Dentistry is a field where care is changing at a very fast pace. However, just because something is new doesn’t mean it is better than what we currently have. Part of a dentist’s job is to find new products and procedures that will give patients faster, better and less expensive care. It takes time and discretion to know which products and procedures those are. If a product can meet those three requirements, it is golden! What follows are some of the most exciting things at the leading-edge of dentistry.
By Mark McOmie, D.M.D.
Dental implants are an area that is everchanging. Today, dental implants can be placed with no pain and little post-op discomfort. They can replace a single tooth, bridge a span of missing teeth, and stabilize dentures. They can even be used by orthodontists to help move teeth. The finished product looks and feels so natural that many people with dental implants can’t remember which tooth is the implant!
For many years there was a gold standard for crowns; it was a gold crown. In the 1960s, the porcelain fused to metal crown was introduced. This allowed dentists to provide a crown that was tooth-colored. In 2009, a new crown material came on the market called Bruxzir, a metal-free alternative. This new crown is designed on a computer and milled using CAD/CAM technology. It is every bit as strong as metal, but beautiful. There are now other materials for crowns that don’t use metal, such as emax and empress, that are also excellent. Porcelain fused to metal crowns often have a dark line at the gumline. This is not seen with these new materials. Restorations that look as if they grew there are now the new standard.
Recently, there has been a lot of talk in the news about the amount of radiation in dental X-rays. Any exposure to radiation needs to be taken seriously and it has been. Decades ago, dental X-ray film was modified so that less radiation was needed for a good image, thus decreasing the amount of radiation exposure. This was subsequently decreased exponentially with digital X-rays. Instead of using film, a sensor hooked to a computer provides images instantly. There are also new devices to collimate the beam to the exact size of the film, again reducing exposure of the patient. The United States Nuclear Regulatory Commission says that an exposure of 50 mSv per year is the maximum safe level of radiation per year from all sources. A s tandard b itewing X-ray done at a dental office with digital sensors has a dose of .00325 mSv. So adding that up, it would take over 15,385 digital bitewing X-rays a year to reach the maximum safe level.
Osteoporosis and Dead Jaw
In the U.S. today, 10 million people have osteoporosis. One in two women and one in eight men will suffer from an osteoporoticrelated fracture in their lifetime. The common treatment for osteoporosis is an antiresorptive drug, such as a bisphosphonate. Brand names of some of these are Fosomax, Boniva, and Actonel. One of the side effects of this treatment can be osteonecrosis of the jaw (ONJ) or “dead jaw.” This means there is a section of the jaw bone that dies. Although the percentage of people taking bisphosphonates and having dead jaw as a side effect is very low ( .1-.4 percent with oral dosing or 2-10 percent with IV dosing), it still must be taken seriously, as the treatment can be difficult.
Unquestionable evidence supports that the benefits of antiresorptive drugs far outweigh the risks of dead jaw. Therefore, one should not be deterred from taking these drugs for fear of dead jaw. However, you should let your dentist know before you begin treatment with these drugs and get any invasive dental procedures completed before you start taking an antiresorptive drug.
Dentistry is making great strides in providing the best dental health for patients. However, childhood dental disease is on the rise, probably due to consumption of acidic food and drink with high sugar content. As this generation is on course to have worse teeth than their parents, having a good general dentist helping your family navigate dental health is a must!