Wasn’t Today Just Supposed to Be a Cleaning?!
There’s a certain type of anxiety every patient experiences when going to the dentist. No, I’m not talking about the discomfort associated with dental treatment, the sound of the drill, or even the sting of the local anesthesia.
I’m talking about the anxiety and disappointment of coming in for a routine check-up and finding out you have cavities.
Everything has been fine at home. You haven’t noticed any sensitivity. You’re brushing your teeth regularly and limiting sugar consumption. Sure, maybe you could floss more often, but overall you feel that you’re doing what you can to safeguard your oral health. Wasn’t this just supposed to be a cleaning, anyway? What gives?
This topic recently hit a little closer to home when several of my close friends brought their children in expecting a simple check-up and ended up needing several restorations. Honestly, this is one of the worst parts of being a dentist, because it’s the one that brings the most complaints and it creates a stigma surrounding dentistry.
Some of the things I’ve heard people say to me, either at the office or in social situations when people learn I’m a dentist:
- “Every time I go in for a dental appointment, my dentist tells me I have another cavity.”
- “My child’s dentist drilled on all my kid’s teeth, just to make more money.”
- “My dentist does extra work on normal, healthy teeth. He must have a new car payment.”
- “They’re doing extra work because I have good insurance.”
And on and on. I’ve heard a thousand different iterations of these.
Why Regular Maintenance is Important
There are a couple of analogies I want to draw to help make this problem easier to understand. The first is cleaning in your house.
Let’s imagine you’re a neat person. You clean up the house once a week, tidying up, dusting the furniture, and cleaning the floors. But you’re human; not a superhero.
Even the neatest of the neat have a “spring cleaning” list:
- Cleaning under your bed
- Behind the dressers
- Scrubbing your wall baseboards
- Sorting out the garage or attic
These are the areas that are harder to get to. When you finally get a look at these areas, you can’t believe how cluttered or dirty they are! When you can’t see something, it’s hard to know what might be lurking underneath.
How About My Health?
Now let’s imagine you’re going to your general practitioner for a check-up. Say you’re a decently healthy 40-year-old and you’re going in for your annual physical. You exercise a little bit, but not every week. You know that diet is important, but you know there is room for improvement. You allow yourself a few indulgences and eat fast food when life gets busy.
At your appointment, the doctor says you need to check your blood pressure and you should have some blood work done to check your cholesterol levels too. Your blood pressure was also higher than you expected it to be and the blood work shows your cholesterol is high. The doctor recommends some significant lifestyle changes and starts you on a few medications to control the blood pressure and cholesterol levels.
You didn’t know what kind of shape you were in because these factors aren’t frequently checked or thought about.
But What Does This Have to Do with My Teeth?
Let’s bring it back. Teeth are particularly susceptible to cavities and decay in the areas that you can’t easily see. To understand why your teeth are predisposed to cavities on the in-between surface more than anywhere else we’re gonna need to talk nuts and bolts for just a moment. Buckle up. 🙂
A quick anatomy lesson. There are three sections of a tooth.
- The outermost layer is called enamel, which is the hardest part of your tooth. Enamel is 96% inorganic minerals such as calcium, phosphorus, magnesium and even trace amounts of copper, zinc, and lead. Think of enamel as the armor surrounding and protecting the more sensitive, softer inner sections.
- Moving inward, the next section of the tooth is the dentin. It is still primarily mineral, but it has more organic material in it than enamel. Because it has more organic material it is naturally softer. This makes it very sensitive to bacteria and decay. It helps to think of this part of the tooth as “less sturdy”. If you can picture your tooth as a house, the enamel would be steel construction materials, and the dentin would be wood construction materials. Dentin, like wood, is more vulnerable to attack.
- Moving inward one more layer is the pulp tissue. This is the tooth’s blood and nerve supply. It is the part of the tooth that’s vital and alive. It is also very susceptible to bacteria and decay and can even transmit the bacteria and decay to other parts of the body.
One more thing about enamel: even though enamel is strong, it can only hold off bacteria for so long, and constant exposure to sugary acids is eventually going to cause problems. So while enamel itself takes much longer to break down, it will become a little leaky and allow the cavity-causing bacteria to seep through to the more sensitive structures inside. And to make matters even worse, when it comes to kids teeth, the layer of enamel isn’t as thick as it is in adult teeth either. That makes baby teeth even more susceptible to cavity formation.
This causes your teeth to look fine on the outside, but on the inside and in-between surfaces, the tooth materials have been under attack. To the naked eye, things look fine, but we’ve got to look inside to see evidence of the problems.
How Do I Stop This From Happening?
There are three ways to avoid this problem:
- Take ownership of your oral health – A healthy mouth starts at home. Be careful about what you eat and drink. Make sugar a treat. Be a stickler about tooth-brushing and flossing. Don’t let a day go by without proper dental hygiene. Don’t ever let your child go to bed with anything to drink besides water.
- Visit the dentist often – Regular check-ups and cleanings will be far more beneficial than dropping in only when you have a problem big enough to notice. Cavities will be less likely to occur, and when they do they’ll get noticed and fixed before they become a major issue.
- You and the dentist are on the same team – People often forget this is the correct approach to their relationship with the dentist. You and your dentist both want to see you have a healthy smile! If you don’t feel this way about your dentist, shop around and find one where you can feel this way.
Our society is often mistrustful of the unfamiliar. Think about how you feel when taking your car to the mechanic or how you feel when you are buying something the seller earns a commission on. Nobody wants to get the wool pulled over our eyes.
The rub with dentistry is the dentist can sometimes slip into “salesman” mode; an idea that makes us really uncomfortable. It should. It doesn’t just happen in the dental profession within the larger healthcare community, but it has happened enough that lots of people are conditioned to think this is the culture within dentistry.
Children’s Dentistry of Charlottesville
At Children’s Dentistry of Charlottesville, we push back against that perceived culture, because we don’t ever want to slip into “salesman mode”. When I treat my patients, I always think about whether or not I would recommend this treatment if my child had the same dental condition. I can tell you this: We operate from a position of empathy. That’s how I was trained, and that’s what we believe.
I could tell you this until I’m blue in the face, but it’s just words until you’ve seen it for yourself. I invite you to come and experience it in person. We will always have your best interests in mind, and I’d love to prove it to you.
Take care and Keep Smilin’!
John T. Will, DDS
A graduate of Loma Linda University Dental School and a resident in the Loma Linda Dental Anesthesiology Program, Dr. Will received extensive education in pharmacology, physiology, internal medicine, and general anesthesia. Dr. Will is a member of the Special Care Dentistry Association and the American Society of Dentist Anesthesiologists. He’s also a Diplomate of the American Dental Board of Anesthesiology. Dr. Will believes every patient should be treated with kindness and respect and is focused on treating the unique dental and oral health needs of all young people.