What is ALARA?

• Category: Dental Technology

Recently in the press there has been a number of articles and newscasts that implicate medical CT(computed tomography) with possible links to some forms of cancer due to high doses of radiation.  It is important to note the differences between medical CT’s and the dental cone beam CT technology(CBCT) we use in our office.  Traditionally, all dentists and medical professionals follow the ALARA (As Low As Reasonably Achievable) protocols concerning radiation levels.  We strive to use to smallest amount of radiation possible to gain the information necessary for accurate diagnosis. Our CBCT device is a revolutionary method of gaining 3-D information without the high levels of radiation found in medical CT scans.

While a medical CT image of the maxilla and mandible is about 2.0 mSv or the equivalent of 243 days of background radiation, and an abdominal CT is the equivalent of 3.3 years of background radiation, a small field CBCT will require only 0.005 – 0.038 mSv or the equivalent of 1 – 5 days of background radiation, depending on the area of interest. A single periapical radiograph is .61 days and a bitewing series (4 films) is 4.6 days of background radiation.

What is Conebeam CT?

• Category: Dental Technology

Conebeam CT (CBCT) provides high resolution, volumetric images that provide complete 3-D views of critical anatomy for more thorough analysis of bone and tooth structure.  CBCT delivers accurate scans with images that are comparable to medical CT but with much lower radiation.  An open image acquisition position while standing is much more comfortable than the closed in medical CT, plus it captures the image in a much quicker time frame.  CBCT is different from the traditional dental films which capture the image in a flat 2-D picture. CBCT is able to provide a more complete and accurate image to study your case. This happens with greater accuracy and much less radiation.  CBCT images are stored inour office and are always available to you or your dentist.  Furthermore, if unusual anatomy or possibility a pathological condition is noticed by Dr Speer or Dr Beherents, we will send the images to a board certified oral maxillofacial radiologist for review and report.

Why Do Dentists Need More Than One type of X-Ray Image?

• Category: Dental Technology

Many of my patients ask the question, why do dentists need different x-ray types?  Most general dentists use three main types of images (radiographs): First is the standard bitewing radiograph.  This shows the crowns of the upper and lower teeth on one side of the mouth.  Here the dentist is looking for decay, bone level, pulp anatomy, type and depth of fillings, and periodontal disease.

The second type of radiograph is the periapical view, here the dentist is taking an image that shows the entire tooth from the top of the crown to the tip of the root, allowing the dentist to visualize the tooth and surrounding structure.  Also in this view the dentist can see if there is any disease in the bone or any unusual anatomy.

The third type is the panoramic view. This is an extraoral imaging technique that provides a 2-D image of the entire jaw and joint structure. Very valuable to see how one structure relates to another and for diagnosis and treatment planning for the whole jaw.

In our office, we use all of the above types of images as well as the Cone Beam CT.  Together these images allow us to diagnose and treat the most complex Endodontic problems as well as helping our dental colleagues in our area to plan and diagnose cases for their patients.

Diabetes and Endodontics

• Category: Diabetes, Endodontic Disease

Patients who have diabetes often face difficult treatment challenges with dental disease and endodontic disease in particular due to poorly controlled blood sugar levels.  Patients with diabetes have a disorder in the metabolism of carbohydrate, fat, and protein.  Diabetes is a life changing and life threatening disease and without proper blood sugar control they face complications such as retinopathy, nephropathy, neuropathy, cardiovascular disease, and infections. It is very important to get your blood sugar under control to prevent these life threatening problems.  Abscess teeth that may benefit from endodontic treatment can be lost due to uncontrolled diabetes.  Please talk with your physician if you have any of these complications.

Our New Cone Beam Device

• Category: Dental Technology

We are pleased to announce the installation of a small field, high-resolution cone beam computed volumetric tomography (CBCT) unit in our office. The Kodak 9000 3D is a small field unit, the first in the region, providing three-dimensional radiographic images of the teeth and jaws, allowing greatly improved viewing of orofacial structures.

While a thorough history and clinical examination are essential for the diagnosis of odontogenic pain, interpretation of periapical radiographs (PAs) is complicated by the background pattern of overlapping roots and anatomic structures such as the maxillary sinus and the zygomatic buttress. The use of computed tomography (CT) enables the evaluation of the true extent of lesions and their spatial relationship to important anatomic landmarks.  A recent study by Low, et al, published in the Journal of Endodontics, has demonstrated a 34% improvement in visualizing lesions of endodontic origin when compared to PA(periapical) radiography alone.

Radiation dose to the patient is another benefit of CBCT imaging. While a medical CT image of the maxilla and mandible is about 2.0 mSv or the equivalent of 243 days of background radiation, and an abdominal CT is the equivalent of 3.3 years of background radiation, a small field CBCT will require only 0.005 – 0.038 mSv or the equivalent of 1 – 5 days of background radiation, depending on the area of interest. A single periapical radiograph is .61 days and a bitewing series (4 films) is 4.6 days of background radiation.