FAQs Continued.....

Root Canals
Q: "Why should I have a root canal? Why not just take the tooth out?"

A: Just as any infected part of the body is treated, infected teeth should be treated and not just simply removed. Teeth provide a valuable function that is more complicated than most people realize. They help chew food, they are what you present to others when you smile, they help with speaking, and they help to support your cheeks and lips by keeping them from caving in. All teeth are designed to share the stress of chewing. When one is lost, the others have to do more work. 

top
 

Should My Dentist Be In The American Dental Association?
Q: "My previous dentist was a member of the American Dental Association, but my new dentist is not. What is the advantage of seeing a dentist that is a member of the American Dental Association?"

A: You are very astute to notice this about your dentist, and I compliment you for this. In Michigan, when a dentist belongs to the American Dental Association ( ADA), he or she also belongs to the Michigan Dental Association (MDA) and to the local dental association. For example, Genesee District Dental Society Members are also members of the MDA and ADA . We are proud of the fact that over 70% of the dentists in the country are members of the ADA and affiliate associations. Any licensed dentist that does not have ethical violations is eligible to become a member. That is not to say that non-members have ethical violations, they just may not choose to become members. 

There are many reasons why your dentist's membership in organized dentistry benefits you as a patient. I have listed some of them here:

  • The ADA provides legislators with sound information which helps affect policy that protects your rights as a patient. These include your right to access care, your right to safety of care, and your right to choose the provider of your care. The ADA and state affiliates spend hundreds of thousands of dollars on these legislative initiatives.
  • The dental associations were instrumental, and continue to be proactive, in encouraging local governments to fluoridate municipal water supplies. Fluoridated water has reduced dental decay in children by over 50%. They also maintain a standard of credibility so only sound research is given credence when considering claims of fluoride health risks. Ongoing reviews and testing of dental materials, along with the ADA Seal of Acceptance, assure that the manufacturer's claims are true and not misleading.
  • The ADA has made sure that insurance companies have been called to question and to court when their dental reimbursement practices become unfair to patients and the dentists that provide their care.
  • Through the Direct Reimbursement initiatives, the ADA is continually trying to show employers that may not offer dental benefits, an affordable option of helping their employees with their dental expenses.
  • The ADA works hard to maintain the standard of dental education to insure that graduates have the skills and competency to properly treat their patients.
  • The dental associations sponsor and organize outreach programs through their foundations and through their members. Programs such as "Give Kids A Smile Day" have provided millions of dollars of free dental care to those that have little or no access to care.

So when you see that your dentist is a member of their dental associations, you know that they are paying their dues to make sure that dentistry here remains the finest in the world. Members of organized dentistry know that they are only a small part of a large cohesive group of professionals that care about the welfare of not only their own patients, but also the public as a whole. They also have the foresight to look beyond their personal needs of today and look forward to the future wellbeing of all that are served by our profession. 

top
 

Sinus Infections and Your Teeth
Q: "I was suffering from chronic sinus infections, only to find out years later, that I had an abscessed upper molar. Why didn't I ever have a toothache, and is this common?"

A: This is more common than you might think. Upper molars and bicuspids often have roots that are separated from the sinus only by a very thin layer of bone. When the nerve in a tooth dies due to a large filling, trauma, crack, or decay, there is no longer any blood supply that goes into the tooth. This makes the "dead" tooth a perfect breeding ground for bacteria, because without blood, your immune system has no way of destroying the bacteria. Eventually the growth of bacteria within the tooth produces puss, and that puss eventually seeps out through the tip of the root. This then causes an infection in the bone around the root. At this point, pressure on the tooth usually becomes very painful and would cause you to seek help from a dentist. However, since the bone at the tip of upper molars and bicuspids is so thin, the puss will easily perforate through the bone and into the sinus. Because the infection is draining into the sinus, and not building up, pressure on the tooth is usually not very uncomfortable. At this point the patient usually thinks they are just having a bad sinus infection. Antibiotics may clear up the infection for a short period, but it usually returns until the tooth is treated. It is a good idea to have a thorough dental evaluation if you have a chronic sinus condition. The tooth may not always be the cause, but if it is, you may enjoy some rapid relief by having the infected tooth treated. There are various tests a dentist can perform to evaluate a tooth that may have a dead nerve and infection. These tests are not usually uncomfortable. Dental X-rays may also provide important information, and that is why routine complete X-ray screenings are considered to be the standard of care. 

top
 

Smoking and Gum Disease
Q: "I have gum disease, and I have been told that smoking is making it worse. Why is that?"

A: Gingivitis is a precursor to Periodontal Disease, and Periodontal Disease, frequently called pyorrhea, is an advanced form of gum disease. Gingivitis is portrayed by inflamed, puffy, and red gum tissue that bleeds easily. Periodontal disease has the same characteristics as gingivitis, but is also portrayed by bone loss around the roots and recession. Both of these involve bacterial infections and an immune response from your body. The immune response, or inflammation, is the most destructive part of the disease process because your body begins to essentially destroy its own tissue. The process that occurs is very similar to the bone destruction in an arthritic joint. Most dental treatment aimed at gum disease revolves around our ability to stop the inflammation or control your body's immune response. 

Smoking has been shown to worsen the incidence and severity of gum disease. The tar deposited on the teeth from smoking acts as an irritant that causes an increased immune response from the body. The tar also makes the tooth surface rough which, in turn, makes it easier for bacterial plaque to accumulate. This also increases the body's immune response leading to inflammation and bone loss around the tooth roots. 

I would be remiss if I did not also mention that death rates from oral and throat cancers are 4-7 times higher in smokers than in non-smokers. Chewing tobacco statistics are no better. It has been shown over and over that tobacco products are hazardous to your health in many ways. There are many resources available to help you quit the use of tobacco products. Over 29 million Americans that used to smoke have given up the habit. I hope you will join them! 

top

Soft Teeth
Q: "I have soft teeth in my family. Is there anything I can do to prevent cavities in my kids?"

A: There are few inherited problems that cause soft teeth; however, children do inherit their parents' dietary and lifestyle habits. This is usually the cause for common family tooth diseases. The bacteria that cause cavities can be passed between parents and their children by kissing or sharing food/eating utensils. Parents who do not get their decay treated will have children who have higher levels of cavity causing bacteria and more cavities. Bad habits of the parents that are passed onto children are inadequate tooth brushing, lack of regular visits to the dentist, chewing sugar containing gum, frequent snacking of high-sugar containing sticky foods, smoking, and excessive carbonated beverages (pop). 

top
 

TMJ
Q: "What does TMJ mean?"

A: TMJ stands for Temporomandibular Joint. It is the joint which allows us movement of our lower jaw. Like other joints, it can be subject to injury with traumatic jaw movements or arthritic changes, both of which can lead to pain with function. TMD, or temporomandibular disorder, is the catch phrase that involves all the symptoms and causes of pain in the TMJ. The diagnosis and treatment of TMD is usually difficult because there are many causes and types of treatments that have to be evaluated. Patients should not expect rapid resolution to TMD. Have patience while the dentist eliminates possible causes and attempts different treatments. 

top
 

What Causes A Burning Tongue?
Q: "I just got over a terrible sinus infection and now my tongue is white and has a burning feeling. What is happening to me?"

A: It sounds like you might be suffering from an oral yeast (Candida) or "Thrush" infection. If you were placed on an antibiotic for your sinus infection, it may have upset the balance between the organisms in your mouth. The bacteria and yeast compete with each other in your mouth. When the bacteria are eliminated, the yeast takes over. This same condition may occur if your immune system is not functioning properly. You should speak with your physician or dentist about this problem. If you have not been on an antibiotic, a blood test may be recommended to evaluate your immune system. 

top
 

Why Do I Need Two Cleaning Visits?
Q: "I have always had my teeth cleaned every six months, except for the last time, for which I was a year overdue. The hygienist at my dentist's office said she could not complete my cleaning in one visit, and I would have to return for a second cleaning which probably would not be covered by my insurance. My teeth didn't feel that dirty, and I question whether this second visit is really necessary. Friends of mine have been overdue for their cleanings, and they did not have to go back a second time. Am I being conned?"

A: The fact that you are questioning the suggestion made by your hygienist does suggest that you are considering her recommendation. I credit you for checking into it more thoroughly instead of just ignoring the recommendation. I will have to make the assumption, in answering your question, that you do not have periodontal disease or loss of supporting bone around the roots of your teeth. If you did have active periodontal disease you would probably have been seeing your hygienist 3 to 4 times per year. 

The "tarter" or calculus that accumulates on your teeth is nothing more than calcified layers of plaque. When these plaque layers harden, they become more and more difficult to remove, especially from the root surface of the tooth below the gum-line. It is difficult for even the most skilled brusher and flosser to clean all of these areas completely. The root surface deposits are usually not visible to the naked eye and are usually detected by feeling below the gums with specialized instruments. These are the most damaging deposits because they cause your gums to bleed and swell and would eventually lead to the loss of bone support around the root. Most dental offices will schedule the appropriate amount of time necessary to remove about 6 months worth of this build-up when you are going on a regular 6-month interval. If you were one year overdue that means you had 18 months of build-up on your teeth and below your gums. It would rarely be possible to remove that much more build-up in the same amount of time and for the same cost. Everyone loves the chore of removing soap scum from the shower stall. Imagine not cleaning the shower for a period three times longer than usual. The neglected shower may not look that different but when you finally get around to cleaning it, it is sure a lot harder and more time consuming. This analogy may help you to understand what happens in the mouth. 

A good dentist and hygienist will put the patient's needs ahead of the time schedule. The goal of treatment is not to just get it done, but to get it done in a way that will benefit the patient. Even with knowing the probable resistance most people would have about the extra visit and extra cost, your hygienist is appropriately making her recommendations based on her patient's needs. Avoiding resistance and conflict with a patient by merely ignoring their true treatment needs is not professionally ethical and is certainly not beneficial to the health of a patient. However, as a patient, you are always entitled to an explanation as to why certain recommendations are being made so don't be afraid to ask questions and for further explanation. In my view, honest and caring dental environments individualize the care of their patients. 

top
 

Why Does The Dentist Examine My Neck?
Q: "Why does the dentist feel my neck during my examination?"

A: There are many diseases of the body that affect the head and neck area. Your dentist is well trained and is providing you a valuable service when he or she examines these areas carefully. It is not uncommon for dentists to detect thyroid disease, various lymph gland cancers, and infections during an examination. Often times a patient is unaware that these problems are present. You would most likely be referred to your physician, for follow up, if some type of disease is suspected by your dentist. 

top 
 

Wisdom Tooth Removal
Q: "My dentist recommended that my wisdom teeth be removed, but they don't bother me. Why should I get them removed?"

A: Not all wisdom teeth require removal, but there are some very good reasons why removal may be a good suggestion. If the wisdom teeth are in an area which makes it impossible for you to keep them clean, then they should be removed. Also, if they are positioned improperly and are pushing on the roots of the molars in front of them (second molars), then removal should be considered because they may cause decay on the root surface of the second molars. Finally, if the wisdom teeth are only partially in, bacteria and food debris can collect under the gum tissue around the wisdom teeth. Eventually this can lead to an infection or abscess which can be quite painful. Generally the best age to remove wisdom teeth is between 14 and 19 years of age or when the root is one third to two thirds developed. It is always important to consider all the risks and benefits of wisdom tooth removal when making a decision to remove them. Don't be shy about asking questions.

top

Previous page