Common sense. Does it seem to you that this has become a rare commodity nowadays? Possibly, then, it is really uncommon sense that we should be talking about.
The latest example of an affront to logic – at least for me – lies in the latest media challenge to oral health. This morning various news agencies including The New York Times, suggested that maybe flossing is really overrated. Apparently, “officials” have never researched the effectiveness of regular flossing.
Now, millions of people are likely to jump on this as a justification for not flossing. But, in reality, the new media sensation is probably not going to change very much at the end of the day. Why? Because I can confidently tell you – based on more than 25-years of personal experience – most people don’t floss anyway. About all this latest “research” will promote is the possibility that some people will feel just a little less guilty about what others with any sense (common or uncommon) already understand is a pretty good idea.
But, it makes for good press. Doesn’t it?
Just for the sake of argument, let’s assume that flossing doesn’t remove plaque. Heck. Some people fail to remove plaque with a toothbrush. That doesn’t mean either fails to benefit the patient, if done properly. I can think of several reasons why flossing helps, though:
Passing floss between the teeth sweeps out the contact point between them – meaning the points where they touch. That’s a source of about 30% of all tooth decay. Your toothbrush typically doesn’t reach those areas, unless you have gaps between your teeth. Floss does reach those areas.
Flossing stimulates blood flow in the gums. One of the body’s first-line mechanisms of defense is to increase blood flow to an affected area. You are effectively helping your body do this in a controlled manner by flossing.
A number of the bacteria under your gums are anaerobic bacteria. That means they don’t grow in room air. So what is a person introducing into the gum pocket when they pull back their gums by flossing? Could it be . . . air? Is it possible that the oxygen in the air could kill some of those bacteria as well?
Think about it.
If we can set aside this newly created question of doubt for just a moment, I would propose that you ask yourself the following question:
“Have I ever flossed consistently?”
By this, I mean every day, and it would have to have included doing so for at least two weeks.
This question is particularly directed to someone if they ever had a gum problem like gingivitis or periodontal disease. Sure, one needs to get rid of tartar and control bacteria as well, but for patients that make the effort to floss (and with only a few qualifications that I can think of), it is almost a sure bet that their gums got better as a result of the daily exercise. First of all, the gums probably bled less afterward. Not in the beginning – to be sure – but after about two weeks of flossing every day, we typically see positive change. Breath improves too. An overall sense of well-being is not out of the question either.
When it comes to flossing sporadically, I agree. It doesn’t help much. It’s kind of like exercising once or twice a month. And let’s face it, that’s where most of the population lives when it comes to flossing — once in a blue moon. Is regular exercise effective, though? What does your common sense tell you?
Why would I hold on to this idea in the face of “new evidence”? Well, I have seen flossing help too many times to just call it a coincidence. Hard core scientists might say “Oh, well, that’s just anecdotal evidence. It doesn’t stand up to real scientific scrutiny.” OK. Then survey practicing dentists. Let’s see if I’m the only one with that observation and experience. I doubt it.
I’m not saying flossing is the only thing you need to do to have healthy gums. It isn’t. Diet and good nutrition are paramount. A healthy immune system doesn’t hurt either. But for Pete’s sake, flossing is cheap, really not all that hard to do once you have practiced it for a while, and it can end up saving you a lot of money in the long run. With health care costs being what they are, I can’t think of too many actions a person can take that bear as much fruit and keep money in their pockets.
But, if the media has just succeeded in making you feel better about not flossing, then OK. Bully for them. (Heaven knows, they do a top notch job spending most of their time getting people to feel less than great.)
And, I suppose there are other ways to handle tooth loss – which, by the way, happens a lot more from gum disease than tooth decay.
As readers of my blog may know, I have long been an advocate of dietary supplements. While the ideal form of nutrition is always a healthy diet, today’s food is simply not the nutrient-rich, non-chemically altered, or non-genetically engineered food our grandparents ate.
While that might just be a topic for another discussion, I want to point out that whereas supplements have their place, it is always prudent to understand what you are consuming and what potential effects it may produce. This advice holds equally true for vitamins and herbs as it does for medications.
While the side-effects of supplements are typically far less dire than those encountered with many common medications, there can be side-effects nonetheless — especially when used in combination with medications.
As dentists, we are particularly interested in knowing what herbal medications a patient takes that may cause drowsiness, excessive bleeding, cardiovascular problems or that interfere with other drugs.
Here are a few examples:
St. John’s Wort, used as a mood enhancer, can interfere with the effectiveness of many heart and blood pressure medications, as well as blood thinners. On the other hand, garlic, ginseng, ginger, chamomile and gingko, to name a few, can cause bleeding after surgery.
A patient given sedatives by a dentist or oral surgeon before surgery who is also taking Valerian root and kava may experience an interaction that causes excessive drowsiness.
Ginseng has been associated with an increased chance of arrhythmias (irregular heart beats. Patients who take ginseng and also get a local anesthetic with epinephrine (commonly used for fillings and many other dental procedures) may be putting themselves at risk for cardiovascular complications.
Echinacea, while it is widely considered to be an immune system enhancer, may inhibit wound healing and increase the risk of post-surgical infection.
This list is by no means exhaustive, and the simple message here is just because an herbal remedy is considered “natural” doesn’t mean you should neglect to inform your dentist that you are taking them. Neither he nor you want to risk negative effects or complications that can come about as a result of interactions.
More likely than not, your doctor will simply ask you to stop taking a particular supplement before surgery or modify the anesthesia accordingly.
Good communication is the key.
Here is another example of this point. Not uncommonly, patients take “baby aspirin” as a blood thinner. Of course, this is not an herb, but many people feel it is not worth mentioning because it is just a “baby” aspirin. That is, until they fail to stop bleeding after an extraction.
You should always be sure to tell your doctor about ALL of the substances you are taking, including prescriptions and over-the-counter drugs. Even doctors aren’t always fully aware of every potential interaction between herbs and drugs, as new drugs are constantly being developed and introduced into the market. It is in your best interest to let your doctor “know before you go.”
If you require that a cosmetic dental crown be placed, it is a good idea to evaluate how you feel about the color of your existing teeth before the process is initiated. If you like the color of your teeth, the dentist will then find a crown shade that matches them.
On the other hand, if you feel that you would like your teeth to be lighter, bleaching may be an option for you. If you know you would like to whiten or lighten the shade of your teeth, it is a good idea to communicate this to the doctor beforehand. Once the final crown or cosmetic restorations are made, it will not be possible to change their color without re-doing them.
While bleaching is generally predictable, the results do not last forever. You may have to touch them up every one to three years. Teeth will re-darken. (This tends to occur more slowly with Power Bleaching.) The rate at which it happens, though, depends upon your habits. The good news is that your teeth can be brightened once again. Just remember, crowns and fillings do not change their color with bleaching — only your natural teeth will lighten.
In today’s challenging economic climate, people find themselves having to make every dollar they spend count. As a result, individuals considering cosmetic dental work face the additional problem of not having such procedures be covered by dental insurance. For some, that puts treatment a little farther out of reach.
While it may be a common perception that cosmetic dental procedures are completely elective, many prospective job seekers have come to realize that having an unattractive smile could make the difference between being hired and being passed over for employment.
One of the most common methods used to improve flaws in a person’s smile has been the use of dental veneers. These are typically thin shells of porcelain that are bonded to the surfaces of a patient’s teeth and can be used to correct a variety of problems: from unsightly old fillings to crooked teeth or chips in the teeth. They can also close gaps, lengthen short teeth, or permanently brighten discolored teeth.
Porcelain has been traditionally chosen for the job because it looks natural, transmits light beautifully, and has excellent color stability. The life expectancy is also good, with many veneers lasting up to fifteen years. Unfortunately, at $1,000 to $2,500 per tooth, they can also be rather expensive.
Nevertheless, apart from the cost, their many advantages have made them a popular choice. There are several disadvantages, however. Among these is that most porcelain veneer procedures are irreversible. This means that the slight amount of tooth reduction necessary to create a natural appearance commits the patient to future veneers. Also, in most cases, multiple visits are required – with anesthesia. And should a veneer ever become damaged, or should it break, it is not easily repaired. It typically requires replacement.
Fortunately, an alternative form of treatment exists. As long as the dentist does not have to restore tooth decay as well, it can generally be performed without anesthesia.
This is known as a direct composite resin veneer. Instead of using porcelain to cover the tooth, a dentist places a very thin layer of composite resin – essentially, a tooth-colored filling material – over the tooth in order to create a similar effect. Whereas in the past, this solution sometimes resulted in a dull, lifeless appearance for a tooth, current composite resins available to dentists have improved significantly. Products on the market today have enhanced physical and optical properties that also allow the dentist to accomplish a dramatic change in a patient’s appearance in as little as one visit. Many composite resins can also be placed with little or no alteration of the tooth’s structure. Every person’s case is different, however. Your dentist should be able to give you an idea of what will be required to obtain the optimal esthetic result for your case. Expect to pay anywhere between $350 to $695 per tooth.
What if you break or chip a composite resin veneer? The repair is usually easy to accomplish in a single visit and at a significantly reduced cost to replacing a porcelain veneer. Are there any disadvantages? Frankly, these are among the most technique sensitive of all dental veneers. The skill of the dentist and their attention to detail are critical elements in achieving a good result.
Talk with your doctor about which options are right for you. It may still be possible for you to enjoy the benefit of veneers – at nearly half the cost. Most dental offices today offer flexible financing options, many of which are interest free. Your perfect smile may be much closer than you think!
Welcome!
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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