When most people think of summer in Michigan they picture sunny days spent at the lake, outdoor concerts and the smell of recently cut grass. Michigan summers are the reward for the punishment that is Michigan winter.
When I think of Michigan summers I think of getting hit in the face with a softball. Or maybe getting an elbow in the incisor while playing basketball. And summer always leads to fall football season, which sometimes leads to broken teeth. I know, I’m kind of weird. But summer is definitely the season of dental sports trauma.
Tooth and other dental injuries are the most common type of head and neck injury sustained during participation in sports.
A tooth knocked out (complete avulsion) while playing sports is likely to cost $20,000 or more to replace over a lifetime
Fixing a tooth or teeth that are broken but not lost during sports will likely create expensive problems that will need to be dealt with over the athlete’s life.
Am I using scare tactics? You betcha! I have treated patients who have needed extensive dental work to fix problems that could have been prevented. They all wish that they had been wearing a mouth guard when they got nailed with that baseball!
I know what you’re thinking. Wearing a mouth guard sucks. They’re bulky and annoying. They make you drool. They look silly. I would agree with you if you’re talking about the store bought “boil and bite” mouth guards. They’re awful. A custom made, lab fabricated dental mouth guard that is appropriately trimmed and adjusted is a whole different story.
"I've got one for every outfit!"
We have mouth guards made in a lab. We use a super accurate impression material to make a model of your teeth and then have a lab fabricate a mouthguard of ideal thickness. A thicker mouth guard offers more protection, but that needs to be weighed against comfort. If it’s not comfortable, you won’t wear it. Since different sports require different levels of protection, we can make a mouth guard in varying thicknesses depending on whether you’re boxing or playing tennis. Whatever sport you play, we’ve got you covered. More importantly, we can get all different colors and styles, add straps for football and even fit patients in braces!
The bottom line is that you should be wearing a mouth guard if you’re playing sports. Most athletes are pretty sure it couldn’t happen to them. I know a few that used to think that. They wear mouth guards now!
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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.
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.”
Did you like this post? Would you like to share it with friends? You can click on the heart shaped icon next to the title of this post and automatically share it on Facebook, Twitter or Google+! Or you can leave a comment by clicking the “ballon” shaped button next to the title. Or send me an email at firstname.lastname@example.org. I’m happy to answer any questions and appreciate your input! If your looking for a dentist in Saginaw, MI I’d like to help out!
I don’t think that these labels are actually meant to educate smokers about the health risks of cigarettes. Everyone knows that cigarettes are horrible for you in many different ways. What the gruesome photos are meant to do is remind you that you’re making a poor decision right at the time you’re making the decision (when you’re going for a cigarette). Will it help? I’m not sure,but I expect the new regulation will trigger a boom in cigarette case sales.
Dentistry’s version of “everyone knows it’s bad for you but does it anyway” is pop. Or soda for those of you in the northeast. Coke, Pepsi, Mountain Dew, Sun Drop. All that stuff is a double whammy for teeth. The acid in it causes the pH in your mouth to drop, which makes cavities. The sugar in it causes the bugs in your mouth to create acid, which lowers your mouth’s pH, which makes cavities.
Just like cigarettes, there’s no redeeming value to pop, except that people like to drink it.
So why not require a label on each and every soda can that reminds the drinker that they’re making a terrible choice every time they choose to have a pop?
I suggest this:
Admit it. You might put down the Mountain Dew if you saw this.
I previously explained what I mean by a "boring dental patient." No offense intended. I think you should be amazing and interesting in all other facets of your life. Stay dentally boring if you can.
You tell me I've had a perfect dental history. Why do I need to keep seeing the dentist?
Your perfect history definitely makes you a low risk for further dental problems. But if things change we want to be able to catch dental problems really early. What kind of change am I talking about?
medical changes: Let's say you're diagnosed with hypertension. Your physician puts you on a medication to control your blood pressure. A major side effect of this and many other medications is a dry mouth. A dry mouth increases your risk for tooth decay. As your risk increases we want to make sure we're seeing you as often as ever so if problems occur we can catch them really early.
dietary changes: I was cavity free before I left for college. I had cavities by the end of my freshman year. I drank more pop and sweetened beverages and ate more sugary foods. It's what college students do. My diet changed and my risk for tooth decay went up.
natural changes due to age: Whether we want to believe it or not, we're all getting older. Your natural saliva flow is reduced as you get older. Older patients are also much more likely to be on multiple medications. Both of these things increase your risk for tooth decay.
It doesn't make me happy to rain on the parade of someone with perfect teeth. Your history does mean that you're less likely to have problems. But we won't know if we don't check!
Whether you have perfect teeth or you're an "interesting case," we'll be here for you! I want to be your Saginaw dentist. If you have questions or would like to make an appointment call the office at (989) 799-9133 or email me at email@example.com. I always answer my own emails!
So stick with me here. Each time you take a sip or a gulp of soda, the acid in it is attacking your teeth. Your saliva takes a certain amount of time to buffer that “acid attack” whether you just sipped or drank a whole can.
So do the math. If it takes you an entire afternoon to sip yourself through a can of soda, you are having an almost constant acid attack for hours at a time. If you drink like the guys above, then you have one acid attack and then your saliva can bring your mouth’s pH back to a normal healthy level.
Yes, you’re reading this correctly…this Saginaw dentist is giving you permission to guzzle. Or better yet, have water instead.
I recently bought a bottle of water at Walgreen. The brand was “Iceland Pure Spring Water” and it featured “pH 8.88” prominently on the label. I read a little further to find:
“…it has one of the naturally lowest mineral contents of any water and a high pH of 8.88. Icelanders live longer than any other nationality; we believe their secret to long life is their water.”
This is an interesting claim. My research (if you want to call finding a cool chart Wikipedia chart research) shows Iceland coming in 3rd to Japan and Hong Kong. FYI…the U.S. comes in tied for 36th place with Cuba and Denmark. So the claim that Icelanders live the longest is in dispute, but what about the pH of their amazing spring water? Could it account for longevity? Should I be worried about my pH?
pH is a measurement of acidiy or alkalinity in an aqueous (water based) solution. A solution that is high in acidity has a low pH and a solution that is more alkaline has a higher pH. pH is measured on a 14 point scale with 0 being the lowest pH (most acidic) and 14 being the highest pH (most basic or alkaline). A pH of 7 is considered neutral, neither majority acid or alkaline. This 14 point scale is logarithmic, which means that each number on the scale is 10 times higher or lower than number above it or below it. For instance, a substance with a pH of 3 is 10 times more acidic than a substance with a pH of 4 and 100 times more acidic than something with a pH of 5.
The pH of the human body is variable depending on the part of the body you’re talking about. The stomach has a pH of about 1…very acidic. This is useful in breaking down the food into smaller, more digestible pieces. Lysosomes, the small bags of chemicals found inside cells are used to break down damaged cell parts. They can have a pH of 4-4.5. Our blood is at a relatively steady pH of 7.34-7.45. The body keeps the pH of our tissues relatively constant completely separate from our diet.
Our mouths are a bit of an exception. The pH can range quite significantly in our mouths due to the presence of acid producing bacteria. Some of the bacteria in our mouths can turn the carbohydrates that we eat into acid. I’ve talked quite a bit about this inpreviousposts. This acid can dissolve the surface of the tooth if it reaches a critical pH. The critical pH, or the pH at which tooth structure begins to dissolve is 6.7 on the root surface of the tooth and 5.2 on the enamel. Diet, habits and saliva flow have a lot to do with how well an individual defends against pH drops in the mouth. But these localized oral pH fluctuations are not the same as pH change of the body.
You often hear claims that the pH of your body being off or unbalanced are the cause of disease. Whether these claims are indirect like my water bottle or more direct as in some blogs or books, they need to be looked at critically. Most of these claims have no basis in science or actual physiology. Beware of diets or claims that talk about “changing your body pH.” Often they direct you to test your saliva to evaluate your body’s pH. That would be akin to checking the inside of your furnace to evaluate what the temperature of your house is! Your body has very specific control mechanisms for regulating your pH through the lungs and kidneys. Your diet makes no difference with regard to your body’s pH, except in your mouth!
Some disease states can result in pH changes. Diabetics can experience diabetic ketoacidosis, which can lower the pH of the blood. This is a consequence of their inability to use sugar in their bodies. However, in healthy individuals this is not a concern.
So, do I think my Iceland Pure Spring Water at a pH of 8.88 will prolong my life? Not really. However, it was cold and delicious and made it so I wasn’t so thirsty. So it did what I was hoping it would!
Do you have comments or questions about this or any of my other posts? Do you like what you see on my blog? Leave a comment here on the blog or feel free to email me at firstname.lastname@example.org. This Saginaw dentist writes all the posts and answers his own email. Thanks for taking the time to read!
…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…
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 email@example.com. We’d be happy to have you!
Chewing gum can be good for your teeth. It also can be bad for your teeth and your jaw joint. Chewing gum will stimulate saliva, which is the major natural defense your teeth have against cavities.
There are two rules that I have for chewing gum. Two and a half, really. They are simple and they are to be followed. Failure to follow them may cause this Saginaw dentist to hunt you down, call you silly names and revoke your license to chew.
Chew sugarless gum. Preferably containing xylitol. There are so many foods and drinks that have an insane amount of sugar in them and many of these don’t have good sugarless options. There are a ton of really good sugarless gums. They’ll stimulate saliva flow after meals and make your mouth feel fresh but they don’t give cavity bugs anything to eat. Win-win.
Chew for 5 minutes or when the flavor is gone, whichever is shorter. The hard core gum chewers hate this. Your jaw joints suffer wear and tear like any other joints. I recommend that you don’t overuse them. I would compare gum chewing all day long with cracking your knuckles. It’s a kind of nervous habit. My evidence is completely anecdotal, but patients that are heavy gum chewers often have a “jaw pop.” It doesn’t necessarily lead to problems or pathology, but it can be annoying. So don’t chew too long.
2.5. If you have braces or an orthodontic appliance, don’t chew gum.
These are the rules. You know the consequences. Chew wisely.
Questions? Comments? Do hard core gum chewers want to send me angry emails? Email me at: firstname.lastname@example.org. I return all of my own email and would be happy to answer questions!
If you don't look any harder you could walk away with the idea that drinking diet soda will lead to strokes. And if you're anything like me, this will lodge in your mind until the next sensational headline tells you something else that many people do on a regular basis is unhealthy and damaging.
Does drinking diet soda really make you more likely to have a stroke? A stroke is damage to the brain due to a temporary interruption of the blood supply. It's very similar to the damage to the heart during a heart attack. What exactly is it in diet soda that makes it more likely for a stroke to happen? According to the articles this same risk isn't found in people who drink regular soda. So are we to assume that it's the artificial sweeteners?
This is a perfect example of preliminary "science" prevented as fact used as a scare tactic. Many news sources have gotten honest about the source of this information, but many others have not. Retractions or good explanations of the methods don't make headlines, but scare tactics do.
The correlation between diet soda and stroke was made in a poster presentation at the "International Stroke Conference." Poster presentations are not the same as peer reviewed medical journals and definitely do not carry the weight of medical consensus. This misinterpretation is not the fault of the scientists presenting the poster so much as the media drawing unsupported conclusions. Simply stated, the connection presented has not been studied enough to make the statements that a lot of news sources are making.
Most news stories do not bother to mention that correlation isn't the same thing as causation. There very well could be a correlation between intake of diet soda and stroke, but by no means does that mean drinking diet soda causes strokes. It's that the individual data points of stroke risk and diet soda intake are often found together. Perhaps overweight and obese people, who are clearly more likely to have strokes and heart attacks, are more likely to report drinking diet soda because they are attempting to lose weight. Perhaps there really is some stroke inducing ingredient in diet soda. The study that is referred to really doesn't make that evident. There needs to be a lot of research and verification to reach a point where causation of disease can be determined.
The news media and others reporting the "drinking diet soda = greater stroke risk" are jumping the gun. They're not interested in reality as much as a good story. A story that might frighten you, but will hopefully be forgotten until the next scary headline.
Is this ever done in dentistry? I think it is. I'll discuss that in another blog soon!
I can see the headline now: “Saginaw dentist wishes cavities hurt more!” Film at 11.
Let’s get this out of the way right away. I don’t want patients to have more pain with their teeth. It’s just that most cavities don’t hurt. Patients hardly ever feel a cavity. Most of the time a cavity becomes noticeable when food gets caught in it. By the time it hurts there’s probably been irreversible damage to the pulp (nerve and blood vessel deep inside the tooth).
Another painless dental problem is periodontal disease or “gum disease.” A combination of bacterial toxins and immune system reactions can cause a patient to lose the bone support surrounding their teeth. Over time this causes a chronic inflammation in the gums and can, over time, cause tooth loss. It sounds horribly painful when I describe it like that. But it’s actually painless.
In moderation, pain will cause us to withdraw from a harmful stimulus. For instance, you yank your hand away from the hot stove. The pain of a burn, or even a potential burn, causes a quick response which actually helps you avoid more serious injury.
We don’t have that with long term, slow moving dental diseases like tooth decay and gum disease. And it’s kind of too bad.
More headlines…this one says, “Saginaw dentist thinks it’s too bad that gum disease and cavities aren’t more painful.”
It’s just that by the time something is painful we’ve probably added acute inflammation and often infection into the mix. This makes treatment more expensive and less predictable. So if you could feel a cavity earlier, maybe we could fix it when it’s cheaper and less expensive to fix. That’s all I’m saying. Really.
Dentists don’t really need much help getting bad press. So I should probably stop while I’m ahead!
Questions, comments or complaints with this post? Do you want to make an appointment with Saginaw’s premiere blogging dentist? (Me. I mean me! 😉 ) Call the office at (989) 799-9133 or email me at email@example.com. I’d love to hear from you!