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Jan 13, 2010 GENERAL DENTISTRY Facing the facts — dental CBCT and medical CT scans by Dr Bruce Howerton, USA Before a practitioner performs surgery, he/she should be equipped with up-to-date knowledge regarding the possible conditions located under soft tissue within the oral cavity. Three-dimensional data generated by cone beam computed tomography (CBCT) technology offers a ‘surgical view’ or slices of the entire field of view from the front, side and under the patient. Cone beam scans assist with determining bone structure, tooth orientation, nerve canals and pathology; that in some cases may preclude the necessity for a surgical procedure. In the past few weeks, various media sources have published articles regarding high exposure of radiation from medical CT scans. Unfortunately, these have generated misconceptions about the dental CBCT, or 3–D cone beam computed tomography scans. The dental CBCT imaging method allows dentists to obtain vital three-dimensional information without exposing patients to high levels of radiation that come from medical CT scans. An in-office imaging method is more convenient; it saves the patient travel time to and from the hospital and for follow-up examinations after treatment. Dentists and other medical professionals ascribe to the ALARA (as low as reasonably achievable) protocol concerning radiation levels. This protocol guides practitioners to expose patients to the least amount of radiation possible while still gaining the most pertinent information for proper diagnosis. For example, for dentists placing implants, having this information beforehand is imperative to determining anatomical variations that can affect the procedure’s success or failure. The differences between dental and hospital scans derive, in part, from the method of capturing the information. The average medical CT scan of the oral and maxillofacial area can reach levels of 1200-3300 microsieverts, the measurement of radiation absorbed by the body’s tissue. These significant levels are attributed to the method of exposing tissues to radiation. With the hospital scan, the anatomy is exposed in small fan-shaped or flat slices, as the machine makes multiple revolutions around the patient’s head. To collect adequate formation, there is overlapping of radiation. In contrast, the dental scan captures all the anatomy in one single cone-shaped beam rotation, decreasing the exposure to the patient of up to 10 times less radiation. For example, radiation exposure using the standard full field of view from an i-CAT CBCT machine (Imaging Sciences International) is 36 microsieverts. These machines are also available in different fields of view, thereby reducing radiation exposure even more, depending upon the needs of the patient. For other comparisons of exposure, consider that a typical 2D full mouth series runs 150 microsieverts while a 2D digital panoramic image ranges between 4.7-14.9 microsieverts. Researchers who have developed this technology have achieved the goal of allowing dentists to achieve the same information gained from medical CT, without the additional radiation exposure. Dentists who do not own their own CBCT machines can take advantage of this imaging method by referring patients to imaging centers to acquire this valuable information. The knowledge obtained from capturing 3D scans has the ability to influence the effectiveness and efficiency of dental treatment. A dental CBCT scan offers the views and detail needed to perform the latest procedures, while avoiding the unnecessary higher levels of radiation emitted from hospital scans. As the technology continues to evolve, the possibilities for improved dental care can only increase. Increased software compatibility with surgical guides and orthodontic applications has made CBCT scanners an imperative for some dental offices. As an oral maxillofacial radiologist and an educator, I firmly believe that with knowledge comes responsibility to provide patients with the best dental care in the safest way possible — a dental CBCT accomplishes this goal without the additional risks involved with hospital scans. Dr Howerton is a board certified oral and maxillofacial Radiologist who practices privately in Raleigh, NC, USA.Facing the facts — dental CBCT and medical CT scans Dental Tribune International For additional information contact Rochester Advanced Dentistry 248.656.2020

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Periodontal disease is a condition that results in the loss of bone around the teeth. If left untreated it can lead to tooth loss and contribute to numerous health problems including heart disease, preterm low weight babies and stroke.

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Dental bonding can improve the aesthetics of your smile in many cases. Whether trying to change the shape of a tooth or fix a shaded or stained area bonding can often times provide you with the results you desire. If you are unhappy with the appearance of your teeth and would like to discuss options to improve your smile contact our office for a cosmetic consultation. Rochester Advanced Dentistry 248.656.2020

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I was never happy with the way my teeth looked. I wasn't happy with the positioning, they were a little "bunny" like and I wasn't happy with the color. Being uncomfortable with your teeth can definatley change a person, often times you don't know how much being uncomfortable changes you until you are no longer dealing with that issue. For me the issue was my teeth. I was not interested in having braces at this point in my life so I opted for the easier faster option... veneers. In two appointments I had a new, beautiful smile. Before we began the veneer process I was able to see a wax mock up of what my new smile would look like. From that moment on I felt very confident that I was making the right decision. I couldn't be happier with my new smile. It has increased my confidence and changed the way that I interact with others. Click here for more before and after pictures Smile by Rochester Advanced Dentistry

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Lasers have been used in the medical field for many years. They have simplified complicated surgeries, reduced pain and promoted better; faster healing. Today we are seeing the same benefits in the dental field when lasers are used. How is a laser used during a dental cleaning?

• The energy emitted from the laser light sterilizes bacteria found in the mouth; one of the main health concerns in dentistry is bacteria entering the blood stream- this step reduces the risk
• Another setting on the laser allows your dental hygienist to kill bacteria deeper under the tissue, this bacteria is responsible for gum disease and periodontal disease, previously this bacteria was almost impossible to reach
• The laser is also used to remove diseased tissue allowing new healthy tissue to grow - previously this was done with metal instruments. The laser facilitates better, faster healing with less postoperative discomfort

Do laser dental cleanings hurt?

• No, the laser setting is very low so in most cases the patient doesn't feel anything, for patients with extremely sensitive gum tissue a topical or local anesthetic may be recommended to eliminate any sensation

What should I expect following the laser cleaning?

• Following a laser cleaning you may be instructed to use a special mouth wash or to avoid flossing the area for a day or two
• There are no physical or dietary restrictions following a laser cleaning
• There is no pain following a laser cleaning

If you would like additional information on laser dental cleanings or to schedule an appointment contact Rochester Advanced Dentistry 248.656.2020

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Have you ever thought about making your teeth whiter or changing the entire shape of them?? Porcelain veneers could be the anser you are looking for.

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