Dental X-ray examinations provide valuable information that helps your dentist evaluate your oral health. With the help of radiographs a dentist can look at what is happening beneath the surface of teeth and gums.
As X-rays from an X-ray machine pass through your mouth they are mostly absorbed by teeth and bone because these tissues, which are called hard tissues, are denser than cheeks and gums, which are called soft tissues. When X-rays strike the film or a digital sensor, an image called a radiograph is created. Radiographs allow your dentist to see hidden abnormalities, like tooth decay, infections and signs of gum disease.
As far as frequency goes, we recommend a six-film series once a year and a full mouth series(18 films) once every five years. These guidelines provides optimal diagnostics over a patients life time and are considered very safe. In my practice we utilize digital X-ray systems that require even less radiation than conventional radiographs.
Finding and treating dental problems at an early stage can save time, money and unnecessary discomfort. Radiographs can help us detect problems in your mouth that otherwise would not be seen and are absolutely necessary.
I will be posting some relevant and useful information on dentistry and related topics. I hope that you can follow my blog and find the posts interesting and helpful! - Dr Ash Khorram
Wednesday, July 6, 2011
Thursday, June 2, 2011
Guide to different types of dental restoration
Different types of dental restorations are designed to do specific jobs. Often the type of restoration recommended is directly dependent on how much healthy tooth structure is remaining after excavation of the pathology. Here is a breakdown of the most common restorations:
1. Sealants- White filling materials in a "flowable" form. Used to fill the decay-susceptible grooves of the back teeth. Usually utilized in children between 6-18 years as a preventative measure.
2. Fillings- Composite or white fillings. Placed directly into the prepared tooth. Used where the existing fillings or areas of decay are small enough that the remaining tooth structure has not been overly compromised.
3. Porcelain Inlays- Used in similar situations as fillings except a pre-made piece of ceramic material is bonded into the tooth. This results in superior physical properties, possibly providing a lifespan of 2 to 3 times longer than a composite filling. Inlays are a top-quality alternative to the composite filling.
4. Porcelain Onlays- Used in situations where the tooth is fractured or has been severely decayed, the onlay is similar to the inlay described above except that the ceramic covers the entire or most of the biting surface. An onlay is more conservative in preparation than a crown, it does not cover the entire visible tooth structure, so there is no need to grind away all sides of the tooth unless there is a specific reason.
5. Crowns(caps)- A crown, the largest single tooth restoration, sometimes cannot be avoided. It covers all sides of the tooth as well as the end. It is used when there is limited tooth structure left, when an existing crown must be replaced, or when the tooth is an "anchor" tooth for a fixed bridge.
6. Veneers- Thin porcelain facings that cover the front side of teeth. Used cosmetically to change the length, color and shape of teeth. Can be preformed with minimal tooth preparation and an excellent choice for a cosmetic make-over.
7. Bridges- Used to replace missing teeth when sufficient "anchor" teeth are available on each side of the gap. Numerous systems are available, including fiber-reinforced ceramics, Zirconium-based ceramics and porcelain fused to metal bridges.
8. Implants-Titanium posts surgically placed into the jawbone. After placement the bone grows around the implant through a process called osseointegration (usually three-six months after placement) and later the restorative phase can begin. Implants are used to support various dental prosthesis ranging from single crowns to a full denture. Given the choice between a bridge and an implant, an implant is considered the superior choice since it doesn't require preparation of adjacent teeth and there for more conservative.
9. Removable Partial Dentures- Used to replace missing teeth when insufficient teeth remain to support fixed bridges or a patient is not a good candidate for dental implants. Partial dentures can be metal or acrylic-based.
10. Removable Complete Denture- Utilized when no teeth remain and implants are not an option due to case specifics. By today's standards this is basically a last resort.
1. Sealants- White filling materials in a "flowable" form. Used to fill the decay-susceptible grooves of the back teeth. Usually utilized in children between 6-18 years as a preventative measure.
2. Fillings- Composite or white fillings. Placed directly into the prepared tooth. Used where the existing fillings or areas of decay are small enough that the remaining tooth structure has not been overly compromised.
3. Porcelain Inlays- Used in similar situations as fillings except a pre-made piece of ceramic material is bonded into the tooth. This results in superior physical properties, possibly providing a lifespan of 2 to 3 times longer than a composite filling. Inlays are a top-quality alternative to the composite filling.
4. Porcelain Onlays- Used in situations where the tooth is fractured or has been severely decayed, the onlay is similar to the inlay described above except that the ceramic covers the entire or most of the biting surface. An onlay is more conservative in preparation than a crown, it does not cover the entire visible tooth structure, so there is no need to grind away all sides of the tooth unless there is a specific reason.
5. Crowns(caps)- A crown, the largest single tooth restoration, sometimes cannot be avoided. It covers all sides of the tooth as well as the end. It is used when there is limited tooth structure left, when an existing crown must be replaced, or when the tooth is an "anchor" tooth for a fixed bridge.
6. Veneers- Thin porcelain facings that cover the front side of teeth. Used cosmetically to change the length, color and shape of teeth. Can be preformed with minimal tooth preparation and an excellent choice for a cosmetic make-over.
7. Bridges- Used to replace missing teeth when sufficient "anchor" teeth are available on each side of the gap. Numerous systems are available, including fiber-reinforced ceramics, Zirconium-based ceramics and porcelain fused to metal bridges.
8. Implants-Titanium posts surgically placed into the jawbone. After placement the bone grows around the implant through a process called osseointegration (usually three-six months after placement) and later the restorative phase can begin. Implants are used to support various dental prosthesis ranging from single crowns to a full denture. Given the choice between a bridge and an implant, an implant is considered the superior choice since it doesn't require preparation of adjacent teeth and there for more conservative.
9. Removable Partial Dentures- Used to replace missing teeth when insufficient teeth remain to support fixed bridges or a patient is not a good candidate for dental implants. Partial dentures can be metal or acrylic-based.
10. Removable Complete Denture- Utilized when no teeth remain and implants are not an option due to case specifics. By today's standards this is basically a last resort.
Monday, May 9, 2011
Mouth Ulcers
Mouth ulcers, sometimes called canker sores, are a common affliction. Often they are simply caused by trauma and heal quickly on their own. The recurrent, bothersome form is known as recurrent aphthous stomatitis or simply aphthous ulcers. Certain triggers for these are stress, acidic foods, specific foods for the individual, trauma, chemical sensitivities, and can play a role in setting off an attack.
The cause of these ulcers is unknown, though it is believed to be some sort of immune mediated condition. At this time it seems aphthous stomatitis is not caused by any infectious agent (viruses or bacteria) and these ulcers are not contagious. Aphthae can also be manifestations of various systemic diseases such as Bechet's syndrome, HIV, autoimmune disorders, Crohn's disease, and the like.
There is no cure for aphthous stomatitis and lesions are basically treated palliatively. A dentist applied treatment, Debacterol, gives almost immediate relief and speeds healing. It is an acidic agent which chemically cauterizes the ulcer surface, sterilizing it, and covering the painful nerve endings. Only available as an in office treatment, Debacterol is 90 percent effective in giving immediate and lasting pain relief. Avoiding known triggers is helpful. A healthy diet with vitamin supplementation is recommended. Excellent oral hygiene, including use of antibacterial rinses (Rx chlorhexidine or OTC Listerine), has been shown to reduce frequency of attacks. Reducing stress is important as well. In severe cases a short course of systemic steroid (prednisone, etc.) may be needed. A new drug Apthasol is on the market and has been shown to have some beneficial effects as well.
The cause of these ulcers is unknown, though it is believed to be some sort of immune mediated condition. At this time it seems aphthous stomatitis is not caused by any infectious agent (viruses or bacteria) and these ulcers are not contagious. Aphthae can also be manifestations of various systemic diseases such as Bechet's syndrome, HIV, autoimmune disorders, Crohn's disease, and the like.
There is no cure for aphthous stomatitis and lesions are basically treated palliatively. A dentist applied treatment, Debacterol, gives almost immediate relief and speeds healing. It is an acidic agent which chemically cauterizes the ulcer surface, sterilizing it, and covering the painful nerve endings. Only available as an in office treatment, Debacterol is 90 percent effective in giving immediate and lasting pain relief. Avoiding known triggers is helpful. A healthy diet with vitamin supplementation is recommended. Excellent oral hygiene, including use of antibacterial rinses (Rx chlorhexidine or OTC Listerine), has been shown to reduce frequency of attacks. Reducing stress is important as well. In severe cases a short course of systemic steroid (prednisone, etc.) may be needed. A new drug Apthasol is on the market and has been shown to have some beneficial effects as well.
Monday, April 4, 2011
Oral Hygiene
Brushing and flossing your teeth are only parts of an optimal oral hygiene program. Most people know that good oral hygiene is important in maintaining the health of the teeth and gums, but it is also important to maintain the health of the entire mouth including other tissues in the oral cavity. In addition to brushing the teeth at least twice a day with fluoride toothpaste and flossing on a regular basis, it is also important to clean other areas of the mouth, particularly the tongue.
The tongue's rough and porous surface can harbor plaque-causing bacteria. Plaque is a bacterial film that forms when food particles collect on teeth, promoting tooth decay and gum disease. If the tongue isn't cleaned regularly and continues to harbor these bacteria, it can serve as a reservoir and re-seed the teeth and gums with bacteria.
Not only do the bacteria coating the tongue contribute to plaque formation, they also can cause odor, resulting in halitosis or bad breath.
The solution to these problems is brushing your tongue with a soft-bristled toothbrush in good condition at least a couple of times a week. An antiseptic mouthwash such as Listerine will also cut down on bacteria that dwell in the mouth.
An alternative to brushing the tongue is the use of a tongue scraper, which is a hand-held device, usually with serrated edges, designed to remove bacteria from the tongue by drawing them across its surface. Tongue scrapers are OK, but they're really no better than a good toothbrush. It's really up to the individual as to how they clean their tongue. The important thing is that they do it on a regular basis.
The tongue's rough and porous surface can harbor plaque-causing bacteria. Plaque is a bacterial film that forms when food particles collect on teeth, promoting tooth decay and gum disease. If the tongue isn't cleaned regularly and continues to harbor these bacteria, it can serve as a reservoir and re-seed the teeth and gums with bacteria.
Not only do the bacteria coating the tongue contribute to plaque formation, they also can cause odor, resulting in halitosis or bad breath.
The solution to these problems is brushing your tongue with a soft-bristled toothbrush in good condition at least a couple of times a week. An antiseptic mouthwash such as Listerine will also cut down on bacteria that dwell in the mouth.
An alternative to brushing the tongue is the use of a tongue scraper, which is a hand-held device, usually with serrated edges, designed to remove bacteria from the tongue by drawing them across its surface. Tongue scrapers are OK, but they're really no better than a good toothbrush. It's really up to the individual as to how they clean their tongue. The important thing is that they do it on a regular basis.
Monday, March 7, 2011
Food Allergies
Food allergy occurs when the immune system mistakenly attacks a food protein as if it were a pathogen. Ingestion of the offending food may trigger the sudden release of chemicals, including histamine, resulting in symptoms of an allergic reaction. Scientists estimate that approximately 12 million Americans suffer from food allergies.
Food allergies can be diagnosed using a skin prick test or a blood test. A skin prick test is usually less expensive and can be done in the doctor’s office. A Positive skin prick tests or immunoassay test results will show that IgE antibody is present in the body, but cannot alone predict that a reaction will occur if the patient were to eat a suspected allergy-causing food. The results of the tests are combined with other information, such as a history of symptoms and the result of a food challenge to determine whether a food allergy exists.
Strict avoidance of the allergy-causing food is the only way to avoid a reaction. Reading ingredient labels for all foods is the key to avoiding a reaction. If a product doesn’t have a label, individuals with a food allergy should not eat that food. If you have any doubt whether a food is safe, call the manufacturer for more information. There is no cure for food allergies. Studies are inconclusive about whether food allergies can be prevented.Food allergies can be diagnosed using a skin prick test or a blood test. A skin prick test is usually less expensive and can be done in the doctor’s office. A Positive skin prick tests or immunoassay test results will show that IgE antibody is present in the body, but cannot alone predict that a reaction will occur if the patient were to eat a suspected allergy-causing food. The results of the tests are combined with other information, such as a history of symptoms and the result of a food challenge to determine whether a food allergy exists.
Symptoms may include one or more of the following: a tingling sensation in the mouth, swelling of the tongue and the throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, loss of consciousness, and even death. Symptoms typically appear within minutes to two hours after the person has eaten the food to which he or she is allergic.
Studies are inconclusive about whether food allergies can be prevented. Parents should become familiar with the early signs of allergic disease such as eczema, hives, repeated diarrhea and/or vomiting in reaction to formulas, wheezing, and talk to a doctor about those symptoms.
At this time, no medication can be taken to prevent food allergies. Strict avoidance of the allergy-causing food is the only way to prevent a reaction. Epinephrine, also called adrenaline, is the medication of choice for controlling a severe reaction. It is available by prescription as a self-injectable device (EpiPen® or Twinject®).
Tuesday, March 1, 2011
Nutrition Tips for Healthier Teeth and Gums.
The types of foods you eat can affect your smile as much as brushing or flossing. Every time you eat sugary or starchy foods, the bacteria in plaque get another chance to form decay-causing acid. But choosing foods that naturally fight bacteria, remove plaque, strengthen enamel, and freshen breath is a good way to preserve your teeth.
1. Celery
Celery protects your teeth in two ways. The extra chewing it requires produces plenty of saliva, which neutralizes the bacteria Streptococcus Mutans that causes cavities. Additionally, chomping on naturally abrasive foods massages gums and cleans between teeth.
2. Cheese
Studies from the last decade show that cheese, with its low carbohydrate and high calcium and phosphate content, provides several benefits for your teeth. It helps balance your mouth's pH (an acidic pH encourages the growth of cavity-causing bacteria). Cheese also preserves and rebuilds tooth enamel and produces saliva, which kills the bacteria that cause cavities and gum disease.
3. Green Tea
Green tea contains substances called Catechins that kill the bacteria in your mouth that turn sugar into plaque. Catechins also wipe out the bacteria that cause bad breath.
4. Kiwis
For their size, kiwis pack more vitamin C than any other fruit. In fact, one large kiwi supplies more than 100 percent of your recommended daily amount. If you don't get enough vitamin C, research shows that the collagen network in your gums can break down, making your gums tender and more susceptible to the bacteria that cause periodontal disease.
5. Onions
Onions contain powerful antibacterial sulfur compounds. In a 1997 test tube study, onions killed various types of bacteria, including S. Mutans. Research indicates that they are most powerful when eaten freshly peeled and raw. Of course, raw onions can do a number on your breath, so be sure to have some fresh parsley on hand.
6. Parsley
Chewing parsley or mint leaves after a pungent meal will help you maintain sweet-smelling breath. These herbs contain Monoterpenes, volatile substances that travel quickly from your bloodstream to your lungs, where their odor is released via your breath.
7. Sesame Seeds
According to fossils, our Paleolithic ancestors had great teeth. Anthropologists suggest that this is partly due to the cleansing action of primitive foods like seeds, which slough off plaque and help build tooth enamel. Sesame seeds, for example, are also high in calcium, which helps preserve the bone around your teeth and gums.
8. Shiitake Mushrooms
A 2000 study in Caries Research showed that lentinan, a sugar found in shiitake mushrooms, prevents mouth bacteria from creating plaque.
9. Wasabi
Otherwise known as Japanese horse-radish, this condiment not only provides zing to sushi, it also protects your teeth. A 2000 study in Biofactors revealed that the substances that make wasabi taste hot, called Isothiocyanates, also inhibit the growth of cavity-causing bacteria.
10. water
Drinking water keeps your gums hydrated and is the best way to stimulate saliva--your body's greatest defense against the bacteria that cause plaque and cavities. Rinsing your mouth with water also helps wash away trapped food particles that decompose in the mouth and cause bad breath.
1. Celery
Celery protects your teeth in two ways. The extra chewing it requires produces plenty of saliva, which neutralizes the bacteria Streptococcus Mutans that causes cavities. Additionally, chomping on naturally abrasive foods massages gums and cleans between teeth.
2. Cheese
Studies from the last decade show that cheese, with its low carbohydrate and high calcium and phosphate content, provides several benefits for your teeth. It helps balance your mouth's pH (an acidic pH encourages the growth of cavity-causing bacteria). Cheese also preserves and rebuilds tooth enamel and produces saliva, which kills the bacteria that cause cavities and gum disease.
3. Green Tea
Green tea contains substances called Catechins that kill the bacteria in your mouth that turn sugar into plaque. Catechins also wipe out the bacteria that cause bad breath.
4. Kiwis
For their size, kiwis pack more vitamin C than any other fruit. In fact, one large kiwi supplies more than 100 percent of your recommended daily amount. If you don't get enough vitamin C, research shows that the collagen network in your gums can break down, making your gums tender and more susceptible to the bacteria that cause periodontal disease.
5. Onions
Onions contain powerful antibacterial sulfur compounds. In a 1997 test tube study, onions killed various types of bacteria, including S. Mutans. Research indicates that they are most powerful when eaten freshly peeled and raw. Of course, raw onions can do a number on your breath, so be sure to have some fresh parsley on hand.
6. Parsley
Chewing parsley or mint leaves after a pungent meal will help you maintain sweet-smelling breath. These herbs contain Monoterpenes, volatile substances that travel quickly from your bloodstream to your lungs, where their odor is released via your breath.
7. Sesame Seeds
According to fossils, our Paleolithic ancestors had great teeth. Anthropologists suggest that this is partly due to the cleansing action of primitive foods like seeds, which slough off plaque and help build tooth enamel. Sesame seeds, for example, are also high in calcium, which helps preserve the bone around your teeth and gums.
8. Shiitake Mushrooms
A 2000 study in Caries Research showed that lentinan, a sugar found in shiitake mushrooms, prevents mouth bacteria from creating plaque.
9. Wasabi
Otherwise known as Japanese horse-radish, this condiment not only provides zing to sushi, it also protects your teeth. A 2000 study in Biofactors revealed that the substances that make wasabi taste hot, called Isothiocyanates, also inhibit the growth of cavity-causing bacteria.
10. water
Drinking water keeps your gums hydrated and is the best way to stimulate saliva--your body's greatest defense against the bacteria that cause plaque and cavities. Rinsing your mouth with water also helps wash away trapped food particles that decompose in the mouth and cause bad breath.
Monday, February 14, 2011
Bad Oral Habits
While it is obvious that our teeth's main purpose is the initial processing of foods before swallowing, it is sometimes not so clear what other functions should be expected! As capable as our teeth are in biting and chewing food, there exists many limitations outside of this realm.
In all my years of clinical experience, I've come across lots of pathologies that are self-inflicted through misuse of teeth. As a general rule, I always tell my patients that when in doubt don't do it. It is easy to forget sometimes that our teeth can be quite fragile under certain circumstances and misuse could cause chips and fractures, resulting in unnecessary dental work. Here is a short list of some common things to avoid; Chewing ice, chewing non-food objects such as finger nails and pens, chewing some hard nuts either with or without shells, cutting strings and aggressive use of toothpicks, just to name a few.
We also recommend night guards to those who have a tendency to clench and/or grind their teeth. They are a small investment to make that can go a long way in preventing reversible or irreversible damage.
Lastly, please remember that it is not that we do not want to see you in the dental office. We just do not want to have to treat you in preventable situations! Please try to avoid using your teeth as a multi-purpose tool, unless of course it is for processing food!
In all my years of clinical experience, I've come across lots of pathologies that are self-inflicted through misuse of teeth. As a general rule, I always tell my patients that when in doubt don't do it. It is easy to forget sometimes that our teeth can be quite fragile under certain circumstances and misuse could cause chips and fractures, resulting in unnecessary dental work. Here is a short list of some common things to avoid; Chewing ice, chewing non-food objects such as finger nails and pens, chewing some hard nuts either with or without shells, cutting strings and aggressive use of toothpicks, just to name a few.
We also recommend night guards to those who have a tendency to clench and/or grind their teeth. They are a small investment to make that can go a long way in preventing reversible or irreversible damage.
Lastly, please remember that it is not that we do not want to see you in the dental office. We just do not want to have to treat you in preventable situations! Please try to avoid using your teeth as a multi-purpose tool, unless of course it is for processing food!
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