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Browsing 4 posts in oral hygiene.

How long will this last?

So there I sit, next to my patient. I’ve removed their temporary crown and am getting ready to place our beautiful new porcelain crown. It’s finely adjusted and exquisitely polished. We’re ready to rock and roll. Then…the question.

“Doc, how long is this crown going to last?”
“How long do you think it should last?” I ask.
“I don’t know. For as much as it costs, it should probably last forever!”

I’ve had some variation of this conversation many times before. I’m asking the patient to spend a bunch of time and money for the work I’m placing. Why shouldn’t it last forever? Or at least a really long time?

In a perfect world, the dentistry that I place will last forever. In this same perfect world, you wouldn’t have to change the oil in your car. Or replace your roof. Or change the filter in your furnace. Or mow your lawn.

Actually, that crown we just placed would love to switch places with your roof. The conditions that your roof has to put up with are a cake walk compared to your crown. A little snow, wind and rain and some gradual temperature changes? Pffffft. Nothing to it!

Let’s do the math.

Let’s say you chew each bite of food 10 times before you swallow it. (A very conservative estimate, but it makes the math easier) Then let’s say each meal you eat has about 20 bites.

You just used that crown 200 times while you ate lunch. Multiply that by 3 meals and you’re working on 600 times per day. If you don’t eat snacks. And don’t even get me started on chewing gum!

So yeah, you use your teeth for chewing a lot. But most restorations will handle everyday chewing pretty handily. Leaving out the unpopped popcorn and olive pits, chewing isn’t the real problem. The real problem is the environment that we’re placing this crown in.

  • Your new crown will have to tolerate temperatures ranging from 150-170 degrees F (hot coffee) to 20-30 degrees F (ice cream). Sometimes within seconds of each other.
  • Most crowns will have to tolerate acid attacks throughout the day.
  • Your crown will be almost constantly covered with bacterial biofilm that resists efforts at removal.
  • Many crowns will find that their owners grind their teeth throughout the night while they are sleeping.
  • Some crowns will need to resist bad habits of their owners like ice chewing and lemons sucking.

The bottom line is, the mouth is a pretty tough place for this beautiful new crown to have to survive!

What’s a realistic estimate for a crown or filling to hold up? The unsatisfying answer: it really depends. In a person who avoids sweets and sodas, who takes exquisite care of their mouth (brushing and flossing), who doesn’t take any medications that might dry their mouth, who doesn’t grind their teeth at night and sees a dentist regularly in an effort to catch problems while they’re still small…you could easily see a restoration last for 15-20 years or longer. Regular wear and tear, even in the most “low risk” patients will probably do in any dental work placed if you live long enough.

How can you make your dental work last as long as possible?

  • Brush 2-3x a day with a soft bristled brush and floss once a day.
  • Chew sugarless gum or suck on sugarless mints after meals to stimulate saliva flow. Preferably flavored with xylitol.
  • Drink lots of water.
  • Avoid sugary foods and reduce between meal snacking.
  • Keep up with regular dental appointments. At least twice a year and more if you have risk factors like taking medications or having conditions that create a dry mouth.
  • If you have problems, get to the dentist for treatment right away!

So, back to my conversation with my patient.

“Doc, how long is this crown going to last?”
“How long do you think it should last?” I ask.
“I don’t know. For as much as it costs, it should probably last forever!”
“The only way I know how to make this crown last for that long is to store it in box. In a really safe place.”
“Um. O.K. Let’s just put it on the tooth and I’ll try to take care of it.”
“Alrighty then!”

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I really should…

  • …stop eating this way.  Donuts for breakfast, fast food at lunch and extra helpings at dinner are really catching up with me.  The doctor has told me for years that my diet is the reason that my cholesterol is so high and that I'm looking at dealing with type II diabetes as I get older…
  • …exercise more often.  I haven't been active on a regular basis for a long time.  It's embarrassing, but sometimes the stairs make me a little winded!  I used to be on the track team when I was in high school.  It would be a lot easier to lose this weight if I just added 30-40 minutes of walking or picked tennis back up…
  • …quit smoking.  It's not like I don't know it's bad for me.  You can't turn on the TV or listen to the radio without hearing some new study describing the health effects of smoking.  I would love to not worry about my breath or the smell on my clothes anymore, too…
  • …floss every day.  Every time I see my dental hygienist she reminds me that my gums are bleeding for a reason.  I don't like to have to see the dentist for fillings and bleeding gums can't be normal.  Maybe my breath would be better if I took a little better care…

Conscience O.K.  Be honest.  Has the little voice in the back of your mind ever said any of these things to you?  Mine has.  Usually when I'm going through the drive thru at Long John Silver's.  Clearly all of these things are important and as a health care professional I recommend that you take each one seriously if it applies to you.  As a person, I'd like to point out that one of those items is quite a bit easier to add to your lifestyle.  If you aren't sure which one, read them again.  If you still aren't sure, remember that I'm a dentist and this blog talks a lot about teeth and dental care.  

Here's the deal.  Get yourself some floss* and put it in the shower.  When you've got the shampoo in your hair, rinse those fingers and pull out a nice long piece.  Take a minute or two and floss those pearly whites.  We've already determined that flossing is gross, but necessary.  Since you're in the shower, you can rinse your mouth and your hands as soon as you're done!  It's a perfect solution, if I do say so myself.  

Then, the next time that little voice in your head bugs you about what you really should do, you can remind it that you've already taken some positive steps!

Now, put down that donut and get to work!

*you can get free floss at our office.  Call to make an appointment at (989) 799-9133 or email me at alan@meadfamilydental.com.  We'd be happy to have you!

Brush first, then floss? Floss first, then brush?

So which comes first, the chicken or the egg?  I’ve heard arguments from knowledgeable people for one or the other.  So which is it?

The main argument for “floss first, then brush” is that flossing is nasty.  It’s very important, but kind of gross.  Even in the cleanest mouth, the bacteria that you find under your gum line (known as “anaerobes“) is pretty smelly.  You get stuff on your hands, you get stuff on the mirror and in general, it’s messy.  So if you floss first, then you can brush the nastiness away.

With that said, I’m a strong proponent of “brush first, then floss.”  When you brush with toothpaste, you’re removing the bulk of the plaque on the teeth as well as placing fluoride on the teeth.  This fluoride helps to remineralize spots on the teeth where cavities have started.  However, you can’t really get your brush in the spots between teeth.  This is where the flossing comes in.  When you floss after you brush, you can force the topical fluoride left behind after brushing into the “in-between” spots.  In this way, you’re getting the most benefit of the fluoride from your toothpaste.

ACT

So what’s the solution for the nastiness of flossing?  My new favorite dental health product: ACT Total Care Mouthwash.  I can see the headlines now: “Saginaw Dentist Shills for Big Pharma.”  What I like about this stuff is that it tastes really good, like a mouthwash, but also delivers an “over the counter” dose of fluoride as well.  There are probably other brands that have both a fresh, minty finish as well as fluoride, but I haven’t seen them yet.

So try both out.  See what you think and let me know at alan@meadfamilydental.com  Honestly, if you’re one of the few people who floss each and every day, I don’t really care when you do it…just keep doing it!