Don’t Wait for Tooth Pain to See Your Dentist

Don’t Wait for Tooth Pain to See Your Dentist

by | Oct 18, 2011 | Uncategorized

Recently, I saw four new patients in my dental office during a given week. All four of those patients scheduled their visits because they perceived pieces of their tooth chipping away. In three out of four of those cases, the offending tooth was so badly decayed that the tooth couldn’t be saved. Yet only one of those patients came in with any discomfort.

The common thread in each of these cases is that the patient waited until the tooth was actually breaking apart to seek dental care. All too often, the trigger that brings people to the dentist is pain. Yet here, we had at least three cases where pain was not a factor and yet the tooth was decaying.

How is this possible?

A little understanding of dental anatomy helps here. The outer layer of teeth, the enamel, is the hardest substance in your body. Because its composition is predominantly mineral, it is possible to have decay throughout that layer without experiencing any sensation. In fact, it is even possible for your dentist to drill that part of the tooth (in most cases) without pain. The next layer under your enamel is called dentin. Decay can travel into the dentin – where it usually spreads more quickly, because it is not as hard – and a person still may not experience pain.

By the time a tooth that is decayed hurts, the decay has generally travelled so far that it nears the innermost layer – the pulp. The pulp contains nerves and blood vessels – so, naturally, pain becomes a factor. If a patient is lucky enough to have enough tooth structure remaining, chances are that the tooth will need a root canal if it is to be saved. Otherwise, extraction is the usual alternative.

One lost tooth can lead, in turn, to still other dental problems. Most notably these include shifting teeth, TMJ problems, periodontal problems, cosmetic difficulties or simply difficulty chewing. It may even lead to the loss of more teeth – not to mention the fact that tooth replacement options can become rather expensive.

Hopefully, just understanding that a lack of pain does not equate to a lack of problems will prompt some readers that haven’t seen a dentist in a long time to do so. Sometimes people fear learning that they have cavities that need to be treated, and so they put off the examination. Consider, however, that it is better to learn you have five teeth that need fillings, than to learn you have several that have to be extracted.

 

The Basics of Dental Care

The Basics of Dental Care

by | Aug 7, 2011 | Uncategorized

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In almost any field there are basics, the fundamental facts or principles from which other truths can be derived.

Without an understanding of these basics we lack the building blocks for greater knowledge or competence.  For example, before we can write we learn our ABCs.   Geometry first requires an understanding of arithmetic, and so on.

Lacking these basics, we can become lost in a sea of information, lacking the correct drops of water that hold the answers to our questions or allow us to be effective.

Know the basics of automotive care and you are likely to have a car that runs well and needs few repairs.   Understand the basics of grammar and you can communicate.

What, then, are the basics of dental care?

While there are several key concepts which I cover in some of my earlier articles, there is one often overlooked principle I want to briefly cover herein.

Let’s first assume you are already in good dental health or, perhaps you weren’t, but now you got things under control.  You are starting off with a “clean slate.”  So, what do you do now?

The simple answer is taking a look at what got you there.

You spent months and maybe hundreds, even thousands, of dollars to handle dental problems that may not even have been causing you pain.  Things feel good and you have gotten the clean bill of dental health from your doctor.  What now?  Continue to do what fixed the problem.

  • Did you start brushing after meals?  Good.  Continue.
  • Did you change your diet to reduce refined carbohydrates?  Good.  Continue.
  • Do you floss every day?  Good.  Continue.
  • Do you come back for your regular visits?  No?!  Why not?

If that was a successful part of the formula, don’t make the mistake I see so many people commit.  There is probably many a dentist who will vouch for the fact that patients come in to them and say:  “Yeah, I had a bunch of dental work done somewhere about fifteen years ago and it is starting to come apart.”  When asked about the time of their last dental visit:  “Oh, it was around then.  Since my teeth were fine, it didn’t see the point of going in for a dental visit.”

Didn’t see – that’s a key point.  There are many conditions that the patient neither sees nor feels.  More importantly, dental health has a direct relationship to overall health.  So the fact that one doesn’t feel gum disease, bone loss, dental cavities or oral cancer – especially in the early stages is a poor excuse not to see your dentist.  Regular checkups are fundamental to defending yourself against serious problems.  Caught early, your treatment can be approached conservatively, saving you time in the dental chair, the potential discomfort of extensive work and, of course, money.

Why is it that patients who visit the dentist regularly seem to need less dental work?  I’d like to think it also has to do with their increased care and effort – but that effort includes keeping up with regular visits.  These checkups can prevent small problems from turning into big ones and help to keep your existing work in good shape.  Don’t be a penny wise and a pound foolish.  See your dentist at least twice a year.

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 that could have been saved.

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.

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 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.

Cavities also tend to form between teeth—places you can’t see. Even I need x-rays to catch them in those areas.

So what does all this mean?
Cavities don’t always show up with pain. Dentists rely on visual checks, dental probes, x-rays, and sometimes laser detection to find them. Even then, spotting decay under old fillings can be tricky.

Don’t wait for pain to tell you something’s wrong. If it hurts, the problem is already advanced—and the treatment will likely be more complex, more costly, and less predictable.

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.

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

Tooth Anatomy

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.

Cavities – Important Information

Cavities – Important Information

by | Jun 5, 2011 | Cavities, Cavity, Dentistry, Tooth Decay

Probably one of the most common dental misconceptions revolves around the idea that in order for a tooth to have a problem it has to hurt. Certainly, if a tooth is aching, we can agree that there is most definitely something wrong. But can a tooth have a cavity and not hurt you?  If so, should this still be a cause for concern?

Watch this short video to learn how this situation may have something to do with you.  CAVITIES 101