Ask the Dentist
1. My husband, Bob, is terrified at even the thought of going to the dentist. What should I do?
3. My new dentist said I don't need fluoride treatments. What has changed?
4. How many teeth are people supposed to have?
5. Dad wants me to take Vitamin C. Mom says the chewable pills are bad for my teeth. Are they?
6. I saw something on TV once about AIDS and dental offices. Is it safe?
7. Can having my tongue pierced and using a tongue bar crack my teeth?
8. Should I spend the money to fix the tooth or just pull it?
9. Why should wisdom teeth on both sides of the mouth be removed when only one side is hurting?
10.Can the teeth on a denture be whitened?
My husband, Bob, is terrified at even the thought of going to the dentist. He says that he had a bad experience as a child that he just can’t get over. He brushes his teeth frequently, but I’m afraid problems may be lurking beyond sight. Any suggestions on how to get him to agree to a dental visit? What can be done with people who are really afraid?
-Cindy of Fort Wayne
Dear Cindy,
See if you can get Bob to agree to a non-threatening appointment consisting of just an exam and any necessary x-rays. This action would put Bob in a position of knowing if he even has a dental problem and how severe it is. It has been my experience that people in Bob’s position typically don’t have as bad a dental problem as they imagine they have. If he needs treatment beyond just a cleaning, make sure he is comfortable with heis dentist. There are over 230 dentists in this area and only about a half dozen of them are truly clueless! That means the odds are overwhelming that he’ll stumble into the office of a highly competent dentist. Attitudes about pain control and fear can vary widely, however. Only about 35% of dental offices in this area offer nitrous oxide (laughing gas), and even fewer offices offer itat no additional charge. Arguable, I believer that any dentist who does not offer nitrous oxide does not take pain control seriously. The combination of nitrous oxide, headphones to drown out the noise of the drill, and the new, powerful Novocain’s delivered by the Wand instead of ol,d-fashioned horse hypodermics, can make the modern dental experience comfortable. If that is not enough, conscious sedation is also an option whose popularity is increasing. You simply take a pill and snooze through the procedure. Your pulse, oxygen saturation, and blood pressure are continuously monitored throughout the appointment. We offer conscious sedation in our office.
After having one of my molars refilled every few years since I was a kid, I recently had a crown done by my dentist. About a month after the crown was glued on, I had a toothache develop. I went back to the dentist and he told that now I needed a root canal. If that tooth needed a root canal, why didn’t he do it before the crown? The doggone root canal ended up costing more that the crown.
-Tammy of Pine Valley
Dear Tammy,
Most teeth that have crowns placed on them have either fractured or they have a long history of increasingly large fillings being placed and replaced as new decay arises and the fillings break. This replacement of large filling s stresses the pulp and this pulpal stress is cumulative. It is likely that the crown was the “straw that broke the camel’s back.” Sure, it would have been better to do the root canal first, but if you had no toothache at the time, doing a root canal would have been overkill. Only about 10% of teeth that have crowns placed need root canals shortly thereafter. If we dentists automatically did root canals on all teeth that were to receive crowns before the crown were placed, just think of how many unnecessary root canals people would get! You were just unlucky. Anytime that a filling to be placed makes up 50% or more of the chewing surface of the tooth you are better off placing a crown, right away. They are much stronger. By refilling a tooth multiple times over a couple of decades, you substantially increase the amount of money you spend on that tooth over a lifetime and you increase the odds that it will eventually need a root canal. It is much better to place the crown on the tooth when it is first indicated. It is always less expensive ultimately to fix it right the first time!
I am 30 years old and have always had fluoride treatments with my teeth cleaning. Recently I moved, and my new dentist said I don’t need a fluoride treatment. What has changed?
-Just Wondering in Wallen
Dear Wondering,
Dental hygienists are the fluoride experts of the dental arena. I’m going to pass your question on to Mary Krouse, RDH, our hygiene director and former Carroll High School valedictorian:
There has been new research on the use of fluoride products. While fluoride is still recommended for patients with a high risk of cavities, routine fluoride treatments provide little benefit to people with low decay rate. If you drink fluoridated water and brush daily with fluoride toothpaste, that may be all you need, as your dentist suggested.
How many teeth are people supposed to have? Our science book says 32, but my teacher says that is not always true.
-Nicole in Churubusco
Dear Nicole,
Your teacher is right! Standard issue is twenty “baby” teeth and 32 “adult” teeth. However, not infrequently people are cheated out of an adult tooth or two. In that case, the baby tooth usually stays in place since there is no adult tooth beneath it to push it out. I have seen people with baby teeth that have lasted until they were almost 60 years old. The number of third molars or “wisdom” teeth is also subject to variation. I have seen people with six wisdom teeth! The normal number is four. Evolution is easing humans toward a lower number of wisdom teeth. Currently, about 20% of people develop only three wisdom teeth or less. So, Nicole, if you only develop three wisdom teeth in your mouth, you can brag to your friends that your are more highly evolved than they are!
I am ten years old. My dad says that it is a good idea for me to take a Vitamin C tablet everyday, but my mom says that the chewable pills I take are hard on my teeth. Are they?
-Heather in Huntertown
Dear Heather,
Chewable Vitamin C is hard on your teeth because the vitamin is an acid and small particles of the pill will get stuck between your teeth and can cause cavities. However, it is probably no worse than eating candy. If you must use chewable vitamin C, take it with a meal and brush your teeth well afterward, as I’m sure you are already doing. Learning to take regular non-chewable pills or caplets is probably a better solution. The value of taking an inexpensive Vitamin C supplement is widely documented. This vitamin is involved in hundreds of processes throughout the human body. I advise all my adult patients to take at least 500mg of Vitamin C every morning and every evening.
I saw something on TV once about AIDS and dental offices. I haven’t been to the dentist for awhile. Is it safe?
Anxious in Albion
Dear Anxious,
Absolutely! In the entire history of AIDS in the USA, there have been five cases where patients contracted the virus in a dental office. Guess What? ALL FIVE WERE IN THE SAME OFFICE! After intensive study, the Center for Disease Control (CDC) determined DR. Acer of Florida, himself an AIDS victim, deliberately infected his patients, most likely by injecting them with his own blood during dental procedures. That was murder. In thousands of dental offices with millions of dental visits since then, NOBODY has caught AIDS at a dental office. Mandated “universal precautions” and advanced infection control techniques make the modern American dental office a very safe place. A look at CDC statistics indicates that AIDS is pretty tough to catch if you behave yourself! Although the “politically correct” crowd won’t want you to know this, the facts are that 44.7% of all AIDS cases are men who have sex with men and 20% of cases are folks involved with injection drug abuse. Only 10.3% are due to heterosexual contact and these are most likely women who had unprotected sex with men who have had sex with other men or men who shot drugs.
What are the consequences, if any, of having a pierced tongue on my teeth? I’m 20 years old and just had my tongue pierced about six months ago. I have been hearing that a tongue bar can cause cracks in a person’s teeth or stress fractures. Is this true?
A pierced tongue college student
Dear Ms. Pierce,
Of course! Reports have been documented from all over the pierced world concerning the fracturing of cusps and teeth due to the impact with tongue bars. Gee, who would have thought that a chunk of steel clanking around in one’s mouth would damage anything? Also a concern is that the point of piercing can get infected or serve as a portal to your bloodstream for STDs. Good luck!
I’ve had several caps put on my back teeth and now I have another tooth that has crumbled away to nothing. Is my only option a root canal and caps? I would like to just have the tooth pulled since it is the one in the far back on the bottom and there’s not much left of it anyway. I don’t want to spend $1,500 on this tooth, but my dentist says it should be capped. My question is can I just tell him to pull it and let it go at that?
Undecided
Dear Undecided,
If you just pull that bottom tooth, the top tooth will gradually drop down and you will eventually lose it, too. You mentioned that you have several caps on your back teeth already. Where would you be today if you had just pulled them instead of putting caps on them? Investing in your infrastructure isn’t exciting, but it is often necessary. It would help if I knew your age and general health. Ultimately it is YOUR tooth, YOUR responsibility and YOUR decision! I certainly don’t know your personal financial situation, but every month I see someone who can’t afford $1,500 for tooth repair but has no problem affording $15,000 for a new car!
My eighteen year old daughter is having trouble with her upper and lower left wisdom teeth. My dentist has recommended that they be removed, as well as the upper and lower right wisdom teeth. Why should I go to the trouble and expense of having the right side wisdom teeth removed when they aren’t hurting her?
Kathy in Fort Wayne
Dear Kathy,
Good question. If wisdom teeth are going to present a problem, they generally do it between the ages of 18 to 25. Without seeing an X-ray, it is difficult for me to evaluate the positioning of the right side wisdom teeth. My guess is that your dentist feels that her right wisdom teeth will soon be causing a problem even if they currently aren’t. I suppose that you could just have her get the left side out if you feel lucky, but you will be doubly unhappy if she has to return in a couple of years for the right side.
If your daughter is put to sleep to remove her wisdom teeth, it really makes sense to get all four out at one time. It is expensive to get put to sleep and it is harder on her body to do twice instead of just once.
Can the teeth on a denture be whitened? How about putting a set of dentures in the dishwasher?
Kathleen in Fort Wayne
Dear Kathleen,
For a technical question like this I called Bill Bryan, of Bryan Dental Lab. His lab is a family business that has been in operation since 1952. He said that modern denture teeth are made of special plastics that do not absorb stains. This means that they will also not absorb any of the tooth whiteners and bleaching agents that are on the market today. Denture teeth come in a wide variety of color-stable shades. It could be that you’ll have to get a new denture and just select a much lighter shade.
Putting dentures through a dishwasher is definitely a poor idea. The extreme heat could warp them.
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