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Jackie, dental question

Posted by Elizabeth 
Jackie, dental question
June 26, 2017 03:48PM
My daughter, she lives in Florida, went to her dentist last week and they took a lot of x-rays, she said 18 of them. They took Bite Wing and Periapical xrays, she has had only one small filling in her life, she is now 60. They have now found a very small decay in between two teeth. I have never had that many xrays at one time, is that what they are doing now? I know you were a Dental Hygienist and can give me some answers.

Re: Jackie, dental question
June 29, 2017 09:04AM
Liz - Your daughter had a Full Mouth Series (FMS) which includes the standard bite wings. It's often done with new patients and many offices typically do the FMS every 4-5 years. It could be that they decided they'd never had a FMS so it was time to do it but it shouldn't be routine for her, given her age and dental history....unless there is evidence of periodontal disease.

The peri-apical xrays in the FMS provide a view of the root tips to evaluate potential abcesses and other problems such as impacted wisdom teeth, periodontal disease and bone loss. Bite wings assess the potential for decay in the interproximal surfaces (between the teeth) that may not be detectable by visual/oral exam. Hopefully, they used a lead-lined apron with a thyroid shield.

She can refuse another FMS if it happens again relatively soon or if there is a problem tooth, they only need one or two periapicals to rule out an abcess or periodontal pocketing. I worked as a temp/fill-in hygienist for several offices at one point in time and I was surprised how many offices did FMS every few years... apparently just adding revenue. But, as I commented, it's important to have at least one baseline for documentation and comparisons later on if bone problems develop.

Re: Jackie, dental question
June 29, 2017 03:18PM

Thank you for your reply----she has been going to this dentist for a few years, she doesn't have decay but a little problem with her gums. She goes more often to the dentist and cleans her teeth and gums throughly, she can't take too much of a vitamin C supplement because her iron level is a little over the range, so she has to watch that. She went to give blood, as that would decrease the iron level, and they wouldn't take it because she is a little below the weight, she has always weighted about 105 her entire adult life.

Now me, my gums are fine but I have had a lot of decay and fillings. I have been going to my dentist for about 25 years, he is great, but i have never had a FMS, just bite wing xrays.

Re: Jackie, dental question
June 29, 2017 03:48PM
Liz - You are welcome.

If the hemochromatosis or 'iron overload' reaches a certain level, typically, they have the patient do a formal blood draw aka phlebotomy ...not for donation but just discard the blood so the iron levels are safe so the patient doesn't have complications. It's just time-consuming, but good to have the periodic evaluations. Here, they do it in a specific hospital setting where they have chairs set up for those receiving chemotherapy and they just schedule time in the chairs for those having the phlebotomy.

On the periodontal issues, it's good to have at least a baseline FMS so they can keep track of bone loss and decide when or if bone-fill may be needed to help avoid tooth loss or other future issues. They'll keep an eye on the trouble areas and probably only take single xrays where needed to watch for progression.

I wish her well with both issues.

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