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.
Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.
In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.
For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.
Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.
It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.
That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”
We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?”
Although usually an orderly process, some permanent teeth don't come in as they should. In fact, they may not come in at all and remain hidden in the gum — a situation called impaction. This creates multiple problems for function, health and, in the case of front canines, appearance.
Canines are the longer and more pointed teeth on each side of the front-most incisors. They help tear and cut food during chewing, a function impaction eliminates. Besides a higher risk for developing abscesses (isolated areas of infection) and cysts, they can also put pressure on neighboring teeth and damage their roots or cause them to erupt abnormally.
Dentists often remove impacted wisdom and other back teeth to lessen these potential problems. Removing canines, though, has additional considerations: besides compromising ideal chewing function, missing canines often create an unattractive smile.
But before considering removal, there's another technique we might be able to use to save the canines and actually draw them down through the gums to their correct position. It's usually part of an overall orthodontic plan to correct a poor bite (malocclusion).
After pinpointing their exact position with x-rays or CT scanning, a surgeon surgically exposes the impacted canines' crowns through the gums. They then bond small brackets to the crowns and attach a small gold chain to each bracket. They fasten the other end of the chains to orthodontic hardware that exerts downward pressure on the impacted teeth. Over several months this pressure can help move the teeth into their normal positions.
Unfortunately, this technique isn't always advisable: one or more of the impacted teeth may be in a difficult position to attempt it. It's usually best in these situations to remove the teeth, usually sooner rather than later for the sake of neighboring teeth.
Fortunately, with today's advanced restorative techniques, we can eventually replace the canines with dental implants, although that's best undertaken after the patient enters adulthood. In the meantime, we can utilize orthodontic means to preserve the open space and provide a temporary restorative solution.
Whatever route taken, these teeth don't have to become a source of problems, especially for your appearance. Whether through orthodontics or restorative dentistry, impacted canines don't have to ruin your smile.
If you would like more information on various orthodontic 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 “Exposing Impacted Canines.”
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods. Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”
The goal of restorative dentistry is to fix up your smile using custom dental devices and treatments. When there’s a dental issue, the ideal solution is to preserve your original teeth and make them stronger. Learn more crowns and bridges, two popular restorative dental treatments that are offered at JC Duncan DDS, PA in Huntersville, NC.
A crown is a tooth covering that’s bonded to the outer surface of your tooth to give it strength and protect it from damage. The inside of the crown is shaped perfectly to cover your natural tooth after some enamel has been removed. The outside of the crown is indistinguishable from the rest of your teeth in its shade, size, shape and contour. Whenever the enamel of the tooth is damaged but the root of the tooth is still healthy, there’s a good chance that a dental crown will be the ideal solution.
When your problem is one or two missing teeth, a dental bridge is one possible fix. A bridge is a device that is made with two crowns on either side and one or two whole replacement teeth positioned at the center. The crowns keep the new teeth anchored in place so that you can chew your food and smile without a second thought. As is the case with crowns, your Huntersville dentist can design bridges that look just like the rest of your teeth.
Who Is a Candidate for Crowns or Bridges?
Remember that in order to get a crown or bridge, you must have one or more teeth that have healthy, strong roots. If the root isn’t strong, the appliance will only be a very temporary fix to a more complicated problem. It’s also important that your gums are free from disease—if you have a problem with gum disease, periodontal therapy or bone grafting may be recommended in advance of a crown or bridge installation.
Talk to Your Dentist
If you think that crowns or bridges may be right for you, get confirmation from Dr. JC Duncan at his Huntersville, NC dentist office. Call the office at (704) 948-1300 today to schedule an appointment.
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