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Posts for: April, 2018

By Howard D. Klein, DMD
April 25, 2018
Category: Oral Health
Tags: x-rays   CAT scans  
HighTechDentistryHowDoWeUseaCATScan

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.

Contact us today to schedule an appointment or to discuss your questions about 3-D scans in dentistry. You can also learn more by reading the Dear Doctor article, “CAT Scans in Dentistry.”


OTCPainRelieversUsuallyEnoughtoRelievePost-ProcedureMouthDiscomfort

Because the mouth is one of the most sensitive areas of the body, we go to great lengths to eliminate pain and discomfort associated with dental work. Anesthesia, both local and general, can achieve this during the actual procedure—but what about afterward while you’re recuperating?

While a few procedures may require prescription opioids or steroids to manage discomfort after a procedure, most patients need only a mild over-the-counter (OTC) pain reliever. There are several brands available from a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like aspirin or ibuprofen work by blocking the release of prostaglandins into the body, which cause inflammation in tissues that have been damaged or injured.

Unlike their stronger counterparts, NSAIDs have fewer side-effects, cost less and aren’t addictive. And unlike opioids NSAIDs don’t impair consciousness, meaning patients can usually resume normal activities more quickly.

But although they’re less dangerous than opioids or steroids, NSAIDs can cause problems if taken at too strong a dose for too long. Its major side effect is interference with the blood’s clotting mechanism, known as “thinning the blood.” If a NSAID is used over a period of weeks, this effect could trigger excessive external and internal bleeding, as well as damage the stomach lining leading to ulcers. Ibuprofen in particular can damage the kidneys over a period of time.

To minimize this risk, adults should take no more than 2400 milligrams of a NSAID daily (less for children) and only for a short period of time unless directed otherwise by a physician. For most patients, a single, 400 milligram dose of ibuprofen can safely and effectively relieve moderate to severe discomfort for about 5 hours.

Some patients should avoid taking a NSAID: pregnant women, those with a history of stomach or intestinal bleeding, or heart disease (especially if following a daily low dose aspirin regimen). If you have any of these conditions or similar concerns, be sure you discuss this with your dentist before your procedure for an alternative method for pain management.

If you would like more information on managing discomfort after dental procedures, 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 “Treating Pain with Ibuprofen.”