A: No, of course not, but it is a bad strategy in my opinion! From time to time a gentleman (or less frequently, a lady), will come to the office in discomfort. He or she will tell me it has been years since their last visit and they ‘only come to the dentist when it hurts’. When I hear it, I ask the Young Dentistry team to brew the coffee and call my wife to let her know I’ll be late. It is usually an indicator that there will be disease progression that will require our attention and we’ll be getting to know our patient very well in the coming weeks and months. Most dental problems do not have symptoms until their later stages. A cavity needs to be big and close to the tooth’s nerve for it to start hurting. By that time, a root canal and crown may be required rather than a small filling. Gum disease does not feel painful at all as it progresses but, at its worst, teeth can be lost if detected too late. Most worryingly, oral cancer is mostly silent and very dangerous if it goes undetected. So my advice is to spend less time and money at the dentist by coming in for regular preventative care.
A: That’s great that you’ve got your toothbrush working twice a day. If your teeth could thank you, they would. Of course, that leads us to flossing. Wait! Before you the tab on your browser in disgust, let me make the case for the much-loathed act of flossing. Teeth typically have surfaces that make close contact with their neighbours. Your toothbrush bristles never make it into those tight quarters. Consider there are usually 26 contact points in a person’s mouth, that makes 26 areas that get missed even after a good brush. Are you surprised to know that these are also the most common spots we find tooth decay? Of course you aren’t. The plaque left behind in those areas contains streptococcus mutans (aka the bad bacteria). If left undisturbed long enough, those bugs will make like a gopher on a golf course and start to burrow. So sweep away the gunk with floss. When you hear the satisfying ‘snap’ as it goes between your teeth, envision the evil little microbes running for their lives. Then nod knowingly to yourself in the mirror. You are preventing tooth decay.
Q: I’d like my teeth to be straighter, but I’m a grown-up and do not want to wear metal braces. Is there anything out there for me?
A: I am a life-long metal brace resistor. Long before I even considered a career in dentistry, back when I was pretty sure I would become a professional racing driver or a Transformer, I gave my parents a very hard time when the orthodontist suggested gluing metal to my teeth to correct a few years of thumb sucking. The compromise reached was a removable retainer that was still half metal and, well, sort of corrected my bite. If only the computers back in those days were not the clunky tape-driven lumps that had the programming power of a modern car key. Because with today’s technology we now have to ability to create thin clear removable appliances that correct misaligned teeth predictably and efficiently. The system I provide at the office is called Invisalign and is a wonder of the modern world. A new set of aligners is worn every two weeks. These aligners are taken out when you eat and clean your teeth, but worn the rest of the time. The aligners are nearly invisible (hence the name) and the comfort they provide over metal and brackets in undeniable. Most people will not notice you are in treatment until the realise how much better looking you have gotten over the course of a few months. Thirty years after my trip to the orthodontist I am currently in Invisalign myself and could not be happier. If you want to learn more about Invisalign, contact the office and we would be happy to show you what it is all about.
Q: After brushing, flossing and monitoring sugar intake, is there anything else that can guard against tooth decay?
A: You may have heard of fluoride. It is a substance in most toothpastes, some mouth rinses, and in Halton Hills, our public drinking water. It is beneficial to teeth because when it comes in contact, it makes them more resistant to tooth decay. Despite the view espoused by Brigadier General Ripper in the 1964 film Dr. Strangelove, water fluoridation is not a “monstrously conceived and dangerous communist plot”. Its benefits were discovered by an American researcher in the the 1930’s who found a link between appropriate concentrations in water and the reduction of tooth decay in a population. Public water fluoridation is now considered one of “one of the 10 great public health achievements of the 20th century.” by the Center for Disease Control in the U.S. (and those people know their diseases). Anecdotally, in my practice, the individuals I see who have never had a cavity, have almost all grown up with fluoride in their water. If an individual seem susceptible to tooth decay, we will frequently recommend a regular application of fluoride varnish on teeth, a prescription-strength toothpaste or a fluoridated mouth rinse. If you don’t drink tap water or if you use well water without naturally occurring fluoride, supplemental tablets may be beneficial as well. As the saying sort of goes: “Talk to your dentist to find out if fluoride is right for you”.
A: On the subject of tooth decay, one factor that every scientific article cites is carbohydrate intake. ‘Carbs’ are consumed by every normal person in the world except for those Atkins-diet zealots and probably some isolated primitive meat-eating tribes. Refined starches, and their building blocks, glucose, fructose, sucrose fuel the bacteria that cause decay. The microbes arrive at the site where the sugar is stuck to the tooth, then secrete lactic acid after they have their power lunch. That acid dissolve the innocent tooth underneath and the hole forms. That hole can now collect more carbs that are now harder to remove. If you eat things that contain carbs that stick to your teeth (candy, breads, dried fruit, cakes etc) or drink sugary things (pop, fruit juice, milk, sugary coffee, sports drinks etc), then you have conditions for decay. This is the important bit: The longer the contact, the greater the risk. So clean it off right away or chug that surgary drink quickly and rinse with water. Or even better, reduce your refined carbohydrate intake altogether and substitute for healthier unprocessed food and water. Those primitive tribes people have beautiful smiles and very few fillings.
A: Tooth decay occurs when food debris and bacteria have a friendly get-together on a tooth’s surface for a prolonged period of time. It does not happen instantaneously, so removing food and plaque quickly is effective for prevention. When someones tells me they brush daily, I know it could mean anything from sticking a toothbrush in their mouth for 10 seconds every morning or brushing thoroughly for 2 minutes after breakfast and before bed. You can probably guess which method is more effective! A full 24 hours of co-mingling bacteria and food is time enough for those acid-spewing microbes to erode enamel and make a cozy-little hideout for future feasts. And a quickie brush, one that might miss some areas, will mean the bacteria and food-fuel will extend the party 48, 72 hours or more. So take your time and brush thoroughly twice a day. It is the first (but not only) step to a clear check-up. The other steps? The next one is a word that begins with ‘F’. Can you guess what it is? I’ll explain more next time.