Creating Healthy Smiles, One Smile At A Time

Tag Archives: Caries


The New York Times is always a good read.  Recently, in honor of April Fools Day, it ran a  series   that highlighted common misconceptions and sought to debunk some of these common myths. Check out misconception #5.

The misconceptions (in no particular order) are:

  • Exercise builds strong bones
  • In an asteroid belt, spaceships have to dodge a fusillade of oncoming rocks
  • The universe started somewhere
  • Spree killers must be mentally ill
  • Baby teeth don’t matter
  • Climate change is not real because there is snow in my yard
  • Migranes are psychological manifestations of women’s inability to manage stress and emotions

a2f8728d524365191783e23b8738836eI certainly can’t claim to be an expert on osteoporosis, the mysteries of space, psychosis, the environment or migranes, so I’m in no position to rebut or support any of these common myths.  But it is fair to say that I know a few things about Baby teeth.  And yes, they do matter!




“I don’t want my child to have any x-rays!”

“I think my child is getting too many x-rays and I’m worried about radiation”

These are just a few of the comments that we hear on a daily basis at our office. Parents are extremely concerned about the amount of radiation that their child is being exposed to, and instead of running from these important questions , our practice welcomes them and we spend a lot of time discussing their concerns.

digital-dental-x-ray-of-human-jawParents, like most individuals, have heard about the dangers of excessive exposure to radiation.  They have most certainly heard about the high levels of exposure when taking a chest x-ray, CAT scan, or MRI.  They have probably also heard that radiation exposure accumulates over a lifetime; hence, the more one is exposed, the greater the amount of lifetime accumulation.

The simplest explanation I usually give parents is that the amount of radiation a bite-wing x-rays  emits is extremely , extremely low – about 10 times less than that of a chest x-ray and 1000x less than a CT scan.  One of the more important things to consider is that  for we are also all exposed to radiation from natural sources all the time.  The average person in the U.S. receives an effective dose of 3 mSv (millisieverts is the scientific unit for radiation dose) from naturally occurring radioactive materials and cosmic radiation.

Radiation Type                                          Radiation Amount

Daily background radiation                     0.008 mSv

Single Digital Bitewing                              0.005 mSv

Digital Panorex                                             0.01 mSv

Cross Country Flight                                   0.03 mSv

Chest X-ray                                                    0.1 mSv

Chest CT                                                          7 mSv

Head CT                                                           2 mSv

To put things in perspective, a single typical dental x-ray is less than a day of usual background radiation, and a panoramic x-ray is 3 times less than flying a plane cross country. One chest CT is the equivalent of 1400 dental x-rays.  In fact, if one lived in higher altitudes such as in Colorado, you areSamolet-13 exposed to 50% (1.5 mSv) more background radiation than those of us at sea level (that’s the equivalent of 300 dental x-rays for those of you keeping count). Click here  for more information.

The takeaway from this data and the multitude of studies done on x-ray safety is one should not worry about the amount of exposure one gets from dental x-rays.  As shown, the amount of exposure is low, and the estimated additional risk of developing cancer as a result is negligible.

All things in life are about considering the cost:benefit ratio. The cost of not taking a dental x-ray is the inability to diagnose disease (dental caries) Lemieux-Dental-Decayand allowing it to progress to a point where one is put at risk of pain, localized and systemic infection, and extensive treatment which could have been avoided.  The cost of taking an x-ray is…..well, as we have seen, is less than a day outside. One should note that people who live in Colorado get 50% more background radiation than those of us in Boston, are deemed some of the healthiest people in the United States, with cancer rates not being any higher.

Certainly, if you do have concerns about the need to take x-rays, I would encourage you to speak with your dentist.  There is a recommended schedule for taking x-rays – the key word here is recommended. There are certainly reasonable cases to be made for not taking x-rays routinely (ie. low caries risk, exfoliating baby teeth) which should be made on a case to case basis.





One never ever hears of a mouse developing a cavity.  That may be because they either never do in fact get cavities (ie. their teeth are somewhat resistant to decay) or that the NIDH (National Institute of Dental Health) has determined that federal funding for research is better off spent in other areas.

Or maybe it’s because they like cheese.

Let me explain.  A May/June 2013 article in General Dentistry, the peer reviewed journal of the Academy of General Dentistry (aka a pretty reliable source) found that cheese changes the pH of the oral environment, suggesting that it may imagehelp reduce the risk of tooth erosion.  If you remember High School chemistry, an increase in pH means the environment is less acidic. Studies have shown that a pH of over 5.5 lessens the chance of tooth erosion, and hence also cavities.

The study, which examined 68 subjects between the ages of 12 and 15, divided these subjects into 3 separate groups and tested their pH levels both before and after their consumption of sugar free yogurt, milk or cheddar cheese.   They found that a rapid rise in oral pH levels was found only in individuals who had consumed the cheese.  This could be because that the very act of chewing stimulates saliva production which in of itself causes a rise in pH.  The authors also hypothesize that there are compounds in cheese which adhere to teeth and are anti-cariogenic in effect.  What these ‘compounds’ are is unclear.

Further google sleuthing by us here at Dentistry For Children, did find that mice can indeed develop cavities. None other than the most famous mouse of all has had to seek out dental care, as shown by this 1938 sketch titled, “Mickey’s Toothache”.  We particularly enjoyed the animators portrayal of the dentist as a  bearded, one legged and saw wielding fellow, though we do take issue with the saw.


The takeaway from this sketch is that at least in Walt Disney’s mind, mice can get cavities and that dentists are kinda scary. Fortunately, we now know that if Mickey had stuck to an all Cheese diet maybe he would have had a fighting chance of having a cavity free life.


Parents often ask us, “At what age do you start seeing children?”  Most parents assume that their children don’t have to be seen until their child has all of their baby teeth, sometime around age 3 or so.  However, we recommend that all children be seen by age one, or within six months of the eruption of their first teeth.

Now while this may seem very early, we believe that “An ounce of prevention is worth a pound of cure”.  And we are not alone – the American Academy of Pediatric Dentistry, the American Dental Association and the American Academy of Pediatrics, all support the one year dental visit. 

Here are a few frequently asked questions about this all important visit:

– Why this emphasis on seeing my baby so young? He/She doesn’t even have any teeth!

   Good question! Cavities can form as soon as a tooth erupts into the mouth.  In fact, baby teeth are highly susceptible to developing cavities if not properly cared for.  “Baby Bottle Tooth Decay”  is seen in children who are put to sleep with a bottle full of formula. This puts the children at risk for significant pain, infection and damage to the developing permanent teeth.  And since, these children are too young to be treated in an office setting, treatment in a hospital under general anesthesia is oftentimes necessary.  We prefer to identify problems at an early age, and through simple recommendations, ensure a lifetime of healthy teeth.

– It doesn’t make sense to schedule an appointment if my infant is too young to have her teeth cleaned.

The age-one dental visit is analogous to a “well child visit” with the pediatrician.  The focus of this visit is on educating parents, discussing cavity prevention and performing a caries risk assessment.  It gives parents an opportunity to learn about proper home care, including brushing techniques, review of diet, proper feeding recommendations, malocclusion that can develop from pacifier use and thumb sucking, appropriate fluoride supplementation and caries prevention.  The goal of this visit is to provide parents with useful information that can be used to prevent cavities from forming in the first place.

– Does my insurance cover this year-one visit?

Most insurance plans do cover this visit.  However, you should check with your carrier to see if the ADA dental code D0145 (Oral evaluation for a patient under three years of age) is covered.