Very often the ideas that I have for articles in this blog come from real-life experiences in my dental practice. One of the things that caught my attention most recently was the prevalence of patients who come in for emergency treatment of broken dentures (typically rather old dentures) and who only have the single set to work with.
Now this creates a real problem for them because it is difficult to go out in public without teeth. People at work who may not know they wear dentures will suddenly become acutely aware of the fact. This can create considerable embarrassment and, even for a retiree, is often enough to prevent attendance at important milestone events such as a graduations, weddings, or anniversaries.
Some repairs can be handled quickly and relatively easily in the office, whereas others have to be sent to a dental laboratory. Depending upon the severity of the problem, that can take time: days, or even up to a week with certain types of dentures.
If you don’t wear dentures, this post may not appear to have anything to do with you. That is, until your mother, father, or grandparent call you in a panic, reporting they just dropped and broke their denture. (Or lost it.) You may find yourself pressed to leave work to bring them to the dentist’s office.
While it may be easy to say that every denture wearer should have a spare set, I understand the economics of the situation. Since I started practice some 20+ years ago, I have seen the cost of producing dentures nearly triple. Nevertheless, there are still many good reasons to think about having a spare set made.
Very often, when making a new denture, your doctor can manufacture a spare set at a reduced cost because he does not have to do the work twice. Similarly, an “economy” version can sometimes be produced by the laboratory which can make a duplicate of your existing denture. It may not be as cosmetic or “perfect” as the original, but it sure is nice to have something to go out and eat with while your main set is being repaired.
And sure, a denture costs more than your average article of clothing — but can you imagine having only one set of pants?! How do you even go out to buy another if you lose it? I suspect that even people who wear hair-pieces have back-ups. They may not want to go out in public without hair, but at least they can still eat.
If you or a loved one only have one denture, seriously consider a spare. And if the denture is older than seven years, it is a good idea to think about a new one. (For more information about why this is recommended check out another one of our blog posts on the subject.) No one needs the stress or embarrassment caused by having to be without teeth.
What?! Is the sky falling? What dentist would dare utter such blasphemy!
Stick with me for a moment. You may learn something about flossing.
Here are the facts as I see them after more than twenty years in dental practice:
Most patients don’t floss. Most patients don’t like to floss. Most patients won’t floss even if you explain the benefits of flossing at every checkup visit for ten years. Most patients are convinced flossing makes their gums bleed and is uncomfortable to do. Most patients will tell you they floss, but “probably not as much as I should.” So really, why bother?
Another observation I have made about flossing regards what people think flossing is. I will sometimes hand a patient a piece of floss and ask them to show me how they floss. Without exception, I have seen patients pass the floss between their teeth and then pop it back out.
That sounds right, doesn’t it? Special effects department please sound the buzzer. That’s not flossing.
Add to this the fact that most patients will only perform this routine once in a while. If you call that “flossing” I say don’t lose sleep over the fact that you are not flossing regularly. That can be effective at pulling food out from in between your teeth, though, so feel free to do so. But if that’s not flossing, just what is it, really?
Flossing is the action of taking a length of floss – either the conventional “string” kind or pre-threaded on a fork-like device – and then passing it between your teeth while holding it in a “C-shape” against the side of the tooth. You then take the floss and rub the edge of the tooth, sliding it all the way under the gum-line in an up and down motion. How often can one do this? After every meal would not be too much. But if people did this at least once a day, the average case would see dramatic results after an average of two weeks of daily flossing.
If you haven’t been flossing regularly here is what you can expect: your gums will bleed when you start to floss. It is also likely to be a little uncomfortable at first. But over time, the bleeding should stop. If you haven’t had a dental checkup and cleaning for a while, it is a good idea to do so this first. Flossing against existing tartar will be an unending battle. Once the teeth are clean, however, daily flossing will usually result in pink, firm and healthy gums that don’t bleed. Other benefits? Fresher breath and reduced inflammation – which also means a lowered chance of heart attack and stroke.
If you only floss once in a while, though, inflamed gums will likely never get up to a point where the occasional activity makes any difference. So, if you don’t make it a discipline, why bother? But if you would like healthy teeth and gums for a lifetime, start flossing today!
Did your last dental checkup find you sinking lower and lower into the dental chair with each cavity your dentist found? If so, one of the first questions you may want to ask yourself is this: are soft drinks a big part of your daily routine? If you answered “yes”, you may want to re-think your dietary habits.
Some of the worst cases of dental decay that I have seen involve sodas, or sweetened (prepared) iced tea. One 12 oz. can of soda averages about 12 teaspoons of sugar. That’s basically liquid sugar. Just cut it out. Read the ingredient list on the bottle or can. Be aware of added concentrates, syrups and juices used to sweeten the drink. If it states high fructose corn syrup (HFCS), read “sugar”.
Imagine sitting next to someone in a restaurant or diner as you watch them put a teaspoon of sugar into a mug of coffee. Then they proceed to put in eleven more! You might just do a double-take.* And yet most people don’t even blink when consuming a can or bottle of soda. Many children (and adults) drink it by the liter.
Aside from the sugar that soft drinks contain, you are essentially giving your teeth an acid bath every time you drink a can or bottle. It’s pretty strong stuff. I understand some cola will loosen rusty nuts on bolts, or even clean battery terminals! Just try to keep it out of your body. If you need help weaning yourself off of the sugar, speak to your doctor about it right away. You will be happy to know there are healthy alternatives. Apart from enamel erosion, drinking soda has been linked to diabetes, formation of kidney stones, osteoporosis and even low potassium levels with associated muscle weakness.
Cutting back on (or preferably eliminating) soda may be one of the most significant things you can do to help your teeth – and the rest of your body.
When we are young our teeth make their way into our mouths through a process known as tooth eruption. How do they know when to stop erupting? Basically, they keep going until they find the opposing tooth. But what if we lose a tooth? Much like a computer program, the tooth opposite the missing one starts looking for the tooth that it is supposed to chew against. If it can’t find i
t, it may erupt all the way to the opposing gum. It’s not that the tooth is growing. The bone below (or above it) moves it into position. Of course, at this point, it’s in the wrong position, and entirely new problems often start to appear.
If this were all that happened, we would have enough to worry about in terms of our ability to chew our food well. This is important for good digestion and nutrition. Unfortunately, when teeth border an empty space they also have a tendency to try to drift into it. This means that teeth may drift forward or backward toward the spaces. Perhaps this is nature’s way of distributing the load now that one of the soldiers has fallen. It is an engineering marvel, but it can become a chewing nightmare.
While all of our teeth are important, structurally, the loss of certain teeth will bring about more change than the loss of others. Think of this in terms of the walls of your house. If you take down a non-supporting wall, the house will still stand. Take out a supporting wall, however, and you have a bigger problem. Teeth are constructed much like an arch, though. If you have ever seen a stone arch, you know it has a keystone at the top that keeps the arch together. Remove that one stone, and the whole thing collapses. In your dental arch, you can think of your canines as a keystone. Lose them, and the ensuing change is rapid. If your teeth were straight, they often won’t be for too much longer.
So, why then, do people lose teeth? The most common reasons that I see are:
Periodontal disease – this is sometimes also referred to as “gum disease” but is really a condition more directly affecting the bone. This is the result of a bacterial infection leading to the permanent breakdown of the bone surrounding the teeth. It is actually the most common form of tooth loss world-wide. Because it is generally not painful, often people have no idea that they have periodontal disease until their teeth start to get loose and fall out.
Tooth decay – this is what many people think is the main cause of tooth loss. And while it is true that tooth decay often does lead to tooth loss, it follows periodontal disease in terms of frequency.
Habits – this is the type of tooth loss that results from such things as tooth grinding or clenching. This area is one in which we often see a “domino-effect” of problems. Sometimes clenching or grinding starts with the loss of a single tooth or an accident resulting in a spinal misalignment. At other times, it may be due to stress, a deficiency, or genetic structural anomaly. In any of these cases, if the grinding or clenching results in the wear of your canines (those “key-stones” again), you may find yourself wearing down ALL of your teeth more rapidly. They are pointy for a reason. When you slide your teeth to the side, they are supposed to keep the back teeth from touching. If they wear down to the point where all of your teeth touch in all directions it is possible to wear them all down. Over the years I have had cases where what brought the patient in to see me in the first place was that they wore down their teeth to the point where they exposed their nerves. (Ouch!)
Accidents – this speaks for itself. And it happens. It may be a sports injury, car accident, a fight, or biting into something hard – but if it breaks off enough of the tooth, it can need to be extracted.
Whatever the cause, if you lose a tooth, you should speak with your dentist about replacement options. Together you can discuss the choices that are best for your circumstance. Where possible, try not to delay correcting your bite for too long. The additional changes that may occur with your bite over time can limit your choices or cost you more to correct. While a nice, straight smile may be desirable cosmetically, a good bite is also important for health and function.
There are a number of factors that can contribute to the formation of dental cavities. One fundamental that will apply to most everyone concerns the reduction of dental plaque. If you want fewer cavities, reduce your plaque levels.
Dental plaque can be defined as a complex microbial community, with greater than 10 to the 10th power bacteria per milligram. (That’s really a lot of bacteria.) Just to keep things simple, though, the problem is that these bacteria produce acids on your teeth – and the acids dissolve the enamel, leading to tooth decay.
After only a few years of practice, it became obvious to me that most people have difficulty identifying plaque. Even now, I’ll begin a dental exam or cleaning on a person and start removing large areas of plaque. If I casually ask the patient about their cleaning regimen, often I’m told “I brushed just before I came in here!”
Since that much plaque can’t form in an hour, the obvious conclusion is that the patient missed it or simply doesn’t see it. Just to be clear, plaque is the soft, sticky film that occurs on the surface of teeth – not the hard substance your dentist or hygienist has to pick away, which is tartar. Though it is basically mineralized plaque, virtually no amount of tooth brushing and flossing will remove tartar after the fact (dentists call it ‘calculus’). Once formed, calculus needs to be removed at your office visit.
It is useful to know that if you control your plaque well, calculus won’t be much of a problem. So let’s focus on that for a moment. What do you do if you feel you are brushing, but the dentist tells you he still sees plaque? Stain it!
Lately, I have been seeing more commercials advertising products for children that stain their teeth blue after they have rinsed with it. The child then brushes until all of the blue stain has been removed. What the liquid is staining is plaque. I think this is a great way to simplify the process of identifying the problem. Whether you are six or sixty, the principle is the same.
If you want to be certain you have gotten the plaque off, rinse with the stain after each meal and then brush (and floss) until you have removed the discolored areas. Barring other systemic or external contributory factors (such as medications leading to a dry mouth), you and your dentist should see a big improvement in the cleanliness of your mouth, and fewer cavities over time!
Dr. Richard Walicki is a dentist practicing general and cosmetic dentistry. While we hope you find the information contained herein interesting and useful, this blog is for informational purposes and is not intended to diagnose any oral disease. Dental conditions should be evaluated by your dental health professional or a qualified specialist.
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