by Dr. Richard J. Walicki | Jul 9, 2016 | Cavities, Cavity, Communication, Dentistry, Prevention, Tooth Decay, Tooth Loss, Toothache
I have little doubt that some patients who visit a dentist and are told they have decay, but don’t experience any symptoms, are convinced that someone is trying to pull the wool over their eyes. There are probably several reasons for this. Possibly, they had been to some unscrupulous person in the past who suggested they had a problem, when they really didn’t.
I can see how that might create skepticism. I mean, it’s conceivable that sort of thing could happen.
But even if that were the case, I sincerely don’t believe it represents the behavior of a majority of dentists. Most of the dentists I know genuinely care about what they do and the people they treat. So maybe these skeptics are just people who don’t trust anyone. I don’t know.
The reality, though, is that these patients will eventually be in for a big surprise when the you-know-what hits the fan. Or – and let’s keep this a family column — when the decay hits the nerve.
But that could take a while.
And I believe that could be where some of the problem lies. A patient tries to use this to their advantage — they want to buy some time. After all, it’s not really being a “problem” for them in that they don’t perceive anything as being different. When the problem eventually does occur, I usually hear: “I never thought it would happen to me.”
A doctor detecting treatable decay usually recommends that the patient handle it at their earliest opportunity.
Why? Well, the patient can catch the problem when it is small, when it is less likely to cause post-operative discomfort, and when it will generally cost them a lot less.
But, first, let’s back up a little and explain why it’s possible to have a cavity – several in fact – and have absolutely no symptoms.
Most decay starts on the outer surface of the tooth called the enamel. It’s roughly 97% mineral in consistency and does not contain nerves. That means it has no feeling. Practically zero. Your dentist could DRILL on that part of the tooth and most of the time you won’t feel it.
Notice that in the earlier paragraph I mentioned “treatable” decay. Well, when would decay not be treatable right away? I can’t speak for other dentists, but I typically won’t treat decay when it is confined to the enamel. Why? It has the potential to re-mineralize. In other words, it has the capacity to fix itself – that is, if you don’t continue to do the things that led to the cavity in the first place. Usually, this is related to your diet, but it can be affected by hormones, or even medications.
Why not mention home care first? Isn’t that important too? Of course it is. It just may not be the most important factor.
Another time a dentist might not treat a cavity could relate to the age of the patient. For a much older patient, there are times when the pain or infection are not likely to come up before the patient passes. Of course, your dentist doesn’t have a crystal ball on that point. (Well, probably not.) But, it wouldn’t make sense to recommend treatment in the majority of those cases.
And this takes us back to the nature of a cavity. They often take a long time to get bigger. (But not always…. Again, no crystal ball here.) The reason has to do with the hardness of the enamel itself. Enamel, for you trivia lovers, is the hardest substance in your body. It’s harder than bone, and that property, along with the lack of sensation, can be problematic.
Here’s why: a cavity is often quite small on the outside of the tooth. It’s actually difficult for decay to work its way through that hard enamel. Most of the time it burrows a narrow channel down to the dentin (only a couple of millimeters away) and then it really starts to spread. Because dentin is softer than enamel, it’s just easier for it to spread more quickly there. By the way, this additional, and deeper, decay – very often still doesn’t hurt – as long as it is far enough away from the nerve.
Meanwhile, your enamel is, for the most part, continuing to hold its form. That stuff is hard. But things are generally hollowing out on the inside of the tooth now — out of sight and out of mind — as the decay continues to spread. Painlessly.
Eventually, your tooth can become very much like an eggshell.
Then one fine day you bite on something, and the hard enamel that was still doing its job holding the form of the tooth caves into the hole below. It just got too thin.
Now, at this point, does the skeptic understand that he got a cavity? Sure. Some of them finally get it. But for others –no! It’s more like: “Hey that blowhard dentist was obviously wrong because he talked about me having cavities years ago, and look – I did fine until now. In fact, I probably just lost a filling! Jeez, this hole just came out of nowhere. It’s probably the fault of some earlier dentist.” (Um, Mr. Skeptic never got the filling though. Remember?)
“Hey doc, how much is this going to cost me? $2,400?!!! (For a root canal, buildup and crown.) Are you insane? Just pull it.”
Now you are going to be missing a tooth, and may lose even more teeth as a result. Yet, when the doc first mentioned it, that cavity was only going to cost $150. How can it suddenly become sixteen times more expensive?!
“Rip-off artist. Seems you can’t trust anyone. . . .”
by Dr. Richard J. Walicki | Jun 17, 2016 | Cavities, Cavity, Communication, Dentistry, Periodontal Disease, Prevention, Tooth Decay, Tooth Loss
The idea that losing teeth is an inevitable part of aging is a common misconception. While it’s true that tooth loss occurs more frequently among older adults, it’s not a foregone conclusion. With proper oral care and preventive measures, you can keep your natural teeth healthy and strong well into your later years.
Why Tooth Loss Occurs
Tooth loss can be caused by various factors, including:
- Gum disease: This is the leading cause of tooth loss in adults. Gum disease is an infection that affects the soft tissues around the teeth, eventually destroying the bone that supports them.
- Tooth decay: This is caused by bacteria that build up on the teeth and form plaque. Plaque produces acids that can erode the enamel, the hard outer covering of the teeth. If left untreated, tooth decay can lead to cavities and eventually tooth loss.
- Trauma: Injuries to the mouth or teeth can also cause tooth loss.
- Other health conditions: Certain medical conditions, such as osteoporosis and diabetes, can increase the risk of tooth loss.
Preventive Measures
The good news is that you can take steps to prevent tooth loss and maintain healthy teeth for a lifetime. Here are some key strategies:
- Practice good oral hygiene: This includes brushing your teeth twice a day for two minutes each time, flossing daily, and using a mouthwash.
- Visit your dentist regularly: For professional cleanings and checkups.
- Eat a healthy diet: Limit sugary foods and drinks, which can contribute to tooth decay.
- Quit smoking: Smoking increases the risk of gum disease and other oral health problems.
In addition to these general recommendations, there are some specific things you can do to protect your teeth as you age:
- Use a toothbrush with soft bristles: Hard bristles can damage your gums and enamel.
- Consider using an electric toothbrush: Electric toothbrushes can be more effective at removing plaque and bacteria than manual toothbrushes.
- Get regular fluoride treatments: Fluoride can help strengthen your teeth and prevent decay.
Myths about Tooth Loss and Aging
There are several common myths about tooth loss and aging. Here are a few of the most prevalent:
- Myth: Losing teeth is a natural part of aging.
- Fact: While tooth loss is more common among older adults, it’s not inevitable. With proper oral care, you can keep your teeth healthy for a lifetime.
- Myth: You don’t need to see the dentist as often as you get older.
- Fact: It’s important to continue seeing your dentist regularly for checkups and cleanings, even as you get older. Regular dental care can help detect and prevent problems early on.
- Myth: There’s nothing you can do to prevent tooth loss.
- Fact: There are many things you can do to prevent tooth loss, including practicing good oral hygiene, eating a healthy diet, and quitting smoking.
Losing teeth doesn’t have to be a part of aging. With proper care and preventive measures, you can enjoy a healthy smile for a lifetime. Talk to your dentist about ways to keep your teeth healthy and strong as you age.
Additional Resources
by Dr. Richard J. Walicki | Mar 7, 2015 | Cavities, Cavity, Dentistry, Medical Issues, Periodontal Disease, Prevention, Tooth Decay
The posting below is actually taken from our Weird Dental “Facts” section. It’s an assortment of dental trivia and facts — some true, some we’re not so sure about 😉 — but either way, we hope to entertain, as well as educate you, with our postings.
We’d also love it if you would subscribe to our YouTube Channel and add your comments. We love hearing from our readers and viewers. It helps us to find out what interests you and how we can make our content more relevant.
This dental fact was prompted by a recent television program I watched that discussed three of the top life-threatening emergencies. We hope you never find yourself confronting this type of problem, so here is the Weird Dental “Fact”:
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A dental infection can kill you.
Weird?
Perhaps.
But also true.
A toothache left untreated can, over time, develop an abscess. (An abscess is an infection that fills with pus and debris.)
Periodontal disease, left untreated, can also develop an abscess over time.
The trouble with many dental problems, though, is that in their early stages they are seldom painful.
In fact, sometimes, they aren’t painful even after they become more advanced. So people tend to put off treating cavities and gum disease hoping it will just go away or get better on its own. Then, when it does get worse, they will often put that off as well This is where it can get really dangerous.
One complication of a dental infection is called Ludwig’s Angina. It’s a type of infection that can travel from the roots of the teeth to the floor of the mouth and under the tongue. The infection can spread very quickly, creating a swelling that can block your airway or prevent you from swallowing. This can be life-threatening.
It can be cured with quick treatment that gets the airway open and with antibiotics, but sometimes surgical intervention is also necessary.
The better solution is to never let your oral health become so neglected as to allow the possibility of this type of infection.
by Dr. Richard J. Walicki | Apr 17, 2013 | Cavities, Cavity, Dentistry, Tooth Decay
And Lay Off The Soda
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.
by Dr. Richard J. Walicki | Mar 17, 2013 | Cavities, Dentistry, Periodontal Disease, Tooth Decay
When we are born we come into the world without teeth. Some of us leave the same way, but that really isn’t what nature intended.
When you are on a liquid diet having teeth doesn’t appear to be vital, since there is obviously nothing to chew. Nature pretty much handles a baby’s nutritional needs with mother’s milk. As we grow and begin to eat solid food, however, having and maintaining healthy teeth becomes an entirely different matter.
So when teeth become lost due to cavities, periodontal disease or trauma, the consequences for good health can become significant. Let’s not forget that digestion begins in the mouth. There are actually two forms of digestion – mechanical and chemical.
Mechanical digestion is the grinding and tearing of food, as in chewing, in order to increase its surface area. Creating a greater surface area means that there is a better chance that chemical digestion can do its job. In chemical digestion, enzymes react with the food to help break it down into simpler substances which can either be absorbed in the bloodstream as nutrients or passed out of the body as waste. This process of breakdown and assimilation occurs within the digestive tract – but it starts in the mouth with your teeth, tongue, and saliva.
Because a full set of adult teeth numbers thirty-two, it seems many people feel the occasional loss of a tooth is a relatively insignificant event. And while it is true that a person can still function with thirty-one, the long-term consequence of losing just one tooth can be more significant than most people realize.
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 much 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 can be rapid. You can lose several teeth – even all – over time. But it’s not just the loss of canines that creates a problem.
Losing a first molar, for example, can create a domino effect of changes in your mouth that can affect your ability to chew easily. It can cause shifting of the teeth in a manner that even affects the appearance of your front teeth. Or, it can lead to periodontal problems and the formation of cavities on portions of the teeth that might not have been otherwise affected before the loss.
The point is that if you lose a tooth, you should consult your dentist about what tooth replacement options are right for you. Today, we have many ways of providing functional replacements that can improve your ability to chew your food, maintain your good appearance, and keep you from losing still more teeth. Depending upon your circumstances and financial considerations, these replacements may include removable dentures, bridges (which are non-removable, cemented tooth replacements), or dental implants (think of them as artificial tooth-roots that have crowns, bridges, or dentures attached to them).
If you are missing a tooth, speak with your dentist about what tooth replacement options are right for your situation. Replacing a lost tooth early is often much less involved (and costly) than when you begin to experience the problems resulting from long-term neglect.
Now, at this point, does the skeptic understand that he got a cavity? Sure. Some of them finally get it. But for others –no! It’s more like: “Hey that blowhard dentist was obviously wrong because he talked about me having cavities years ago, and look – I did fine until now. In fact, I probably just lost a filling! Jeez, this hole just came out of nowhere. It’s probably the fault of some earlier dentist.” (Um, Mr. Skeptic never got the filling though. Remember?)
