X-Rays and Radiation Safety

Although our office is full of technologically advanced tools and space-age materials, the most common conversation starter is our trusted x-ray machine.  Between hygiene checkups and emergency appointments, we are often asked "Are dental X-rays safe? Do I REALLY need another set?" The answer to both these questions is a resounding yes. After our recent post on adding the Dexis Dexsheild to our radiation safety protocol, we wanted to take a moment to explain what x-rays are, how they work and why they are some of the safest diagnostic tools available to the medical world.

Since the end of the atomic age, the word "radiation" has gained an increasingly worsening reputation. It is a scary concept; invisible and potentially harmful energy that can travel through walls. However, it is important to remember that radiation has always been around us since the beginning of time. The sun, the atmosphere and even large rocks all give off measurable radiation. This environmental exposure jumped drastically with the rise of consumer electronics. From your television to your toaster, most common household items contribute to the yearly radiation we receive. 

X-Rays are a subtype of radiation that has ideal properties for medical imaging. They have no mass or charge and travel in straight lines with fixed wavelengths. When they reach a material, they are either transmitted through, reflected or absorbed. This allows x-ray films to image biological tissues. A developed x-ray film tells us about relative densities of an object; denser materials will appear white, while empty spaces look grey or black. This allows us to visualize tooth decay, as the developed picture will indicate where the tooth structure has demineralized and become more porous.

When you receive an x-ray at our office, you are receiving a dose of radiation that is less than half the background radiation from a typical day. This equivalency falls drastically if you sunbathe or spend a lot of time outdoors without sunscreen. Our machines are calibrated to give the absolute safest dose possible to obtain a diagnostic quality image. This is not easy to achieve; both too much AND too little power can make an x-ray more harmful to a patient. Overall, dental and medical imaging (x-rays, CT-scans, MRIs) account for about 1% of the average yearly radiation a patient receives. We feel that this is an excellent trade for the incredible diagnosing power we gain from their use.

Pictured: some of the digital x-ray equipment at our office

While some products claim to match the abilities of x-rays without the drawbacks, none are as reliable, predictable or useful. For this reason, radiography machines are the gold standard in dental imaging around the world. The job of individual offices is then to keep their patients as safe as possible, to maximize quality while minimizing side effects. At Thousand Oaks Family Dentistry, we have many protocols that are focused on this idea. Our radiography system is fully electronic, from the beam timers to the digital sensors. This means we can deliver the lowest and most predictable level of radiation for every patient. This is followed up with a number of protective factors, from using lead aprons with thyroid collars, to our Dexsheilds and collimated (protectively enclosed) beam head. In every aspect, we meet or exceed the standards set out by the local and federal government.

If you still have concerns about radiation and why it is used in a dental setting, please give us a call. We know that radiography can seem intimidating or dangerous, and want to do our best to ease your mind. Our office is extremely confident in the safety and quality of the images we produce and would love to show you how and why we use them!

New Technology- DEXsheild X-Ray Sheild

The DEXsheild is a black ring that focuses the radiation produced by an X-Ray beam to the exact dimensions of our digital sensors.

When receiving medical, dental or pharmaceutical care, safety is everyone’s main concern. Adverse reactions, side effects and allergies can all make a treatment undesirable or unrealistic for your personal needs. As such, our office is always looking for new ways to minimize any potential risks while maximizing our patients’ wellness. Most recently, we have updated our X-Ray safety protocol to include the new DEXsheild radiation shield.

For starters, it is important to note that dental X-rays are an extremely safe and useful diagnostic tool. A standard dental X-ray produces roughly a quarter of the radiation you would receive on any given day. Yearly, it represents a negligible fraction of radiation exposure that our bodies absorb from the sun, consumer electronics and other sources. At our office, we further minimize any risks by utilizing high sensitivity digital X-ray sensors, radiation aprons with thyroid collars and modern X-ray beams. In short, we make sure every patient is safe and protected to standards exceeding those laid out by the ADA and other governing bodies.

The DEXsheild fits in to our current safety standards by narrowing the beam of radiation that the patient is exposed to. We have always used devices called collimated X-ray beams. Here, a thick metal tube essentially focuses the radiation produced by the beam to the oral region. While the sensor can detect and develop an image, the rest of your body is largely unexposed to any X-rays. The DEXsheild works by taking the place of a standard targeting ring (the red, blue and yellow rings we have on the outside of the sensor holders) and blocking the released radiation to the exact dimensions of the sensor. It essentially functions as a secondary safety apron, but for your mouth!

X-rays represent an indispensable tool at any dental office. The information provided from a few quick photographs can give us fantastic perspective into if a tooth is healthy, why it might be hurting or what we can do to repair it. We also understand that many patients are concerned about radiation exposure and want to know how we are keeping them safe. If you have any questions or concerns on ANY of our safety protocols, please give us a call. Our patient’s safety is our primary concern and we are happy to alleviate any of your worries!

Fluoride- The Facts

One of the most controversial topics in dentistry (and possibly all of healthcare) is the use of fluoride in our water supplies and dental products. What is it? Why do we use it? Could it harm my family? Today, we would like to take a moment to lift the myths and mysteries away from fluoride- a safe and effective measure for remineralizing and protecting teeth.

Fluoride (F-) is a negatively charged ion, similar to chloride ion (Cl-) in sodium chloride (Table salt). As such, it needs to be bound to a positively charged ion to exist as a solid mineral. This is why the labels on toothpastes and other dental products will list “stannous” fluoride or “sodium” fluoride as the active ingredient. The first part of the compound merely serves as a safe means of stabilizing the F- ion for delivery. Like table salt, when a compound with fluoride is dissolved into a solution, some of the ions will split into two, leaving a small portion of free floating F- ions.

The chemical mechanism by which Fluoride remineralizes and repairs is quite simple. The outer enamel layer of our teeth is essentially a crystal composed of calcium and phosphate. As acid, biofilms and bacteria break down this crystal, the calcium and phosphate become weakened and dissolve into our saliva. Fluoride works by encouraging the two compounds to reunite and incorporate back into the enamel. Similarly, If teeth are exposed to fluoride during development, the enamel tends to grow stronger and more resistant to decay. Scientific studies have also shown that fluoride inhibits bacteria’s ability to produce acid and stick to the teeth. This combination of effects makes fluoride an excellent candidate for fighting tooth decay.

Since fluoride needs to be in close proximity to the teeth to work, it’s effectiveness is dependent on exposure time and the not amount consumed. For example, swishing for 30 minutes with shot glass of fluoridated water would be more effective than gulping down a glass of fluoridated water in 30 seconds. Likewise, this is the reason toothpaste is not (and should not be) consumed for it to work ideally.

Since 2007, the water supply in Southern California has been fluoridated to a level of about 0.7 PPM (parts per million). The EPA suggests that any any fluoride level under 2.0 PPM is safe for consumption, while levels between 0.7PPM and 1.2PPM are ideal for medical effectiveness. As such, our water supply is well within safe limits. Additionally, some sources of water are naturally fluoridated without man made intervention. Here, governments and municipalities will occasionally have to de-fluoridate water before it is ideal for consumption. In addition to water supplies, many dental products and supplements contain fluoride in safe levels. Typically, any product advertising “anticavity” or “helps rebuild teeth” contains some amount of fluoride.

Although the medical benefits and potential risks of fluoride are well known and documented, some individuals feel that it is unsafe for human use. Common sources of fear are over impaired glucose metabolism, pineal gland hardening, poisoning and decreased cognitive ability. It is important to note that no reputable scientific journal supports any of these claims in regards to fluoride administered or used properly.

Many websites that quote scientific studies to prove the harms of fluoride typically cite outdated or unreliable papers, or do not understand (or relay) what the paper proves. For example, some studies have highlighted that fluoridated water can be dangerous when administered in extremely high levels. This is very true; large doses of fluoride can be quite harmful or even deadly, just like too much tylenol, alcohol or allergy medication. However, when used properly, fluoride is an extremely safe method of protecting our teeth.

In reality, the main concern with fluoride use and exposure is the onset of fluorosis in young children. As the adult teeth develop, overexposure to fluoride can cause white streaks or marks to appear within the outer enamel layer. This is typically found in children who start to take fluoride supplements at a very early age or are have their teeth brushed very often with too much toothpaste. To help prevent fluorosis, we recommend that children ages three and under should only brush with a smear of fluoride toothpaste, while ages six and under should brush with a pea sized portion. Your child should always be guided or supervised during brushing, to ensure they are applying toothpaste, spitting and rinsing properly. Extra fluoride supplements and treatments should be avoided, unless recommended by a dental professional. In general, fluorosis is generally a concern only until age 8, when the adult teeth have finished developing.

At Thousand Oaks Family Dentistry, we are firm believers in the efficacy of fluoride. We offer topical fluoride treatments for all patients with active tooth decay. In addition, we recommend ACT Fluoride rinse instead of mouthwash for our adult patients who have a history of cavities.  For those with aggressive decay, we offer a range of products that combine fluoride with xylitol, calcium and phosphate to arrest further cavities before they progress. In total, our entire spectrum of preventative recommendations incorporate fluoride to some degree. If you would like to know more about fluoride, how it works or why we use it, please call our office. We want you to feel assured about all of your dental health needs and choices!