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Mountain Brook, AL Gentle Dentist
Mountain Brook Smiles
120 Office Park Drive
Mountain Brook, AL 35223
(205) 423-9140
Mountain Brook Gentle Dentist
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Posts for: February, 2018

By Mountain Brook Smiles
February 17, 2018
Category: Dental Procedures
Tags: x-rays  
BitewingX-RaysanImportantToolinEarlyToothDecayDetection

It's difficult to measure how x-ray imaging has transformed dentistry since its use became prominent a half century ago. As equipment and methods standardized, the technology revolutionized the way we diagnose tooth decay and other mouth-related issues.

One of the more useful of these methods is called the bitewing x-ray. The term comes from the shape of the device a patient holds between their teeth with the film attached on the side toward their tongue. We direct the x-ray beam to the outside of the patient's cheek, where it passes through the teeth to expose on the film. Its particular design provides clearer images since the patient's bite helps keep the film still and distortion-free, making it easier to view signs of early tooth decay.

Bitewing x-rays usually consist of four films, two on either side of the mouth, necessary to capture all of the teeth (children with smaller jaws, however, often only require one film per side). How frequently they're conducted depends on a number of factors, including the patient's age: children or young adolescents are usually filmed more frequently than adults, usually every six to twelve months. Frequency also depends on a patient's particular decay risk — the higher the risk the more frequent the x-ray.

Regardless of how often they're performed, a similar application principle applies with bitewing x-rays as with any other radiological method: As Low As Reasonably Achievable (ALARA). With the ALARA principle in other words, we're looking for that sweet spot where we're able to detect the earliest stages of dental disease with the least amount of radiation exposure.

Bitewings fit this principle well: a patient receives only a fraction of the radiation exposure from a four-film bitewing as they do from a daily dose of environmental radiation. Factor in new digital technology that reduces exposure rates and bitewings pose virtually no health risk to patients, especially if conducted in a prudent manner.

The benefits are well worth it. Thanks to bitewing x-rays we may be able to diagnose decay early and stop it before it causes you or your family member extensive tooth damage.

If you would like more information on the importance of x-rays in dentistry, please contact us or schedule an appointment for a consultation.


By Mountain Brook Smiles
February 02, 2018
Category: Oral Health
Tags: snoring   sleep apnea  
SleepApneaandBehavioralProblemsinChildrenHowYourDentistCanHelp

We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).

The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.

What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.

Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.

There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.

If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”