The CAT scan is a relatively recent technique in dentistry, used to get an image of what’s happening deep within your jaws. You may be wondering what a CAT scan tells us that a conventional x-ray picture does not, and whether it is worth the extra expense to get one. And how does a CAT scan compare with a conventional x-ray in terms of radiation exposure?
CAT stands for “computer assisted tomography.” Often it’s just called a CT scan, for “computerized tomography.” The word “tomography” comes from roots meaning “slice” and “write.” Tomographic techniques take repeated two dimensional pictures, similar to repeatedly slicing through an object, and then assembles them with a computer to produce a three dimensional (3-D) image.
The latest type of CT scan used in dentistry is called CBCT, or Cone Beam Computed Tomography. The Cone Beam refers to a spiral beam of x-rays, which is used to create a series of two dimensional images from which a computer creates a 3-D image. Such an image is of great value in assessing problems and planning treatment.
Here are just a few examples of how a CBCT scan can be used. Orthodontists can see skeletal structures and developing teeth that are still inside the jawbone while planning strategies for directing the teeth in order to arrive at a better bite. Oral surgeons can find impacted or missing teeth, see their locations, and view their proximity to nerves and sinuses, assisting them in planning surgeries. These scans are particularly useful for root canal specialists because they show root canals that are less than a millimeter wide and even reveal accessory canals that may not be visible on conventional x-rays. In cases of sleep disorders such as sleep apnea, a CBCT during sleep can be used to view a person’s airway and how it may be blocked by the tongue and other soft tissues in a person’s throat during sleep.
Compared to background radiation, the amount of radiation delivered in dental x-rays is minimal. A CBCT delivers a dose of radiation that is less than a typical full mouth x-ray series but more than a typical two dimensional panoramic radiograph. Generally CBCT scanners deliver lower doses than medical CT scanners.
With one low-dose CBCT scan, we can get an accurate idea of the internal structure of your bones and teeth and how they are situated in relation to each other. Prior to the availability of such images, many of these relationships had to be discovered in the course of a surgery or other treatment. Thus such a scan can aid greatly in the quality of treatment you will receive.
Fans of the classic bumbling-buddies comic film “Dumb and Dumber” will surely remember the chipped front tooth that Jim Carrey sported as simpleminded former limo driver Lloyd Christmas. Carrey reportedly came up with the idea for this look when considering ways to make his character appear more “deranged.” He didn't need help from the make-up department, however… He simply had his dentist remove the dental bonding material on his left front tooth to reveal the chip he sustained in grade school!
Creating a Bond
A dental cosmetic bonding involves application of a composite filling material that our office can color and shape to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed. This is the quickest and lowest-cost option to repair a chip.
When a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it.
A veneer can be used to hide smaller areas of missing tooth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface also may be necessary to fit a veneer.
A chipped tooth makes an impression, but generally not a flattering one. Nearly 20 years after “Dumb and Dumber” hit the theaters, the only thing Jim Carrey had to do recently to hint at a sequel for his nitwitted character was tweet a photo of that goofy grin!
If you would like more information about repairing a chipped tooth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”