty at first with speaking and tongue comfort, though most grow accustomed to the braces within a couple of weeks. Because lingual braces are relatively new, there's been a limited number of orthodontists offering it.
But lingual braces are just one of the ways to straighten teeth. Modern dentistry offers several ways to give you your dream smile. If you have dental problems or would like to improve the look of your smile, please contact us or schedule a consultation, and we can discuss your options. To learn more, read the Dear Doctor magazine articles “Lingual Braces” and “The Magic of Orthodontics.”
For years preparing teeth for fillings or other restorations has required the use of a drill. Although quite effective in removing decayed structure and preparing the tooth for bonding, it usually requires a local anesthetic. That and the noise it generates can be unsettling for many patients.
In recent years, a different type of technique known as “air abrasion” has increased in popularity among dentists. Known also as “particle abrasion,” the technique uses a stream of fine particles to remove decayed tooth structure and is less invasive than the traditional drill. Although the technology has been around since the mid-20th Century, recent developments in suction pumps that remove much of the dust created have made it more practical. It also works well with new natural-looking bonding materials used for tooth structure replacement.
The fine particles — usually an abrasive substance like aluminum oxide — are rapidly discharged through a hand-held instrument using pressurized air aimed at affected tooth areas. Decayed teeth structure is softer than healthier tissue, which allows air abrasion to precisely remove decay while not damaging the other.
Besides removing decay or abrading the tooth for bonding, air abrasion can also be used to minimize stained areas on surface enamel and to clean blood, saliva or temporary cements from tooth surfaces during dental procedures. It’s also useful for smoothing out small defects in enamel or aiding in sealant applications.
It does, however, have a few limitations. It’s not as efficient as the traditional drill with larger cavities or for re-treating sites with metal (amalgam) fillings. Because of the fine texture of the abrasive particles, affected teeth need to be isolated within the mouth using a rubber dam or a silicone sheet. High-volume suction must be continually applied to capture the fine particles before the patient swallows them or it fills the procedure room with a fine cloud of material.
Still, while air abrasion technology is relatively new, it has clear advantages over the traditional drill in many procedures. As advances in the technology continue, air abrasion promises to offer a more comfortable and less invasive experience in dental treatment.