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When was the last time you had a dental exam?

When was the last time you had a dental exam?

by | Apr 12, 2017 | Cavities, Cavity, Dentistry, Fear, Medical Issues, Nutrition, Periodontal Disease, Prevention, Tooth Decay, Tooth Loss, Toothache

Many people believe that since they aren’t experiencing dental symptoms – like tooth pain or bleeding gums – then all must be well.

Unfortunately, a sizable number of dental problems, including cavities and periodontal disease (bone loss around your teeth), just don’t produce obvious symptoms in their early stages.  At least not symptoms that tend to be obvious to patients.

In fact, by the time people the average person experiences pain, his dental issue is typically pretty far along.  And all too often, by then, the problem can also be quite expensive to handle.

It might amaze you to discover the types of problems your average dentist encounters every week, many of which you would expect to be painful, but they just aren’t.  They can still result in tooth loss though.

Pretty much anyone who has ever worked in a dental office for any length of time will tell you this is so.  And they will tell you that you can inform some people that they have a problem, but unless it is “real” to them, they just won’t do anything about it.

They may come back a few years later (or maybe sooner) – usually with an emergency – desperately wanting to save the tooth that you told them about earlier.  Of course, by now, it may be too late.  And very often they will have forgotten it was ever discussed at all, because it was never a realistic problem for them to begin with.

Human nature can be funny that way.

So, keeping that in mind, it’s generally a good idea to get checked out by a dentist.  Regularly.

The best news you can hear is that everything looks great.

But sometimes getting a confirmation that you don’t have cavities or gum disease is not the only reason to get a dental exam.  Over the years, I have detected cancer (not just oral cancer) – as well as a host of other non-dental problems – that might have been overlooked had the patient not scheduled an exam.  Obviously, we refer patients to an appropriate specialist for treatment when we discover medical problems outside the scope of dental practice.

Other benefits of getting a dental exam:  I can recall many patients who told me that what they thought were unrelated health problems simply resolved when their oral problems were gotten under control.  These have included digestive problems, low energy problems, elevated blood cell counts, hypertension, and more.

Over the years, some people have told me they don’t want to get a dental exam because they don’t want to discover they have any problems.   I guess that works.

Just maybe not too well.

Your overall health is connected to your oral health.  Take a look at this infographic.  Then think it over. . . .

Do Dental Implants Make Financial Sense?

Do Dental Implants Make Financial Sense?

by | Mar 5, 2017 | Bridge, Cavities, Cavity, Dentistry, Dentures, Implant, Periodontal Disease, Tooth Loss, Tooth Replacements

Because tooth-loss so often creates long-lasting and generally negative effects for personal health and, not infrequently, appearance – the entire array of tooth replacement options has long been an important subject in the dental field.  Dentists not infrequently discuss which options are best for their patients, given different circumstances.  And if there is any debate in the profession at all, you can be sure the public will also question which options make the most sense for them.

The truth is there is no one right answer.  Each person’s circumstances differ – whether the reasons are anatomic, functional, emotional, or financial.

But the question is still an important one to ask, because patients face new realities when they lose even one tooth.  These changes include (but are not limited to):

  • Difficulty chewing
  • Altered speech
  • Food impaction
  • Jaw pain
  • Drifting teeth

And, then there are the secondary effects:

  • Poor health resulting from a changing diet
  • Compromised appearance
  • Self-consciousness/embarrassment
  • An inability to wear dentures
  • Financial challenges created by the need to address these problems

It is this last point that I want to touch upon here, because I have observed a good deal of confusion surrounding dental implants.  As a dentist, I am obligated to review all options with an individual when discussing their tooth replacement options – regardless of affordability.  I can’t, and don’t, pre-judge anyone financially when discussing their choices.

Commonly, though, when I raise the subject of dental implants, I get an immediate reaction along the lines: “Oh, forget it. I could never afford that.  How about a bridge?”

Now, I’m not going to try to convince you that implants are cheap. Restore a full mouth with dental implants and it is likely to be costly.  Nevertheless, cheap is relative.  For some of my patients, even a small filling can be perceived as expensive.  For my wealthy patients, they might be prepared to spend any price for what they perceive will serve them best.  Lucky them.  Right?

What I hope to do here, however, is to show you when an implant may make the most sense for a person. And — at least, when when it comes to replacing a single tooth — a dental implant may just be the way to go.

But first, permit me to remind you again – there is no one right answer for everybody.  Your choices may be very different depending upon whether you are 25 or 85 years old, for example.

I’m sure you can fill-in still other reasons that affect your decision-making process.  But for now, let’s consider the following scenario:

A patient loses one tooth.

For the sake of argument, we’ll call it a lower right first molar.   Suddenly, the patient realizes this is annoying.  Their bite is changing; their gums are sore.  They feel the need to do something.  Now.

Here are a few options. I’m just going to list the main ones, but there are sub-sets to some of these:

  1. Do nothing anyway.
  2. A removable denture.
  3. A non-removable bridge,
  4. A dental implant.

For the purposes of this discussion, the patient has already decided that doing nothing isn’t working for them.

So, the next option is a removable denture.  I usually get “the face” on this one.

And with good reason.  Food gets caught around partial dentures every time you eat.  You will have to remove the appliance after EVERY meal and clean it separately from your own teeth.  Certain foods will also cause it to dislodge as you eat, allowing some of the food to get caught between the denture and your gums.  The cost – depending upon what kind of partial you have made – will typically range between $750 and $1,500.† The recommended replacement time: every 5 to 7 years.  The reality – people replace them roughly every 15 years.  Sometimes more.  The longer they put off the replacement though, the more issues they may face with the replacement.

Bottom line:  Removable dentures are potentially uncomfortable.  Average lifetime replacement cost if you are 25 years old, (based on an average life expectancy of about 79 years, and an average 10-year replacement rate – not adjusting for inflation) is going to be nearly $7,000.

Next, we’ll take up considering a “bridge.”  It’s called a bridge because it spans a gap (like a bridge spans a body of water) with a fake tooth, or teeth, in between the ones that are still there.  The trouble is that you must shave down the supporting teeth to little stubs so that the result will look natural and be strong enough to take the force of daily chewing.  For the most part, bridges look, and can often feel like, your natural teeth; but you do have to floss under the fake tooth after every meal.  Food will get caught under there, whether you perceive it or not.  If you don’t clean it regularly, the life expectancy of your bridge will be shorter.

Now, the cost on this option can really be widely variable, because some teeth need to have fillings replaced before they can be used as supports for the bridge.  In other cases, the teeth may end up with root canals if the process of shaving them down results in lingering sensitivity.  This doesn’t always happen, but it is a risk.  If the tooth needs that additional treatment it will cost you more.

The average cost to replace a single tooth with a bridge is about $3,500.  Again, that can be a little more, or less, depending upon what part of the country – or even what part of a city, you live in.

If, on the other hand, you also need to place or replace fillings on the teeth being used as supports, and you need to do root canals as well, it could be as much as $7,000.

Roughly, double.

The average lifetime replacement cost with the same parameters given above (25 years old with an average life expectancy of 79 years and a 10-year average replacement rate) is going to be: $31,500.  And that assumes that the underlying teeth will be strong enough to survive that many replacements.

That brings us to dental implants.

Here is the breakdown:  The average implant cost in many metropolitan areas is around $1,800 – $2,200.  If you end up needing a bone graft before the implant can be placed, though, add another $550.  (Basically, a graft is adding bone to your jaw when you don’t have enough for the implant.) So far, these costs are just for the implant.  It doesn’t include the cost of the crown.  Add about another $2,100 for the parts needed to make up what supports the crown above the gumline, and the crown itself.  If your tooth is short, and there isn’t enough tooth height to which your crown can be easily cemented, you might need something called a UCLA abutment — it lets your dentist screw down the crown instead of cementing it.  That could cost you more.  How much depends upon the lab your dentist uses, but $500 more wouldn’t be unusual.

On the low end, one implant may cost $3,900.  On the high end, let’s round up to $4,900.

So, what about the average lifetime cost?

$4,400.

That’s less than either partial dentures or bridges!

Why?

Because, unless you bite into a rock, grind your teeth uncontrollably, or have some serious illness that causes you to lose bone around the implant – any of which can happen to you with the other options as well – you will probably have your implant for life.  Still, no one can guarantee this because, sometimes, plain ol’ dumb luck will factor into any equation.

But, you can’t get a cavity on an implant.  On the other hand, you still can get a cavity on the teeth that support your partial denture, or bridge (and crowns, for that matter).

So, do the math.  Look at your circumstances, and decide what is right for you.  But when your dentist starts talking to you about dental implants, hear them out.  It just might be more cost effective than you realize.

† [Note: The prices mentioned here are just averages in US Dollars at the time of this writing.  Actual costs could be more, or less, depending upon where you live.]

You CAN Take Care of Your Teeth

You CAN Take Care of Your Teeth

by | 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

Toothpaste and Your Dental Work

Toothpaste and Your Dental Work

by | Sep 3, 2013 | Cavities, Dentistry, Prevention, Tooth Decay

Very often patients ask me about what toothpaste they should use.  Seldom, however, am I asked about the best technique for cleaning teeth, when brushing should be done, how often they should brush, or for how long.

The subject of tooth cleansers can be confusing.  There are pastes, powders, cavity-fighting and gum-protecting formulas, as well as whitening varieties.  Most toothpastes use some form of mild abrasive to clean teeth, while others rely on enzymes to lift the stains out of your teeth. Some are foaming and some are not.  Most contain fluoride, while others don’t.

While I do have a personal favorite toothpaste, I honestly believe that an effective job of cleaning can be accomplished with the vast majority of toothpastes available on the market.  Why are there so many out there?  In a word: marketing.  I’m pretty sure toothpaste companies have discovered that if a toothpaste has the word “whitening” on it, they are likely to sell more than if it is omitted — even if the whitening benefit is small.

Some people have even taken to the idea that almost anything will work to clean your teeth.  Even soap.  Here is a short video I ran across recently that discusses this, and also why you may not want to wash your mouth out with soap.  I tend to agree that you should use the right product for the correct purpose.

 Click on the toothbrushes below to view the VIDEO:

For the curious, here is an earlier posting that answers some of the other questions discussed above, including how often you should brush.

What You Need to Understand About Cavities

What You Need to Understand About Cavities

by | Feb 16, 2013 | Cavities, Cavity, Dentistry, Tooth Decay, Toothache

Is it possible to have a cavity and not know it?

Understanding

Consider this article a public service announcement.  I really dislike it when patients lose their teeth unnecessarily.  My practice philosophy is that if a person has a dental problem, the goal is to handle that difficulty first, but then empower the patient with the correct knowledge that will keep him out of trouble from there on out.  Ideally, my hope is that most future visits to my office will only be for routine maintenance.

Unfortunately, and all too often, I encounter new patients with teeth that are so badly decayed there is little hope of salvage.  Possibly just as frequently, I find these patients scheduling a checkup – usually after a long absence from dental care – who are surprised to learn that they have any cavities at all.  Sometimes they will think they lost a filling when, in fact, a piece of their enamel has broken away.

Why are they surprised?  The common denominator seems to be the idea that cavities are supposed to hurt.

Well, sometimes they do hurt.  But most of the time – especially in the early stage – they don’t.

In fact, by the time a tooth does start to hurt you it’s usually pretty bad.  More often than not, it is so bad that a dentist is evaluating whether it can be treated with endodontic (root canal) therapy or whether it needs to be extracted.  A little understanding of basic dental anatomy is helpful here.

Take a look at the illustration below:Cavities

The outer layer of the tooth is comprised of enamel.  This is the hardest substance in your body.  It breaks up your food and is designed to last you a lifetime.

And now, here is the important part for you to understand:  it doesn’t contain any nerves.

It is more than ninety-five percent mineral.  Water and organic materials make up the balance. And because it doesn’t have nerves, it doesn’t have feeling.  This is actually quite practical since it wouldn’t do to have pain every time you bit into something.  On the other hand, it also means that it can be decayed without giving you a warning.

In fact, decay can also travel into the supporting layer – the dentin – and still not cause you pain.  It usually has to travel pretty close to the inner layer that contains the blood vessels and nerves – the pulp – before you feel it.  Of course, by then, the tooth has generally undergone considerable destruction.

Another factor that makes spotting decay difficult is the way it spreads.   I have drawn two black triangles into the enamel above.  Notice that the narrow point is on the outside of the enamel.  The broader base faces the inside of the tooth.  This is how decay usually travels.  Sometimes, it will undermine the interior of the tooth while the outer, harder enamel still maintains its form . . . until it eventually crumbles because the underlying supporting dentin has been eaten away by decay.

Many cavities also form at the contact point between two teeth.  These are areas that you simply cannot see.  Even the dentist needs an x-ray to spot these cavities in most cases.

So what does all this really mean?  Spotting decay is not always that easy.  As dentists, we use visual examination, but we also rely on probes, x-rays, and even laser detection devices to locate cavities.  Even then, it can be difficult to find cavities under existing fillings.

Don’t rely on pain to tell you if you have a cavity in your tooth.  If you do, you can be assured that your treatment is likely to be more uncomfortable, expensive, and may even result in the loss of a tooth that could have been treated much more easily earlier in the game.

If you have a loved one, who still has their teeth and hasn’t seen a dentist in a while, have them read this article.  You may be saving them from quite a bit of discomfort – not to mention time and money – if they catch potential problems before they are hopeless.

Some of you may be thinking, “No big deal.  If it’s that bad, I’ll just pull it.”   OK, sometimes that is necessary, but therein lies a lesson for another day.