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50 Secrets From Real Dentists

by Reader’s Digest Magazine, on Tue Apr 13, 2010 7:55am PDT
By Chris Woolston

Dentists from across the country tell us what they’re really thinking as they peer at our teeth.

Do you floss about as often as you flip your mattress? Do you spend more time putting toothpaste on your brush than actually cleaning your teeth? Dentists notice these things. And that’s not all. They also know when you’re asking for a procedure that’s going to disappoint you and when insurance companies are stinting on the care your smile needs. We asked 22 dentists from across the country to tell us what they’re really thinking as they peer at our teeth. What came out of their mouths will change the way you treat yours.

You Don’t Get It
Some truly educated people think that if nothing in their mouth hurts, they’re fine. High cholesterol doesn’t hurt, either, but it’s a big problem. I honestly think that the general population doesn’t understand that their mouth is part of their body.
– Danine Fresch Gray, DDS, general dentist, Arlington, Virginia

If your hands bled when you washed them, you’d run to the doctor. But in the public’s mind, bleeding gums are okay. Unless you’re really whaling away with your brush, if your gums bleed even a little, that’s periodontal disease, period.
– Ron Schefdore, DMD, general dentist, Chicago, Illinois

The advice to see your dentist twice a year applies only if you have healthy gums. Most people don’t.
– Chris Kammer, DDS, cosmetic dentist, Middleton, Wisconsin

Many of my patients have periodontal disease affecting their back teeth, but their front teeth are fine. Evidently, they brush only what others see.
– Joel Slaven, DDS, general dentist, Valencia, California

Dentists often tell patients with advanced gum disease to floss more often. But flossing is useless at that point. Imagine trying to clean out the bottom of a shirt pocket with a piece of string tied to your fingers.
– Reid Winick, DDS, holistic dentist, New York, New York

People come to me with a mouthful of tooth decay and say, “I got my grandfather’s soft teeth.” I don’t even know what soft teeth are.
– Bryan Tervo, DDS, expert at JustAnswer.com

When someone meets you for the first time, the first thing they notice is eyes. Second is teeth, and third is hair. But people spend way more money on their hair than their teeth.
– Damian Dachowski, DMD, general dentist, Horsham, Pennsylvania

Proper oral hygiene requires ten minutes of brushing and flossing every day. The average adult spends two or three minutes total, and kids do even worse.
– Joel Slaven, DDS

Our Noses Still Work
People who smoke try to cover it up with mints or mouthwash, but that stench is steeped into their gum tissue and the tissues in their mouth.
– Jennifer Jablow, DDS, cosmetic dentist, New York, New York

Brushing doesn’t go deep enough into the gums to reach the plaque that causes bad breath. You need to floss every day and get a cleaning every few months. If you do all that and still have bad breath, I start looking into diet and checking for health problems.
– Ned Windmiller, DDS, general dentist, Stillwater, Minnesota

A mouthwash with alcohol dries out your mouth — you’ll smell nice and minty for a half hour, but then the bad breath comes back worse than ever.
– Gary Herskovits, DDS

If your breath is bad, we won’t tell you unless you ask.
– Gary Herskovits, DDS, family dentist, Brooklyn, New York

“New and Improved”? Yeah, Right
There’s no reason to sanitize a toothbrush unless you’re sharing it with other people. Those UV devices and other germ zappers are totally unnecessary.
– Joel Slaven, DDS

There’s a limit to what toothpaste can do. New whitening formula? It can get rid of surface stains, but it can’t whiten like a bleach.
– Careen Young, DDS, prosthodontist, Beverly Hills, California

The electric toothbrush is one of the best things to ever happen to dentistry. The newer ones replicate professional cleaning — they won’t reach much below the gum line, but they’re far superior to regular toothbrushes. The cheap ones are okay for kids, but you’ll have to pay more than $75 for a really good brush with a warranty and replacement heads.
– Danine Fresch Gray, DDS

I wish people still used the Waterpik [a water-shooting device that was popular in the 1970s]. Each tooth is surrounded by a putrid, germy moat of saliva. If you replace that moat every day, you’ll go a long way toward keeping your mouth clean and your gums healthy.
– Chris Kammer, DDS

We Blame You When Baby Teeth Go Bad
It’s not unusual for me to see a beautiful little child dressed to the nines with teeth rotted down to the gums. And I’ll see teenagers from affluent homes with nine cavities. It’s just a total breakdown in parental supervision.
– Joel Slaven, DDS

For the past 20 years, we’ve been telling parents about baby bottle tooth decay and not to let a child go to sleep with a bottle. But I haven’t seen much of a change.
– Winifred J. Booker, DDS, pediatric dentist, Owings Mills, Maryland

The bacteria that cause cavities can be spread from mother to baby through saliva. If you have poor dental health and you taste your baby’s food and then pop the same spoon into his mouth, you’re putting him at risk.
– Mark Helpin, DMD, pediatric dentist, Philadelphia, Pennsylvania

Kids with dental problems often struggle in school. They’re distracted and easily agitated. Teachers will say they have behavior problems, but they really have toothaches.
– Winifred J. Booker, DDS

I have to extract a lot of baby teeth that are abscessed or heavily decayed. Parents think there’s no reason to pay attention to baby teeth because they fall out. But when a tooth comes out prematurely, other teeth crowd in to fill up the space. Without the right treatment, it turns into a mess.
– Paul Hettinger, DMD,general dentist, Orlando, Florida

I call soda pop the liquid chain saw. It cuts through teeth. And it’s not just the sugar — it’s the acid.
– Chris Kammer, DDS

Free Advice
If you want to reduce the bad bacteria in your mouth, you should be all over xylitol [a sugar substitute found in chewing gum]. It changes the chemistry of your mouth. Six or seven pieces of xylitol gum every day will help keep cavities away.
– Chris Kammer, DDS

Some people give up on tooth whitening because the gel irritates their teeth and gums. Just use a fluoride rinse or gel before and after — it’ll make your teeth much less sensitive.
– Ned Windmiller, DDS

With any kind of mouth piercing, there’s a huge risk of infection if it’s not done in a really sterile environment. I’ve seen cases where we’ve had to cut out pieces of the tongue because the infection was so rampant. Even when things go well, virtually everyone I see with a tongue piercing has chipped front teeth. Don’t pierce your tongue.
– Jay Grossman, DDS, cosmetic dentist, Brentwood, California

Quit Worrying
Amalgam [silver] fillings do release a small amount of mercury through wear and tear in the mouth. But you’d have to have about 300 fillings for the mercury level to get high enough to pose even the smallest risk.
– Edmond Hewlett, DDS, prosthodontist, Los Angeles, California

Taking metal fillings out can release more mercury than leaving them in.
– Brody Hildebrand, DDS, orthodontist, Dallas, Texas

Composite [tooth-colored] fillings are popular, but a metal filling is going to be more durable, especially for bigger jobs.
– Brody Hildebrand, DDS

I have amalgam fillings in my own mouth. There’s no proof that they do any harm. Convincing patients to remove their fillings for health reasons is quackery.
– Michael Alkon, DMD, general dentist, Holmdel, New Jersey

A lot of patients are worried that dental X-rays can cause cancer, but if you’re outside for an hour, you’re exposed to more radiation than you’d get from a full set of dental X-rays. What I worry about is that if I don’t take an X-ray, I might miss something serious.
– Bryan Tervo, DDS

Your Teeth Can Alert Us to Disease
Misaligned teeth can cause migraine headaches. If we can align the teeth and fix the bite, the pain often goes away.
– Mai-Ly Ramirez, DDS, general dentist, San Francisco, California

One of the first signs of diabetes is bleeding gums. I started taking blood samples from all my patients with bleeding gums and bone loss around the teeth and discovered that many of them were diabetic or prediabetic.
– Ron Schefdore, DMD

We’re Not Miracle Workers
Patients come in with pictures of celebrities and say, “I want to look just like her.” I’m sitting there thinking, You can’t have a smile that looks like Angelina Jolie’s, because you don’t have a face that fits those teeth. It’s like when you get your hair color done — you can’t just put the same highlights or lowlights in everybody’s hair.
– Jay Grossman, DDS

Teeth get whiter when they dry out. Some dentists promise that their office procedures will make your teeth four shades whiter. But if you leave your mouth open for an hour, you could easily be two shades whiter just from dehydration.
– Careen Young, DDS

If you bleach your teeth too often, it can thin the enamel. Your teeth can end up almost translucent.
– Jennifer Jablow, DDS

We Feel Your Pain
People say something difficult is like pulling teeth. But pulling teeth is really fast and easy.
– Mark Mutschler, DDS, pediatric dentist, Oregon City, Oregon

A study showed that tooth implants increase libido, probably because people feel much more confident without missing teeth or dentures sliding all over the place.
– Jim Janakievski, DDS, periodontist, Tacoma, Washington

Many people without insurance don’t go to a dentist until they’re in a tragic situation. They could wind up needing $20,000 worth of work.
– Paul Hettinger, DMD

When choosing a dentist, Check if the magazines in the waiting room are current. That shows attention to detail.
– Michael Alkon, DMD

Don’t eat a heavy garlic lunch before coming to see us — we’d appreciate that.
– Jennifer Jablow, DDS

Do you think your morning breath isn’t that bad?

Bad breath can be from a combination of smelly foods like garlic. However, if you have chronic bad breath (halitosis) it is actually not from the food that you eat, but from from volatile sulfur compounds (VSC) in your mouth. The VSCs are actually a build-up of anaerobic bacteria in your mouth. The bacteria likes to live on your tongue, your gums, and crevices of your teeth that do not get much oxygen. The bacteria feeds off food that you eat and especially likes sugary products. As the bacteria utilizes the food into energy it releases sulfur as a by-product, which causes the smell. Not only does the bacteria produce bad breath, but it can also cause gum disease, tooth decay, dry mouth, and sinus problems.

Breath mints are not going to make the problem go away either. Mints may mask the problem for a few minutes, but as soon as the mint is gone the bad breath is back. The only way to fix the problem is to get rid of the bacteria. Dr. McCargar, a Scottdale dentist says, “Brush your teeth twice daily. Floss and a tongue scraper are the most likely ways to get rid of the problem bacteria on your tongue and your gums. Alcohol-based mouth washes can actually dry out the mouth more and make it more susceptible to bacteria, so choose an alcohol-free mouthwash like biotene.” Dr. McCargar stresses that routine cleanings and proper oral hygiene can get you back on track to having kissable breath again.

Root Canal Treatment

Most adult teeth will last a lifetime. However, if a tooth becomes infected or injured it can be saved through root canal treatment. Years ago, the tooth would have been extracted. But, removing the tooth is not the best option now. When a tooth is removed and not replaced it can cause the other teeth to shift and become crooked or crowded. This can decrease chewing efficiency, and increase the risk of gum disease as it is more difficult to clean improperly aligned teeth. A replacement tooth (an implant or a bridge) is an option but is often much more expensive and more involved. Therefore, having a root canal can save the tooth, your smile, and your wallet.

If you have an untreated cracked tooh, a deep cavity, or a traumatic injury to a tooth it is likely that the enamel (the exterior portion of the tooth that is hard and lies on the exterior of the tooth – it also protects against cavities) has been compromised. This allows entrance of bacteria into the deeper levels of the tooth. The bacteria travels through the dentin (the hard tissue on the inside of the tooth that supports the outer layer of tooth enamel) and into the pulp. The pulp extends from the pulp chamber in the middle of the crown down each root to the tip that lies in the bone of the jaw. The infection is felt because there are tons of nerves inside the pulp that radiate to the brain signaling that something is wrong. Beyond the pain, often swelling and redness are symptoms that are experienced as well. Without treatment the bacteria can damage the bone that anchors the tooth to the jaw and can result in a bone infection that is difficult to treat.

So, to treat the tooth, the dentist will first administer local anesthesia. Then, the dentist will remove the infected part of the tooth all the way to the pulp. The pulp or its remnants are then removed carefully from both the pulp chamber and the root canal(s). Each root is cleaned and shaped to allow it to be filled. Medication is often placed in these areas to eliminate any bacteria. A temporary filling will be placed on the tooth while your permanent crown is being made. Most likely you will be sent home with a prescription for antibiotics. In the final step, the tooth will be fully restored by a crown or a filling. The purpose is to strengthen the tooth and improve its appearance.

Dr. McCargar says “Many people are very fearful of having a root canal done, but I assure you that it is a completely painless procedure. The most pain that one feels is due to the infection and once the infection is treated then so is the pain.”

Are Dental Implants an Option for you?

Are you missing a tooth or perhaps several teeth? Did you think that a denture or a bridge was your only option to replace the missing teeth? Dental implants are also a viable option for people who are missing teeth and in good general health.

A missing tooth may cause you to feel self-conscious, but there are also health concerns too. If a missing tooth is not replaced, the surrounding teeth can shift. Harmful plaque and tartar can collect in new hard-to-reach places creating tooth decay and periodontal disease. Bone loss can occur in the region of the missing tooth. Missing teeth can affect the biting force of the remaining teeth. As the bite changes to compensate for the lost tooth, there is a risk of extra pressure and discomfort on the jaw joints, which may lead to temporomandibular disorder (TMD). Missing teeth can also affect your speech.

An implant is basically a type of screw that is placed into the jaw surgically to function as a sturdy anchor for the replacement teeth. The screw is made of titanium so it is compatible with the body. The implant process can take several months. First, the implant is surgically placed into the jaw and a screw is inserted into the implant to prevent gum tissue and other debris from entering. The gum is then secured over the implant, where it will remain covered for approximately three to six months while the implant fuses with the bone (osseointegration). It is likely that there will be swelling and tenderness. Next, after three to six months the implant is uncovered and the dentist attaches an extension (post) to the implant. The gum tissue is allowed to heal around the post. Some implants require a second surgery in which a post is attached to connect the replacement teeth. With other implants, the implant and post are one unit placed in the mouth during the initial surgery. Once healed, the implant and post can serve as the foundation for the new tooth. Finally, the dentist makes a custom artifical tooth (crown) to fit and blend with your other teeth. Once completed the crown is attached to the implant post.

(click to enlarge)
Regular dental visits afterwards are crucial to the life and long-term success of the implant. Dr. McCargar at Scottsdale Dental Arts says, “Disease or trauma can cause tooth loss, but there are options for restoring your smile.” Dr. McCargar stresses that because implants require surgery not all patients are good candidates for implants, but he recommends that if you are interested in discussing your options to contact their Scottsdale dental office.