We finally added digital x-rays to our office. It was a big expense but it was well worth it. Digital x-rays have been available for a number of years, however, the quality didn’t come close to film. With the recent advances in technology, the number of megapixels available now can match good quality x-ray film. There are two types of digital x-rays. One system uses a phosphor plate in place of the film, the other uses a direct sensor just like the light sensor in your digital camera. The phosphor plate must be sent through a scanner which is then processed by a computer which inherently causes a delay in viewing the resulting radiograph. The sensor type provides almost instantaneous feedback due to to it’s direct connection to the computer, however, the sensor is quite bulky and can be uncomfortable. We chose the phosphor plate system due to it’s sensor (it’s thinner than regular x-ray film) for the ultimate comfort for our patients. The radiation dosage that is needed to obtain good radiographs is less than that of film and there is no messy chemicals to fool with during processing.
Having your child run to you, mouth bleeding and holding their front tooth in their hand can be a very disconcerting thing. The key is-don’t panic. There are methods to save the tooth, but you must not delay. Time is of the essence. Your first thought is to clean the tooth since it came from the dirty ground. Make certain that you DON’T CLEAN THE TOOTH! It can rinsed with salt water or milk. If these aren’t available, then tap water will do. Saliva works great since there are bacteria fighting antibodies in it. It is best to replace the tooth back into the socket within 20 minutes of the injury. This would be best done by a dentist, but that is not always possible since most injuries happen during off-hours and even then, by the time the child hands you his tooth, you are probably close to the 20 minute mark already. That means you will need to be the one to reinsert the tooth. This is not the time to be squeamish. Your cool, calm actions can mean the difference between your child enjoying a beautiful smile or a lifetime of maintaining replacements. First, have your child vigorously swish with water to remove any blood clots that may have formed in the socket. Next is crunch time. Take the previously rinsed tooth and quickly and firmly insert the tooth back into the socket. This will probably bring stars and a few tears to your child’s eyes, but you’ve got to remember-it’s tough love. Once the tooth is back in the socket, have your child close their teeth together to make sure that it doesn’t interfere with the bite, then you can ajdust the alignment as needed. A dentist would be best seen within 24 hours for follow up care.
Ever woken up to a toothache? Chances are it was caused by pulpitis, an inflammation of the dental pulp, a collection of nerves and blood vessels inside your tooth. A mild pulpitis can cause symptoms of cold sensitivity. If the condition is allowed to progress, then it can lead to lots of pain and suffering. The most common cause of pulpitis is decay. Bacteria can get down inside a cavity and form acids and toxins that can injure the pulp (nerve). If allowed to continue unchecked, it can lead to much discomfort and to pulpal death. Another cause of pulpitis can be exposed roots. Normally a tooth has an enamel coating, but if the gums begin to recede, then cementum and dentin can be exposed. Dentin has microscopic tubules that lead to the nerve. Bacteria can get into these tubules and can cause sensitivity. For temporary relief of pulpitis until you can get to a dentist, the best thing is an anti-inflammatory such as Ibuprofen. Pharmacies may have toothache drops which have oil of cloves in it or temporary filling material (zinc oxide and eugenol) to plug the hole. Once at the dental office, if decay is the cause of the pulpitis, then the dentist many times can simply remove it and place a filling. If the pulpitis is due to receded gums, then the dentist can apply a desensitizing agent on the root surface to help alleviate the pain.
A periapical x-ray is a closeup of a particular tooth or teeth. If your dentist recommends one, by all means, have him take it. I recommend periapical x-rays to my patients anytime they say that they are having pain in a particular area, if there is deep decay in a tooth or if there is a problem or defect that is apparent on a bitewing x-ray (the x-ray that is used to detect cavities and gum disease) but cannot be seen in it’s entirety. When viewing a periapical x-ray, the dentist will look at the bone around the root, the height of the bone for periodontal (gum) defects, intactness of the root and for any other pathology (disease process) that could be visible. If a darker area exists on the x-ray around the tip of the root, then that could mean that there is a dead nerve inside the tooth. Dark areas up the side of the root could mean a possible root fracture. Dark areas at the crest of the bone (the portion closest to the crown of the tooth, i.e. the part of the tooth that you see) is usually an indication of bone loss due to gum disease. Pathological conditions can show up as either light or dark areas. This could be indicative of a tumor or cyst. That’s why it is so important to allow your dentist to take a periapical x-ray if he recommends it.