The Affordable Dentist

The Affordable Dentist

by | Dec 5, 2011 | Cavities, Cavity, Cosmetic Dentistry, Dentistry, Periodontal Disease, Tooth Decay, Toothache

Let’s face it: seeing a doctor – any sort of doctor – can be expensive. And dentists are no exception. But if a person’s diet and home care have been lacking, the cost of dental treatment can quickly sky-rocket. One of the problems with dental care has to do with the fact that many patients still suffer from the idea that if they don’t feel anything wrong with their teeth, then all is well.Broken piggy bank

Unfortunately, when it comes to teeth, most people miss the boat entirely with this concept. The reason is simple: the outer part of the tooth – the enamel – is mostly mineral and has no nerves. That means you can have a cavity and not know it. Several, actually. Most dentists will attest to the fact that many patients are shocked to learn they have any cavities at all.

The trouble is that by the time a cavity actually gets big enough to pose a problem, it’s a PROBLEM. For most people that trouble is spelled P-A-I-N.

It’s really no small wonder that so many individuals associate going to the dentist with toothaches. For those patients, it is the only time they will actually make an appointment. They go because they now know they have a cavity. Pain is a huge motivator. . . .

By the time a tooth hurts, though, the cavity is usually pretty close to the nerve. This means that if there is still enough tooth structure left to work with, the dentist may consider a root canal to remove the source of the pain – in other words – the nerve. Usually, this is not cheap. A root canal on a molar can cost over a thousand dollars when performed by a specialist. Then the patient has to go back to the dentist to have the tooth built up again (because so much tooth structure was lost to decay) and finally, the tooth may even need a crown. Lacking a blood supply and nerve thanks to the root canal, the tooth is now brittle and can break. Since your back teeth get a lot of pressure when you chew, failing to crown it may result in the tooth cracking and all that money you spent on the root canal goes out the window.Cracked Tooth

In a number of cases, because many people simply fear getting a root canal (not because they actually had one, but because they heard that a friend of a friend had a bad experience, and they never want to go through THAT), they opt to remove the tooth instead.

But now they have to replace the missing tooth or else their teeth will shift around and their bite goes awry. And fixing that new problem typically costs even more!

It can be frustrating.

Many people figure no one will see a missing back tooth, so why not pull it, since that is cheaper? At least they think so – until they notice their front teeth starting to form gaps, and find that food gets stuck all over the place whenever they eat. But then again, what if it’s a front tooth that needs to go?

You possibly think: “Wow, this is a problem, but I still really need to find something cheap.” OK, then. If you live in Philadelphia, you may Google “affordable Philadelphia dentist” or “cheap dentist.” A number of listings for dental implants appear, maybe some for “affordable cosmetic dentistry.” Wow, this isn’t sounding at all affordable!!! Wait! A couple of dental schools come up too. “Hmmm. Do I really want someone in their first year of dental clinic restoring my front tooth? It will be less expensive. But, then again . . . .”

Affordable DentistThe affordable dentist is someone who will understand your situation and can help you to find a workable solution for your circumstances. Many offices offer low-cost or interest-free programs that help you get the work you need today and then spread payments out over time. In some cases, it may be helpful to set up a lay-away program, especially if you have specific needs for which you have been given an estimate of treatment costs. In this manner you won’t end up spending your money on other less-essential items. Many offices will assess a minor fee to manage this plan, but it is usually quite small.

In the meantime, it is essential to keep yourself out of trouble with good preventive dental practices. Learn what diet has to do with your teeth and which home care habits are best. Remember, when it comes to teeth and gums, “no pain” most definitely does not always mean “no problems”.

The Top 5 Ways To Avoid A Dental Emergency

The Top 5 Ways To Avoid A Dental Emergency

by | Dec 2, 2011 | Cavities, Cavity, Dentistry, Periodontal Disease, Tooth Decay, Toothache

“If it ain’t broke, don’t fix it.”  Isn’t that how the saying goes?

Well, when it comes to teeth, most people really can’t tell if it’s broken.Tooth Pain

Consider these interesting dental tidbits:

  • Periodontal (gum) disease is the number one cause of tooth loss world-wide. That’s basically a condition in which you lose the bone that surrounds your teeth, so that even healthy teeth may fall out.
  • Most people who get cavities diagnosed by their dentist didn’t have any idea that they even had a cavity.
  • A substantial number of patients who clench or grind their teeth — resulting in worn-out, chipped, and cracked teeth — swear that they don’t.
  • Some patients who come into a dental office convinced that they have a cavity because of pain, actually don’t have a cavity at all.

What the heck?! Yeah, it can get a little confusing, and that’s probably why at one point or another many people find themselves confronting a dental emergency. Some emergencies are simply the result of accidents. After nearly twenty years of practice, I have seen quite a lot of these too. But in reality, the vast majority of dental emergencies are simply caused by neglect. So here are a few tips on how to stay out of trouble:

1. Never open anything with your teeth. Just don’t do it. I have restored countless teeth after people tried to open or hold objects with their teeth. It’s not worth it. Grab a scissor, pliers, bottle-opener or whatever you need to do the job. Your teeth were made to chew your food.

2. Use an athletic mouth guard if you play sports. Sports are fun and can be great exercise. They can also cause teeth to get punched out, kicked out or knocked out. Use a professionally made mouth guard if you play sports.

3. See your dentist regularly. Some things can even be tough for your dentist to detect. Unless you have x-ray vision and can see inside your own head, you will never know if you have decay between your teeth until it is so large that it starts to look ugly or pieces of the tooth actually fall apart. Also, you don’t want your first realization that you have periodontal disease to come from noticing that your teeth are loose. Your dentist should also be checking for oral cancer at your examination visits. If you have it, early diagnosis can be a matter of life or death.

4. Brush and floss your teeth daily. There is simply no substitute for prevention. Brushing your teeth after every meal and flossing at least once a day goes a long way in protecting you from oral diseases — not to mention bad breath.

5. Wear a custom night guard if you grind or clench your teeth. Bruxism — the term used for the grinding or clenching of teeth, has been observed by dentists to be increasing in frequency among their patient populations. No doubt, stress has a great deal to do with this, but if you have been diagnosed with bruxism don’t take it lightly — because your teeth won’t either. I have also noticed a significant rise in bruxism over the last 10 or so years and its effects can be devastating.Emergency Dental Care

Oh, and that emergency dentist you were thinking of using. You know, you saw the billboard on the way to work. He’s the one that is willing to see you 24/7. So, in the worst case scenario, you will have someone to go to, right?

I wonder how many people he has actually treated at 3:00 AM? If it happens at all, I’m certain it doesn’t happen often. Sure, you can CALL him 24/7, but you’ll be seen at the first opportunity. And if he does agree to see you after hours or on a weekend, it will likely cost you a few extra hundred in addition to the cost of your treatment. By the way, be prepared to bring cash, because he may not accept checks or a credit card from a brand-new emergency patient.

The moral of the story is simple. Use common sense and just don’t let things get that far along. If it has been more than six months since you have seen your dentist (unless you have full dentures) you are over-due. Even patients with dentures should see their dentist at least once a year to check the fit of their dentures, be evaluated for adjustments or relines, to have the dentures cleaned, and to check for oral cancer.

How long has it been since your last dental visit?

Why You Might Have a Cavity Without Even Knowing It

Why You Might Have a Cavity Without Even Knowing It

by | Jul 14, 2011 | Cavities, Cavity, Tooth Decay, Toothache


Another cavity?!

Consider this article a public service announcement. I really dislike seeing patients lose teeth to tooth decay that could have been prevented.

My philosophy is simple: if a patient has a dental problem, I address it—but just as importantly, I give them the tools and knowledge to prevent future issues. Ideally, most visits after that are just for routine maintenance.

Why You Might Have a Cavity and Not Even Know It

Unfortunately, I often meet new patients with teeth so badly decayed there’s little chance of saving them. Just as frequently, I see people who finally schedule a checkup—often after years away from dental care—shocked to learn they have cavities. Many assume they lost a filling, when in fact, a chunk of enamel has broken off.

So why the surprise?
Most people believe cavities are supposed to hurt. Sometimes they do. But in the early stages, they’re usually painless. By the time a tooth actually hurts, the cavity has likely reached a serious stage. Often, I’m deciding whether to attempt a root canal—or whether extraction is the only option. A basic understanding of dental anatomy helps explain why.

Scroll down to the illustration below.

The outer layer of your tooth—enamel—is the hardest substance in your body. It’s made to last a lifetime and helps you chew your food efficiently. But here’s the key: it doesn’t have nerves. Enamel is more than 95% mineral. The rest is water and organic material. Because it lacks nerves, it doesn’t feel anything. That’s useful—you wouldn’t want pain every time you bit into food. But it also means decay can silently destroy it without causing any warning signs.

Even when decay reaches the underlying layer—dentin—you may still feel nothing. Only when it approaches the soft center—the pulp, where nerves and blood vessels live—do you usually feel pain. By then, the damage from a cavity is often extensive.

To make matters worse, decay doesn’t spread in a straight line. Take a look at the black triangles in the diagram. A cavity often starts at a small point on the outside and fans out wide inside the enamel. The tooth might look intact—until the undermined enamel collapses due to internal damage.

diagram showing cavity progression through enamel and dentin toward the pulp of a tooth

How Dentists Detect a Cavity Early

Cavities often form between teeth—places you can’t see. Even I need x-rays to catch them in those areas. Dentists rely on visual checks, dental probes, x-rays, and sometimes laser detection to find decay. Even then, spotting it under old fillings can be tricky.

Modern dental technology has made early cavity detection far easier. Digital x-rays produce high-resolution images with minimal radiation. Laser-based devices, such as DIAGNOdent, can detect tiny lesions before they become visible to the eye. These advances allow dentists to restore enamel with less invasive procedures—often saving the tooth before it ever hurts.

Preventing Future Cavities

Regular dental visits, daily brushing and flossing, and a balanced diet are the best ways to stop cavities before they start. Using fluoride toothpaste and limiting sugar intake help protect enamel. If you’d like to learn more about keeping your enamel strong naturally, read this related article.

Another simple habit that makes a difference is drinking water throughout the day. It rinses away food particles and helps neutralize acids that can erode enamel. If you sip coffee, soda, or juice often, consider rinsing with water afterward. Saliva production also matters—dry mouth, caused by medications or dehydration, increases your risk of cavities.

For people prone to recurrent decay, your dentist may recommend professional fluoride treatments or prescription-strength remineralizing pastes. These can rebuild weakened enamel and reduce sensitivity before a cavity takes hold.

The Takeaway

If someone you care about hasn’t seen a dentist in a while, ask them to read this article. You might help them avoid discomfort, costly procedures, and even tooth loss. Don’t wait for pain to signal that something’s wrong—a silent cavity can be far more damaging than one that hurts.

And for those thinking, “If it gets bad, I’ll just pull it,”—well, sometimes that’s necessary. But that’s a conversation for another day.

🦷 Learn more: How Cavities Form – American Dental Association

diagram of a cavity forming in a tooth between the enamel and dentin layers
I Didn’t Have A Toothache Until The Dentist Filled My Tooth

I Didn’t Have A Toothache Until The Dentist Filled My Tooth

by | Jun 26, 2011 | Cavities, Cavity, Dentistry, Tooth Decay, Toothache

I have been practicing dentistry for just over twenty years. In that time, I have had strangers, friends and family ask me questions about their dental problems. Maybe this question is one that has come up for you too. One of the more frequent queries I run across goes something like this:

“I recently went to the dentist and I was told I needed to have a filling done. It didn’t bother me before, but it does now – and what’s more, I’m being told I’ll probably need a root canal! Did I mention the tooth wasn’t bothering me? But now I’m looking at over $2,000 in dental bills, because once I’m done with the root canal I’ll have to put a crown on the tooth!”

Are you thinking, hmmm, that darned dentist probably should have just left the tooth alone?Toothache

Yeah, that’s usually what they are thinking too.

One of the first questions I then ask is: “Was there already a large filling on the tooth?” Invariably, the answer has been “yes.” In which case, my response is usually “Well, then, it’s really not that unusual.”

The first thing to understand is that the tooth was already treated before. The fact that it already has a large filling, suggests that either the original decay was extensive or it had to be replaced several times. Depending upon the location in the mouth, and severity of pressure placed upon the teeth, fillings do require replacement. Teeth are also not immune to new decay and larger fillings do not typically last as long as smaller ones.

So, picture a filling that originally came close to the nerve. Now, there is either new decay between the old filling and the remaining tooth structure – putting it even closer to the nerve – or there may be a fracture occurring between the tooth and filling because there is not enough enamel left to support the filling. Either way, the nerve is under assault.

The next comment is usually “Well, since it wasn’t bothering me, shouldn’t he have just left it alone?” Trust me, this is not a favorite situation for your dentist either. If he leaves it alone, the likelihood of it turning into a root canal is higher. Then the question becomes “why didn’t he tell me about it sooner?” And if it doesn’t turn into a root canal the patient risks losing the tooth if it fractures. So, really, the tooth’s chances of remaining calm are better if it is treated sooner.

Probably the biggest problem here is the omitted communication. Most of the time, the patient simply wasn’t told there would be a risk of post-operative sensitivity. While the dentist can’t entirely control whether the tooth will recover from a deep cavity or not, it helps when the patient knows there is a chance of later discomfort. The moral of the story: don’t put off your dental treatment. Small cavities conserve more tooth structure and seldom bother you afterwards. Large or deep feelings always put the tooth at risk of more treatment or greater discomfort.