It’s like this…drinking a lot of pop can cause cavities. The more pop you drink, and the slower you drink it, the greater your chances of getting cavities.
I’ve written about this before. A lot, actually. In fact, many of my patients get sick of me telling them about it. But hey…I’m a doctor. I’ll bet diabetics get tired of hearing their physician tell them that they need to lay off the M&M’s and donuts, too.
I recently examined a patient who admitted to being a serious on-the-job pop drinker. He told me with no prompting that he was done with pop. He didn’t like how it made his teeth look. So, of course, I took a picture.
"pop cavities" (click to enlarge)
He had a few things going on that are classic for pop drinkers:
front teeth: He had quite a few cavities, but they were limited mostly to his upper front teeth. If you think about it, that kind of makes sense. When you sip a highly acidic and sugary beverage what does it hit first? Your upper front teeth. So that’s where the acid and sugar starts to work.
“white spot” lesions: This is the chalky, white spotting that you can see on tooth enamel that has been partially dissolved by acid. The good news about white spot lesions is that with some intensive fluoride treatment they can be reversed. However, continued acid and sugar will cause a white spot lesion to turn into a…
“pop cavities:” That’s just what I call them. This is the yellowish-brownish hole you can see once the acid has really broken through the enamel of your tooth. The second layer is darker colored and much more susceptible to the acid. Once you lose your enamel, that tooth is a much greater risk to form a pop cavity.
So what can you do if you like your pop so much that you don’t want to stop? I have a couple suggestions:
So, are you a pop drinker? You ought to check out your front teeth in a mirror. Or, better yet, come in the office and let us take some photos. We can take a look at them together on the iPad and see if you’ve got any “pop cavities.”
Did you find this post refreshing? Fizzy? Annoying? 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
Yesterday ABC played a story in their “Hidden America” series entitled “Do Dentists Turn Children Away.” It’s an emotional piece, for sure. It features many adorable low income kids in various states of dental distress and it levels some pretty serious charges at government and the dental community. Chris Cuomo, the story’s reporter, ended the story with, “…we went after them 5 years ago, it didn’t get done. This time we will not rest. This is unacceptable.” Diane Sawyer replied “And what about the good dentistsout there that want to help the 60% [of children on Medicaid without a dentist] who are living their lives right now and can’t wait…” Chris Cuomo went on to mention that some dentists are “doing the right thing…” The take home message I get from this report is that “dentists don’t care about poor kids.”
"not acceptable!"
This report comes on the heels of ABC’s coverage of “dental x-rays causing brain tumors.” It seems that dentists are getting all kinds of help from ABC news to tarnish our images this month! Like we needed it! So why won’t dentists take care of these needy kids? Is it that they don’t care? Or maybe they’re just unwilling to make less money while helping poor people. Either way, dentists are clearly bad guys.
I can only speak for myself. I’ve discussed this with other dentists often and most tend to agree with my perspective, though. I do take limited amounts of Michigan’s version of Medicaid dental coverage for kids/adolescents/young adults. Why don’t I take more? Here’s a few of those reasons:
limited services: This is probably the main reason that I’m hesitant to get more involved with these programs. I have a toolbox that I bring with me when I treat patients. (Not literally…I actually have an office!) I have a lot of different treatments to offer for different dental problems. Some of these tools work better in some situations, some work better for others. In extensive problems, some of these just aren’t workable. One of the things that frustrates me is that Medicaid will pay for a root canal procedure to save a tooth, but they will not allow you to restore the tooth appropriately after the root canal treatment! A lot of teeth that end up requiring a root canal have lost a lot of tooth structure. A filling is inadequate for these teeth, but that’s what is covered. If I go ahead and do what I feel as appropriate, the program will not cover it and it becomes the patient’s responsibility. Most patients aren’t willing or able to pay for the appropriate treamtent. So, my toolbox gets much smaller for patients using these programs.
limited payment: The fees that the Medicaid programs pay are low. That’s what everyone knows. The news programs always say this, but they never dig any deeper than that. To be specific, Healthy Kids dental in Michigan reimburses my office at about 50% of my regular fee. People hear this and think that dental offices make 50% less when they see kids on the Healthy Kids program. That’s not accurate. Most dental offices are small businesses run to make a profit. A dental office needs to collect a certain amount of money just to pay rent, utilities, equipment costs, employees…the basics. This is called overhead, and every business has it. You need to average a certain number of dollars for each unit of time in order to keep the doors open. If you don’t average this amount, the office doesn’t make a profit. Some offices can change their overhead structure by working more quickly, seeing more patients, using less expensive materials or paying their employees less to make up this difference. I won’t do that. I don’t want to have to change the way I treat patients to be able to participate with the program. My patients expect amazing service and a certain atmosphere and I’m not willing to sacrifice that. You may think that makes me a snob, but I think my patients appreciate it. So, when I see Healthy Kids patients, I’m working for free. The good news is, overhead is figured on an average, so I’m willing to take a loss on some patients. But as I mentioned before, I limit the number of patients I will see on the program.
ethical traps: Medicaid programs give each provider dentist a particular menu of procedures and their associated codes that are covered benefits. It could be tempting for a dentist to “overuse” a code that they wouldn’t normally charge separately for. I’m not saying that it’s wrong to do so and I’m not saying that it is common. All I’m saying is the that the temptation to “overcode” can be there.
All kids deserve healthy teeth!
dental prevention: Most dental diseases, especially in children are 100% preventable. These programs are at their absolute best when they are used for prevention: specifically early childhood examination and education of good dietary and brushing habits. Unfortunately, most people end up in need of these services after a child has problems, often really bad problems. The horse is already out of the barn at that point. These programs become much less helpful for those patients, and they will often need extensive care that can only be handled by pediatric dentists.
This is where I’m coming from. I’m not sure it would be a satisfying answer for Diane Sawyer. It’s a lot better TV when you can point the finger of blame at a particular group, especially when a lot of folks are pretty anxious about that group in the first place. The news media plays a story that riles people up, and then they forget about it. In the mean time, people look at dentists as greedy and uncaring. If you feel like dentists aren’t doing good things for poor kids, you need to ask yourself: in the same position, would you be willing to work for free? How much work would you be willing to do for free?
The Michigan Dental Association will be sponsoring it’s first Mission of Mercy in June of 2013. These amazing events allow Michigan dentists to see around 2000 patients in a weekend for no charge. Next year’s Mission of Mercy will be held on campus at Saginaw Valley State University. I’m planning on being a part of the 2013 MOM. I think this kind of event is an effective way to help people who might otherwise not be able to get dental care. So Diane Sawyer might have it wrong about dentists!
Did you find this post frustrating? Thought provoking? Angering? 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
I recently wrote about some new research that connected dental x-rays to a common brain tumor called a meningioma. Unfortunately, the news media took the “connection” from the research and made some pretty sensational claims. It made a lot of dentists pretty mad and it made a lot of patients pretty nervous.
Today I got a suggestion from a Facebook friend:
“Al, I’ve seen the phrase ‘levels of radiation that are so small as to be insignificant’ used a fair bit in the last few years. Particularly in relation to the Japanese disaster and the observation of levels of radiation around the world due to it…I think it would be instructive to have hard numbers to compare to background and other common sources that are considered safe.”
I agree. I’ve been explaining how safe x-rays are to patients for so long, I’ve kind of forgotten about the actual amounts of radiation that we expose them to. So let’s talk a little bit about radiation.
Electromagnetic radiation like visible light and x-rays travels in waves. And I have a cool graphic of it.
Electromagnetic radiation, or EMR, is any form of energy that travels in a wave. Visible light, radio waves, microwaves and x-rays are all forms of EMR that are common to us. The different types of EMR are characterized by their wavelength and frequency. Longer wavelength radiation like radio waves and have a lower frequency and are considered “low energy.” The shorter the wavelength the higher the frequency of the energy and generally these are “higher energy.” Very high energy like x-rays and gamma rays that can cause an electron to break away from an atom are considered ionizing radiation. These are the kinds of radiation that can cause health problems. Too much ionizing radiation can cause damage to the DNA in a person’s cells, which can lead to tumor formation and even cancer. The high energy state of x-rays is also what makes them so useful for seeing structures inside the body. Visible light is stopped by the skin and soft tissues around your bones and teeth, but x-rays can penetrate through them to show us things that we cannot see with visible light alone.
Harm from radiation sources is “dose dependent,” which means that more is worse. So in order to maintain safe levels of radiation in the dental office we need to know what kind of dose that we’re giving. The dose of radiation is measured in millirems or mrem. You can actually calculate common radiation doses using this chart from the American Nuclear Society.
So what is a “safe” level of radiation dosage? According to the American Nuclear Society the average level of radiation per person in the United States is 620 mrem/year. The safe allowable dose for people that are exposed to radiation in their work (nuclear plant workers, radiology technicians) is 5000 mrem/year.
Here are some examples of radiation dosages for different common exposures:
1 bitewing or PA dental x-ray: 0.5 mrem
2 hours in a jet plane: 1 mrem
1 panoramic dental x-ray: ~3 mrem
living in a stone, adobe or concrete house (instead of wood frame): 7 mrem/year
a full mouth set of dental x-rays: 9 mrem
chest x-ray: 10 mrem
1 pack of cigarettes each day: 36 mrem/year
chest CT scan: 700 mrem
whole body CT scan: 1000 mrem
These numbers reflect conventional film x-rays. Many dentists use digital x-ray technology which needs significantly less radiation to make x-ray images. In some cases the amount of radiation needed is 80% less than conventional film radiography, which would yield even lower radiation doses.
How much is too much?
Even though dental x-rays have an incredibly low dose of radiation, it makes sense to limit the amount of radiation as much as possible. Patients with a proven track record of low decay rate are an example of a type of patient that may not need diagnostic x-rays each year. Other diagnostic methods like high magnification with intense lighting, evaluating saliva flow and dietary evaluation can help determine a patient’s risk for new decay. For patients who have experienced cavities recently or new patients that don’t have a track record with their dentist, taking dental x-rays on a regular basis is necessary diagnostic tool.
So what’s a patient to do? How do you know if an x-ray is necessary? You need to ask your dentist. And if you don’t feel like your dentist is hearing you, perhaps you need to find another. Having a relationship with a dentist whose opinion you trust is a great way to know that you’ve found a good balance between too many x-rays and not enough information to prevent dental problems.
Did you find this post helpful? Zealous? Wonderful? 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
I see it all the time. A look of concern on a mom’s face while their child is having their teeth cleaned. “Are there cavities?” they wonder. “Will they need braces?” Wouldn’t it be nice if you could relax in our comfortable waiting room knowing that your kid is going to have a brilliant dental check up? Here’s some things you can do to give your kids a really good shot at dental health!
Be a great example: Your kids see and hear everything that you do. And they somehow always repeat what you’ve said at incredibly bad times (think “daddy doesn’t like Grandma’s cooking” at Thanksgiving dinner). So they see how you take care of your teeth, too. They notice if you brush and floss often, or not. They’ll see you chew sugarless gum after meals and will probably want some, too!
Get your teeth fixed: tooth decay and gum disease are a bacterial infections. They are transmitted in a similar fashion to a cold. The bugs that cause tooth decay are almost always transmitted from mother to child, although anyone who is a prominent care provider (dads, grandparents) can also transmit them. What I’m saying is that your kids will have your bugs. What determines what kind of bugs you have? People who have lots of cavities, particularly lots of untreated cavities will have nastier bugs. So, if you’ve got a history of lots of cavities or you have work that you need to have done, you probably have nastier cavity bugs. And you’ll probably transmit them to your kids. The moral of the story…have your teeth fixed and your kids will have healthier teeth.
Bring ‘em in early, and often: The American Academy of Pediatric Dentistry (AAPD) recommends “first visit by first birthday.” Practically speaking, you should bring them in once they have their first tooth. And they should be checked every year after that until they start having their teeth cleaned, which is usually around the age of 4. Having a dentist look at your child’s teeth often can help find problems while they’re small. Since baby teeth are actually more susceptible to cavities than adult teeth, this is pretty important.
You brush their teeth, then let them brush their teeth: It’s great to raise independent children. It’s great that they want to take care of themselves. But you need to brush their teeth. An adult should brush first, then the kiddo brushes second. Parents, you’ll need to brush with a firm hold on your little cherub’s head. And you need to retract (pull apart) their lips with the hand that you’re holding their head with so that you can see the surfaces of their teeth. As one pediatric dentist once told me, “if you can’t see what you’re brushing, you’re not brushing it well.” Once you’ve scrubbed all the surfaces, then let the child have a chance to do the same thing. How long until they’re old enough to brush on their own? Well, my oldest is 4 years old and I’m thinking it’s going to be 6 more years of me using the “loving headlock” on him.
No bottles in bed!
Don’t put a baby down with a bottle: Don’t get in the habit of putting your baby down with a bottle. Once they get used to it, it’s much more difficult to break the habit, so don’t do it! Even if you’re giving them formula or breast milk, there are still sugars in them that can be turned into acid by cavity bugs. Pediatric dentists often times call the massive tooth decay found in very young children “baby bottle tooth decay” for a reason. If you have to put a baby to bed with a bottle, use only water!
Reduce the juice: When you think of fruit juice you think of “wholesome” and “healthy.” When I think of fruit juice I think “tons of sugar” and “high acid content.” Kids should have limited fruit juice intake. It’s really tough on teeth and almost always has a lot of added sugar. I know it goes against how fruit juice is marketed, but it’s true. Eating fruit = great! Drinking fruit juice = really bad for teeth. If you want to give your kids juice, do it at meal times…not snack time!
If you do these things the risk factors for cavities and other dental problems can be reduced significantly! So when you’re waiting for your baby to have their cleaning finished you can sit back, relax and know you’ve done your job. Ahhhh! Doesn’t that feel better?
Did you find this post helpful? Informative? Bone headed? 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
Sooner or later, it’s probably going to happen. If you’ve got a tongue stud or a lip piercing, you’re going to break a tooth. Or maybe something worse.
Really, I don’t like being the square who tells you that your pierced tongue is a problem. I’d love to tell you that there’s no risk to your teeth and gums. But I’d be lying. It’s not that every single tongue or lip piercing is going to break a tooth, but you increase your risk significantly by doing it. Just like drinking a lot of pop increases your risk for cavities. In fact, oral piercings increase your risk of several dental problems.
"Doc, I'm terrified of needles!"
If you’ve ever been around someone with a new piercing, you’ll find that people play with them. It’s a new and different feeling and it’s your tongue’s job to make sure it checks everything out in your mouth. So you’ll clack that thing against your teeth. Or you’ll push it up against the roof of your mouth. You’re going to mess around with it. Worse than that is the fact that you have these two weighted masses (one on the top, one on the bottom) on either side of your tongue that can affect your tongue’s proprioception. Proprioception is a very fancy word that describes the way your nervous system just knows where it’s parts are. The reason that you can touch your nose with your eyes closed is because you have proprioceptive nerve cells that describe to your brain where your finger is compared to your nose. It’s like the body’s GPS system for it’s parts. Adding a tongue stud throws these proprioceptive nerves off the same way holding a barbell in your hand would throw off that little “touch your nose with your finger” exercise. The likely result is that you’re going to accidentally bite that thing or whack it against a tooth. Do this enough times and you’ll probably break a tooth.
an odd place for a tooth to break
I recently saw a patient who had a broken tooth that was sensitive. I see a lot of broken teeth, but this one was broken in an odd place. So I asked him if there was a great story…and there was. His answer, “I used to have a tongue piercing. It broke that tooth, so I took it out the day I broke it.” So, there you have it. He decreased his risk of another broken tooth by taking it out!
There are little strings that attach your lower lip to your jawbone. Look in a mirror while you pull your lower lip forward and you’ll see them. These things are called frena (singular: frenum). Some folks have a frenum attachment that’s pretty close to the gum line of their lower front teeth. If you add a lip piercing, you can get a pretty consistent tug on these frena. And sometimes, the gum tissue starts to recede around those front teeth.
It's all fun and games until your gum starts receding
This kind of aggressive recession actually causes you to lose the bone that supports those teeth. What can happen then? You could lose those teeth. Often the procedures needed just to hang onto those teeth (gum grafts and other reconstructive procedures) can be expensive and unpredictable. So again, having this kind of a piercing isn’t a guarantee that you’ll have these problems, but it increases your risk of problems significantly.
Finally, the piercing procedures themselves have a great risk of infection. I’ve been told that the people that do piercings take great care to make sure that they use clean and sterile instruments and I have no reason not to believe them. But even the cleanest and best procedures done by folks with high levels of training are at risk for infection. Most people wouldn’t choose to have surgery on their lip or tongue without a good reason. But oral piercings are essentially surgery, or at least the healing that you must do is the same. All surgeries have risk of infection, and piercings are no different. Worse than that, someone who’s gone through the decision to have a piercing and the procedure itself isn’t likely to take it out. Even if it’s the problem causing an infection!
"I didn't sign up for an infected tongue!"
What can I say? I’m a buzz kill. Oral piercings increase your risk of broken teeth, gum problems and infection. You shouldn’t do it. But if you do, realize that there are problems, sometimes expensive problems, that you may have to deal with! On the other hand, I want you to know that if you have a problem with a piercing, I’m happy to help. I’ve treated many people with complications from piercings and I can help if you’ve had a “piercing induced problem.” You can easily request an appointment on the website or call us at (989) 799-9133. We’re here for all of our patients…even those with piercings!
Did you find this post helpful? Silly? Earth shaking? 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
You know the ones. They’ve never had a cavity in their life. They have beautiful straight teeth but have never been further than the dental hygienist’s chair. They’ve never experienced the drooly feeling of a numb lip or been subjected to their dentist’s cheesy jokes (yeah, it’s not just me.)
If you are one of those people, then good for you! No one aspires to be an “interesting case” for their dentist. Rest assured that this Saginaw dentist loves all kinds of patients…interesting or boring.
So what’s the difference between a “boring” patient and an “interesting” patient? Can patients that have had a lot of dental needs learn something from those that haven’t? Probably. Let’s look a little closer.
In general, the “boring” patient has reduced risk factors compared to those who need a lot of work. These risk factors can include hereditary factors, dietary factors, anatomic factors and personal habits. There isn’t necessarily a single reason that will make or break you for risk of dental problems. It’s almost always a combination.
You almost always get your oral bacteria (mouth bugs) from your mom. Or whoever your primary caregiver was at the time you first had teeth. If they suffered from a lot of cavities and gum disease, you probably inherited some pretty tough mouth bugs.
The grooves on your back teeth (and some front teeth) can be deep or shallow. This is determined by genes. People with deeper grooves are at much greater risk to develop groove cavities.
If you have reducedsaliva flow, you’re much more likely to have dental problems. Reduced saliva flow can come from age (older folks seem to have reduced saliva flow), some illnesses and particularly from certain medications. There could be some genetic factors involved with your natural level of saliva flow, too.
If you grind your teeth, you’re much more likely to have dental problems. Most tooth grinding takes place while you sleep and is not under your voluntary control. Most everyone has some amount of night time grinding but actual tooth damage depends on how hard and how often you grind your teeth. Your level of stress, size of your jaw and chewing muscles could have a lot to do with this.
Your diet can have a lot to do with how much dental trouble you experience. If you eat a lot of sugary foods or drink a lot of sugary beverages (pop and juice come to mind) the mouth bugs that you have can turn that into acid, which can cause cavities. If you eat a lot of acidic foods (citrus or pop, for instance) this can cause the enamel on teeth to dissolve! Some cultures eat food with a lot of abrasive materials in them (Central/South American and Middle Eastern cultures come to mind) which can also cause tooth troubles.
I’m definitely not taking anything away from those who work hard at taking care of their teeth! If you brush correctly and often, you’re much less likely to have cavities. If you’re a regular flosser (and not just the day before your cleaning!) it’s going to show up in healthy gums and less cavities. How well you take care of your teeth definitely matters!
The good news is, we have control over at least a few of these factors. You can’t really control where you get your mouth bugs, but there are things we can do to change them. You can’t control if you have deep grooves on your back teeth, but closing them up early and aggresively can reduce the troubles you experience. Even though we can’t really prevent tooth grinding, we can make an appliance to keep the damage to your teeth at a minimum. Diet and how you take care of your teeth is 100% under your control!
So to the boring dental patient I say “kudos to you!” The rest of us aspire to be like you and you help us understand what we can do to reduce our own dental problems!
But does that mean that you don’t really need to come to the dentist?
Did find this post helpful? Awe inspiring? Annoying? 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
It’s basketball season. So we’re seeing a lot of fans. MSU fans, U of M fans, Pistons fans and a whole lot of different high school basketball team fans. Those fans LOVE rebounds! Those aren’t the rebounds that I’m talking about.
Quite a few of our patients 50 and older are taking some kind of anticoagulant medication. Aspirin, Coumadin, Plavix or even the newest ones like Exanta are used to prevent the buildup of plaques in the arteries of the heart. And they work. They cause the blood to be less “sticky,” which can help reduce the risk of heart attack, stroke and embolism in those with artery blockage. The side effects are that they can cause bruising and extended bleeding from wounds. Some dental treatments, particularly surgeries like tooth removal, can cause mild to moderate bleeding. Since bleeding is the first step in wound healing, this is O.K.
In the past, those taking anticoagulant medications were sometimes told to stop taking them 2-3 days prior to a tooth extraction. It was a gray area. Some docs said 2 weeks, some docs said a couple days and some docs said “don’t worry about it.” A lot of patients have been taking these medications for awhile and what they remember is that they stopped taking them for an extraction.
More recent research has described the “Plavix rebound.” It happens when someone discontinues anticoagulant therapy suddenly. Like 2 days before an extraction. This rebound effect puts the patient at significantly higher risk of stroke, heart attack and embolism for the NEXT 90 DAYS! Although most of the current research is with Plavix, the same effect has been known for quite some time with older anticoagulants.
So let’s say you’re on an anticoagulant and you need a tooth removed. My experience has been that in most cases we can remove the tooth and control any bleeding in the office without taking you off your medication. We have a lot of techniques including more minimally invasive surgical techniques as well as wound closure techniques that make postoperative bleeding a non-issue. If you or your doctor have concerns about wound healing I’m happy to discuss it with your doctor. But my guess is that now the risk of “rebound” is much greater than the risk of postop bleeding.
So here’s the deal: DON’T STOP TAKING YOUR ANTICOAGULANT MEDICATION WITHOUT TALKING TO YOUR DENTIST AND YOUR DOCTOR. Even if you stopped it in the past.
Did find this post helpful? Awe inspiring? Annoying? 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
"Jokey smurf thought nothing of the filling that fell out last week. He wasn't as Jokey when his cheek swelled up."
“It didn’t hurt, Doc. So I didn’t come in…”
I hear this from patients. A lot!
Many dental problems actually don’t hurt. A couple examples:
gum disease: Usually doesn’t hurt, even with advanced loss of bone around the tooth. Teeth can often become loose with little to no pain.
early tooth decay: Painless. Tooth decay can often advance almost all the way to the nerve of the tooth with little or no pain
broken teeth: a relatively common problem called “cracked tooth syndrome” actually hurts before the tooth breaks, but feels better once the tooth actually breaks!
“O.K. Doc. I hear you. Tooth problems don’t always hurt. So, if it doesn’t hurt, how do I know I have a problem?”
That’s a good question. When a patient isn’t having any problems we would say that don’t have any symptoms. But they may have signs of trouble that they aren’t aware of.
Symptom: ”a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality. A symptom is subjective, observed by the patient, and not measured.”
Sign: “A dental sign is an objective indication of some medical fact or characteristic that may be detected by a dentist during a dental examination…”
So, how does a patient know if there are any signs of problems? They need to go to the dentist. Regularly. Ideally they go to a dentist that they trust and that they’ve developed a relationship with over a period of time. A dentist uses symptoms (from the patient) as well as signs (collected by examination) to find problems. Ideally, problems are found when they’re very small and need minimal treatment. The best way to make sure problems are found early is by scheduling regular checkups with your dentist. Every six months is the minimum that I would recommend.
Some patients should be seen more often than every 6 months. Who are these patients?
Patients who have “unstable” periodontal disease: If there’s advanced bone loss and we’re not sure that we’ve arrested the disease process we’ll want you to come in more often. Every three months is preferred.
Patients with a high rate of decay: If you’ve had multiple cavities in the last year I’m going to want to check you pretty often. I’m also going to want to help monitor your diet (less pop, more xylitol gum) and probably will recommend fluoride varnish treatments every three months, or even more often.
Patients on a lot of medications: multiple medications often means a dry mouth. Dry mouth is a huge risk for tooth decay.
Patients with a history of head and neck radiation: radiation treatment for cancer can cause your salivary glands to produce much less saliva. This is a huge risk factor for tooth decay and these patients should be seen every 3 months or more often for preventive care.
“Aren’t you just trying to scare us into coming in more often?”
We go to any length to get you to make an appointment at Mead Family Dental
No. But if that’s what it takes, I’ll put on my Ghostface mask.
The bottom line is this…just because it doesn’t hurt doesn’t mean that everything is fine. You should be seeing your dentist at least every 6 months. Plus, you should make an appointment immediately if you have any of the following:
a broken tooth: Whether it hurts or not, this needs to be seen and treated. A broken tooth that doesn’t hurt is a time bomb waiting to ruin your weekend, your vacation or a good night’s sleep. Broken teeth seem to know about Murphy’s Law and usually become a problem when your dentist isn’t in the office.
a food catcher: Do you have a spot between your teeth where food always gets stuck? These “food traps” can and should be treated. This is a great place for a cavity to start.
lost crown or filling: As much as you’d like to believe (and so would I) that all dental work lasts forever…it doesn’t. A crown or filling that comes out is a none-to-suble hint that there’s a problem. This needs to be seen!
trauma: Did little Billy bump his tooth on the coffee table? Did Dad take a softball to the chin? Teeth that have been bumped can sometimes act up. Even if everything feels O.K., you should have your dentist take a look.
Make sure to let your dentist know if you do have symptoms. A patient’s description of the problem is the first step in determining a diagnosis. If your dentist isn’t listening to your concerns and symptoms, speak up or find another dentist!
Did find this post helpful? Annoying? 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
"I haven't been to the book store because I haven't had a gift card..."
Bookstore employee: “Hi, how can I help you?”
Customer: “Well, I haven’t been to the bookstore in a long time because I didn’t have a gift card. But my employer bought me a gift card, so I’d like to buy some books! I was thinking of getting the latest Stephen King novel.”
BE: “Oh, I’m sorry. Your gift card won’t allow hardcover fiction titles. They only allow for paperback. We do have several of his older titles in paperback, though.”
C: “Hmmm. O.K. Well, maybe I could try something in nonfiction. Maybe Freakonomics or The Tipping Point?”
BE: “Again, I’m really sorry. This gift card can only be used to buy boring nonfiction. Interesting nonfiction isn’t covered by your gift card.”
C: “Jeez. O.K. So, maybe I’ll just get this magazine then.”
BE: “That’s fine. Your total is $6.95.”
C: “Wait. Um. I’d like to use my gift card. Can I do that?”
BE: “Your gift card has a deductible. You can’t use it for purchases under $50. So, is that cash or credit?”
Dental “insurance” isn’t really like insurance at all. Insurance is meant to protect you against unpredictable calamity to yourself, your family and your stuff. For the most part, dental care is something that can be planned for and isn’t “calamity based.” A lot of dental care consists of regular maintenance which is distinctly different than a heart attack, a car accident or a flood…events that normally are covered by insurance.
Dental benefits are a lot like a gift card. Your dental benefits give you a certain amount of money to be used toward dental care in a given year. Most plans don’t allow you to carry over an unused amount to the next year, so it’s “use it or lose it.” The incentive to the patient is to use their “insurance” to the fullest.
So, if the insurance companies know that they’re obliged to give each subscriber $x/year when the premiums received are less than this amount, how can they make money? They have several strategies.
The insurance company knows that a certain number of people are not going to use the benefits that their employer paid for. Many people won’t see the dentist even if they have a “gift card” that will help pick up the bill. To the insurance company, this is free money.
Most insurances have strict control over what they will allow patients to use their benefits for. Some policies won’t allow you to use your dental benefits for tooth colored fillings. Some policies won’t allow x-rays each year. These limitations control costs by requiring the patient to pay more “out of pocket” for them if they decide they would like to have the service done.
Some insurances cover nothing on really valuable dental services. Dental implants are the best treatment for missing teeth that dentistry has to offer. Most dental insurances will not allow you to use your benefits for the surgical placement of an implant, even when they will allow you to spend your benefits on a less conservative treatment like a bridge or a partial.
Some insurances require that the patient pays a certain amount out of pocket before being allowed to use their dental benefits. This is called a deductible and is one more way to discourage subscribers from using their benefits.
So if dental benefits are like a gift card, the gift givers are control freaks! I’m not claiming that dental benefits have no value. People with little or no dental problems will do great using their dental benefits. But like a gift card, dental benefits may not cover all of what you want or need for dental care. The mistake that many patients make is to believe their dental needs are in some way related to how much money they have on their gift card. If you’ve got a gift card for $15 in the bookstore, you’ll be able to pick up a couple magazines, but you’ll probably have to kick in a little if you’re looking to pick up the latest John Grisham hardcover.
If you like this post, 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
I really don’t know how a car works. I’m good with the fact that you need to put gas in it. I can even change a flat tire. But the part where you turn the key and it runs is just plain magic to me. I know, I should probably turn in my man card. I also know you’re supposed to change the oil every x number of miles (3000? 5000?). I spent a fair amount of time in oil change places recently. Both my car and my wife’s van were quite overdue for oil changes, so I finally got over to the oil change place to have it done.
It seems like the mechanic on duty always suggests a barrage of filter and fluid changes in addition to the oil change. The suggestions are always in flashing red letters on the computer monitor helpfully placed next to the driver’s side window. A harried mechanic always manages to bring an air filter over to the window that looks as if it was recently plucked from a sandstorm. It seems like there’s always something more that I should be doing to maintain my car and there’s no such thing as a 10 minute oil change. I go in wanting an oil change and come out with a radiator flush, new wiper blades and the guilt associated with telling the mechanic that I’m not going to have him clean my brake fluid reservoir. My quick $25 maintenance almost always turns into an hour or more costing $200!
Why do I feel taken advantage of? Why do I dread going to get my oil changed? There are a couple of reasons. First, I don’t like to feel stupid. I don’t know how cars work and the oil change places know this. I don’t really know if what they’re suggesting is necessary. Even when I do everything they ask, they always suggest more the next time. It’s a knowledge problem. They know more about the how a car works than I do so I have to trust that they’re being honest and that I really need the services that they’re suggesting. Of course, they’re both diagnosing the problems with my car and selling the “solution.”
"When was the last time you had your teeth cleaned?"
Secondly, I feel guilty when I’ve gone over my mileage. Life is hectic and sometimes I don’t get back before 3,000 miles have gone by. Of course there’s that sticker in my window that reminds me that I’m overdue every time I get in the car, too. On top of that, the oil change places say 3,000 miles, but the manufacturer says 5,000. So which is it?
All of this strikes me as a near perfect analogy to dental checkups. How are you supposed to feel when your dentist tells you that you need a filling but nothing even hurts? Why does it seem like they always want to take x-rays? And you just know that they’re going to give you a hard time about not flossing enough. It seems like every time you come in there’s something else you have to pay for and it’s awkward to constantly tell them “no!”
Dentist’s have more knowledge about teeth and dental problems than patients do. That’s why they’re dentists. So there can be a conflict. Dentists get paid to diagnose and fix problems, just like the oil change places. The difference is that dentists have a code of ethics that they are supposed to follow that means they always put the patient’s best interests first. Does that mean that dentists are always great at it? Not necessarily. But it’s something that most dentists I know aspire to.
Our office wants you to make great choices about your dental care. So we do some very specific things to make your dental office experience unlike a trip to the oil change place:
We take a lot of pictures: We’ve got all kinds of cameras (intraoral, extraoral and microscope mounted!) and we take photos for our records. A lot of times a photo can help a patient understand a diagnosis or a treatment better than just a spoken description.
We strive for informed consent: We try to explain (in words and pictures) our findings and suggest treatments to solve the problem. On top of that, we explain the consequences of not treating the finding. We’ll make sure you understand what the treatment entails and also what the treatment costs before you choose a treatment.
The patient can always say “no.”: This is a big deal. You’re in charge and you always have the final say. Sometimes we dentists get all wrapped up in all the cool stuff that we can do for a patient without making sure it’s what the patient wants to do!
We build relationships: Most of our patients have been with us for a long time and we’ve built up a level of trust. We always try to build this same kind of trust with new patients and we understand that this doesn’t happen overnight. Patients need to understand that we’ll be here when you’re ready!
So, the next time I get my oil changed and they recommend that I should have my bearings packed and antifreeze tested I’m going to follow my own advice. I’m going to ask them to explain what the bearings do. I’m going to ask them to show me my antifreeze and why they think it should be tested. And I’m going to make sure I understand (at least a little) what they’re suggesting and I’m going to ask them what the consequences are of not doing it.
If you like this post, 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.
If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!
