Sep 28, 2021
You brush, you floss, you’ve started scraping your tongue, and you come in for regular check ups. Perhaps you’ve been wondering why you need to get dental x-rays on top of your excellent oral care routine. Are dental x-rays really necessary for your oral health? The answer is yes: dental x-rays are a useful diagnostic tool for Dr. Brunacini and Dr. Karagiorgos and help them detect damage and disease not visible during a general exam. This month we spoke with Dr. Karagiorgos about why dental x-rays are an important part of your oral health care.
Dental X-rays provide dentists the opportunity to identify any potential problems in the mouth. What exactly are you looking for when you review X-rays?
Dr. Karagiorgos: X-rays are a very important diagnostic tool that allow dentists to see more of people’s teeth than what we can see in the mouth with just magnifying lenses and a headlight. With x-rays we can see things like tooth decay between adjacent teeth, we can see if there are any potential problems under the gums, in the bone or in the roots of the teeth.
Are there any types of x-rays that hurt or require special preparation or protection?
Dr. Karagiorgos: Dental x-rays themselves don’t hurt per se. There are conditions in some patients that can make it a little more difficult for those patients to take x-rays. For example, patients with a limited ability to open their mouth, patients that have a very strong gag reflex or some that have larger bony protrusions in their mouths. X-rays have evolved and improved quite a bit over the years. At Falmouth Dental Arts, we have state-of-the-art digital x-ray sensors that allow us to take and immediately see diagnostic images in high resolution, using far less radiation than the previous generation film x-rays.
What are the most serious diseases or conditions that you can prevent thanks to taking regular X-rays?
Dr. Karagiorgos: X-rays can help us routinely detect things like dental decay and tooth infections. X-rays can also help us diagnose very serious general health problems. We can see pathology in the bone like invasive cysts or cancerous tumors. Panoramic films and 3D cone beam x-rays that rotate around the head are commonly used to evaluate the jaw joints or to see wisdom teeth coming in. These x-rays with expanded fields of view can also help us see things like restricted airways, salivary blockages or even calcifications in the circulatory system of the neck which can put patients at increased risk of stroke.
What has been the most surprising thing that you have seen on Dental X-rays?
Dr. Karagiorgos: I just got back from a dental convention where a dentist presented the latest imaging technology. He presented us a slide showing x-rays taken on a 6 year old boy. His images showed what looked like a round metal object in the boy’s left sinus. The x-ray image was of such great quality that we were able to make out George Washington’s bust! It turns out that without anyone’s knowledge, the boy had lodged a quarter so deep into his nose that it ended up in the boy’s maxillary sinus. That was pretty surprising to see, but even more surprising was the very next slide.
It was an x-ray of the sinus of the boy’s 8-year-old brother. Apparently, the brother had a lego brick in the exact same location!
Are there any medical conditions or situations where you advise patients to not undergo x-rays?
Dr. Karagiorgos: Typically, no. Dental X-rays are of lower doses of radiation. They are considered generally safe. That said, we specifically try to limit x-ray exposure to expectant women. We are always weighing the risks and benefits of every treatment, and this includes taking x-rays.
As dentists, we practice the ALARA principle with radiation. ALARA stands for “as low as reasonably achievable”. This principle means that even if it is a small dose of radiation, if there is no direct benefit, you should try to avoid it.
Thank you, Dr. Karagiorgos!
When was the last time you had x-rays of your teeth taken? We recommend routine Bitewings x-rays for adults every 1-2 years depending on decay history, gum health, and dry mouth. For children and teens we recommend it every year. Major films are recommended every 3-5 years for both adults and children to monitor growth and development as well as periodontal health. Call our office today at 207.781.5900 to make your appointment!
*Image courtesy of www.wikipedia.org
Jul 30, 2019
Antibiotic prophy….say what?! For most of our patients, antibiotic prophylaxis is something they’ve never heard of and don’t need to worry about. However, for some of our patients, particularly with heart conditions, it can be an important part of their oral health care. In short, antibiotic prophylaxis is the use of antibiotics before a dental procedure to prevent a bacterial infection elsewhere in the body. It is a treatment that may be recommended for you after talking with your physician and Dr. Brunacini or Dr. Karagiorgos. There are side-effects and risks to taking antibiotics, so antibiotic prophylaxis is only used when the benefit outweighs the risk for you. To learn more, we talked with Dr. Karagiorgos.
1. What is Antibiotic Prophylaxis?
Dr. Karagiorgos: Antibiotics usually treat bacterial infections, but sometimes physicians or dentists recommend antibiotics prior to a treatment, such as a teeth cleaning or root canal, to reduce the risk of infection. This is because during some dental treatments, bacteria from the mouth can enter the bloodstream and cause infection elsewhere in the body. We only recommend this for certain patients, which is why it’s important to have a conversation with us and your physician.
2. Who Could Benefit from Antibiotic Prophylaxis?
Dr. Karagiorgos: With a few exceptions, most patients who require antibiotic prophylaxis before a dental visit will need it for one of two major reasons:
- Risk of infection to replacement (artificial) joints–commonly the hip, knee, or shoulder.
- Risk of infection in the heart.
The American Heart Association recommends antibiotics before dental procedures only for individuals with the highest risk of infection. This includes patients who have:
- A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.
- A history of endocarditis (heart infection).
- A heart transplant with abnormal heart valve function.
- Certain congenital heart defects, including:
- Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), which has not been fully repaired, including in children who have had surgical shunts and conduits.
- A congenital heart defect that has been completely repaired with prosthetic material or a device (for the first six months after the repair procedures).
- Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at, or adjacent to, a prosthetic patch or prosthetic device.
If you’re not sure what these guidelines mean for you and your particular heart condition, make sure to ask your cardiologist; “Do I need to take antibiotics for dental work?”
3. What if I’ve had Hip Surgery or a Joint Replacement?
Dr. Karagiorgos: For many years, people that had undergone surgery for replacement of a joint (most commonly hip or knee joints) had to take antibiotics before any dental procedures. While this is generally still required for patients with two or more replacement joints, the American Dental Association no longer recommends routine antibiotics prior to dental procedures to prevent prosthetic joint infection.
Many orthopedic surgeons have their own criteria for deciding which of their patients might be at risk of joint infection with dental procedures (even cleanings). That is why in most cases I defer to a patient’s orthopedic surgeon to decide and prescribe prophylactic antibiotics for dental visits.
If you have any questions about your particular situation, make sure to discuss them with me or Dr. Brunacini, as well as your orthopedic surgeon or physician. This is especially important if you have a significant immunodeficiency or previously suffered an infected prosthetic joint. We are part of your health care team and will work together to determine if you have a need for antibiotic prophylaxis.
4. What Else Should I Know?
Dr. Karagiorgos: Good oral health and good general health go hand in hand. So, keep up with your regular oral care routine of brushing twice a day, flossing at least once a day, and seeing your dental team with us for regular cleanings.
At Falmouth Dental Arts you will notice that we ask you about any changes to your health history at every visit. This includes medications that you are taking and any allergies you may have. It is important for us to know what medications that you take, and in what dosages and frequency. If you take many medications and it becomes difficult for you to remember them, then you can ask your physician to give you a current list that you can carry with you. This information is important for us to know when determining the best course of treatment and care for you.
Also, I find it fascinating that the turnover of new tissue in the oral cavity is one of the fastest in the body! Ever notice how a pizza burn in your mouth heals in a matter of days? The mouth is a great window into the body, often reflecting systemic disease before it can be determined by other means. This is why we thoroughly examine all of the mouth, not just the teeth. We want to help you be healthy in your mouth and your whole body!
Thank you, Dr. Karagiorgos!
If you have questions about antibiotic prophylaxis or about how your health issues may impact your dental care, please give us a call today at 207.781.5900. We are here to be your healthcare partner and provide you with the best oral care possible!
*Image courtesy of www.medlineplus.gov
