OST Blog

You’re parents, so you worry. It comes with the job description! That’s why you make regular appointments with your children’s doctors and dentists for preventive care and examinations. That’s why you make sure your kids wear mouth guards and other protective gear when playing sports. And that’s why you want to know all about the X-rays that are used when your children need dental treatment.

First of all, it’s reassuring to know that the amount of radiation we are exposed to from a single dental X-ray is very small. A set of bitewing X-rays, for example, exposes us to an amount of radiation that is approximately the same as the amount of radiation we receive from our natural surroundings in a single day.

Even so, doctors are especially careful when children need X-rays, because their bodies are still growing and their cells are developing more rapidly than adults. And children often have different oral and dental needs than adults, which can require different types of imaging.

In addition to the usual X-rays that are taken to discover cavities, fractures, or other problems, young patients might need X-rays from their dentists or orthodontists:

• To confirm that their teeth and jaws are developing properly.
• To make sure, as permanent teeth come in, that baby teeth aren’t interfering with the arrival and position of adult teeth, and that there’s enough space in the jaw to accommodate them.
• To plan orthodontic treatment.

And if your child has any dental or medical conditions that can best be treated by an oral surgeon, diagnostic X-rays might be needed. Dental X-rays are used, for example, in order to:

• Check the progress and placement of wisdom teeth before they are extracted.
• Locate fractures, breaks, or other damage to the teeth and jaws after an accident or injury.
• Discover and treat damage or infection which recurs after root canal work.
• Diagnose and plan treatment for conditions which might require corrective jaw surgery.
• Facilitate the placement of dental implants when children have lost or missing teeth. Because young jaws are still growing, this placement requires special care.

So, how do oral surgeons and radiologists make sure your child’s radiation exposure during any X-ray procedure is as minimal as possible?

Radiologists, the physicians who specialize in imaging procedures and diagnoses, recommend that all dentists and doctors follow the safety principal known as ALARA: “As Low As Reasonably Achievable.” This means using the lowest X-ray exposure necessary to achieve precise diagnostic results for all dental and medical patients.

Moreover, radiologists are devoted to raising awareness about the latest advances in imaging safety not only for dental and medical practitioners, but for the public, as well. With children in mind, pediatric radiologists from a number of professional associations have joined together to create the Image Gently Alliance, offering specific guidelines for the specific needs of young patients.

And because we are always concerned about the safety of our patients, medical and dental associations around the world, including the American Association of Oral and Maxillofacial Surgeons, the Academy of Pediatric Dentistry, the American Dental Association, the American Dental Hygienists’ Association, the Canadian Academy of Pediatric Dentistry, and the Canadian Dental Hygienists Association, are Image Gently Alliance member organizations.

The guidelines recommended for X-rays and other imaging for young people have been designed to make sure all children have the safest experience possible whenever they visit the dentist or the doctor. As oral surgical specialists, Dr. Ford and Dr. Guter and our team work to restore children’s smiles through many different procedures, and we ensure that imaging is safe and effective in a number of ways:

• We take X-rays only when they are necessary.
• We provide protective gear, such as apron shields and thyroid collars, whenever needed.
• We make use of modern X-ray equipment, for both traditional X-rays and digital X-rays, which exposes patients to a lower amount of radiation than ever before.
• We set exposure times based on each child’s size and age, using the fastest film or digital image receptors.

We know your child’s health and safety are always on your mind, so you’re proactive about medical and dental care. And your child’s health and safety are always on our minds, too, so we’re proactive when it comes to all of our medical and dental procedures.

Please free to talk with our Virginia Beach, VA team about X-rays and any other imaging we recommend for your child. We want to put your mind at ease, knowing that X-rays will be taken only when necessary, will be geared to your child’s age and weight, and will be used with protective equipment in place. Because ensuring your child’s health and safety? That comes with our job description!

According to the International Congress of Oral Implantologists it is rare that your body will reject your dental implants. However, this does not mean that your dental implant will not fail. A successful dental implant is one that is placed in healthy bone and is properly cared for after the surgery takes place.

There is only one major reason why a dental implant would be rejected: a titanium allergy. The majority of dental implants are made with titanium because it has proven to be the most biologically compatible of all metals. On average, less than one percent of potential dental implant recipients reported an allergy to titanium.

Dental Implant Failure

The most common cause of dental implant failure in the upper and lower jaw is bacteria. Everyone has bacteria in their mouth. If you have bacteria in your jawbone at the time of your dental implant, it can spread from implant to implant, causing dental implant failure.

If you do not take proper care of your dental implants, that could also cause them to fail. You also have to take proper care of the implant and keep your mouth clean. The development of excessive bacteria around the implant and in surrounding tissues can lead to implant failure.

Teeth grinding is another reason dental implants fail. When you grind your teeth, it can move the implants out of position. Therefore, you should wear a mouthpiece when you go to sleep if you know you grind or clench.

If you take care of your implants by practicing good oral hygiene and visit our Virginia Beach, VA office, you should not have any problems with your new dental implants. As always, ask Dr. Ford and Dr. Guter about any questions or concerns you have about you dental implants.

No one really looks forward to a wisdom tooth extraction, even a straightforward one. Fortunately, you can be confident that your oral and maxillofacial surgeon has the experience and the skill to make your extraction experience as safe and comfortable as possible.

But what happens when your situation is not quite so straightforward? Dr. Ford and Dr. Guter and our team have the experience and the skill to diagnose and treat these more complex extractions as well.

One of the potential complications with an impacted wisdom tooth is its close proximity to the Inferior Alveolar Nerve (IAN) of the jaw.  When the roots of the impacted tooth are fully developed, they can rest very close to, put pressure on, or, in rare cases, even wrap around this nerve.

Why is this a problem? Because these nerves supply feeling to the lower lip, gums, chin, and teeth. If a nerve is damaged during extraction, a patient might be left with pain or numbness in these areas, which can affect sensation, speech, and eating. While this nerve damage is usually temporary, in rare cases it can be permanent.

But an impacted tooth, left alone, can also have serious consequences—pain, infection, and damage to neighboring teeth and bone. So what’s the answer in this complicated case?

Talk to Dr. Ford and Dr. Guter. We have the training and skill to detect any potential nerve involvement when you need a wisdom tooth extraction, and we have a procedure to help prevent damage to the nerve if it lies too close to the roots. The coronectomy is a specialized surgery used only to treat impacted teeth when the nerves of the lower jaw might be compromised.

What is a coronectomy, exactly? The tooth can be thought of in two distinct segments—the crown, which is the part of the tooth that rises above the gum when the tooth erupts, and the roots below, which anchor each tooth in the jaw. A “coronectomy” means the removal (“ectomy”) of the crown (“corona”) of the tooth.

In this procedure, we will divide the tooth into two parts. After making a small incision to expose the tooth, the crown will be removed, and the root section left in the jaw. When the procedure is completed, the incision in the gums will be closed with sutures. Recovery is much like recovery for any other tooth extraction.

Once the coronectomy is completed, you might be asking, “What happens to those roots that were left behind?” Another good question!

• Very rarely, the roots become infected or cause irritation to surrounding tissue and will need to be removed.
• Occasionally, root fragments can start to emerge through the gums, just as a whole tooth would. But since they must move away from the nerve in order to erupt, they can be extracted without endangering the nerve.
• The most common result? The remaining root segment becomes permanently encased by bone tissue within the jawbone, never to cause problems again.

Are there times when, even though a wisdom tooth is bordering on a nerve, this procedure might not be advisable? Yes. Infection and decay in the tooth, tooth mobility, periodontal disease near the tooth, a horizontal tooth (where sectioning the tooth could damage the nerve), and other conditions might mean that a coronectomy is not possible. In that case, Dr. Ford and Dr. Guter can discuss further options with you.

No one really looks forward to wisdom tooth extraction. Fortunately, even in complicated situations, your oral and maxillofacial surgeon has the experience and the skill to provide the answers you need for an extraction experience that is as safe and comfortable as possible.

Any more questions? Contact our Virginia Beach, VA office to see if a coronectomy is the answer for you.

There are many understandable reasons why you might be feeling less than enthusiastic about your upcoming implant procedure, extraction, or any other dental surgery.  Perhaps anxiety is an issue, or your teeth are extremely sensitive. You may have a low pain threshold, an easily triggered gag reflex, or require longer or more complex work during your visit. These are also excellent reasons to consider sedation dentistry.

Of course, Dr. Ford and Dr. Guter will always try our best to make sure that every procedure is pain free. A local anesthetic will be provided to numb the surgical area completely. You might decide that this all that you need, especially for relatively simple procedures. But if you would prefer to remain completely aware, but feel less anxious, if you would like deep sedation throughout the entire procedure, or if you want something in between, talk to us about making sedation part of your treatment.

The most common methods of sedation include:

• Oral Sedation

Usually, oral medications that reduce anxiety are given in pill form. The level of sedation and how much you will be aware during your procedure will depend on the dosage, and you will need time to recover from the drug’s effects after we are done.

• Nitrous Oxide

Commonly referred to as “laughing gas,” this has been used since the 1800’s to relieve dental anxiety and reduce pain.  Today’s equipment is designed to provide a precise mixture of nitrous oxide and oxygen inhaled through a mask that you will wear throughout the procedure. Once the mask is removed, you will recover quickly.

• IV Sedation

Medication will be delivered through an intravenous line placed in a vein. This delivery system allows the sedative to take effect very quickly, unlike oral sedation, and adjustments to the sedation level can be made throughout the procedure. This method will also require recovery time when your work is complete.

Because your concerns and condition are unique, we will tailor your sedation to fit your specific needs, and our experience and training enable us to recommend the sedation that is best for you. We will take a careful health history to make sure that whichever medication is used won’t interact with your other medications or affect any pre-existing medical conditions.

Oral and maxillofacial surgeons are trained in a hospital-based residency program to administer and monitor every type of sedation. Because sedation in all its varieties is a regular part of our practice, we have the medical knowledge and skill to provide you with a safe and comfortable surgical experience. If you think sedation dentistry might be right for you, this procedure is something we are happy to discuss before your appointment at our Virginia Beach, VA office.