Preventative Care
Exams and Cleaning
A comprehensive exam includes the (clinical) examination of the teeth and gums, a full mouth of x-rays and a cleaning.
Prevention is the key to avoiding having relatively minor oral conditions from progressing to more serious dental problems. The aim of both home and in office oral hygiene is maintain healthy gums (gingiva), tongue, and other soft tissue (mucosa) while also preventing cavities from forming. When detected early, the treatment is usually less invasive, less painful, less expensive, and more successful. The basis of sound dental care is twice a year exam and cleaning. The exam is intended to screen for cavities, infection and oral cancer. It should be emphasized that hardened plaque, which turns into calculus or tartar, cannot be removed with tooth brushing and requires professional intervention. We customize cleanings on the basis of your periodontal (gums and bone) health. Use of ultrasonic scalers is sometimes needed to make the procedure more comfortable and effective. We utilize medicated gels along with prescription mouth rinses in problem areas if necessary.
Sealants
Sealants should be used as part of a child’s total preventive dental care. Dental sealants are thin plastic coatings which are applied to the chewing surfaces of the molars (back teeth). Most tooth decay in children and teens occurs on these surfaces. Sealants cover the chewing surfaces to prevent decay. Applying sealants does not require drilling or removing tooth structure. It is an easy, painless, three step-process:
We clean teeth with special toothpaste. A special cleaning liquid, on a tiny piece of cotton, is rubbed gently on the tooth and is washed off. Finally, the sealant is painted on the tooth. It takes about a minute for the sealant to form a protective shield. Sealants should be checked regularly, and reapplied if they are no longer in place. Children and adults at high risk of dental decay may benefit from using additional fluoride products, including dietary supplements, mouth rinses, and professionally applied gels and varnishes.
Oral Cancer Screening
One in every 10,000 will develop oral cancer. The incidence of oral cancer is much higher in males than females; higher for Hispanic and black males than for white males. The rate increases with age and becomes more rapid after age 50 and peaks between ages 60 and 70. Each year, more than 36,500 new cases of cancer of the mouth and throat (oral cavity and pharynx) are diagnosed, and more than 7,800 people die of these diseases. The 5-year survival rate for these cancers is only about 50%. Detection of cancer lesions in the early stages increases the survival rate for people with these cancers. Oral cancers are largely preventable type, since most oral cancers are related to tobacco use, alcohol use, or both. Clinically, screening for oral cancer is done by visual examination of the oral cavity and by the use of Velscope. Under a special blue light, there is a change in the natural fluorescence of healthy tissue changes in the presence of tumors/cancers. http://nidcr.nih.gov/DataStatistics/FindDataByTopic/OralCancer/OralCancerIncidence.htm
X-Ray Exposure
A common concern is the amount of radiation we are exposed from taking dental x-rays. A typical dental x-ray image exposes us to about 0.3 units of radiation (mrem). A full mouth of x-rays is roughly 5.4 mrem and a panoramic x-ray about 2 m rem. By contrast, according to the National Council on Radiation Protection (NCRP) and the American Nuclear Society, the average resident of the U.S. receives about 620 mrem every year; half is from natural background sources and half from man made sources. About half of the man-made radiation exposure is related to CT scans. Natural source of radiation comes from outer space, radioactive materials in the earth, and small amounts of radioactive material in most foods we consume. Some typical sources of radiation exposure include smoke detectors (1 mrem per year), living in a brick house (10 mrem from the radioactive materials in the masonry), cooking with natural gas (10 mrem from radon gas in the natural gas supply), reading a book for 3 hours per day (1 mrem from small amounts of radioactive materials in the wood used to make the paper) flying in an airplane (5 mrem for one cross-country flight), smoking a pack of cigarettes a day (36 mrem), mammogram (42 mrem), an abdominal x-ray (700 mrem). Water contains small amount of dissolved uranium and thorium and both plants and animals contain radioactive carbon and potassium. We receive about 2 mrem per year from sleeping next to someone due to the very small amounts of naturally occurring radioactive materials (carbon-14 and potassium-40) in our bodies. About 5000 mrem/year is the safe allowable dose for people who are exposed to radiation in their work.
Gum Disease (Periodontal)
The early stage of periodontal disease is called gingivitis. It often results in gums that are red and swollen and may bleed easily. Gum disease usually starts with plaque, a sticky film of bacteria and bacterial byproducts that constantly forms on teeth. If plaque is not removed with thorough daily brushing and cleaning between teeth, gums become irritated and inflamed. Persistent plaque combines with minerals from saliva to form a harder substance commonly referred to as calculus or tartar, which provides a constant source of inflammation and irritation. The irritated gum tissue may detach from the bone and teeth and form spaces called pockets. Bacteria move into the pockets where they continue to promote irritation/inflammation. Left untreated, the process can continue until the bone/gums and other tooth-supporting tissues are destroyed.
Tooth Decay-Dental Cavities
Tooth decay is the most common chronic disease in the world. Bacteria which live in the mouth form a sticky substance called plaque. The plaque combines with sugary and starchy foods. The end products of bacteria metabolism are acids, which damage tooth enamel by dissolving the enamel minerals. The destruction of enamel starts minutes after eating. For this reason, we recommend that brushing and flossing of teeth be done as soon as feasible after eating/snaking. Plaque which is not removed combines with minerals from saliva and, over time, will harden into calculus or tartar, which causes further damage to both hard (bone) and soft (gum) tissue surrounding the tooth. Calculus or tartar cannot be removed by tooth brushing alone and requires professional intervention. Dental caries is not a life-threatening disease. Caught early, cavities can be treated easily and with minimal discomfort. If not treated, decay can lead to tooth pain and/or infection, and the tooth would need a root canal treatment or extraction.
Dental Infections
Dental infections can result from an untreated tooth that required a root canal or from gum diseases. While dental infections are usually localized, they can spread causing airway obstruction (Ludwig’s angina), travel through the blood stream (sepsis) and spread to the brain. The result is severe infection and, if left untreated, possibly death. About one in every 2600 hospital admission is due to infection of dental origin.