Dental X-Rays, Do I Really Need Them?

Dental X-Rays, Do I Really Need Them?

 

Doctor, do I really need to take dental x-rays? This is a question frequently posed by our patients and one that requires thoughtful consideration. The reason why people may question or refuse the need for dental x-rays often relates to the issue of safety. No one wants to expose themselves to radiation needlessly, and on this point everyone can agree. However, we cannot overlook the benefits of dental x-rays: They allow us to detect small problems of the teeth and bone of the jaws before they become big problems. So what is the balance? How often can we safely take x-rays and how often should we?

 

A typical dental x-ray image. Smile!

A typical dental x-ray image. Smile!

Before answering the question, we must understand a bit about x-ray exposure. Radiation is measured in units called millisieverts. This is a metric measurement, so it uses a similar scale to what we use for distance. One millimetre is 1/1000th of a metre. Dental x-rays are measured in microsieverts. So just as a micrometre is 1/1000th of a millimetre, a microsievert is 1/1000th of a millisievert. To put it another way, it is 1000 times less.

The fact is that radiation occurs naturally all around us, to the point where we are naturally exposed to about 4 millisieverts every year. This number increases if we live in a part of the world with longer sun exposure, at higher elevations, if we fly on airplanes, watch television, or smoke cigarettes. A typical digital dental x-ray examination of 4 bitewing x-rays is 0.8 microsieverts. Remember that is 5000 times less than your average natural exposure yearly dose! Dental x-rays are among the lowest sources of diagnostic imaging x-rays used.

 

dental x-ray dentist montreal downtown

The only films we use are digital, which correspond to the 6th row from the top. As described in the chart, 18 to 20 films is 0.0039 mSv, meaning one film is less than 0.0008 mSv.

Now that doesn’t mean that we need excessive amounts of images. For new patients, Dr. Seminara will review your history, examine your mouth and teeth then decide whether you need radiographs and what type. For most patients, this will mean bitewings and selected periapical images. These can give us valuable diagnostic information about the teeth, bone, roots and other structures of the jaws. Once we know your general dental status, a recall schedule can be fixed with regular x-rays as needed.

A Bitewing X-ray

A Bitewing X-ray

A Periapical X-ray

A Periapical X-ray

 

 

 

 

 

 

 

The average patient in our office who is at low risk (someone who get cavities infrequently) would be recommended to have bitewing x-rays done once every 18 to 24 months. A patient at higher risk would be recommended to have them done every 6 to 12 months. More are taken for patients with advanced needs, such as gum disease or root canals. Emergency visits may also require images to help diagnose the cause of the acute problem. We take care to limit exposure by using digital x-ray sensors and specials machines that specifically target the mouth area, reducing exposure to other body parts. In fact, the body is covered by a protective lead apron for this very purpose.

Dr. Seminara’s x-ray recommendations are always based on your specific individual needs and the standard of care as prescribed by the Order of Dentists of Quebec and the Canadian Dental Association. Our goal is to take as few as necessary to keep your teeth and mouth in perfect health!

New Video: Welcome to Dr. Seminara’s Dental Practice!

 

 

This video was created by Dr. Seminara and the Downtown Montreal Dentistry team to welcome patients to our practice and to give them a look at the patient experience in our office, from the moment they walk in the door until the moment they leave. Our goal is  to introduce ourselves to you so that when you visit us you can feel comfortable with us and with our dental practice environment.

Our official office mission statement is “We are committed to providing exceptional dental care in a compassionate and caring environment”. These are the words we live by everyday. From Dr. Seminara, to Kim and Laurie our wonderful hygienists, to Chami our assistant and Carla our receptionist, we all choose to focus on maintaining an exceptionally high standard of care.

Our growing practice is accepting new patients, and we would all like to extend an invitation to you to come and visit us at our office, visit our website, check our Facebook page, or just to give us a call or send us an email.

 

Dr. Seminara Appointed to the ACDQ

We are proud to announce that Dr. Seminara has been appointed to the ACDQ Board of Directors for the Montreal Anglophone region. The ACDQ is the Association des Chirurgiens Dentists du Quebecor the Quebec Dental Surgeons Association. It’s mission is to study, defend and develop the professional, economic, social and moral interests of its members. It also promotes improvement of dental health by facilitating access to care and encouraging research, social action and humanitarian assistance. Dr. Seminara joins 23 other directors from all the regions of Quebec, the ACDQ President, Speaker, and staff, all working together towards a common goal – the general advancement of the profession of dentistry.

Dr Seminara Downtown Dentist Montreal

Said Dr. Seminara: “I am honoured to have been chosen to fill this role, and am looking forward to working with my colleagues to improve our profession and our ability to provide exceptional dental care. To be a part of the ACDQ board of directors is to be at the highest levels of collective decision making among dentists in Quebec.”

Interesting Dental Implants Advertisement

 

Cowboy tough dental implants

This clever advertisement was seen at the Scottsdale, Arizona rodeo on Dr. Seminara’s last trip out there to the Spear Dental Education Centre. Keeping up with the latest techniques and technologies in any field is important, but particularly when it affects your health and welfare. Dental Implants are just one of the many topics that are covered in depth at a typical two to three day session at the Spear Centre. Advanced classes in Occlusion (how your teeth come together), Treating the Worn Dentition, and Treatment Planning are also taught.

It is essential for a dentist to engage in as many high quality continuing educational activities as possible, and Dr. Seminara has made it his mission to learn all he can from the best dentists around. In any given year, he takes two to three times the amount of courses recommended by the Order of Dentists of Quebec. Many of these courses are given by McGill, many others by local study clubs such as the Montreal Dental Club, of which Dr. Seminara currently sits as President. He has also traveled to seminars in Arizona, Vancouver, Chicago, North Carolina, Atlanta, Toronto and will be heading to Boston in May and June for advanced courses on dental implants.

Dr. Seminara at course on dental implants

The crowd at a conference on Treating the Worn Dentition in Chicago that Dr. Seminara attended in 2015

Dental Implants are one of the most successful, yet complex treatments that we perform at the office. We have restored hundreds of implants over the years and helped hundreds of people regain their smiles, chewing function and confidence. It is amazing to consider that from the mid 1980s to today, the use of implants in dentistry has increased by over 1000%! We are fortunate to be able to help our patients benefit from this service, and it is through diligent training and study that we have maintained our cutting edge knowledge. A final thought about the cowboy from the rodeo. Not so long ago, he’d have to make due with a partial denture, or perhaps even go without teeth at all. Well that certainly isn’t the case anymore. Now he can replace the teeth he lost falling off his bull with implants!

The rodeo cowboy seconds before being thrown from his bull

The rodeo cowboy seconds before being thrown from his bull. He will very likely soon be in the market for some “Cowboy Tough Dental Implants”

Top Five Reasons to Floss

Every six months, you visit the dentist for a cleaning — and likely a lecture about the importance of flossing. But if you’re like many dental patients, the advice travels in one ear and out the other — much like, well, dental floss gliding between the spaces of your teeth.

But flossing does about 40% of the work required to remove sticky bacteria, or plaque, from your teeth. Plaque generates acid, which can cause cavities, irritate the gums, and lead to gum disease. Each tooth has five surfaces. If you don’t floss, you are leaving at least two of the surfaces unclean. Floss is the only thing that can really get into that space between the teeth and remove bacteria.

Here are the top five reasons to floss your teeth regularly:

  1. Flossing is the most effective way to remove plaque buildup from in between your teeth. Plaque is a sticky substance that is full of bacteria, which if left uncleaned can lead to cavities, gum disease, and bone loss around your teeth. All of these conditions, if allowed to progress, can lead to the loss of a tooth
  2. Flossing also removes food particles from between your teeth. Removing these, combined with removing plaque, can lead to fresher breath.
  3. Gum disease is hard to diagnose if you are not trained on what to look for. Some of the signs are bleeding gums and gum recession. Flossing regularly can help prevent both these conditions.
  4. People suffering from heart disease or who have had heart surgery must be very vigilant with their oral hygiene. The mouth is a gateway to harmful bacteria that may reach cardiac tissue and cause a condition called endocarditis. Moreover, if you suffer from heart disease, by keeping your mouth and teeth clean, you can reduce the risk of complications. Several current scientific studies has demostrated a link between gum disease and heart disease.
  5. Diabetic patients are more likely to develop gum disease, which in turn can increase blood sugar and diabetic complications. People with diabetes are more likely to have gum disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections.

And here is a bonus reason: People who floss regularly are less likely to get the usual “importance of flossing” lecture from the hygienist at their recall visit!

how-to-floss-fingers-and-teeth

Standard flossing technique

 

For more information about gum disease and your health, visit https://www.perio.org/consumer/gum-disease.htm

How Finger Nail Biting can Impact your Oral Health

That's a real nail-biter

That’s a real nail-biter

 

Lets talk about biting your nails, and why it is bad for you. Did you know that nail biting (technically called Onychophagia) can be harmful to your teeth and overall oral health? Not many people know the extent to which this bad habit can impact your beautiful teeth.

Nail Biting’s Impact

Let’s take a closer look at how your nail biting habit can cause damage to your teeth.

Cleanliness: You touch a lot of different surfaces with your hands throughout a given day. Nail biting transfers those bacteria and dirt that has collected under your nails to your mouth and stomach. Even if you wash and sanitize your hands regularly, bacteria will still enter your system. This bacteria can cause damages to your teeth and even lead to illness or stomach irritation.

Besides this, if you are breaking the skin around your nails as you bite them, you can actually transfer bacteria from your mouth to your fingers resulting in painful infections.

Stress: Nail biting can place a lot of extra and unwanted stress on your teeth. This pressure can actually cause them to shift and move from their natural placement in your mouth. This can cause soreness and even lead to the potential for orthodontic treatments in the future.

Wearing Your Teeth Down: Over time, nail biting can actually wear down your teeth. This can impact the enamel and strength of your teeth. Worse yet, continuous nail biting can actually cause teeth to chip or crack. Fillings and porcelain crowns and veneers can also break due to nail biting.

Money, Money, Money: Since nail biting can lead to significant oral health and teeth damages, many people will have to invest more money and time on their dental care over their lifetime. The Academy of General Dentistry estimates that a nail biter will spend up to 4000$ more on dental care over their lifetime than a non-nail biter. Wouldn’t you rather spend that money on anything else, rather than nail biting?

Did you know that almost 50% of children between 10 and 18 bite their nails? Think about how much damage nail biting can do over 8 years. And while studies show that many people stop by the age of 30, nail biting can damage your oral health significantly during that time period.

Want to know some tips to stop biting your nails? We will discuss that in a future post…

Toothpaste Tips

How much toothpaste do you really need?

When you catch a print or TV ad for a toothpaste company, what do you see? A toothbrush being slathered with a heavy dose of toothpaste to create that fancy wave at the end, right?

Not only does this make the product look great, but it encourages us to use more, thus selling more product. Pretty smart from a marketing perspective, but not at all necessary from a dental health perspective.

While toothpaste is an important component in the maintenance of healthy teeth, it’s both the frequency and brushing motion itself that are paramount, and therefore only a pea size amount of toothpaste is needed to get the job done.

downtown dentist seminara toothbrush

The amount of toothpaste the toothpaste company wants you to use

dentist downtown montreal

The amount of toothpaste you actually need to use

Teaching

  • A downtown dentist's tools


Dr. Seminara was honoured to be a guest lecturer at PACC (Pearson Adult Career Centre) , where he gave a course titled “The Role of the Dental Assistant in the Dental Office” to a new class of aspiring future dental assistants.

 

Despite being involved with teaching dental students at McGill University for the past 10 years, this was Dr. Seminara’s first foray into instructing other members of the dental health care team. The students were bright and engaging, and they will no doubt become great dental assistants following graduation. Special thanks to PACC teachers Tammy and Liesa for the invitation!

 

Seminara at PACS

Dr. Seminara and the class pose for an after-lecture photo

More than Just Teeth: Dentists and Oral Cancer

Many people may not be aware of all the things their dentist is checking for during their dental exam. Certainly, we examine the teeth and gums, both clinically (in the mouth) and on the x-rays. However, one of the most important parts of every visit to the dentist is the oral cancer screening exam. No other health professional you visit is as adept at identifying oral cancer as your dentist, and in fact should you ask your GP physician, most would refer you to see a dentist or an ENT specialist (Ear-Nose-Throat).

Oral cancer is a malignant tumour that starts in cells of the mouth. Malignant means that it can spread, or metastasize, to other parts of the body. This type of cancer can form on the tongue, throat, saliva glands, hard palate and floor of the mouth under the tongue. According the the World Health Organization, oral cancer is the 11th most common form of cancer worldwide, ahead of leukemia, ovarian and pancreatic cancers. Risk factors include smoking, alcohol consumption, family history or exposure to HPV, Human-Papilloma Virus.

But what exactly does it look like? The truth is, it can look like a lot of things. A red ulcer that doesn’t heal, white patches or a lump or hard bump are some of the more common presentations. However, sometimes it looks like nothing at all, and sometimes what looks like one of the above described problems can in fact be a benign issue. I don’t want to put too many unpleasant images in this article, but here are two photos, one example of a squamous cell carcinoma of the mouth and one of a traumatic ulcer caused by biting the inside of the mouth. (both images from oralcancerfoundation.org)

Squamous Cell Carcinoma

Squamous Cell Carcinoma

Ulcer due to Cheek Bite

Ulcer due to Cheek Bite

 

 

 

 

 

 

 

They don’t look all that different, but the consequences of not recognizing the squamous cell carcinoma quickly could be very serious. If your dentist is suspicious about something in your mouth, the first step may be to perform a biospy right in the office, or a referral to an oral cancer specialist for assessment. Following positive identification, further treatment would be undertaken with an oncologist or surgeon, much like other forms of cancer treatment.

On a personal note, I’ve been in practice for 10 years and have performed dozens and dozens of biopsies, and referred a similar number of patients to specialists to assess suspicious lesions. Thankfully, none have yet tested positive for oral cancer. However, I know that the thorough exams that I conduct are of vital importance to my patients and their families and may help to save someone’s like. For more information on Oral Cancer:

http://www.maboucheensante.com/en/mouth101/diseases/cancer

http://www.cda-adc.ca/en/oral_health/complications/diseases/oral_cancer.asp

http://www.oralcancerfoundation.org