Best time to go to the dentist? 2:30

Two thirty. Tooth hurty? Get it?

I know it’s an old one but it always makes me smile. Except when it’s true.

Regular dental check-ups aren’t a money grab. You may think your dentist is giving your chompers a cursory glance to justify his/her fee. Nope. Your dentist is checking your fillings (if you have them) for damage. They are on the lookout for recession (that is a whole ‘nother post). They are also looking at the tissues in your mouth and your tongue. They are looking for changes in these tissues that you may not see or you may think are normal looking bumps and splotches.

Having said that, if something twinges in your mouth, and by that I mean, if you have a tooth that suddenly starts talking to you when you eat or drink something hot or cold, make the call. You may not be due for your hygiene appointment for another 3 months, but a lot can happen in that time. You wouldn’t wait 3 months to get your car in to the mechanic if something was clunking under the hood would you? Probably not, because the bill to repair whatever was wrong will be soooo much bigger if you wait. Same goes for your teeth.

I digress.4271967801516

First: no comments necessary about the size of the filling or the fact it is an amalgam (silver) filling or that you can see another filling on the other molar.

Second: no comments necessary on the quality, clarity or framing of the photos either. My dentist didn’t know I wanted them until after they were taken. They were for insurance pre-authorization purposes.

Back to my tooth. One day, I noticed the tooth was being a little fussy. This poor molar  was occasionally feeling a little sensitive. I’m not talking about eating ice cream and needing to be peeled from the ceiling kinda sensitive. It was much milder than that. But it was enough to make me sit up and take notice.

I booked in for a spec exam within 2 days. The discomfort felt like it might have been from sinus pressure. I haven’t had a cold or any kind of sinus issue for a long time. In the past, my colds went directly to sinus infection-land and these used to happen frequently. Once I changed my eating habits, (quit gluten among other things) I haven’t had a cold or flu (or anything that everyone around me gets hit with) in years. I’m not exaggerating. My nick-name is Robot-Princess (that, is again, another story). I just don’t get sick. So sinus pain, though I used to experience it frequently when I was younger, was now unfamiliar. Then I thought, maybe, I’ve cracked my tooth. At the time, I wasn’t sure which would have been a preferential outcome. Sinus infections suck because of the antibiotics, how lousy they make you feel and the havoc they wreak on your gut flora. A cracked tooth also sucks, because, well, cracked tooth. The picture and x-ray showed I had a fracture. Ugh!

Upon removal of the old filling, we got a look at how bad it really was. What we thought was a small hairline crack from the filling to the edge was far more than I had bargained for. 4276152886016

I had cracked my tooth from stem to stern under that silver filling. I’m a clencher. I wear a night guard every night to protect my teeth from me. I must do some of the damage during the day. I’m damn lucky my entire tooth didn’t break in half. (And yes I know, the photo is 180 degrees rotated in comparison the the other picture.) Heroic efforts were made to protect the integrity of this poor molar. Thankfully, I did not need root canal therapy. The tooth was and still is vital.

My dentist and his team are amazing. They provide support and just the right amount of teasing when necessary. I now have a pretty crown on the tooth and the cold sensitivity has been kicked to the curb. Had I waited to have my tooth looked at, it could have been a whole lot worse.

The lesson to be learned from this? If something feels different in your mouth, be it hot or cold sensitivity, or your bite feels outta whack, don’t wait. Get to the dentist. Invest the money and time in yourself. You need your teeth to help you chew and talk and you need them to last a lifetime.

Oh, and floss.

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Do you swear to tell the tooth?

 

What’s the big deal with baby teeth?

Baby teeth come with many names. Milk, deciduous, primary  all mean the same set of teeth. The teething guidelines below, vary with every child. Some kids will be later than these posted ages and some with be way ahead and have a full mouth of chompers by their first birthday. I’ve seen 9 year old children with all of their permanent dentition with the exception of wisdom teeth. (I can’t help but think the trickle down effect of the foods we eat plays a major role in the eruption of kids teeth today. All those hormone infused foods have an end point don’t they?)teething chart.png

You may be thinking, kids lose these first teeth so what’s the big deal about taking care of them?

  • S/he doesn’t like it when I brush her/his teeth. So? Get in there and do it. You can make brushing fun. If they start screaming and crying, well, you have better visibility now don’t you?
  • Who cares if they get a cavity? Pull it out. That’s an easy and cheaper fix than having a filling done. No, be responsible and get the tooth repaired. Cavities hurt, can make eating painful and also give nasty breath. Do you really want those things for your precious little one? (Please don’t threaten your child with a trip to the dentist if they don’t behave. This does not serve any purpose other than vilify the people who are there to help. Dental environments can be scary enough on their own, with the weird smells and sounds, without a parent filling a little mind with terrifying images.) Decay in a baby tooth can also affect the permanent tooth waiting to erupt.
  • What if a tooth gets knocked out? Another tooth will grow in to replace it right? Well, yes and no.

Yes. In the right circumstances, an adult or permanent tooth will take the place of the shed baby tooth. If you are lucky, it erupts into the correct position in the mouth. Hooray!

No. Sometimes Mother Nature throws a curveball your way and simply does not form an adult tooth under a baby tooth. Seek the opinion of an Orthodontist. Not a general dentist who also does braces. You want a specialist for this job. This may involve having the baby tooth removed and spaces closed or keeping the primary tooth as long as possible and preparing for a dental implant once growth is complete.

Yes. The permanent tooth will erupt either in front of or behind the baby tooth providing you with a shark-look (rows of teeth). This could possibly lead to some crowding out of the adult teeth. You may need the baby teeth removed to help with this scenario.

 

No. There may very well be an adult tooth lurking under the gums, but for some reason, it has decided to grow in a different location. (picture Bugs Bunny tunnelling underground and arriving inthe middle of a bullfight, expecting to find himself at Pismo Beach, “I knew I shoulda taken a left turn at Albuquerque”)

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Teeth can be impacted in the roof of the mouth, causing damage to the roots of the surrounding teeth. Sometimes, teeth can fuse themselves to the jawbone and will not move up and into occlusion. This is called an ankylosed tooth. These cases are best handled by an Orthodontist as well.

 

Mother Nature designed our baby teeth to act as guides for the permanent teeth. In an ideal world, the adult tooth erupts directly below the baby tooth causing the root to resorb. As the permanent tooth moves toward the gum line, the baby tooth becomes loose and is shed. The adult tooth shouldn’t be far behind the baby tooth falling out. If a baby tooth is lost prematurely, (many a trampoline can boast of claiming a tooth or two) it is important to preserve that space to prevent a loss of arch length and the subsequent crowding. You may be thinking the holding appliance the dentist recommends is just a money grab. No, it’s not. Holding appliances serve a great purpose and not just to pad a wallet. They maintain the space to allow the permanent tooth the best chance to erupt where it is supposed to. (think of saving a place in line at the movies for your friend)

Both the Canadian and American Orthodontic Associations recommend an early assessment by a certified Orthodontist around age 7.

  • Why see them so young? Some bite issues and habits can be corrected and modified during a child’s growth.
  • Why an Orthodontist and not my regular dentist? These women and men have had several years of education and training, specific to orthodontics, in addition to their regular dental degree.

Initial consultations may involve a Panorex x-ray. Regular bite-wing x-rays (the ones taken at the check-up and cleaning appointment) do not provide all the necessary information about what is happening in your child’s mouth. This image is a fantastic diagnostic tool to alert you of missing teeth, extra teeth (yes, that can happen) ankylosed and impacted teeth.

We’ll chat more about teeth and how they fit together another time.

 

Floss ~ the other F-word

Do you swear to tell the tooth? The whole tooth? And nothing but the tooth?

We are going to chat a little bit about oral health. That in itself almost sounds dirty, but it isn’t. Or it shouldn’t be.

Just a few basic dental facts so we are all on the same page. We’ll keep this simple.

Typically there are 20 baby (or milk) teeth with up to 32 permanent (or adult) teeth. I say up to because that includes wisdom teeth. Not everyone develops these. Now, having stated these numbers, there are always those folks who grow extra teeth and those who never form some. We can chat about this another time.

Teeth are composed of layers:

  • Enamel: hardest substance in your body, mineralized outer layer covering the top or crown of the tooth
  • Dentin: is almost like a bone and makes up the majority of the tooth bulk  and is protected by the enamel for the crown (and cementum on the root, not labelled in this diagram)
  • Pulp or pulp chamber: the middle of the tooth and has the “live” or “vital” connection via blood vessels to your jaws (yes, teeth can die)

normal-tooth_1

Plaque (you’ve heard of that before) is the film (microbial biofilm) that builds on your teeth during the day and at night. It is usually colourless but it is responsible for bad breath (halitosis), red, irritated gums (gingivitis) and if left undisturbed, can harden into tartar. It commonly forms at the gum line and can work it’s way under the gums, down the root of the tooth. Plaque feeds on sugar (from foods we eat, such as carbohydrates) and produces acid in the mouth. This eventually leads to. . . (dramatic pause) cavities. This is why removing plaque daily, is critical.

Removing plaque is a two-step process. Flossing and brushing. Flossers, in my over 20 years experience in the dental/orthodontic world, fall into several categories.

  1. Those who do it daily
  2. Those who do it when they get something stuck between their teeth
  3. Those who do it a day or two before seeing the dentist/hygienist to try to fool them into thinking that they actually floss every day (doesn’t work, we can tell)
  4. Those who do it for a few days after seeing the dentist/hygienist as they feel motivated by a good pep talk/lecture

Those of you who do it daily, congrats! Pat yourself on the back. You are ahead of the game.

Those who don’t floss daily, well, that’s kinda like not cleaning the underside of the toilet seat. It’s gross.

I get why you don’t do it. When you finally break out that tortuous string, it hurts. Even if your technique is good. Your gums bleed. They get really red. They swell up twice or even three times their normal size. They throb (kinda like when you work a muscle you haven’t used in a while). And at that point, you throw that hateful minty thread into the garbage and vow never again! I’m here to tell you it doesn’t have to be that way. Join the flossers. Drink the proverbial Kool-aid.

The fact your gums bleed when you clean them should cause all the alarm bells to go off in your head. If you washed your hands and they bled, you’d be pretty concerned right? Gum tissue isn’t any different.

Get your floss, waxed, unwaxed, plain or flavoured and get to it. If you opt to use a floss pick, please wipe the little piece of floss before moving on to the next spot, otherwise you are just moving your plaque from place to place. Don’t get me wrong, a floss pick is better than not flossing at all. There are no rules stating you have to floss in the bathroom. If you aren’t offending anyone, do it while watching tv. Do it in the shower (don’t let the floss go down the drain though). Like Nike says: Just Do It. That first time? Yes, it will hurt. Yes it will bleed, maybe even a lot. Yes your gums will puff up and throb. Get over it. It falls under the heading of “suck it up buttercup” and you do it again the next day. And the next. And the next. Keep showing up to your floss date. In a few days, the bleeding settles down and maybe even stops. The puffiness and redness settles down and you may notice your gums are a lighter shade and are hugging your bone more. Hooray! That throbbing or pulsing sensation is likely gone now too. Guess, what? Your breath smells a whole lot better too. Next time you see the dentist or hygienist, you won’t get a lecture either.