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An article was released to the public stating that dental X-rays contribute to a type of brain cancer. After reading an article like this, your first thought may be to avoid dental X-rays, but you may want to hold off on that quick judgment. As with any treatment we offer at Alpine Oral and Facial Surgery, education is your most valuable tool in deciding what is best for you.

How often dental X-rays are taken is based on risk for infection, physical symptoms, and clinical findings. The American Dental Association (ADA) is a governing body over the dental profession. The ADA states, “ . . . healthy adults receive routine mouth X-rays every two to three years. Dental X-rays are recommended every one to two years for children and every 1.5 to three years for teens. Children often require more X-rays than adults because of their developing teeth and jaws and increased likelihood for cavities.”

A "caries risk category" often determines how often dental X-rays are taken. The most recent documented resource to determine a caries risk is Caries Management by Risk Assessment (CAMBRA). This was adopted by the ADA and is used by dental professionals giving interval recommendations for X-rays.

With knowledge of your risk for dental infection, you will be informed by Dr. Holtzen of the interval at which dental X-rays should be taken. You can rest assured that the standards published by the ADA have been researched extensively and are there to protect your personal health and safety.

Dental X-rays are most commonly digital, which significantly reduces exposure. There is more radiation exposure from the sun or in an airplane than in a dental X-ray. It is common practice to use a lead apron with a thyroid collar for protection during X-ray exposure.

Having a cavity means having an active, potentially harmful infection. Diagnosing such infection with minimal exposure through digital dental X-rays at our Missoula or Hamilton office does more good than harm.

When you have a tooth extracted, your body immediately sets to work to help protect the affected area. The blood that collects at the site of the extraction clots to cover and protect the wound. This is a normal response, and protects the nerves and bone that have been exposed with the removal of your tooth. Normally, the gum tissue will close over the area within a few weeks.

But sometimes the clot becomes dislodged or dissolved before you have a chance to heal. This condition is known as “alveolar osteitis,” or dry socket. Sensitive nerves and bone in the extraction site are exposed to air and outside substances causing intense pain. Bacteria and food particles can also contaminate the wound and lead to pain and infection in the area around the socket.

There are certain activities that should definitely be avoided to reduce the risk of dry socket.

• Straws and suction

The action of using a straw causes suction that can dislodge the clot. You can still enjoy the soothing coolness of a milkshake, but use a spoon.

• Spitting

You might be tempted to rinse and spit immediately to clean your mouth, but spitting can also dislodge the clot. We will let you know how to clean your mouth and teeth for the next few days.

• Smoking

Not only does smoking provide a suction effect that can remove the clot, but smoking and chewing tobacco can slow healing as well.

There are also steps you can take to aid the healing process.

• Caring for your extraction site

We’ll give you instructions on caring for your mouth and teeth for the next few days. Gentle care for the extraction site is vital. And treat yourself gently as well. Rest if you need to, and avoid activities that might impact your wound.

• Choose your beverages carefully

Hot drinks can loosen the clot protecting the wounded area, and alcohol, caffeine, and carbonation also put your healing at risk. Water is a safe choice not only for healing, but for keeping hydrated.

• Think about your diet

Stick to soft foods for the first day or so and chew on the side opposite your extraction site. Foods which can lodge in the teeth, like peanuts, popcorn, nuts, and seeds, should be avoided completely.

• Watch for symptoms of dry socket

How do you know if you have a dry socket? Monitor your pain and the appearance of the site after the extraction. For the first few days, you might feel some pain in the immediate area. Pain that intensifies after three or four days is usually not a result of the extraction. An unpleasant odor or taste in your mouth could be a sign of dry socket. You might look in the mirror and notice that the clot is no longer there, or appears to have been dislodged. If any of these symptoms occur, call Missoula or Hamilton at once. If you are experiencing dry socket, the extraction site will need to be cleaned and protected from further injury.

Dry socket is a relatively rare occurrence, but if you have any symptoms that concern you, we want to hear about them. Dr. Holtzen will work with you to make your extraction treatment go as smoothly as possible. Talk to us about your concerns before any oral surgery, and we will provide detailed information for the procedure and for the healing process afterward. Keep us in the loop as you recuperate, and we will work together to make your recovery a speedy one.

Halitosis is the fancy, scientific word for “bad breath.” Dr. Holtzen and our team know there are several reasons why you may have halitosis; let’s look at a few:

• Gum disease (also known as periodontal disease) – There are five main types of gum disease, and each one can range from mild to severe. For example the most common one is gingivitis; it is caused by bacteria in the plaque that has been allowed to build up, usually as a result of poor oral hygiene. A more serious and uncommon type of gum disease is called necrotizing periodontal disease. It is most common in people who have a suppressed immune system.
• Smoking
• Dry Mouth – This can be caused by something as simple as a medication you take.
• Food – Of course, if you eat something that is potent like garlic, it is going to give you bad breath.
• Diseases of the Body – Some diseases such as sinus infections and diabetes, among a few other types of infections, can also cause you to have halitosis.

How to Get Rid of Halitosis

The most obvious answer to how to get rid of halitosis is to practice good oral hygiene, although, depending on the cause of halitosis it may not be that simple. If you have an infection that is causing the halitosis then you may need an antibiotic to clear up the infection and then the bad breath will go away. Here are more tips:

• Brush your teeth after every meal and before bed.
• Floss your teeth. The more plaque you get out of your teeth, the better chance you have of not getting cavities or bad breath.
• Address any medical conditions that are not related to your teeth that can be causing the halitosis.
• Ask Dr. Holtzen for a prescription mouthwash that kills bacteria.

Halitosis (bad breath) can be an embarrassing condition to live with, but there are plenty of ways to get rid of it permanently. Start by talking to a member of our team at our Missoula or Hamilton office.

It is common to experience dentine hypersensitivity, with symptoms ranging from moderate to severe. Why does it happen and how do you know if this sensitivity is something to be concerned about? The first step is to determine the cause.

The most common cause of the sensitivity is exposure of the dentin. Dentin is the layer immediately surrounding the nerve of the tooth. It is alive and usually covered by the gum tissue. When gum recession is present hypersensitivity is common. Other contributors to temporary tooth hypersensitivity include teeth whitening and dental procedures such as fillings, periodontal treatment, and braces placement or adjustment. These are temporary and should be of no concern.

Permanent hypersensitivity, however, may require treatment. To understand the cause of sustained hypersensitivity, let us explain the structure of dentin and why it serves as a ‘hot spot’.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When dentin tubes are exposed, there is a direct connection between the mouth and dental pulp, which houses the nerve and blood supply of the tooth. External stimuli, such as mechanical pressure (tooth grinding or clenching - bruising the ligaments holding the teeth in place), temperature changes, as well as chemical stimuli (sweet–sour) are transmitted to the pain-sensitive dental pulp and activate nerve endings. A short and sharp pain is the result. These external stimuli cause fluid movement in the open tube that is transmitted as pain sensations. Something needs to be placed into the dentin tube to plug it and stop this fluid movement.

The first step in doing something about dental hypersensitivity is to determine the cause; our professional team at Alpine Oral and Facial Surgery can help you with this. Whether the sensitivity is due to exposed dentin or an underlying cause such as abscess or decay, corrective measures are needed. Contact us sooner rather than later so Dr. Holtzen can reduce the sensitivity, and provide you with some relief!