I realize that this sounds kind of silly coming from a dentist who actually enjoys restoring teeth. But you must realize that in a perfect world, there would be no dental decay. Gum disease would be nothing more than a bad dream. The perfect world would be one where no one would need the services of a dentist or dental hygienist. Teeth would be self cleaning, perfectly white and straight and I would be out of business.
It’s fine. I’d find something else to do. I could spend more time working on my podcast.
But it’s not a perfect world. Dental disease is still rampant. People have decay and gum disease. People break teeth and fillings all the time. So we dentists are doing fine.
The “no dentistry is the best dentistry” concept is still pretty great, though. The idea of doing the least to teeth makes me feel better. Every restoration I place, no matter how meticulously crafted and handled is still way worse than what mother nature originally gave you. In fact, I’m just as happy if you have boring teeth as I am with exciting cases!
Each treatment plan that we create takes this into account. If I’m going to propose a treatment to any part of your mouth it’s important that my treatment leaves you better off than when you started. Whether that is the placement of the very first restoration a tooth has ever had or me removing of a sick tooth I want it to improve the health of that patient. Which means we (the patient and I) have to consider how invasive any given treatment is before we embark upon any permanent treatment.
How do we do this? First, I’ll probably take photos, videos or x-rays of whatever condition we’re looking at. I use these images to explain to the patient what I’m seeing, what the condition is (the diagnosis) and whatever treatment options they have. This includes the option of no treatment with my best guess as to what would happen if the condition isn’t treated. This leads to a conversation between the patient, myself and usually our team.
These are “we” decisions, not “me” decisions. When we determine the best option for the patient, we move forward. The best option is almost always the least invasive for the situation whenever possible.
My favorite treatment? Doing an in depth, microscope based exam on a patient that’s making great choices and taking care of themselves in such a way that I can say, “you look terrific! I don’t have any treatment to recommend!”
Did this make you feel minimalist? Did it make you want to floss your teeth? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, or you can “tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
Your brain is an amazing organ. Not only does it automatically control much of what your body does all day, every day…it manages a huge number of sensory inputs. From your toes to the top of your head, your skin is a giant sensory organ sending your brain constant signals about temperature, pressure and sometimes pain. Your ears are constantly sending your brain input from all the sounds happening around you. Your eyes are like two incredible HD cameras sending ridiculous amounts of visual data that your brain has to assemble into the things you see at any given moment. In short…your brain has a lot to do.
In order to make that possible, your brain has to learn some short cuts. Let’s be honest…all of the input your brain gets isn’t important. Brains are used to making decisions about survival. It’s definitely more important to notice the tiger jumping out from behind that tree than it is to remember that the car that just passed you a few miles back was blue. So the brain is pretty good at filtering out the stuff that’s less important.
Take for example the town where my mother grew up. It was outside a large chemical plant. When I would visit my grandparents the first thing I would notice was a distinct and strong “chemical” smell. It wasn’t exactly unpleasant, but it was very noticeable. It usually only took a few minutes before I didn’t notice the smell any more. My brain decided the distinct smell wasn’t a threat and it pushed the mute button. I just didn’t notice it after that. Brains need to be able to do this because the amount of stimulus that reaches the brain at any given moment would be otherwise unbearable!
Then you show up to your dentist’s office. Your dentist does an exam and it seems like all they have to say is negative stuff. Your fillings are wearing out. You have a couple of teeth that are broken. You’ve got some places between your teeth where food gets stuck. And then you’re all like, “hey Doc, why so negative? My teeth feel fine!”
And then you remember that yeah, now that you think of it, when you eat things like roast beef or anything stringy they always get stuck in the same spot. And wait a minute…a piece of that tooth not the lower right did kind of chip off, but it doesn’t hurt. In fact, I forgot about it.
Remember that crazy brain you have? The one that can tune out the way your dog smells after it got sprayed by a skunk? It realized that your survival wasn’t threatened by that obnoxious roast beef catcher between your lower molars, so it tuned that sucker out.
A partially broken tooth. Just one of the many problems you could get used to and not even realize!
The problem is that many of the dental problems I see every day don’t hurt one bit. Tooth decay is usually painless until it reaches the nerve of the tooth! Periodontal disease is usually doesn’t hurt right up until your teeth get loose! The beauty of regular dental care is that your dentist is outside of that amazing brain of yours and can help you determine where you might need some help and where you’re doing fine.[/caption]
So definitely trust your brain when you’re hiking through the African savannah or crossing the street. But maybe trust your dentist a bit more about the condition of your teeth. Because it’s possible you’ve gotten used to something that could cause you pain or problems down the road!
Did this make you rub your teeth with your tongue? Did it make you want to slide underneath one of our microscopes so we can get a closer look? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
The Halloween decorations are still up, but not for too much longer. It’s still about ghosts and goblins for now, but soon it’s going to be more about turkey and stuffing.
I hear this noise. It’s a quiet, barely audible ticking. But it seems like it’s getting a little louder. And a little louder.
You see, although the calendar says we have 1/6th of the year left, it kind of lies. Because time in the last two months of the year becomes much more precious. The holidays bring their own special kind of busy. Whether it’s stocking up for a Thanksgiving feast or Christmas shopping for the grandkids, everything takes time.
If you’re anything like me…you’ve let things pile up. You’ve got a lot of things you were hoping to get done in 2017 and now we’re getting close to the end of the year.
A lot of you probably left some needed dental work until now. Now is the time you can use benefits without worrying about the fact that you “might need them for an emergency.” Your benefits run out at the end of this year and you’re leaving money on the table. You’ve already spent those dollars on premiums or spend downs. My friends, that money is gone.
If you’ve got benefits left and treatment that’s been diagnosed…it’s go time. It’s “let’s use the benefits we paid for time.” Let’s do this.
Call (989) 799-9133. As of now (November 1st…and counting) we’ve still got a little room on the schedule. But it’s going to fill up.
Do. Not. Wait.
That ticking you’re hearing…it’s going to get louder.
Did this make you feel urgent? Are you feeling like you need to get some dental work done? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
I recommend a crown or an onlay to lots of my patients. It’s one of the most common procedures we do and we do it very well if I say so myself. A crown is created by a lab and cemented over top of a patient’s existing tooth structure to restore form and function and to reinforce that patient’s tooth. They’re very predictable and work really well.
“How much does this wonderful service cost?” you might ask.
The answer is going to vary by geography but it’s typical for a crown to cost around $1000. A little less in some place, a lot more in others.
“A thousand bucks? You’ve got to be kidding me! That’s a lot of money for one tooth! Who do you think I am, Bill Gates?”
I hear you. $1000 is a lot of money. Who wouldn’t want to spend it on something else. Something fun like a phone, some shoes, a trip or whatever. But let’s take a look at that $1000.
Our office charges slightly less than that $1000, but the math is easier with $1000.
Most dental benefits companies will replace a crown after it’s been in the mouth 5 years. That is not typical, though. My experience tells me that crowns typically last 15 years or more if the patient has good oral hygiene, good saliva flow and has risk factors like dry mouth and high decay rate under control. Lets take 15 years as a reasonable lifespan for a crown.
Now be honest…what other things do you own that have lasted for 15 years? Is your car 15 years old? How about your phone? Your shoes? Bottom line, there’s almost nothing that you spend money on (sometimes a LOT of money on) that lasts as long as dentistry does in a healthy mouth.
A $1000 crown costs you $1000 on the day that you pay for it (or less if you are using a dental benefit…your mileage may vary).
If that crown lasts for 15 years, you’ve amortized your investment in that crown to $66.66 per year. So for $67 you’ve got a beautiful and functional tooth that you probably don’t have to give another thought.
Is $67/year a little too abstract for you? How about this. You’re talking about $5.55/month over 15 years for that crown. One less latte from Starbucks will give you pain-free beauty and function.
OK…let’s get stupid here. 18 cents per day. That crown is three nickels and three pennies per day for 15 years of chewing, smiling and not thinking about it. I’d say it’s worth it in spades.
It actually gets better, though. I’ve seen crowns last longer than 15 years. If you’re really good about taking care of your teeth and watching your diet there is no reason a crown cannot last longer. I’m not going to pretend that ever crown is problem free. To be honest, if we’re trying to restore a particularly broken down tooth, it’s tougher to get that predictability and longevity. Furthermore, some teeth require root canal treatment (again…the more beat up the tooth, the more likely this is). So I don’t want to oversimplify.
The point is to look beyond the price tag that you see in the office and think of the cost over the life of the crown. These restorations feel expensive on the front end, but if you look at the long run they’re a pretty great bet!
Did this make you feel thrifty? Did it make you want to invest in a new crown? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
Last week I found myself in a spot that I don’t like to be in. A couple of times. I found myself preparing a crown on a tooth that was in much worse shape than I would like. One case was a new patient that I had just started treating. The other patient was one that had waited on treating the tooth until it broke. We had diagnosed an “incomplete fracture” on the tooth some months (years?) before and recommended a crown, but for whatever reason the patient had decided to wait. As I’ve discussed in the past, most dental problems don’t hurt until they’re a big problem.
Crowns or onlays are “indirect restorations.” Which means they are made indirectly from the tooth, by a lab. Direct restorations are made right on the tooth…most people would call these “fillings.” By the time a tooth is in need of an indirect restoration there has probably been a lot of tooth structure lost. Most of these teeth have been worked on before, often having had direct restorations placed. How do we know when a tooth is ready for an indirect restoration? There are a few signs I look for:
cracks: the way teeth are designed is interesting. The outer enamel layer is very brittle and it’s stuck to a deeper dentin layer that is slightly softer which surrounds the pulp (nerve, blood vessel and connective tissue) which is soft and gooey. This is some amazing structural design, but as you age and your teeth are filled, heated, cooled and used for biting…they can develop cracks. Sometimes the cracks are superficial, sometimes they are deep. The good news is that at Mead Family Dental we’re pretty good at finding them. The microscopes that we use throughout the whole office are great at helping us see fractures in teeth…often before they become a big problem.
wear spots: as you age, you wear your teeth. Some people wear their teeth significantly more than others. Just like tires, once you’ve worn your teeth down, they don’t fix themselves!
existing restorations that are failing: What do you mean my filling broke? It’s only been in there for 15 years! I wish every restoration I placed would last forever, but that’s not how it works. Ask yourself this question: has it ever seemed like you justbought a new set of tires and then you see that you actually got them 50,000 miles ago? Yeah…restorations in teeth seem kind of like that, too.
decay under an existing restoration: Your mouth is full of bacteria and your teeth are covered in biofilm…even if you’re a terrific brusher! Those bacteria are tiny and all it takes is a small leak in a filling or crown for them to sneak underneath and start multiplying. It happens to the best of fillings and crowns. Luckily, we can usually fix that decay so long as we are able to catch it early.
Your adult teeth have been functioning in your mouth since you were about 6 years old. They’ve been through a lot. Accidentally biting an olive pit, millions of hot—>cold and cold—>hot thermocyles (have you ever eaten ice cream while drinking coffee?) and hundreds of thousands of acid attacks. Frankly, teeth hold up amazingly well considering what we put them through. There’s no shame in having to reinforce what you were born with. In fact, I would suggest that it’s best to do this as soon as any of those signs start showing up.
Here’s the thing…the longer we let the problem go, the more difficult it is to fix. Ask any dentist and they’ll tell you. It’s much easier to save a tooth before it’s broken than after. Small cavities are much easier to deal with than big cavities. I’d much rather do an onlay on a tooth now than wait until it needs a root canal. I realize this sounds incredibly self serving for the guy who gets paid to fix your teeth to tell you that you should jump on things earlier than later. But remember, I’m a giant wuss when it comes to delivering bad news. I’d much rather place a really well fitting crown on a tooth with a healthy nerve and gums and solid bone to support it. The longer we wait on cracks, decay and failing restorations the worse the outcome is likely to be. No dentist wants to “make the save.” Teeth that have these problems are more difficult to clean up, more difficult to impression and more difficult for the lab to make an ideal restoration.
So, the moral of the story is…don’t wait! Often times I can make the save. But I’d much rather not have to!
Did this make you feel safe? Did it make you want to only eat soft and lukewarm things? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.