By Paul S. Yi, D.D.S., P.A.
May 20, 2019
Category: Oral Health
Tags: x-rays  
HowDentistsProvideYourChildtheBenefitofX-RaysasSafelyasPossible

X-ray imaging is such an intricate part of dentistry, we usually don't think twice about it. Without it, though, the fight against dental disease would be much harder.

At the same time, we can't forget that x-rays are a form of electromagnetic radiation that can penetrate human tissue. It's that very quality and the difference in the absorption rate between denser bone and teeth and softer diseased tissue that makes disease diagnosis possible.

But this same penetrative power can potentially harm the tissues it passes through. For that reason when practicing any form of x-ray diagnostics, dentists follow a principle known as ALARA, an acronym for "As Low As Reasonably Achievable." In lay terms ALARA means getting the most benefit from x-rays that we can with the lowest dose and exposure time possible.

While practicing ALARA with x-rays is important for patients of any age, it's especially so for children who are more sensitive to radiological energy given their smaller size and anatomy. We can't use the same settings, dosages or exposure times with them as with an adult.

To protect children, dentists have developed techniques and protocols that lessen their exposure time and rate, while still providing usable images for diagnosing disease. The bitewing is a good example of safe and effective pediatric x-ray imaging.

A bitewing is a plastic device holding exposable film that patients bite down on and hold in their mouth while x-raying. The x-rays pass through the teeth and gums and expose the film behind them on the bitewing. Using a bitewing we can capture a set of two to four radiographs to give us a comprehensive view of the back teeth, while exposing the child less radiation than they normally receive daily from background environmental sources.

This and other advances in equipment and digital imaging greatly reduce the amount of radiation patients receive during x-rays. If, though, you're still concerned about your child's x-ray exposure, talk with your dentist who can explain in more detail the x-ray safety protocols they follow. Just like you, they want your child to be as safe as possible while still benefiting from the diagnostic power of x-rays.

If you would like more information on safety precautions using x-rays with children, 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 “X-Ray Safety for Children.”

EarlyOrthodonticTechniquesCouldStopGrowingBiteProblems

The longer many health problems go on, the worse they become. Treating them as early as possible could stop or slow their development.

That holds true for poor bites: while we can certainly correct them later in life, it's often better to "intercept" the problem during childhood. Interceptive orthodontics attempts to do this with treatments that influence how the jaws and other mouth structures develop during childhood. Many of these techniques are usually best implemented before puberty.

For example, some very complex problems called cross bites can occur if the upper jaw grows too narrowly. We might be able to stop this from happening by using an orthodontic appliance called a palatal expander during the childhood years. It works because the bone at the center of the palate (roof of the mouth) has a gap running back to front until the early teens when the gap closes.

We fit the palatal expander up under and against the palate, then extend out metal arms from a center mechanism to the back of the upper teeth that exert outward pressure on them. This widens the center gap, which the body continually fills with bone as the device gradually exerts more pressure. Over time this causes the jaw to widen and lessens the cross bite. Timing, though, is everything: it's most effective before the gap closes.

Another way to aid jaw growth is a Herbst appliance, a hinged device that alters the movement of the jaws. As a child wears it, a Herbst appliance draws the lower jaw forward to develop more in that direction. Like the palatal expander, it's best used before significant jaw growth occurs.

These are just two examples of techniques and tools that can guide structural growth and prevent bite problems. Because they're most effective in the early years of oral development, your child should undergo an orthodontic evaluation as early as age 6 to see if they need and can benefit from an interceptive treatment.

Interceptive orthodontics can stop or at least slow a growing bite problem. The effort and expense now could save you much more of both later on.

If you would like more information on interceptive orthodontics, 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 “Interceptive Orthodontics: Timely Intervention can make Treatment Easier.”

By Paul S. Yi, D.D.S., P.A.
April 30, 2019
Category: Oral Health
WhyYouShouldFlossAroundtheImplantsSupportingYourBridge

We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.

But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.

Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.

To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.

With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.

You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.

To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.

If you would like more information on caring for your dental restoration, 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 “Oral Hygiene for Fixed Bridgework.”

By Paul S. Yi, D.D.S., P.A.
April 20, 2019
Category: Dental Procedures
Tags: celebrity smiles   crowns  
DentalCrownsfortheKingofMagic

You might think David Copperfield leads a charmed life:  He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.

“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”

Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?

In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.

There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.  Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.

If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”

By Paul S. Yi, D.D.S., P.A.
April 10, 2019
Category: Oral Health
Tags: oral cancer  
ToDetectOralCancerEarlySeeYourDentist

This month marks the 20th annual observance of Oral Cancer Awareness Month. Last year, over 50,000 people in the US were diagnosed with oral cancer, and over 10,000 people died from the disease. The 5-year survival rate for oral cancer is only around 57%, making it more deadly than many other types of cancer. But if oral cancer is caught and treated early, the 5-year survival rate jumps to over 80%. This is one reason why regular dental checkups are so important—we can be your best ally in detecting oral cancer in its early stages.

Oral cancer is particularly dangerous because it often develops without pain or obvious symptoms. Early detection greatly improves the chances of successful treatment, but signs of the disease frequently go unnoticed until the cancer is advanced. Fortunately, dentists and dental hygienists are trained to recognize signs of oral cancer in the early stages, when it is most treatable. Oral cancer can appear on any surface of the mouth and throat, with the tongue being the most common site, particularly along the sides, followed by the floor of the mouth. As part of a regular dental exam, we examine these surfaces for even subtle signs of the disease.

Screenings performed at the dental office are the best way to detect oral cancer, but between dental visits it's a good idea to check your own mouth for any of the following: white or red patches, lumps, hard spots, spots that bleed easily or sores that don't heal. Let us know if any of these symptoms don't go away on their own within two or three weeks.

Using tobacco in any form is a major risk factor for oral cancer, especially in combination with alcohol consumption. Although the majority of people diagnosed with oral cancer are over age 55, the fastest growing segment of new diagnoses are among young people due to the rise in cases of sexually transmitted human papillomavirus (HPV) in young adults.

A routine dental visit can do much more than preventing and treating tooth decay and gum disease—it might even save your life! If you have questions about oral cancer or are concerned about possible symptoms, call us as soon as possible to schedule an appointment for a consultation.





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