Posts for: February, 2018

By Gray Yallaly & Black D.D.S.
February 26, 2018
Category: Oral Health
Tags: x-ray  
The21stCenturyPromisesBetterDentalDiagnosticswithConeBeamImaging

X-rays revolutionized dental care in the 20th Century. The same could happen in the 21st Century as cone beam computed tomography (CBCT) becomes a fixture beside the traditional x-ray machine.

CBCT made its debut in dental offices about a decade and a half ago. It utilizes the same invisible energy as traditional x-rays to create images of the face and jaw. But unlike traditional x-rays, which can only depict structures in the two dimensions of width and height, CBCT can create three-dimensional images in amazing detail.

The CBCT's x-ray projector rotates around a patient's head. As it emits a cone-shaped beam of x-rays, the device simultaneously collects anywhere from 150 to 599 distinct image views. It transmits these views to a computer that assembles them into three-dimensional images that can be viewed on a computer display.

From the data file of images, dentists can re-format a variety of views and angles of teeth, jaws and other facial bones at various levels of magnification. Because of this wide range of views, all in striking detail, CBCTs are highly useful among other things for diagnosis of malocclusions (bad bites), the size and location of infections, obstructions at possible implant sites, or jaw problems prior to surgery.

Because they expose a patient to higher doses of radiation than a standard x-ray machine, they're normally limited to more complex oral situations. That means you'll still undergo standard x-rays for most of your dental treatment needs. CBCT radiation levels are lower, however, than medical CT scans, which use a fan-shaped beam that can expose a patient to ten times the radiation of a CBCT. For dental care, a CBCT machine also produces greater image detail than an MRI.

Depending on your needs, CBCT may one day be a part of your dental care.  With their range and accuracy, it could play a major role in helping you attain good health.

If you would like more information on cone beam diagnostics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Getting the Full Picture with Cone Beam Dental Scans.”


By Gray Yallaly & Black D.D.S.
February 18, 2018
Category: Dental Procedures
Tags: gum disease   loose tooth  
HaveaLooseToothYoullNeedThisTwo-PhaseTreatmenttoSaveIt

Although periodontal (gum) disease usually affects your gums first, your teeth may eventually suffer. That’s because the disease can damage both attaching gum tissues and supporting bone.

One advanced sign of this is when one or more teeth become loose. A loose tooth is an alarm bell that you’re about to lose it.

Fortunately, we can often treat loose diseased teeth with a two-phase approach. First and foremost, we need to bring the gum infection under control by removing plaque and calculus (tartar) — the “fuel” for the infection — from all tooth and gum surfaces. Depending on how extensive it is, we have options: we can use specially designed hand instruments to remove plaque and calculus, ultrasonic equipment that loosens and flushes plaque and calculus away, or, if necessary, conventional or laser surgery.

Depending on the extent of the infection, in some cases we may need to use regenerative surgical techniques like gum and bone grafting to replace lost tissue. Healing takes time, though, which leads to the second phase of treatment — securing the loose tooth during gum healing.

The most common way is through a bite adjustment, where teeth are altered to equilibrate chewing forces evenly. This results in all the teeth being hit at the same time allowing the loose teeth to heal and tighten up.

Another option is splinting teeth together. Although there are different methods, the basic idea is to join the loose teeth with stable teeth like pickets in a fence. One way is to bond splinting material across the back surfaces of the involved teeth. Another way is to cut in a small channel across the teeth and insert and bond a rigid strip of metal to splint the teeth in place.

The splint is usually a temporary measure while the gums heal. In some situations, though, we may need to perform a permanent splint by crowning the affected teeth and then splinting the crowns together. If you have a grinding habit we may also prescribe a night guard to limit the damage done while you sleep.

Before deciding on which technique is best for you, we would first need to evaluate the health of the affected teeth to see whether the effort would be worth it. It could be the tooth’s supporting bone structure has become so deteriorated that it might be better to extract the tooth and consider an implant or other replacement. First, though, we would attempt if at all practical to save the tooth — and the sooner we begin treating it, the better your chances for such an outcome.

If you would like more information on loose teeth and gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment for Loose Teeth.”


By Gray Yallaly & Black D.D.S.
February 03, 2018
Category: Dental Procedures
Tags: dental implants  
WhatyoucanExpectifYoureUndergoingImplantSurgery

If you’re considering different options for tooth replacement, dental implants are likely high on your list. Implants have a proven reputation for both durability and life-like appearance that can restore mouth function and revitalize your smile.

There is one aspect concerning implants, however, which gives people pause — the surgical procedure required to place the implants in the jawbone. If you’re leery about undergoing this procedure we can put your mind at ease — for most patients implant surgery is a minor, pain-free process with little discomfort afterward.

While there are variations in style, implants generally have two major components: a titanium post that’s implanted into the jawbone and a permanent life-like crown that’s affixed 6 to 12 weeks after implant surgery. Titanium is the metal of choice because of its affinity with bone cells; over time bone will grow to and attach itself around the implant, a process known as osseo-integration. The metal post is normally spiral in shape, allowing it more surface area for bone to adhere to.

In the beginning of the procedure we administer local anesthesia to fully numb the area before proceeding. After accessing the bone through tiny incisions in the gum tissue, we create a small channel in the exposed bone. A surgical guide may be used to prepare the precise location for the implant with a series of drilling sequences that increases the channel until it matches the implant size. While this takes place, you should only feel a mild vibration and a little pressure from the drill.

The implants are then removed from their sterile packaging and placed immediately into the prepared site. The gum tissues are then sutured into place with self-absorbing sutures. Most people have only mild discomfort after the surgery that can be managed with a prescription-strength non-steroidal anti-inflammatory drug like ibuprofen. We may also prescribe antibiotics and other care instructions to ensure successful gum tissue healing.

With proper planning and precise implant placement by skilled hands, implant surgery is an easy and uneventful procedure. And, with your new crowns in place, your new, beautiful smile will make the experience a distant memory.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Surgery.”