Ask most people about the number one thing they hate about visits to the dentist and they’ll answer, ‘the drill!’ Just the sound alone is enough to send shivers down the spine of even the bravest souls! Modern advances in anaesthesia make the drill a relatively painless experience, but for those who really can’t stand it, there is an alternative called air abrasion. Also called microabrasion, air abrasion works in a similar manner to the sandblasters used to clean graffiti off walls.
A special device blows a powerful air-borne stream of super-fine aluminium oxide particles out of its tip. Aiming this stream at the tooth means that the particles bounce off the tooth, blasting the decay away. The technique can leave behind a gritty feeling which is easily rinsed away. Sometimes a rubber dam may be placed inside the mouth to serve as a particle barrier. A vacuum hose or water spray can also be used to minimise the debris.
The use of high-tech imaging makes it easy for patients to see what their dentist is describing, and allows them to see what is actually going on inside their mouths.
Digital radiography is similar to conventional X-rays and allows dentists to detect decay and bone loss, and can also be used as an aid in root canals. To take an image, your dentist will place a sensor on the tooth that looks like a piece of film. This technique is faster than the conventional technique, so you will be exposed to lower doses of radiation. The advance of the digital technique is the speed and the ability to adjust contrast and brightness very easily. Also, no chemicals are needed to process the film.
Intra-oral cameras were first developed in 1987. It is a wand-like device with a tiny magnifying lens that projects an image from inside a patient’s mouth onto a screen. The image, magnified up to 40 times, allows the dentist to see fractured enamel, gum recession, fracture lines in teeth, and any decomposition in restorations. It also allows the patient to see the problems. The images allow accurate diagnosis and can be used to provide documentation for insurance purposes.
Extra-oral cameras take images from the outside looking into the mouth.
Lasers are used in dentistry for many procedures. As an alternative to the traditional drill, a laser may reduce the need for anaesthesia. Lasers are very precise and reduce healing times. Lasers can be used for teeth whitening, ulcer removal, gum therapy, cavity preparation and removal of decay. In the future, laser technology may be used to prevent decay by strengthening the tooth.
Unlike conventional dental instruments, lasers are whisper quiet. You may experience a rush of air, since air suction is often used to keep the area cool and cleaner. Compared to conventional techniques, laser surgery results in less bleeding, swelling and post-operative discomfort. Lasers really are the way of the future!
When X-rays pass through your mouth, more X-rays are absorbed by the denser teeth and bone than by soft tissues like cheeks and gums, before striking the film. This creates an image on the radiograph. The dense areas appear lighter and the less dense areas are darker. X-rays allow your dentist to safely and accurately detect hidden abnormalities. In dentistry, X-rays are critical diagnostic tools used to pinpoint cavities and spot other problems not visible to the naked eye.
How often dental X-rays (radiographs) should be taken depends on the patient’s individual health needs. It is important to recognize that just as each patient is different from the next, so should the scheduling of X-ray exams be individualised for each patient. Your medical and dental history will be reviewed and your mouth examined before a decision is made to take X-rays of your teeth.
The schedule for needing radiographs at recall visits varies according to your age, risk for disease and signs and symptoms. Recent films may be needed to detect new cavities, to determine the status of gum disease or for evaluation of growth and development. Children may need X-rays more often than adults. This is because their teeth and jaws are still developing and because their teeth are more likely to be affected by tooth decay than those of adults.
There are three type of radiographs that are routinely taken:
Bitewings are used to help diagnose cavities between the teeth.
Periapical X-rays show the entire tooth, including the root and surrounding bone. These are useful in diagnosing an abscess, impacted tooth or bone loss from periodontal disease.
Panoramic X-rays are a panoramic photograph that allows the dentist to see a broad view of the entire structure of your mouth, including your jaw, in a single image. Within one large film, panoramic X-rays reveal all of your upper and lower teeth and parts of your jaw. Panoramic X-rays are a very useful screening tool used for extracting wisdom teeth, and can reveal abnormal growths or cysts in the jaw bone.
Dentists are sensitive to your concerns about exposure to radiation from X-rays, and are trained to prescribe them when they are appropriate. State-of-the-art technology and staying abreast of the latest diagnostic advances allows your dentist to know which procedures and X-ray films can minimize your exposure to radiation.
All of the necessary precautions are taken to minimize your exposure to X-rays during a typical dental diagnostic procedure. Patients always wear a lead apron and thyroid collar to avoid unnecessary radiation to other parts of the body. Not everyone needs X-rays taken on a regular basis. However, some patients may need to have X-rays taken in order to address suspected problems in their teeth or tooth structures, gums, or jaw bones.
The ionising radiation that you receive from one dental X-ray is substantially less that the radiation you receive every day in the sun. Advances in technology such as higher-speed X-ray film and measurement devices have made dental X-rays even safer today. This is not to say that any unnecessary radiation can harm the tissues in your body. X-rays can diagnose certain conditions and help a condition from becoming worse; the benefit outweighs the risk. In general, children need X-rays more often than adults because their mouths grow and change rapidly. The Australian Academy of Paediatric Dentistry recommends X-ray examinations every six months for children with a high risk of tooth decay. Children with a low risk of tooth decay require X-rays less frequently.
X-ray films detect much more than cavities. For example, X-rays are needed to reveal erupting teeth, diagnose bone diseases, treat an injury, or plan orthodontic treatment.
Imagine that, instead of having dentures, your dentist could regenerate your natural teeth using your DNA. Or what if, instead of using filling material, your dentist could modify the bacteria that causes dental disease. In the future, a simple swab from inside your mouth could provide enough information for an individualised dental treatment. If all this sounds a bit too ‘science fiction’ to be believed, just wait. These are some of the things that could well become routine for dentists of the future.